1
HESI PN Exit Exam V1
(2025/2026) – Actual NGN
Format with Verified
Questions and 100% Correct
Answer Keys
This document provides Version 1 (V1) of the HESI PN Exit Exam, containing 75 Next
Generation NCLEX (NGN)-style questions for the 2025/2026 exam cycle. Questions reflect
realistic NCLEX-PN content, incorporating multiple-choice, select-all-that-apply (SATA),
prioritization, and case study formats. Focus areas include delegation, care management,
pharmacology, and patient safety. Correct answers are highlighted in yellow, with
evidence-based rationales in red, ensuring accuracy and alignment with current PN
standards. The content is formatted for clarity and editability, suitable
HESI PN Exit Exam V1 (Questions 1–75)
Question 1 (Multiple Choice)
A licensed practical nurse (LPN) is assigned to a client with type 2 diabetes who reports
dizziness. Which action should the LPN take first?
a) Administer insulin as prescribed
b) Check the client’s blood glucose level
c) Offer the client a high-carbohydrate snack
d) Notify the registered nurse (RN)
Correct Answer: b) Check the client’s blood glucose level
Rationale: Dizziness in a client with diabetes may indicate hypoglycemia or hyperglycemia.
Checking blood glucose is the first step to determine the cause and guide interventions.
Administering insulin or offering a snack is premature, and notifying the RN follows assessment
(American Diabetes Association [ADA], 2021).
Question 2 (Select All That Apply)
, 2
Which tasks can the LPN delegate to an unlicensed assistive personnel (UAP)? (Select all
that apply)
a) Measure vital signs for a stable client
b) Administer oral medications
c) Perform a sterile dressing change
d) Assist with ambulation
e) Document intake and output
Correct Answers: a) Measure vital signs for a stable client, d) Assist with ambulation, e)
Document intake and output
Rationale: UAPs can perform non-invasive tasks like measuring vital signs, assisting with
ambulation, and documenting intake/output under LPN supervision. Administering medications
and sterile procedures are within the LPN’s scope, not the UAP’s (National Council of State
Boards of Nursing [NCSBN], 2020).
Question 3 (Prioritization)
The LPN is caring for four clients. Which client should the LPN assess first?
a) Client with hypertension, BP 140/90 mmHg
b) Client with COPD, oxygen saturation 88%
c) Client with diabetes, blood glucose 150 mg/dL
d) Client with fracture, reporting mild pain
Correct Answer: b) Client with COPD, oxygen saturation 88%
Rationale: Oxygen saturation of 88% indicates hypoxemia, a priority per the ABCs (airway,
breathing, circulation). BP 140/90 mmHg, glucose 150 mg/dL, and mild pain are less urgent and
can be addressed after stabilizing breathing (American Heart Association [AHA], 2020).
Question 4 (Multiple Choice)
A client is prescribed digoxin 0.125 mg daily. The LPN notes a heart rate of 58 bpm. What
should the LPN do next?
a) Administer the dose as prescribed
b) Hold the dose and notify the RN
c) Check the client’s blood pressure
d) Encourage fluid intake
Correct Answer: b) Hold the dose and notify the RN
Rationale: Digoxin toxicity risk increases with bradycardia (HR <60 bpm). The LPN should hold
the dose and notify the RN for further evaluation (e.g., serum digoxin levels). Administering the
dose is unsafe, BP is secondary, and fluids are unrelated (AHA, 2020).
Question 5 (Case Study – 6 Questions)
, 3
Case Study: A 70-year-old client with heart failure is admitted with dyspnea, edema, and weight
gain of 5 lbs in 3 days. Vital signs: BP 150/90 mmHg, HR 92 bpm, RR 24 breaths/min, SpO₂
90%.
Question 5.1: What is the priority nursing action?
a) Administer furosemide as prescribed
b) Assess lung sounds
c) Elevate the client’s legs
d) Increase oxygen flow
Correct Answer: b) Assess lung sounds
Rationale: Dyspnea and edema suggest possible pulmonary edema. Assessing lung sounds for
crackles guides interventions (e.g., diuretics, oxygen). Assessment precedes action per the
nursing process (AHA, 2020).
Question 5.2: Which task can the LPN delegate to the UAP?
a) Administer oxygen at 2 L/min
b) Weigh the client daily
c) Teach the client about diuretics
d) Assess edema
Correct Answer: b) Weigh the client daily
Rationale: UAPs can perform non-invasive tasks like daily weights. Administering oxygen,
teaching, and assessing edema are within the LPN’s scope, not the UAP’s (NCSBN, 2020).
Question 5.3: The client is prescribed furosemide 40 mg IV. What should the LPN monitor?
a) Blood glucose
b) Potassium levels
c) Platelet count
d) Thyroid function
Correct Answer: b) Potassium levels
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, risking arrhythmias. Glucose,
platelets, and thyroid are not directly affected (AHA, 2020).
Question 5.4: The client reports dizziness when standing. What is the most likely cause?
a) Hypoglycemia
b) Orthostatic hypotension
c) Hyperkalemia
d) Respiratory alkalosis
Correct Answer: b) Orthostatic hypotension
Rationale: Furosemide and heart failure can cause volume depletion, leading to orthostatic
hypotension. Hypoglycemia, hyperkalemia, and alkalosis are unrelated to the symptoms (AHA,
2020).
HESI PN Exit Exam V1
(2025/2026) – Actual NGN
Format with Verified
Questions and 100% Correct
Answer Keys
This document provides Version 1 (V1) of the HESI PN Exit Exam, containing 75 Next
Generation NCLEX (NGN)-style questions for the 2025/2026 exam cycle. Questions reflect
realistic NCLEX-PN content, incorporating multiple-choice, select-all-that-apply (SATA),
prioritization, and case study formats. Focus areas include delegation, care management,
pharmacology, and patient safety. Correct answers are highlighted in yellow, with
evidence-based rationales in red, ensuring accuracy and alignment with current PN
standards. The content is formatted for clarity and editability, suitable
HESI PN Exit Exam V1 (Questions 1–75)
Question 1 (Multiple Choice)
A licensed practical nurse (LPN) is assigned to a client with type 2 diabetes who reports
dizziness. Which action should the LPN take first?
a) Administer insulin as prescribed
b) Check the client’s blood glucose level
c) Offer the client a high-carbohydrate snack
d) Notify the registered nurse (RN)
Correct Answer: b) Check the client’s blood glucose level
Rationale: Dizziness in a client with diabetes may indicate hypoglycemia or hyperglycemia.
Checking blood glucose is the first step to determine the cause and guide interventions.
Administering insulin or offering a snack is premature, and notifying the RN follows assessment
(American Diabetes Association [ADA], 2021).
Question 2 (Select All That Apply)
, 2
Which tasks can the LPN delegate to an unlicensed assistive personnel (UAP)? (Select all
that apply)
a) Measure vital signs for a stable client
b) Administer oral medications
c) Perform a sterile dressing change
d) Assist with ambulation
e) Document intake and output
Correct Answers: a) Measure vital signs for a stable client, d) Assist with ambulation, e)
Document intake and output
Rationale: UAPs can perform non-invasive tasks like measuring vital signs, assisting with
ambulation, and documenting intake/output under LPN supervision. Administering medications
and sterile procedures are within the LPN’s scope, not the UAP’s (National Council of State
Boards of Nursing [NCSBN], 2020).
Question 3 (Prioritization)
The LPN is caring for four clients. Which client should the LPN assess first?
a) Client with hypertension, BP 140/90 mmHg
b) Client with COPD, oxygen saturation 88%
c) Client with diabetes, blood glucose 150 mg/dL
d) Client with fracture, reporting mild pain
Correct Answer: b) Client with COPD, oxygen saturation 88%
Rationale: Oxygen saturation of 88% indicates hypoxemia, a priority per the ABCs (airway,
breathing, circulation). BP 140/90 mmHg, glucose 150 mg/dL, and mild pain are less urgent and
can be addressed after stabilizing breathing (American Heart Association [AHA], 2020).
Question 4 (Multiple Choice)
A client is prescribed digoxin 0.125 mg daily. The LPN notes a heart rate of 58 bpm. What
should the LPN do next?
a) Administer the dose as prescribed
b) Hold the dose and notify the RN
c) Check the client’s blood pressure
d) Encourage fluid intake
Correct Answer: b) Hold the dose and notify the RN
Rationale: Digoxin toxicity risk increases with bradycardia (HR <60 bpm). The LPN should hold
the dose and notify the RN for further evaluation (e.g., serum digoxin levels). Administering the
dose is unsafe, BP is secondary, and fluids are unrelated (AHA, 2020).
Question 5 (Case Study – 6 Questions)
, 3
Case Study: A 70-year-old client with heart failure is admitted with dyspnea, edema, and weight
gain of 5 lbs in 3 days. Vital signs: BP 150/90 mmHg, HR 92 bpm, RR 24 breaths/min, SpO₂
90%.
Question 5.1: What is the priority nursing action?
a) Administer furosemide as prescribed
b) Assess lung sounds
c) Elevate the client’s legs
d) Increase oxygen flow
Correct Answer: b) Assess lung sounds
Rationale: Dyspnea and edema suggest possible pulmonary edema. Assessing lung sounds for
crackles guides interventions (e.g., diuretics, oxygen). Assessment precedes action per the
nursing process (AHA, 2020).
Question 5.2: Which task can the LPN delegate to the UAP?
a) Administer oxygen at 2 L/min
b) Weigh the client daily
c) Teach the client about diuretics
d) Assess edema
Correct Answer: b) Weigh the client daily
Rationale: UAPs can perform non-invasive tasks like daily weights. Administering oxygen,
teaching, and assessing edema are within the LPN’s scope, not the UAP’s (NCSBN, 2020).
Question 5.3: The client is prescribed furosemide 40 mg IV. What should the LPN monitor?
a) Blood glucose
b) Potassium levels
c) Platelet count
d) Thyroid function
Correct Answer: b) Potassium levels
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, risking arrhythmias. Glucose,
platelets, and thyroid are not directly affected (AHA, 2020).
Question 5.4: The client reports dizziness when standing. What is the most likely cause?
a) Hypoglycemia
b) Orthostatic hypotension
c) Hyperkalemia
d) Respiratory alkalosis
Correct Answer: b) Orthostatic hypotension
Rationale: Furosemide and heart failure can cause volume depletion, leading to orthostatic
hypotension. Hypoglycemia, hyperkalemia, and alkalosis are unrelated to the symptoms (AHA,
2020).
