HESI PN Exit Exam 2025: 200 Questions with Verified
Answers and Detailed Rationales
1. A nurse is assessing a client with COPD who is experiencing dyspnea. Which
position is most effective to improve breathing?
A. Supine with legs elevated
B. High Fowler’s with arms supported on an overbed table
C. Side-lying with pillow support
D. Trendelenburg position
Correct Answer: B
Rationale: High Fowler’s with arm support allows maximal lung expansion and helps the
client use accessory muscles. Other positions worsen respiratory effort.
2. A client receiving digoxin reports nausea and visual halos. Which action should the
nurse take first?
A. Notify the provider
B. Check the client’s apical pulse
C. Hold the next dose
D. Draw serum potassium levels
Correct Answer: B
Rationale: Digoxin toxicity requires immediate assessment. The apical pulse must be
checked before any further intervention.
3. A client with DKA is receiving IV insulin. Which electrolyte requires close monitoring?
A. Sodium
B. Potassium
,C. Calcium
D. Magnesium
Correct Answer: B
Rationale: Insulin shifts potassium into cells → risk of dangerous hypokalemia.
4. Postoperative client reports sudden chest pain and dyspnea. What is the priority?
A. Administer opioid analgesics
B. Apply oxygen at 2 L/min
C. Assess lung sounds
D. Notify the provider
Correct Answer: B
Rationale: Possible pulmonary embolism — oxygen is the fastest stabilizing measure.
5. A client with severe anemia is most likely to exhibit which symptom?
A. Bradycardia
B. Fatigue
C. Hypertension
D. Cold intolerance
Correct Answer: B
Rationale: Low Hgb reduces oxygen delivery → fatigue. Bradycardia and hypertension
are not typical.
6. A client with pneumonia has thick secretions. Which intervention is most important?
A. Restrict fluids
,B. Encourage ambulation
C. Increase humidification
D. Administer antitussive
Correct Answer: C
Rationale: Humidification thins secretions, improving airway clearance.
7. A diabetic client with neuropathy is teaching foot care. Which statement requires
correction?
A. “I will check my feet daily.”
B. “I can soak my feet to soften calluses.”
C. “I will wear cotton socks.”
D. “I will wear properly fitting shoes.”
Correct Answer: B
Rationale: Soaking increases risk of burns and infection.
8. A client receiving TPN suddenly develops shortness of breath and chest pain. What is
the priority?
A. Stop the infusion
B. Check blood glucose
C. Place the client in left Trendelenburg
D. Assess IV site
Correct Answer: A
Rationale: Air embolism risk — stop the infusion immediately.
9. Which client is at highest risk for pressure injury?
, A. Ambulatory client with hip fracture
B. Client with fever and poor intake
C. Client with immobility and incontinence
D. Client receiving IV antibiotics
Correct Answer: C
Rationale: Moisture + immobility = highest breakdown risk.
10. A nurse is preparing to administer a blood transfusion. Which action is essential?
A. Prime tubing with dextrose
B. Verify identity with another nurse
C. Warm blood before use
D. Use a 24-gauge catheter
Correct Answer: B
Rationale: Two-nurse verification prevents fatal transfusion errors.
11. A client with heart failure gains 2 kg in 24 hours. What should the nurse do?
A. Encourage increased fluids
B. Assess for edema and crackles
C. Hold all cardiac meds
D. Document only
Correct Answer: B
Rationale: Rapid weight gain = fluid retention → assess for worsening HF.
12. A client taking furosemide has lab results. Which requires intervention?
Answers and Detailed Rationales
1. A nurse is assessing a client with COPD who is experiencing dyspnea. Which
position is most effective to improve breathing?
A. Supine with legs elevated
B. High Fowler’s with arms supported on an overbed table
C. Side-lying with pillow support
D. Trendelenburg position
Correct Answer: B
Rationale: High Fowler’s with arm support allows maximal lung expansion and helps the
client use accessory muscles. Other positions worsen respiratory effort.
2. A client receiving digoxin reports nausea and visual halos. Which action should the
nurse take first?
A. Notify the provider
B. Check the client’s apical pulse
C. Hold the next dose
D. Draw serum potassium levels
Correct Answer: B
Rationale: Digoxin toxicity requires immediate assessment. The apical pulse must be
checked before any further intervention.
3. A client with DKA is receiving IV insulin. Which electrolyte requires close monitoring?
A. Sodium
B. Potassium
,C. Calcium
D. Magnesium
Correct Answer: B
Rationale: Insulin shifts potassium into cells → risk of dangerous hypokalemia.
4. Postoperative client reports sudden chest pain and dyspnea. What is the priority?
A. Administer opioid analgesics
B. Apply oxygen at 2 L/min
C. Assess lung sounds
D. Notify the provider
Correct Answer: B
Rationale: Possible pulmonary embolism — oxygen is the fastest stabilizing measure.
5. A client with severe anemia is most likely to exhibit which symptom?
A. Bradycardia
B. Fatigue
C. Hypertension
D. Cold intolerance
Correct Answer: B
Rationale: Low Hgb reduces oxygen delivery → fatigue. Bradycardia and hypertension
are not typical.
6. A client with pneumonia has thick secretions. Which intervention is most important?
A. Restrict fluids
,B. Encourage ambulation
C. Increase humidification
D. Administer antitussive
Correct Answer: C
Rationale: Humidification thins secretions, improving airway clearance.
7. A diabetic client with neuropathy is teaching foot care. Which statement requires
correction?
A. “I will check my feet daily.”
B. “I can soak my feet to soften calluses.”
C. “I will wear cotton socks.”
D. “I will wear properly fitting shoes.”
Correct Answer: B
Rationale: Soaking increases risk of burns and infection.
8. A client receiving TPN suddenly develops shortness of breath and chest pain. What is
the priority?
A. Stop the infusion
B. Check blood glucose
C. Place the client in left Trendelenburg
D. Assess IV site
Correct Answer: A
Rationale: Air embolism risk — stop the infusion immediately.
9. Which client is at highest risk for pressure injury?
, A. Ambulatory client with hip fracture
B. Client with fever and poor intake
C. Client with immobility and incontinence
D. Client receiving IV antibiotics
Correct Answer: C
Rationale: Moisture + immobility = highest breakdown risk.
10. A nurse is preparing to administer a blood transfusion. Which action is essential?
A. Prime tubing with dextrose
B. Verify identity with another nurse
C. Warm blood before use
D. Use a 24-gauge catheter
Correct Answer: B
Rationale: Two-nurse verification prevents fatal transfusion errors.
11. A client with heart failure gains 2 kg in 24 hours. What should the nurse do?
A. Encourage increased fluids
B. Assess for edema and crackles
C. Hold all cardiac meds
D. Document only
Correct Answer: B
Rationale: Rapid weight gain = fluid retention → assess for worsening HF.
12. A client taking furosemide has lab results. Which requires intervention?
