PN HESI EXIT EXAM 2026 | HESI PN EXIT EXAM
WITH NGN | ACTUAL EXAM | Complete Exam
Questions & Correct Verified Answers | Latest 2025 /
2026 Update | Already Graded A
1. A 72-year-old client recovering from a right-sided stroke is receiving thickened
liquids and pureed foods. Which clinical finding best indicates that the client’s
swallowing precautions are effective?
A. Absence of coughing during meals
B. Moist-sounding lung fields on auscultation
C. Client reports thirst after each meal
D. Weight loss of 0.5 kg in one week
Correct Answer: A
Rationale: Absence of coughing or choking (A) is an immediate behavioral sign of safe
swallowing. Moist lung sounds (B) suggest possible silent aspiration. Thirst (C) is
common with thickened liquids and does not reflect safety. Minimal weight change (D)
is within normal fluctuation and not a sensitive indicator.
2. A postpartum client who had a cesarean birth 36 hours ago complains of sudden
sharp chest pain and shortness of breath. Her heart rate is 110 beats/min,
respiratory rate 28 breaths/min, and O2 saturation 89%. Which action should the
PN take first?
A. Administer the prescribed PRN acetaminophen 650 mg PO
B. Apply oxygen at 4 L/min via nasal cannula
,C. Encourage use of the incentive spirometer every hour
D. Document the findings and continue routine care
Correct Answer: B
Rationale: Sudden chest pain, tachypnea, and hypoxemia are classic for pulmonary
embolism; oxygenation is the priority (B). Acetaminophen (A) treats pain but not
hypoxia. Incentive spirometry (C) is preventive, not emergent. Documentation without
intervention (D) delays life-saving treatment.
3. A 5-year-old child with asthma is receiving albuterol via nebulizer. Which finding
indicates to the PN that the treatment is effective?
A. Heart rate increases from 100 to 120 beats/min
B. Respiratory rate drops from 30 to 22 breaths/min
C. Peak expiratory flow rate remains unchanged
D. The child states, “My mouth tastes funny.”
Correct Answer: B
Rationale: Decreased respiratory rate (B) signifies reduced work of breathing and
bronchodilation. Mild tachycardia (A) is an expected side effect, not efficacy.
Unchanged peak flow (C) shows lack of improvement. Taste change (D) is irrelevant to
airway patency.
4. A client with type 2 diabetes is prescribed metformin 1000 mg PO twice daily.
Which client statement requires immediate follow-up by the PN?
A. “I had a small bout of diarrhea yesterday.”
B. “My heart has been fluttering for the past hour.”
,C. “I missed one dose last week.”
D. “I take the pill with breakfast and dinner.”
Correct Answer: B
Rationale: Palpitations or “fluttering” (B) may indicate lactic acidosis, a rare but
life-threatening adverse effect of metformin. Mild GI upset (A) is common. Missed
doses (C) and correct timing (D) are routine teaching points.
5. A pregnant client at 28 weeks gestation reports severe headache, blurred vision,
and epigastric pain. Her blood pressure is 160/110 mm Hg. Which nursing action
is priority?
A. Encourage left lateral positioning
B. Start a 24-hour urine protein collection
C. Notify the RN or provider immediately
D. Offer a high-protein snack
Correct Answer: C
Rationale: Signs indicate severe preeclampsia; immediate provider notification (C) is
required to prevent eclampsia. Left positioning (A) and urine collection (B) are
appropriate but not the first priority. A snack (D) is irrelevant.
6. A client with major depressive disorder is started on sertraline 50 mg daily. After
7 days the client states, “I feel more energetic but still have no interest in
activities.” Which conclusion by the PN is most accurate?
A. The medication is fully effective
B. The client is experiencing medication-induced mania
, C. Partial improvement; monitor for increased suicide risk
D. The dose is too low and should be doubled
Correct Answer: C
Rationale: Increased energy without mood improvement can precede suicidal action in
depressed clients; partial response requires close monitoring (C). Full effect (A) takes
4–6 weeks. Mania (B) would include grandiosity or recklessness. Dose changes (D) are
provider decisions.
7. A 6-month-old infant is brought to the clinic for immunizations. Which
assessment finding should the PN report before administering the vaccines?
A. Temperature of 38.5 °C (101.3 °F)
B. Mild eczema on cheeks
C. Parent reports loose stools this morning
D. The infant is teething
Correct Answer: A
Rationale: Moderate fever (A) is a contraindication to live vaccines and requires provider
evaluation. Mild eczema (B), loose stools (C), and teething (D) are not contraindications.
8. A client with chronic kidney disease stage 4 is prescribed epoetin alfa. Which
laboratory value best reflects the effectiveness of this therapy?
A. Hematocrit increases from 24% to 32% over 4 weeks
B. Serum potassium decreases from 5.2 to 4.8 mEq/L
C. Creatinine decreases from 3.5 to 3.0 mg/dL
WITH NGN | ACTUAL EXAM | Complete Exam
Questions & Correct Verified Answers | Latest 2025 /
2026 Update | Already Graded A
1. A 72-year-old client recovering from a right-sided stroke is receiving thickened
liquids and pureed foods. Which clinical finding best indicates that the client’s
swallowing precautions are effective?
A. Absence of coughing during meals
B. Moist-sounding lung fields on auscultation
C. Client reports thirst after each meal
D. Weight loss of 0.5 kg in one week
Correct Answer: A
Rationale: Absence of coughing or choking (A) is an immediate behavioral sign of safe
swallowing. Moist lung sounds (B) suggest possible silent aspiration. Thirst (C) is
common with thickened liquids and does not reflect safety. Minimal weight change (D)
is within normal fluctuation and not a sensitive indicator.
2. A postpartum client who had a cesarean birth 36 hours ago complains of sudden
sharp chest pain and shortness of breath. Her heart rate is 110 beats/min,
respiratory rate 28 breaths/min, and O2 saturation 89%. Which action should the
PN take first?
A. Administer the prescribed PRN acetaminophen 650 mg PO
B. Apply oxygen at 4 L/min via nasal cannula
,C. Encourage use of the incentive spirometer every hour
D. Document the findings and continue routine care
Correct Answer: B
Rationale: Sudden chest pain, tachypnea, and hypoxemia are classic for pulmonary
embolism; oxygenation is the priority (B). Acetaminophen (A) treats pain but not
hypoxia. Incentive spirometry (C) is preventive, not emergent. Documentation without
intervention (D) delays life-saving treatment.
3. A 5-year-old child with asthma is receiving albuterol via nebulizer. Which finding
indicates to the PN that the treatment is effective?
A. Heart rate increases from 100 to 120 beats/min
B. Respiratory rate drops from 30 to 22 breaths/min
C. Peak expiratory flow rate remains unchanged
D. The child states, “My mouth tastes funny.”
Correct Answer: B
Rationale: Decreased respiratory rate (B) signifies reduced work of breathing and
bronchodilation. Mild tachycardia (A) is an expected side effect, not efficacy.
Unchanged peak flow (C) shows lack of improvement. Taste change (D) is irrelevant to
airway patency.
4. A client with type 2 diabetes is prescribed metformin 1000 mg PO twice daily.
Which client statement requires immediate follow-up by the PN?
A. “I had a small bout of diarrhea yesterday.”
B. “My heart has been fluttering for the past hour.”
,C. “I missed one dose last week.”
D. “I take the pill with breakfast and dinner.”
Correct Answer: B
Rationale: Palpitations or “fluttering” (B) may indicate lactic acidosis, a rare but
life-threatening adverse effect of metformin. Mild GI upset (A) is common. Missed
doses (C) and correct timing (D) are routine teaching points.
5. A pregnant client at 28 weeks gestation reports severe headache, blurred vision,
and epigastric pain. Her blood pressure is 160/110 mm Hg. Which nursing action
is priority?
A. Encourage left lateral positioning
B. Start a 24-hour urine protein collection
C. Notify the RN or provider immediately
D. Offer a high-protein snack
Correct Answer: C
Rationale: Signs indicate severe preeclampsia; immediate provider notification (C) is
required to prevent eclampsia. Left positioning (A) and urine collection (B) are
appropriate but not the first priority. A snack (D) is irrelevant.
6. A client with major depressive disorder is started on sertraline 50 mg daily. After
7 days the client states, “I feel more energetic but still have no interest in
activities.” Which conclusion by the PN is most accurate?
A. The medication is fully effective
B. The client is experiencing medication-induced mania
, C. Partial improvement; monitor for increased suicide risk
D. The dose is too low and should be doubled
Correct Answer: C
Rationale: Increased energy without mood improvement can precede suicidal action in
depressed clients; partial response requires close monitoring (C). Full effect (A) takes
4–6 weeks. Mania (B) would include grandiosity or recklessness. Dose changes (D) are
provider decisions.
7. A 6-month-old infant is brought to the clinic for immunizations. Which
assessment finding should the PN report before administering the vaccines?
A. Temperature of 38.5 °C (101.3 °F)
B. Mild eczema on cheeks
C. Parent reports loose stools this morning
D. The infant is teething
Correct Answer: A
Rationale: Moderate fever (A) is a contraindication to live vaccines and requires provider
evaluation. Mild eczema (B), loose stools (C), and teething (D) are not contraindications.
8. A client with chronic kidney disease stage 4 is prescribed epoetin alfa. Which
laboratory value best reflects the effectiveness of this therapy?
A. Hematocrit increases from 24% to 32% over 4 weeks
B. Serum potassium decreases from 5.2 to 4.8 mEq/L
C. Creatinine decreases from 3.5 to 3.0 mg/dL
