NEXT GEN PN HESI Exit Exam 2026 with
130 Questions and Answers | Solutions
to Pass on First Attempt
SECTION 1: FUNDAMENTALS & SAFETY
1. The LPN/LVN receives the client's next scheduled bag of TPN labeled with the additive NPH
insulin. Which action should the nurse implement?
A. Hang the solution at the current rate
B. Refrigerate the solution until needed
C. Prepare the solution with new tubing
D. Return the solution to the pharmacy
Correct Answer: D. Return the solution to the pharmacy
Rationale: NPH insulin should never be added to TPN solution. This is an unsafe practice
and the solution should be returned to the pharmacy immediately.
2. The practical nurse enters a male client's room to administer routine morning medications,
and the client is on the phone. Which action is best for the PN to take?
A. Ask another nurse to go back with the medication when the client hangs up
B. Wait for the client to excuse himself from the telephone conversation, and observe the client
taking the medication
C. Return the medication to the client's drawer and document the client refused the dose
D. Leave the medication with the client and let him take it when he finishes the conversation
Correct Answer: B. Wait for the client to excuse himself from the telephone conversation,
and observe the client taking the medication
Rationale: The PN should wait and observe the client taking the medication to ensure safety
and proper administration. Leaving medication unattended is unsafe.
3. The PN and UAP find a client unresponsive in bed. What action should the PN instruct the
UAP to take first?
,A. Call the rapid response team
B. Check the client's pulse
C. Lower the bed and open the airway
D. Get the crash cart
Correct Answer: C. Lower the bed and open the airway
Rationale: The priority in an unresponsive client is airway management. The UAP should be
instructed to lower the bed and open the airway while the PN assesses the client.
4. The PN observes a UAP bathing a bedfast client with the bed in the high position. Which
action should the PN take?
A. Remain in the room to supervise the UAP
B. Determine if the UAP would like assistance
C. Assume care of the client immediately
D. Instruct the UAP to lower the bed for safety
Correct Answer: D. Instruct the UAP to lower the bed for safety
Rationale: The bed should be in the lowest position for patient safety during care. The PN
should correct this safety issue immediately.
5. During a home health visit, the PN observes an older client living with offspring who appears
fearful, unkempt, and severely weight-losing. What should the PN do?
A. Educate the client about personal hygiene
B. Report suspected abuse to supervisor and protective services
C. Ignore as this is normal aging
D. Discuss concerns directly with offspring
Correct Answer: B. Report suspected abuse to supervisor and protective services
Rationale: Signs of abuse include fearfulness, poor hygiene, and severe weight loss. The PN
has a legal and ethical duty to report suspected abuse.
6. While providing oral care for a client who is unconscious, the nurse positions the client
laterally and uses a basin to collect secretions. Which intervention is best for the nurse to
implement?
,A. Swab the oral cavity with a washcloth
B. Use oral swabs with normal saline
C. Provide a Yankauer tip for oral suction
D. Support the head with a small pillow
Correct Answer: B. Use oral swabs with normal saline
Rationale: Oral swabs with normal saline are the safest and most effective method for
providing oral care to unconscious clients.
7. When assessing clients with dark skin tones, where should the PN look to best observe signs
of cyanosis or pallor?
A. Finger and toenails
B. Palms and soles
C. Sclera and conjunctiva
D. Lips and oral mucosa
Correct Answer: D. Lips and oral mucosa
Rationale: In clients with dark skin tones, the lips and oral mucosa provide the most reliable
assessment for cyanosis or pallor because these areas have less pigmentation.
8. [SATA] A patient has been placed on airborne precautions due to suspected tuberculosis.
Which interventions should the nurse include in the plan of care?
A. Place the patient in a negative-pressure airborne infection isolation room (AIIR)
B. Wear an N95 respirator mask when entering the room
C. Don a gown and gloves for all contact with the patient
D. Keep the door to the patient's room closed at all times
E. Instruct the patient to wear a surgical mask during transport outside the room
Correct Answers: A, B, D, E
Rationale: Airborne precautions for tuberculosis require an AIIR with negative pressure (A),
an N95 respirator for anyone entering the room (B), the door kept closed to maintain negative
pressure (D), and a surgical mask on the patient during transport (E). Gown and gloves (C) are
required for contact precautions, not airborne precautions alone.
, 9. A nurse obtains the following vital signs on an adult patient: BP 98/60 mmHg, HR 112 bpm,
RR 22 breaths/min, and SpO2 93% on room air. Which finding should the nurse report to the
charge nurse first?
A. Heart rate of 112 bpm
B. Blood pressure of 98/60 mmHg
C. Respiratory rate of 22 breaths/min
D. SpO2 of 93% on room air
Correct Answer: D. SpO2 of 93% on room air
Rationale: Using the ABC (Airway, Breathing, Circulation) prioritization framework, oxygen
saturation of 93% on room air is the most concerning finding because it indicates hypoxemia.
Normal SpO2 is 95–100%. The nurse must address oxygenation first.
10. A nurse is providing perineal care to an uncircumcised male patient. Which technique is
correct?
A. Retract the foreskin during cleansing and leave it retracted afterward
B. Retract the foreskin during cleansing and return it to its natural position after cleaning
C. Cleanse from the rectal area toward the pubic area
D. Use hot water to improve the cleansing process
Correct Answer: B. Retract the foreskin during cleansing and return it to its natural
position after cleaning
Rationale: The foreskin must be retracted to expose the glans for thorough cleaning, but it
must always be returned to its natural position after cleaning to prevent paraphimosis. Leaving
the foreskin retracted (A) can impair circulation and cause tissue damage.
11. [Ordered Response] A nurse is using the nursing process to care for a patient with a new
diagnosis of hypertension. Place the steps of the nursing process in the correct order.
Correct Order:
1. Data collection/Assessment
2. Nursing diagnosis
3. Planning
130 Questions and Answers | Solutions
to Pass on First Attempt
SECTION 1: FUNDAMENTALS & SAFETY
1. The LPN/LVN receives the client's next scheduled bag of TPN labeled with the additive NPH
insulin. Which action should the nurse implement?
A. Hang the solution at the current rate
B. Refrigerate the solution until needed
C. Prepare the solution with new tubing
D. Return the solution to the pharmacy
Correct Answer: D. Return the solution to the pharmacy
Rationale: NPH insulin should never be added to TPN solution. This is an unsafe practice
and the solution should be returned to the pharmacy immediately.
2. The practical nurse enters a male client's room to administer routine morning medications,
and the client is on the phone. Which action is best for the PN to take?
A. Ask another nurse to go back with the medication when the client hangs up
B. Wait for the client to excuse himself from the telephone conversation, and observe the client
taking the medication
C. Return the medication to the client's drawer and document the client refused the dose
D. Leave the medication with the client and let him take it when he finishes the conversation
Correct Answer: B. Wait for the client to excuse himself from the telephone conversation,
and observe the client taking the medication
Rationale: The PN should wait and observe the client taking the medication to ensure safety
and proper administration. Leaving medication unattended is unsafe.
3. The PN and UAP find a client unresponsive in bed. What action should the PN instruct the
UAP to take first?
,A. Call the rapid response team
B. Check the client's pulse
C. Lower the bed and open the airway
D. Get the crash cart
Correct Answer: C. Lower the bed and open the airway
Rationale: The priority in an unresponsive client is airway management. The UAP should be
instructed to lower the bed and open the airway while the PN assesses the client.
4. The PN observes a UAP bathing a bedfast client with the bed in the high position. Which
action should the PN take?
A. Remain in the room to supervise the UAP
B. Determine if the UAP would like assistance
C. Assume care of the client immediately
D. Instruct the UAP to lower the bed for safety
Correct Answer: D. Instruct the UAP to lower the bed for safety
Rationale: The bed should be in the lowest position for patient safety during care. The PN
should correct this safety issue immediately.
5. During a home health visit, the PN observes an older client living with offspring who appears
fearful, unkempt, and severely weight-losing. What should the PN do?
A. Educate the client about personal hygiene
B. Report suspected abuse to supervisor and protective services
C. Ignore as this is normal aging
D. Discuss concerns directly with offspring
Correct Answer: B. Report suspected abuse to supervisor and protective services
Rationale: Signs of abuse include fearfulness, poor hygiene, and severe weight loss. The PN
has a legal and ethical duty to report suspected abuse.
6. While providing oral care for a client who is unconscious, the nurse positions the client
laterally and uses a basin to collect secretions. Which intervention is best for the nurse to
implement?
,A. Swab the oral cavity with a washcloth
B. Use oral swabs with normal saline
C. Provide a Yankauer tip for oral suction
D. Support the head with a small pillow
Correct Answer: B. Use oral swabs with normal saline
Rationale: Oral swabs with normal saline are the safest and most effective method for
providing oral care to unconscious clients.
7. When assessing clients with dark skin tones, where should the PN look to best observe signs
of cyanosis or pallor?
A. Finger and toenails
B. Palms and soles
C. Sclera and conjunctiva
D. Lips and oral mucosa
Correct Answer: D. Lips and oral mucosa
Rationale: In clients with dark skin tones, the lips and oral mucosa provide the most reliable
assessment for cyanosis or pallor because these areas have less pigmentation.
8. [SATA] A patient has been placed on airborne precautions due to suspected tuberculosis.
Which interventions should the nurse include in the plan of care?
A. Place the patient in a negative-pressure airborne infection isolation room (AIIR)
B. Wear an N95 respirator mask when entering the room
C. Don a gown and gloves for all contact with the patient
D. Keep the door to the patient's room closed at all times
E. Instruct the patient to wear a surgical mask during transport outside the room
Correct Answers: A, B, D, E
Rationale: Airborne precautions for tuberculosis require an AIIR with negative pressure (A),
an N95 respirator for anyone entering the room (B), the door kept closed to maintain negative
pressure (D), and a surgical mask on the patient during transport (E). Gown and gloves (C) are
required for contact precautions, not airborne precautions alone.
, 9. A nurse obtains the following vital signs on an adult patient: BP 98/60 mmHg, HR 112 bpm,
RR 22 breaths/min, and SpO2 93% on room air. Which finding should the nurse report to the
charge nurse first?
A. Heart rate of 112 bpm
B. Blood pressure of 98/60 mmHg
C. Respiratory rate of 22 breaths/min
D. SpO2 of 93% on room air
Correct Answer: D. SpO2 of 93% on room air
Rationale: Using the ABC (Airway, Breathing, Circulation) prioritization framework, oxygen
saturation of 93% on room air is the most concerning finding because it indicates hypoxemia.
Normal SpO2 is 95–100%. The nurse must address oxygenation first.
10. A nurse is providing perineal care to an uncircumcised male patient. Which technique is
correct?
A. Retract the foreskin during cleansing and leave it retracted afterward
B. Retract the foreskin during cleansing and return it to its natural position after cleaning
C. Cleanse from the rectal area toward the pubic area
D. Use hot water to improve the cleansing process
Correct Answer: B. Retract the foreskin during cleansing and return it to its natural
position after cleaning
Rationale: The foreskin must be retracted to expose the glans for thorough cleaning, but it
must always be returned to its natural position after cleaning to prevent paraphimosis. Leaving
the foreskin retracted (A) can impair circulation and cause tissue damage.
11. [Ordered Response] A nurse is using the nursing process to care for a patient with a new
diagnosis of hypertension. Place the steps of the nursing process in the correct order.
Correct Order:
1. Data collection/Assessment
2. Nursing diagnosis
3. Planning
