2025 HESI CRITICAL CARE EXIT EXAM TESTBANK 2

HESI PN EXIT V1 EXAM NCLEX (NGN), Case-based Scenarios, Actual Qs & Ans to Pass the Exam THIS HESI PN EXIT CONSISTS OF 75 Questions and Answers multiple-choice questions (MCQs)** with four options (A–D), answers, and detailed rationales aligned with HESI PN Exit Exam 2025 standards. Some questions are flagged as **NCLEX-style (NGN)**, and relevant **case studies/vitals** are integrated where applicable. 1. An elderly client who is 12 hours postoperative for a hernia repair suddenly becomes agitated, staggers out into the corridor, and demands to be set free. After assisting the client back to bed and administering pain medication, which intervention is best for the practical nurse (PN) to implement? - A. Notify the healthcare provider and request a prescription for restraints to minimize the client's danger to self. - B. Raise the side and notify the family to come sit with the client to reorientate and cooperate. - C. Administer prescribed narcotic antagonist to reverse the effects of any analgesic accumulation. - D. Instruct a UAP to keep the upper side rails up and check on the client every 15 minutes until the client is resting. Correct answer B. Raise the side and notify the family to come sit with the client to reorientate and cooperate. Rationale: ..The best immediate action is to ensure the client's safety while providing a calming presence through family support. Restraints should only be used as a last resort. 2. A male client attends a community support program for mentally impaired and chemically abusing clients. The client tells the practical nurse (PN) that his drug of choice is cocaine and heroin. What is the greatest health risk for the client? - A. Hepatitis - B. Glaucoma - C. Diabetes - D. Hypotension Correct answer A. Hepatitis. Rationale: ..Sharing needles or engaging in risky behaviors associated with drug use puts the client at high risk for hepatitis infections. 3. The practical nurse (PN) is charting vital signs on a handwritten flow sheet and realizes that an error has been made. What should the PN do to rectify the error? - A. Draw one line through the entry and insert the correct information. - B. Chart the correct information in the column. - C. Obliterate the entry and insert the correct information. - D. Notify the charge nurse that the entry needs to be revised. Correct answer A. Draw one line through the entry and insert the correct information. Rationale: ..The correct method for correcting a charting error in a medical record is to strike through the incorrect information with a single line, then write the correct information, ensuring clarity and accountability. 4. The PN selects the ventrogluteal site for an adult’s IM injection. Which is the correct location? A. Upper outer quadrant of the buttock B. Lateral aspect of upper thigh C. Lateral hip (greater trochanter area) D. Dorsogluteal Correct answer C Rationale: ..The ventrogluteal site is at the lateral hip, considered safest due to fewer major nerves or vessels. 5. The Charge nurse brings a #18 catheter with a 30 mL balloon to the practical nurse (PN) who is preparing to insert a catheter in a female client who weighs 50 kg. Which action should the PN take first? - A. Ask the client if she has previously been catheterized. - B. Obtain a 30 mL syringe and a vial of sterile water. - C. Consult with the charge nurse about the catheter. - D. Position the client and observe the urinary meatus. Correct answer C. Consult with the charge nurse about the catheter. Rationale: ..Consulting with the charge nurse is the best first step to ensure the appropriate size is used and to verify any relevant patient information. 6. The practical nurse (PN) is caring for a client newly diagnosed with diabetes mellitus (DM). Which finding is an early sign of hypoglycemia? - A. Bradycardia - B. Tremors - C. Polyuria - D. Difficulty swallowing Correct answer B. Tremors. Rationale: ..Tremors are a classic sign of hypoglycemia, indicating the body's need for glucose. 7. While caring for a client with Guillain-Barré syndrome, which finding should the practical nurse (PN) report to the charge nurse? - A. Lower leg weakness/cramping - B. Irregular heart rate - C. Profuse diaphoresis - D. Full facial flushing Correct answer B. Irregular heart rate. Rationale: ..An irregular heart rate in a client with Guillain-Barré syndrome can indicate autonomic nervous system involvement, which is a serious complication. 8. A client at 39 weeks gestation is admitted in early labor. During the focused assessment, the practical nurse (PN) reviews the obstetrical history with the client who states that she has been pregnant five times but only has two living children, both of whom were full-term. The other three pregnancies were miscarriages during the first trimester. Which parity should the PN document for term, premature, abortion, and living (TPAL) for the client? - A. Term 3, Premature 0, Abortion 3, Living 2 - B. Term 6, Premature 3, Abortion 3, Living 2 - C. Term 2, Premature 3, Abortion 3, Living 2 - D. Term 2, Premature 1, Abortion 0, Living 3 Correct answer C. Term 2, Premature 0, Abortion 3, Living 2. Rationale: ..The TPAL system counts full-term births, preterm births, abortions (loss before 20 weeks), and living children. 9. A client who is at full-term gestation in active labor complains of a cramp in her legs. Which intervention should the practical nurse (PN) implement? - A. Massage the calf and foot. - B. Check the pedal pulse in the affected leg. - C. Extend the leg and flex the foot. - D. Elevate the leg above the heart. Correct answer C. Extend the leg and flex the foot. Rationale: ..This maneuver can relieve muscle cramps effectively. 10. The practical nurse (PN) is caring for a client with psychosis who demonstrates an inability to communicate effectively. Which method should the PN use to interact with the client? - A. Touch the client when speaking. - B. Engage in regular contact. - C. Discourage group activities. - D. Establish a no harm contract. Correct answer B. Engage in regular contact. Rationale: ..Regular contact helps build rapport and encourages communication. 11. The practical nurse (PN) is preparing cefazolin 400mg IM for a client with a positive infection. The available vial is labeled Cefazolin 1 gram, and the instructions for the reconstitution state for IM add 2 mL sterile water for injection. Total volume after reconstitution is 2.5 mL. After reconstitution how many mL should be administered to the client? (ENTER NUMERIC VALUE ONLY): Correct answer 1 mL. Rationale: ..To achieve a dose of 400mg from a 1 gram (1000mg) vial, the calculation is (400mg/1000mg) * 2.5 mL. 12. An older client who fell down several stairs 4 hours ago is scheduled for a magnetic resonance imaging (MRI). What information should the practical nurse (PN) obtain from the client? - A. Allergy to iodine-based dyes. - B. History of previous myelogram. - C. Last time food was consumed. - D. Presence of a metal implant. Correct answer D. Presence of a metal implant. Rationale: ..Safety checks for MRIs primarily address the presence of any metal implants that could interfere with the procedure. 13. The practical nurse (PN) is reviewing instructions for the use of pilocarpine drops with a client who has glaucoma. The client replies that the drops should be used to anesthetize the eye if eye pain is experienced. What action should the PN implement? - A. Document in the chart that the client understands the action and use of the eye drops. - B. Explain to the client that the eye drops do provide pain relief, but do not anesthetize the eyes. - C. Reteach the client about the action of the eye drops to decrease pressure in the eyes. - D. Reassure the client that the drops will not be needed often since eye pain in glaucoma is not common. Correct answer C. Reteach the client about the action of the eye drops to decrease pressure in the eyes. Rationale: ..Educating the client about medication use is critical, especially in glaucoma treatment where understanding is necessary for compliance. 14. The practical nurse (PN) heard adventitious breath sounds while auscultating the lungs of an older adult who is receiving an IV of 5% dextrose in water (D5W) at 100 mL/hour. Which action should the PN take next? - A. Document the findings and monitor the client. - B. Report the findings to the charge nurse. - C. Slow the D5W infusion rate to 50 mL/hour. - D. Review the last balance of intake and output. Correct answer B. Report the findings to the charge nurse. Rationale: ..Adventitious breath sounds may indicate fluid overload or respiratory complications, needing immediate attention. 15. A client in the psychiatric unit's dayroom is becoming agitated, talking incessantly, and starting to yell and swear at the other clients. Which action should the practical nurse (PN) implement first? - A. Administer a PRN medication for agitation. - B. Instruct a UAP to stay with the client. - C. Escort the client to a calm and quiet place. - D. Notify the client healthcare provider. Correct answer C. Escort the client to a calm and quiet place.