HESI PN COMPREHENSIVE EXAM
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
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SAFE, EFFECTIVE CARE ENVIRONMENT
HEALTH PROMOTION AND MAINTENANCE
PSYCHOSOCIAL INTEGRITY
PHYSIOLOGICAL INTEGRITY
PHARMACOLOGICAL AND PARENTERAL THERAPIES
REDUCTION OF RISK POTENTIAL
PHYSIOLOGICAL ADAPTATION
MATERNAL-NEWBORN NURSING
PEDIATRIC NURSING
MENTAL HEALTH NURSING
LEADERSHIP, DELEGATION, AND CLINICAL JUDGMENT
This examination assesses the practical nursing candidate's
readiness for entry-level practice and NCLEX-PN success. It
evaluates clinical judgment, prioritization, delegation, safety,
pharmacology, maternal-newborn care, pediatric care, mental
health, and leadership. The test utilizes multiple-choice, select-all-
that-apply, and NGN unfolding case study formats to measure
decision-making and critical thinking. Emphasis is placed on real-
world application, evidence-based practice, and managing complex
,client scenarios. Candidates must demonstrate competency in all
core domains to ensure safe and effective care delivery.
SECTION ONE
1. A practical nurse (PN) is preparing to administer medications
on a medical-surgical unit. The nurse notices that the
electronic medication administration record (eMAR) for one
client shows a newly ordered antibiotic that was entered by a
night-shift nurse but has not yet been verified by the
pharmacy. The client is due for the first dose in 15 minutes.
Which action should the nurse take first?
A. Administer the dose as scheduled and document the verification
later
B. Contact the pharmacy to confirm the order and obtain
verification before giving the medication
C. Ask the charge nurse to co-sign the administration
D. Hold the medication until the next scheduled dose and notify
the provider
Correct answer: B
RATIONALE: Medication safety requires that all orders be
verified by pharmacy before the first dose is given. Contacting the
pharmacy ensures the order is accurate and complete, preventing
potential medication errors. Administering without verification or
delaying without clarification both increase risk to the client.
2. 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.
3. A client with pneumonia has a fever of 103°F (39.4°C). Which
intervention should the nurse implement first?
A. Administer acetaminophen
B. Remove excess blankets
C. Apply a cooling blanket
D. Increase oral fluids
Correct answer: B
RATIONALE: The first-line, least invasive intervention for fever
is to remove external sources of insulation (excess blankets and
heavy clothing) to promote heat dissipation through radiation and
convection. After this non-pharmacological measure, if the fever
persists, the nurse should administer an antipyretic such as
, acetaminophen. A cooling blanket is a more aggressive intervention
used for severe hyperthermia and is not the first choice.
4. A nurse is assessing a client with a chest tube after thoracic
surgery. The water seal chamber has continuous bubbling.
What should the nurse do?
A. Document as normal
B. Check for an air leak
C. Clamp the chest tube immediately
D. Increase suction pressure
Correct answer: B
RATIONALE: Continuous bubbling in the water seal chamber
indicates an air leak in the chest tube system. The nurse should first
assess the entire system for loose connections, cracks, or
disconnections. Clamping the chest tube immediately is dangerous
because it can lead to a tension pneumothorax.
5. 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
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
SAFE, EFFECTIVE CARE ENVIRONMENT
HEALTH PROMOTION AND MAINTENANCE
PSYCHOSOCIAL INTEGRITY
PHYSIOLOGICAL INTEGRITY
PHARMACOLOGICAL AND PARENTERAL THERAPIES
REDUCTION OF RISK POTENTIAL
PHYSIOLOGICAL ADAPTATION
MATERNAL-NEWBORN NURSING
PEDIATRIC NURSING
MENTAL HEALTH NURSING
LEADERSHIP, DELEGATION, AND CLINICAL JUDGMENT
This examination assesses the practical nursing candidate's
readiness for entry-level practice and NCLEX-PN success. It
evaluates clinical judgment, prioritization, delegation, safety,
pharmacology, maternal-newborn care, pediatric care, mental
health, and leadership. The test utilizes multiple-choice, select-all-
that-apply, and NGN unfolding case study formats to measure
decision-making and critical thinking. Emphasis is placed on real-
world application, evidence-based practice, and managing complex
,client scenarios. Candidates must demonstrate competency in all
core domains to ensure safe and effective care delivery.
SECTION ONE
1. A practical nurse (PN) is preparing to administer medications
on a medical-surgical unit. The nurse notices that the
electronic medication administration record (eMAR) for one
client shows a newly ordered antibiotic that was entered by a
night-shift nurse but has not yet been verified by the
pharmacy. The client is due for the first dose in 15 minutes.
Which action should the nurse take first?
A. Administer the dose as scheduled and document the verification
later
B. Contact the pharmacy to confirm the order and obtain
verification before giving the medication
C. Ask the charge nurse to co-sign the administration
D. Hold the medication until the next scheduled dose and notify
the provider
Correct answer: B
RATIONALE: Medication safety requires that all orders be
verified by pharmacy before the first dose is given. Contacting the
pharmacy ensures the order is accurate and complete, preventing
potential medication errors. Administering without verification or
delaying without clarification both increase risk to the client.
2. 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.
3. A client with pneumonia has a fever of 103°F (39.4°C). Which
intervention should the nurse implement first?
A. Administer acetaminophen
B. Remove excess blankets
C. Apply a cooling blanket
D. Increase oral fluids
Correct answer: B
RATIONALE: The first-line, least invasive intervention for fever
is to remove external sources of insulation (excess blankets and
heavy clothing) to promote heat dissipation through radiation and
convection. After this non-pharmacological measure, if the fever
persists, the nurse should administer an antipyretic such as
, acetaminophen. A cooling blanket is a more aggressive intervention
used for severe hyperthermia and is not the first choice.
4. A nurse is assessing a client with a chest tube after thoracic
surgery. The water seal chamber has continuous bubbling.
What should the nurse do?
A. Document as normal
B. Check for an air leak
C. Clamp the chest tube immediately
D. Increase suction pressure
Correct answer: B
RATIONALE: Continuous bubbling in the water seal chamber
indicates an air leak in the chest tube system. The nurse should first
assess the entire system for loose connections, cracks, or
disconnections. Clamping the chest tube immediately is dangerous
because it can lead to a tension pneumothorax.
5. 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
