HESI PN COMPREHENSIVE ASSESSMENT
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
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CORE DOMAINS
Management of Care and Prioritization
Safety and Infection Control
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Health Promotion and Maintenance
Psychosocial Integrity
Basic Care and Comfort
INTRODUCTION
The HESI PN Comprehensive Assessment evaluates the practical
nursing student's readiness for NCLEX-PN success and entry-level
professional practice. The examination assesses clinical judgment
through multiple-choice and Next Generation NCLEX-style items
emphasizing prioritization, delegation, and safe decision-making.
Content covers all practical nursing domains with emphasis on
management of care, safety, pharmacology, and physiological
adaptation. This assessment measures the candidate's ability to
recognize and analyze cues, prioritize hypotheses, generate
solutions, and evaluate outcomes in realistic clinical scenarios. The
,HESI score provides predictive data regarding first-time NCLEX-PN
success, with scores of 850 or higher indicating acceptable readiness
and 900 or greater suggesting optimal preparation.
SECTION ONE: QUESTIONS 1–100
1. A postoperative client reports sudden shortness of breath
and chest pain. Which action should the PN implement first?
A. Administer the prescribed PRN oxygen at 2 L/min via nasal
cannula
B. Elevate the head of the bed to 90 degrees
C. Notify the rapid-response team immediately
D. Check the client's oxygen saturation with pulse oximetry
Correct answer: D
RATIONALE: The PN's first action is to obtain objective data to
quantify the client's respiratory status. Checking SpO2 provides
immediate information that guides subsequent interventions.
Administering oxygen or elevating the head may be needed, but
only after assessment. Notifying the rapid-response team is
appropriate if assessment confirms compromise, but data must be
gathered first .
2. A client is prescribed 500 mL of 0.9% saline to infuse over 4
hours via gravity tubing with a drop factor of 15 gtt/mL. The PN
should regulate the drip rate to how many drops per minute?
,A. 15
B. 21
C. 31
D. 42
Correct answer: C
RATIONALE: 500 mL × 15 gtt/mL ÷ 240 min = 31.25 ≈ 31 gtt/min.
Options A and B are too slow and would prolong infusion; D is too
fast and risks fluid overload .
3. The PN is assessing a newborn 12 hours after birth and
documents a respiratory rate of 48 breaths/minute. Which
action is appropriate?
A. Notify the pediatrician immediately
B. Reassess in 30 minutes; document as normal
C. Begin blow-by oxygen
D. Obtain a stat chest X-ray
Correct answer: B
RATIONALE: Normal newborn respiratory rate is 30–60
breaths/min; 48 falls within this range. No intervention is required
unless other signs of distress are present. Immediate notification,
oxygen, or X-ray is unnecessary .
4. A client with chronic kidney disease is prescribed
aluminum hydroxide 600 mg PO with meals. The PN should
teach the client that this medication is ordered primarily to:
, A. Prevent phosphate absorption
B. Decrease serum potassium
C. Reduce gastric acid secretion
D. Bind dietary sodium
Correct answer: A
RATIONALE: Aluminum-based antacids bind dietary
phosphate in the gut, preventing hyperphosphatemia common in
CKD. They do not affect potassium, are weak acid reducers, and do
not bind sodium .
5. The PN observes an assistive personnel (AP) entering the
room of a client on contact precautions without donning
gloves. Which statement by the PN is most appropriate?
A. "You must wear gloves before touching anything in this room."
B. "I'll report you to the nurse manager if you do that again."
C. "Let me help you finish the task so we can save time."
D. "It's okay this time because you're only bringing water."
Correct answer: A
RATIONALE: The PN must enforce infection-control policies
respectfully and immediately. Option A provides clear, non-punitive
correction. Threatening, enabling, or excusing undermines safety .
6. A client receiving morphine PCA after abdominal surgery is
difficult to arouse and has a respiratory rate of 8 breaths/min.
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
CORE DOMAINS
Management of Care and Prioritization
Safety and Infection Control
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Health Promotion and Maintenance
Psychosocial Integrity
Basic Care and Comfort
INTRODUCTION
The HESI PN Comprehensive Assessment evaluates the practical
nursing student's readiness for NCLEX-PN success and entry-level
professional practice. The examination assesses clinical judgment
through multiple-choice and Next Generation NCLEX-style items
emphasizing prioritization, delegation, and safe decision-making.
Content covers all practical nursing domains with emphasis on
management of care, safety, pharmacology, and physiological
adaptation. This assessment measures the candidate's ability to
recognize and analyze cues, prioritize hypotheses, generate
solutions, and evaluate outcomes in realistic clinical scenarios. The
,HESI score provides predictive data regarding first-time NCLEX-PN
success, with scores of 850 or higher indicating acceptable readiness
and 900 or greater suggesting optimal preparation.
SECTION ONE: QUESTIONS 1–100
1. A postoperative client reports sudden shortness of breath
and chest pain. Which action should the PN implement first?
A. Administer the prescribed PRN oxygen at 2 L/min via nasal
cannula
B. Elevate the head of the bed to 90 degrees
C. Notify the rapid-response team immediately
D. Check the client's oxygen saturation with pulse oximetry
Correct answer: D
RATIONALE: The PN's first action is to obtain objective data to
quantify the client's respiratory status. Checking SpO2 provides
immediate information that guides subsequent interventions.
Administering oxygen or elevating the head may be needed, but
only after assessment. Notifying the rapid-response team is
appropriate if assessment confirms compromise, but data must be
gathered first .
2. A client is prescribed 500 mL of 0.9% saline to infuse over 4
hours via gravity tubing with a drop factor of 15 gtt/mL. The PN
should regulate the drip rate to how many drops per minute?
,A. 15
B. 21
C. 31
D. 42
Correct answer: C
RATIONALE: 500 mL × 15 gtt/mL ÷ 240 min = 31.25 ≈ 31 gtt/min.
Options A and B are too slow and would prolong infusion; D is too
fast and risks fluid overload .
3. The PN is assessing a newborn 12 hours after birth and
documents a respiratory rate of 48 breaths/minute. Which
action is appropriate?
A. Notify the pediatrician immediately
B. Reassess in 30 minutes; document as normal
C. Begin blow-by oxygen
D. Obtain a stat chest X-ray
Correct answer: B
RATIONALE: Normal newborn respiratory rate is 30–60
breaths/min; 48 falls within this range. No intervention is required
unless other signs of distress are present. Immediate notification,
oxygen, or X-ray is unnecessary .
4. A client with chronic kidney disease is prescribed
aluminum hydroxide 600 mg PO with meals. The PN should
teach the client that this medication is ordered primarily to:
, A. Prevent phosphate absorption
B. Decrease serum potassium
C. Reduce gastric acid secretion
D. Bind dietary sodium
Correct answer: A
RATIONALE: Aluminum-based antacids bind dietary
phosphate in the gut, preventing hyperphosphatemia common in
CKD. They do not affect potassium, are weak acid reducers, and do
not bind sodium .
5. The PN observes an assistive personnel (AP) entering the
room of a client on contact precautions without donning
gloves. Which statement by the PN is most appropriate?
A. "You must wear gloves before touching anything in this room."
B. "I'll report you to the nurse manager if you do that again."
C. "Let me help you finish the task so we can save time."
D. "It's okay this time because you're only bringing water."
Correct answer: A
RATIONALE: The PN must enforce infection-control policies
respectfully and immediately. Option A provides clear, non-punitive
correction. Threatening, enabling, or excusing undermines safety .
6. A client receiving morphine PCA after abdominal surgery is
difficult to arouse and has a respiratory rate of 8 breaths/min.
