HESI PN EXIT EXAM LATEST
PN HESI EXIT COMPLETE EXAM
Real Exam Questions and Correct Answers | A-Grade | 2026/2027 Updated
Aligned with the 2026-2027 HESI PN Exit Examination Blueprint and NCLEX-PN Test Plan Standards
Total Questions: 190 | Cognitive Distribution: 30% Recall, 50% Application, 20% Analysis | Format: 80%
Scenario-Based, 20% Direct Recall
Sections: 8 NCLEX-PN Client Need Categories | Question Styles: Prioritization, Delegation, Dosage Calculation, Lab
Interpretation, Clinical Judgment
Section 1: Management of Care
Advocacy, Delegation, Prioritization, Continuity of Care, Legal/Ethical Practice, & Case Management
Q1: The PN is caring for four clients. Which client should the PN assess FIRST?
A. A client 2 hours post-colonoscopy reporting mild abdominal cramping
B. A client with chronic heart failure requesting a refill of water
C. A client who is post-op day 1 from hip surgery with new onset of dyspnea [CORRECT]
D. A client 3 days post-appendectomy preparing for discharge teaching
Correct Answer: C
Rationale: Using the ABC priority framework, new onset dyspnea in a postoperative client suggests possible
pulmonary embolism, atelectasis, or fluid overload and represents an immediate threat to airway/breathing. Mild
cramping post-colonoscopy is expected, water refill is routine, and discharge teaching can wait. Test-taking strategy:
when a question asks 'assess first,' look for the option describing the most acute change in ABC status, especially in
postoperative clients.
Q2: The RN assigns the PN to care for four clients. Which client assignment is most appropriate for the PN
scope of practice?
A. A client receiving a titrated heparin drip requiring hourly aPTT monitoring
B. A client who is 12 hours post-thoracotomy with a chest tube and intermittent bloody drainage
C. A client 3 days postTotal knee replacement receiving oral analgesics and antibiotics [CORRECT]
D. A client admitted 2 hours ago with acute GI bleeding and a continuous IV infusion of pantoprazole
Correct Answer: C
Rationale: The PN scope includes caring for stable clients with predictable outcomes. The client 3 days post-TKR on
oral medications with an established recovery trajectory fits this profile. Titrated heparin, immediate post-thoracotomy,
and acute GI bleeding all require RN-level assessment and complex interventions beyond PN scope. Test-taking
strategy: PN assignments favor clients who are stable, post-acute phase, with routine care needs and predictable
responses.
A-Grade Verified | NCLEX-PN Aligned | Comprehensive Rationales
,HESI PN Exit Exam Latest | PN HESI Exit Complete Exam | 2026/2027 Updated Page 2
Q3: Which of the following tasks is appropriate for the PN to delegate to a UAP?
A. Measuring intake and output on a client with a Foley catheter [CORRECT]
B. Reinforcing discharge teaching about a new diabetic medication
C. Assessing a stage 2 pressure injury for signs of infection
D. Explaining the purpose of an upcoming colonoscopy to a client
Correct Answer: A
Rationale: Measuring I&O; is a routine, protocol-driven task that falls within the UAP scope. Teaching, assessment,
and explanation require nursing judgment and are non-delegable. The 5 rights of delegation confirm: right task (I&O;),
right circumstance (stable client), right person (UAP), right direction (clear instructions), right supervision. Test-taking
strategy: UAP may perform ADLs, ambulation, vital signs on stable clients, and I&O; - never teaching, assessment, or
judgment-based activities.
Q4: A client scheduled for an elective cholecystectomy refuses to sign the consent form after the surgeon has
explained the procedure. What is the most appropriate action by the PN?
A. Explain the risks again to ensure the client understands the procedure
B. Notify the surgeon so the surgeon can speak with the client before surgery [CORRECT]
C. Document the refusal and proceed with preoperative preparation
D. Ask a family member to convince the client to sign the consent
Correct Answer: B
Rationale: Informed consent requires the provider (surgeon) to explain risks, benefits, and alternatives. If the client
refuses after explanation, the PN must notify the surgeon, who must address the client's concerns and re-evaluate. The
nurse's role is to witness the signature and verify understanding, not to obtain consent or persuade. Forcing or coercing a
family member violates autonomy. Test-taking strategy: when consent is questioned or refused, the answer is always to
notify the provider.
Q5: A 78-year-old client with advanced dementia has no advance directive but has a daughter holding durable
power of attorney for health care. The client develops a treatable pneumonia. What should the PN do FIRST?
A. Administer the prescribed antibiotics as ordered [CORRECT]
B. Ask the daughter to make decisions regarding treatment
C. Notify the health care provider of the lack of advance directive
D. Withhold antibiotics until an ethics consult is obtained
Correct Answer: A
Rationale: Pneumonia is a treatable condition and the standard of care is to provide prescribed treatment. The durable
POA becomes relevant for decisions about withholding/withdrawing life-sustaining treatment, not for routine
prescribed care. Withholding antibiotics would constitute neglect. The provider and POA should be involved for
end-of-life decisions, but treatable acute conditions warrant standard treatment. Test-taking strategy: distinguish
between routine treatment (administer as ordered) and end-of-life decisions (involve POA/ethics).
A-Grade Verified | NCLEX-PN Aligned | Comprehensive Rationales
,HESI PN Exit Exam Latest | PN HESI Exit Complete Exam | 2026/2027 Updated Page 3
Q6: The PN receives a phone order from a provider for morphine 4 mg IV for a postoperative client. What
should the PN do?
A. Administer the medication and document the order as received
B. Repeat the order back to the provider, confirm, then administer and document [CORRECT]
C. Ask the provider to come to the unit to write the order before administering
D. Refuse to accept a telephone order and request the provider send it via fax
Correct Answer: B
Rationale: Telephone orders require the PN to use the 'read-back' verification process to confirm accuracy with the
provider before administration. This prevents medication errors and is a standard safe practice. After verification and
administration, the order must be documented with the provider's name, time, and 'read back and verified.' Test-taking
strategy: read-back verification is always required for telephone orders; refusing or delaying pain management is
inappropriate.
Q7: Which client should the PN identify as the HIGHEST priority during shift report?
A. A client 4 hours post-cardiac catheterization with stable vital signs
B. A client with COPD whose SpO2 dropped from 94% to 88% over the last hour [CORRECT]
C. A client with type 1 diabetes scheduled for a fasting blood glucose
D. A client receiving IV antibiotics for cellulitis with no complaints
Correct Answer: B
Rationale: A 6% drop in SpO2 to 88% in a COPD client indicates acute respiratory compromise requiring immediate
assessment and intervention. Using ABC and the 'unstable vs. stable' framework, the client with declining respiratory
status is the highest priority. The post-cath client is stable at 4 hours, the diabetic's fasting glucose is routine, and the
antibiotic client is stable. Test-taking strategy: a changing/declining value trumps a static stable value.
Q8: The PN discovers that a colleague appears impaired during shift. What is the most appropriate action?
A. Confront the colleague privately and offer to cover their assignment
B. Report the observation to the nursing supervisor immediately [CORRECT]
C. Document the concern in the colleague's personnel file
D. Wait until the end of shift to discuss concerns with the colleague
Correct Answer: B
Rationale: Patient safety is the priority; an impaired nurse poses a direct threat to clients. The PN must report
immediately to the supervisor who can remove the nurse from client care and initiate appropriate evaluation. Private
confrontation delays client protection; documenting in personnel files is not within the PN's role; waiting until end of
shift compromises client safety. Test-taking strategy: when patient safety is at risk, escalate immediately through the
chain of command.
Q9: A client diagnosed with terminal cancer tells the PN, 'I don't want any more treatment. Let me die
peacefully.' What is the best response?
A. 'You should discuss this decision with your family before stopping treatment.'
B. 'I'll notify your health care provider so we can discuss your wishes and options.' [CORRECT]
C. 'Don't give up hope; new treatments are being developed all the time.'
D. 'Are you sure? Your family would be devastated to lose you.'
Correct Answer: B
Rationale: The client has the right to refuse treatment (autonomy), and the PN must advocate by communicating this to
the provider. Options A and D introduce guilt and undermine autonomy; option C gives false hope. The therapeutic
response acknowledges the client's right and activates the care team. Test-taking strategy: respect client autonomy,
advocate for the client, and engage the provider for treatment decisions.
A-Grade Verified | NCLEX-PN Aligned | Comprehensive Rationales
, HESI PN Exit Exam Latest | PN HESI Exit Complete Exam | 2026/2027 Updated Page 4
Q10: A client is being discharged after a total hip replacement. Which discharge instruction is the PRIORITY
to reinforce?
A. Use a raised toilet seat for the next 6 to 8 weeks
B. Notify the provider for fever, increased hip pain, or drainage from incision [CORRECT]
C. Perform hip flexion exercises three times daily
D. Continue taking the prescribed stool softener daily
Correct Answer: B
Rationale: Recognizing and reporting signs of complications (infection, dislocation, DVT) is the priority because early
intervention prevents severe outcomes. While all instructions are important, recognition of complications addresses the
highest risk to client safety. Hip flexion beyond 90° is actually contraindicated post-THR. Test-taking strategy: priority
discharge teaching focuses on what the client must report immediately - safety comes before comfort measures.
Q11: The PN is preparing to administer prescribed morphine to a client. The client states, 'I don't want to
take anything that could make me addicted.' What should the PN do FIRST?
A. Administer the medication anyway because it has been ordered
B. Educate the client about the difference between dependence and addiction [CORRECT]
C. Withhold the medication and document the client's refusal
D. Notify the provider to change the medication order
Correct Answer: B
Rationale: A client has the right to refuse medication, but the PN should first provide education to support informed
decision-making. Many clients confuse physical dependence with addiction; education empowers the client to make an
informed choice. If the client still refuses after education, the PN respects the refusal, documents, and notifies the
provider. Test-taking strategy: when a client refuses treatment, first provide education to support informed consent.
Q12: The PN notices a UAP preparing to ambulate a client who is on fall precautions and is currently dizzy.
What is the most appropriate action?
A. Allow the UAP to ambulate the client with a gait belt
B. Reassign the UAP to a different client and ambulate the client with the PN [CORRECT]
C. Have the UAP ambulate the client with two assistants
D. Tell the UAP to ambulate the client only if a family member is present
Correct Answer: B
Rationale: An actively dizzy client on fall precautions requires nursing assessment before ambulation, which is beyond
UAP scope. The PN must either ambulate the client personally or assign an RN if available. Allowing a UAP to
ambulate an unstable client violates the five rights of delegation. Test-taking strategy: if the client's status changes or is
unstable, nursing judgment is required - return the task to the licensed nurse.
Q13: A client asks the PN for information about another client on the unit who is a neighbor. What is the best
response?
A. 'I can only confirm whether the client is on the unit but cannot share other information.' [CORRECT]
B. 'The client is doing well; I'll let them know you stopped by.'
C. 'I'll have to ask the client if they want me to share that information.'
D. 'You should ask the client directly when you visit.'
Correct Answer: A
Rationale: HIPAA protects all client health information, including whether the client is in the facility. The PN should
not confirm presence without the client's permission and should not share any clinical information. Option C is partially
correct but verification with the client is best handled by informing the requester of HIPAA limitations. Test-taking
strategy: HIPAA requires explicit client permission to release any information, including presence in the facility.
A-Grade Verified | NCLEX-PN Aligned | Comprehensive Rationales
PN HESI EXIT COMPLETE EXAM
Real Exam Questions and Correct Answers | A-Grade | 2026/2027 Updated
Aligned with the 2026-2027 HESI PN Exit Examination Blueprint and NCLEX-PN Test Plan Standards
Total Questions: 190 | Cognitive Distribution: 30% Recall, 50% Application, 20% Analysis | Format: 80%
Scenario-Based, 20% Direct Recall
Sections: 8 NCLEX-PN Client Need Categories | Question Styles: Prioritization, Delegation, Dosage Calculation, Lab
Interpretation, Clinical Judgment
Section 1: Management of Care
Advocacy, Delegation, Prioritization, Continuity of Care, Legal/Ethical Practice, & Case Management
Q1: The PN is caring for four clients. Which client should the PN assess FIRST?
A. A client 2 hours post-colonoscopy reporting mild abdominal cramping
B. A client with chronic heart failure requesting a refill of water
C. A client who is post-op day 1 from hip surgery with new onset of dyspnea [CORRECT]
D. A client 3 days post-appendectomy preparing for discharge teaching
Correct Answer: C
Rationale: Using the ABC priority framework, new onset dyspnea in a postoperative client suggests possible
pulmonary embolism, atelectasis, or fluid overload and represents an immediate threat to airway/breathing. Mild
cramping post-colonoscopy is expected, water refill is routine, and discharge teaching can wait. Test-taking strategy:
when a question asks 'assess first,' look for the option describing the most acute change in ABC status, especially in
postoperative clients.
Q2: The RN assigns the PN to care for four clients. Which client assignment is most appropriate for the PN
scope of practice?
A. A client receiving a titrated heparin drip requiring hourly aPTT monitoring
B. A client who is 12 hours post-thoracotomy with a chest tube and intermittent bloody drainage
C. A client 3 days postTotal knee replacement receiving oral analgesics and antibiotics [CORRECT]
D. A client admitted 2 hours ago with acute GI bleeding and a continuous IV infusion of pantoprazole
Correct Answer: C
Rationale: The PN scope includes caring for stable clients with predictable outcomes. The client 3 days post-TKR on
oral medications with an established recovery trajectory fits this profile. Titrated heparin, immediate post-thoracotomy,
and acute GI bleeding all require RN-level assessment and complex interventions beyond PN scope. Test-taking
strategy: PN assignments favor clients who are stable, post-acute phase, with routine care needs and predictable
responses.
A-Grade Verified | NCLEX-PN Aligned | Comprehensive Rationales
,HESI PN Exit Exam Latest | PN HESI Exit Complete Exam | 2026/2027 Updated Page 2
Q3: Which of the following tasks is appropriate for the PN to delegate to a UAP?
A. Measuring intake and output on a client with a Foley catheter [CORRECT]
B. Reinforcing discharge teaching about a new diabetic medication
C. Assessing a stage 2 pressure injury for signs of infection
D. Explaining the purpose of an upcoming colonoscopy to a client
Correct Answer: A
Rationale: Measuring I&O; is a routine, protocol-driven task that falls within the UAP scope. Teaching, assessment,
and explanation require nursing judgment and are non-delegable. The 5 rights of delegation confirm: right task (I&O;),
right circumstance (stable client), right person (UAP), right direction (clear instructions), right supervision. Test-taking
strategy: UAP may perform ADLs, ambulation, vital signs on stable clients, and I&O; - never teaching, assessment, or
judgment-based activities.
Q4: A client scheduled for an elective cholecystectomy refuses to sign the consent form after the surgeon has
explained the procedure. What is the most appropriate action by the PN?
A. Explain the risks again to ensure the client understands the procedure
B. Notify the surgeon so the surgeon can speak with the client before surgery [CORRECT]
C. Document the refusal and proceed with preoperative preparation
D. Ask a family member to convince the client to sign the consent
Correct Answer: B
Rationale: Informed consent requires the provider (surgeon) to explain risks, benefits, and alternatives. If the client
refuses after explanation, the PN must notify the surgeon, who must address the client's concerns and re-evaluate. The
nurse's role is to witness the signature and verify understanding, not to obtain consent or persuade. Forcing or coercing a
family member violates autonomy. Test-taking strategy: when consent is questioned or refused, the answer is always to
notify the provider.
Q5: A 78-year-old client with advanced dementia has no advance directive but has a daughter holding durable
power of attorney for health care. The client develops a treatable pneumonia. What should the PN do FIRST?
A. Administer the prescribed antibiotics as ordered [CORRECT]
B. Ask the daughter to make decisions regarding treatment
C. Notify the health care provider of the lack of advance directive
D. Withhold antibiotics until an ethics consult is obtained
Correct Answer: A
Rationale: Pneumonia is a treatable condition and the standard of care is to provide prescribed treatment. The durable
POA becomes relevant for decisions about withholding/withdrawing life-sustaining treatment, not for routine
prescribed care. Withholding antibiotics would constitute neglect. The provider and POA should be involved for
end-of-life decisions, but treatable acute conditions warrant standard treatment. Test-taking strategy: distinguish
between routine treatment (administer as ordered) and end-of-life decisions (involve POA/ethics).
A-Grade Verified | NCLEX-PN Aligned | Comprehensive Rationales
,HESI PN Exit Exam Latest | PN HESI Exit Complete Exam | 2026/2027 Updated Page 3
Q6: The PN receives a phone order from a provider for morphine 4 mg IV for a postoperative client. What
should the PN do?
A. Administer the medication and document the order as received
B. Repeat the order back to the provider, confirm, then administer and document [CORRECT]
C. Ask the provider to come to the unit to write the order before administering
D. Refuse to accept a telephone order and request the provider send it via fax
Correct Answer: B
Rationale: Telephone orders require the PN to use the 'read-back' verification process to confirm accuracy with the
provider before administration. This prevents medication errors and is a standard safe practice. After verification and
administration, the order must be documented with the provider's name, time, and 'read back and verified.' Test-taking
strategy: read-back verification is always required for telephone orders; refusing or delaying pain management is
inappropriate.
Q7: Which client should the PN identify as the HIGHEST priority during shift report?
A. A client 4 hours post-cardiac catheterization with stable vital signs
B. A client with COPD whose SpO2 dropped from 94% to 88% over the last hour [CORRECT]
C. A client with type 1 diabetes scheduled for a fasting blood glucose
D. A client receiving IV antibiotics for cellulitis with no complaints
Correct Answer: B
Rationale: A 6% drop in SpO2 to 88% in a COPD client indicates acute respiratory compromise requiring immediate
assessment and intervention. Using ABC and the 'unstable vs. stable' framework, the client with declining respiratory
status is the highest priority. The post-cath client is stable at 4 hours, the diabetic's fasting glucose is routine, and the
antibiotic client is stable. Test-taking strategy: a changing/declining value trumps a static stable value.
Q8: The PN discovers that a colleague appears impaired during shift. What is the most appropriate action?
A. Confront the colleague privately and offer to cover their assignment
B. Report the observation to the nursing supervisor immediately [CORRECT]
C. Document the concern in the colleague's personnel file
D. Wait until the end of shift to discuss concerns with the colleague
Correct Answer: B
Rationale: Patient safety is the priority; an impaired nurse poses a direct threat to clients. The PN must report
immediately to the supervisor who can remove the nurse from client care and initiate appropriate evaluation. Private
confrontation delays client protection; documenting in personnel files is not within the PN's role; waiting until end of
shift compromises client safety. Test-taking strategy: when patient safety is at risk, escalate immediately through the
chain of command.
Q9: A client diagnosed with terminal cancer tells the PN, 'I don't want any more treatment. Let me die
peacefully.' What is the best response?
A. 'You should discuss this decision with your family before stopping treatment.'
B. 'I'll notify your health care provider so we can discuss your wishes and options.' [CORRECT]
C. 'Don't give up hope; new treatments are being developed all the time.'
D. 'Are you sure? Your family would be devastated to lose you.'
Correct Answer: B
Rationale: The client has the right to refuse treatment (autonomy), and the PN must advocate by communicating this to
the provider. Options A and D introduce guilt and undermine autonomy; option C gives false hope. The therapeutic
response acknowledges the client's right and activates the care team. Test-taking strategy: respect client autonomy,
advocate for the client, and engage the provider for treatment decisions.
A-Grade Verified | NCLEX-PN Aligned | Comprehensive Rationales
, HESI PN Exit Exam Latest | PN HESI Exit Complete Exam | 2026/2027 Updated Page 4
Q10: A client is being discharged after a total hip replacement. Which discharge instruction is the PRIORITY
to reinforce?
A. Use a raised toilet seat for the next 6 to 8 weeks
B. Notify the provider for fever, increased hip pain, or drainage from incision [CORRECT]
C. Perform hip flexion exercises three times daily
D. Continue taking the prescribed stool softener daily
Correct Answer: B
Rationale: Recognizing and reporting signs of complications (infection, dislocation, DVT) is the priority because early
intervention prevents severe outcomes. While all instructions are important, recognition of complications addresses the
highest risk to client safety. Hip flexion beyond 90° is actually contraindicated post-THR. Test-taking strategy: priority
discharge teaching focuses on what the client must report immediately - safety comes before comfort measures.
Q11: The PN is preparing to administer prescribed morphine to a client. The client states, 'I don't want to
take anything that could make me addicted.' What should the PN do FIRST?
A. Administer the medication anyway because it has been ordered
B. Educate the client about the difference between dependence and addiction [CORRECT]
C. Withhold the medication and document the client's refusal
D. Notify the provider to change the medication order
Correct Answer: B
Rationale: A client has the right to refuse medication, but the PN should first provide education to support informed
decision-making. Many clients confuse physical dependence with addiction; education empowers the client to make an
informed choice. If the client still refuses after education, the PN respects the refusal, documents, and notifies the
provider. Test-taking strategy: when a client refuses treatment, first provide education to support informed consent.
Q12: The PN notices a UAP preparing to ambulate a client who is on fall precautions and is currently dizzy.
What is the most appropriate action?
A. Allow the UAP to ambulate the client with a gait belt
B. Reassign the UAP to a different client and ambulate the client with the PN [CORRECT]
C. Have the UAP ambulate the client with two assistants
D. Tell the UAP to ambulate the client only if a family member is present
Correct Answer: B
Rationale: An actively dizzy client on fall precautions requires nursing assessment before ambulation, which is beyond
UAP scope. The PN must either ambulate the client personally or assign an RN if available. Allowing a UAP to
ambulate an unstable client violates the five rights of delegation. Test-taking strategy: if the client's status changes or is
unstable, nursing judgment is required - return the task to the licensed nurse.
Q13: A client asks the PN for information about another client on the unit who is a neighbor. What is the best
response?
A. 'I can only confirm whether the client is on the unit but cannot share other information.' [CORRECT]
B. 'The client is doing well; I'll let them know you stopped by.'
C. 'I'll have to ask the client if they want me to share that information.'
D. 'You should ask the client directly when you visit.'
Correct Answer: A
Rationale: HIPAA protects all client health information, including whether the client is in the facility. The PN should
not confirm presence without the client's permission and should not share any clinical information. Option C is partially
correct but verification with the client is best handled by informing the requester of HIPAA limitations. Test-taking
strategy: HIPAA requires explicit client permission to release any information, including presence in the facility.
A-Grade Verified | NCLEX-PN Aligned | Comprehensive Rationales
