PN HESI EXIT EXAM 2026 | HESI PN EXIT EXAM
WITH NGN | ACTUAL EXAM | Complete Exam
Questions & Correct Verified Answers | Latest
Update | Already Graded A
1
A 68-year-old client with heart failure is receiving digoxin 0.25 mg PO daily. Which
finding should the PN report immediately?
A. Serum digoxin level 0.8 ng/mL
B. Apical pulse 52 beats/min
C. Potassium 3.8 mEq/L
D. Client denies nausea
Correct Answer: B
Rationale: A pulse below 60 beats/min can indicate digoxin toxicity and should be
reported before administering the next dose. The therapeutic serum range (A) is 0.5–0.9
ng/mL; 0.8 is acceptable. Potassium (C) is within normal limits. Denial of nausea (D) is
expected.
2
A 30-week-pregnant client reports painless bright-red vaginal bleeding. The PN notes a
soft, non-tender uterus and fetal heart rate 150 beats/min. Which condition is most
likely?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Vasa previa
Correct Answer: A
Rationale: Painless bleeding with a soft uterus after 28 weeks is classic for placenta
previa. Abruptio (B) presents with painful, firm uterus. Preterm labor (C) involves
contractions. Vasa previa (D) bleeding is usually minimal and fetal heart rate shows
variable decelerations.
3
A 4-year-old child with leukemia has a platelet count of 18,000/mm³. Which intervention
is most appropriate for the PN to implement?
A. Encourage active outdoor play
B. Apply firm pressure to any injection site for 5 minutes
C. Administer aspirin for fever
D. Use a soft toothbrush and electric razor
Correct Answer: B
,Rationale: Firm pressure prevents bleeding from puncture sites. Outdoor play (A)
increases injury risk. Aspirin (C) is contraindicated due to antiplatelet effects. Electric
razors (D) are for adults; pediatric clients should avoid razors entirely.
4
A client with schizophrenia tells the PN, “The FBI put a chip in my brain.” Which
response by the PN demonstrates therapeutic communication?
A. “That must feel frightening.”
B. “The FBI does not do that sort of thing.”
C. “Tell me more about the chip.”
D. “You know that’s not real, right?”
Correct Answer: A
Rationale: Acknowledging the client’s feelings (A) builds trust without arguing or
reinforcing the delusion. Correcting (B, D) can damage rapport. Asking for details (C)
may reinforce the delusion.
5
The PN is preparing to administer insulin. Which order should be questioned?
A. Regular insulin 6 units subcut daily
B. NPH insulin 20 units subcut at 0700
C. Insulin glargine 18 units subcut BID
D. Insulin aspart 4 units subcut AC breakfast
Correct Answer: C
Rationale: Glargine is long-acting and prescribed once daily; BID dosing (C) is unsafe
and should be clarified. The other orders (A, B, D) are appropriate.
6
A client with COPD has an oxygen saturation of 82% on room air. Which oxygen
delivery device is appropriate for the PN to apply?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 6 L/min
C. Simple face mask at 10 L/min
D. Venturi mask at 24% (4 L/min)
Correct Answer: D
Rationale: COPD clients are at risk for hypoventilation with high oxygen; controlled
low-flow via Venturi mask (D) targets 88–92% saturation. High-flow devices (A, B, C)
can suppress hypoxic drive.
7
A postoperative client has a prescription for morphine 10 mg IV q4h PRN. The PN notes
a respiratory rate of 8 breaths/min. What is the first action?
A. Administer naloxone 0.4 mg IV
B. Apply oxygen via non-rebreather
C. Stimulate the client and call the RN
,D. Document the finding and reassess in 30 minutes
Correct Answer: C
Rationale: Stimulating may temporarily increase respirations; the RN must be notified
immediately for further orders. Naloxone (A) requires an order or protocol. Oxygen (B) is
adjunctive. Delayed reassessment (D) is unsafe.
8
A newborn’s blood glucose is 35 mg/dL. Which intervention should the PN perform first?
A. Feed the baby formula or breast milk
B. Obtain a repeat heel-stick
C. Administer IV dextrose 10%
D. Place the newborn under a radiant warmer
Correct Answer: A
Rationale: Early feeding (A) is the least invasive first step for asymptomatic
hypoglycemia. Repeat stick (B) delays treatment. IV dextrose (C) is for symptomatic or
persistent hypoglycemia. Warmer (D) addresses temperature, not glucose.
9
A client with depression is started on sertraline. Which finding requires immediate
intervention?
A. Mood improvement after 1 week
B. Reports of insomnia
C. Expressing suicidal ideation with plan
D. Decreased appetite
Correct Answer: C
Rationale: Suicidal ideation with plan (C) is an emergency requiring immediate
intervention. Mood improvement (A) is expected. Insomnia (B) and appetite change (D)
are common side effects to monitor, not immediate emergencies.
10
A client has a nasogastric tube connected to low intermittent suction. The PN notes the
output is 1200 mL in 4 hours. Which action is priority?
A. Document the output
B. Assess for signs of dehydration
C. Clamp the tube and notify the RN
D. Irrigate the tube with saline
Correct Answer: C
Rationale: Excessive output can lead to fluid/electrolyte imbalance; clamping the tube
and notifying the RN (C) prevents further loss while awaiting orders. Documentation (A)
and assessment (B) are ongoing. Irrigation (D) is unnecessary unless blocked.
11
A client with a chest tube has no bubbling in the water-seal chamber and tidaling is
absent. Which interpretation is correct?
, A. The lung has re-expanded or the tube is kinked
B. There is an air leak
C. The suction is too high
D. The system is functioning normally
Correct Answer: A
Rationale: Absence of bubbling and tidaling may indicate lung re-expansion (desired) or
an obstruction/kink (undesired) and requires assessment. Bubbling (B) would indicate
air leak. High suction (C) is unrelated.
12
A 6-month-old infant is to receive digoxin 0.5 mL PO. Which action by the PN is
appropriate?
A. Mix the medication in the baby’s formula
B. Use a 3 mL syringe to measure the dose
C. Administer the medication rapidly to prevent spitting
D. Measure using a household teaspoon
Correct Answer: B
Rationale: A 3 mL oral syringe provides accurate measurement. Mixing with formula (A)
is discouraged because the full dose may not be taken. Rapid administration (C)
increases gagging risk. Household teaspoons (D) are inaccurate.
13
A client with diabetes has a blood glucose of 48 mg/dL and is conscious but diaphoretic.
Which action should the PN take?
A. Give 4 oz orange juice
B. Administer 1 mg glucagon IM
C. Start an IV of D5W
D. Recheck glucose in 4 hours
Correct Answer: A
Rationale: Conscious hypoglycemia is treated with 15 g fast-acting carbohydrate (4 oz
juice = ~15 g). Glucagon (B) is for unconscious clients or inability to swallow. IV
dextrose (C) requires an order. Rechecking (D) should occur in 15 minutes.
14
A client with a C. difficile infection has frequent loose stools. Which isolation precaution
is appropriate?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Protective environment
Correct Answer: A
WITH NGN | ACTUAL EXAM | Complete Exam
Questions & Correct Verified Answers | Latest
Update | Already Graded A
1
A 68-year-old client with heart failure is receiving digoxin 0.25 mg PO daily. Which
finding should the PN report immediately?
A. Serum digoxin level 0.8 ng/mL
B. Apical pulse 52 beats/min
C. Potassium 3.8 mEq/L
D. Client denies nausea
Correct Answer: B
Rationale: A pulse below 60 beats/min can indicate digoxin toxicity and should be
reported before administering the next dose. The therapeutic serum range (A) is 0.5–0.9
ng/mL; 0.8 is acceptable. Potassium (C) is within normal limits. Denial of nausea (D) is
expected.
2
A 30-week-pregnant client reports painless bright-red vaginal bleeding. The PN notes a
soft, non-tender uterus and fetal heart rate 150 beats/min. Which condition is most
likely?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Vasa previa
Correct Answer: A
Rationale: Painless bleeding with a soft uterus after 28 weeks is classic for placenta
previa. Abruptio (B) presents with painful, firm uterus. Preterm labor (C) involves
contractions. Vasa previa (D) bleeding is usually minimal and fetal heart rate shows
variable decelerations.
3
A 4-year-old child with leukemia has a platelet count of 18,000/mm³. Which intervention
is most appropriate for the PN to implement?
A. Encourage active outdoor play
B. Apply firm pressure to any injection site for 5 minutes
C. Administer aspirin for fever
D. Use a soft toothbrush and electric razor
Correct Answer: B
,Rationale: Firm pressure prevents bleeding from puncture sites. Outdoor play (A)
increases injury risk. Aspirin (C) is contraindicated due to antiplatelet effects. Electric
razors (D) are for adults; pediatric clients should avoid razors entirely.
4
A client with schizophrenia tells the PN, “The FBI put a chip in my brain.” Which
response by the PN demonstrates therapeutic communication?
A. “That must feel frightening.”
B. “The FBI does not do that sort of thing.”
C. “Tell me more about the chip.”
D. “You know that’s not real, right?”
Correct Answer: A
Rationale: Acknowledging the client’s feelings (A) builds trust without arguing or
reinforcing the delusion. Correcting (B, D) can damage rapport. Asking for details (C)
may reinforce the delusion.
5
The PN is preparing to administer insulin. Which order should be questioned?
A. Regular insulin 6 units subcut daily
B. NPH insulin 20 units subcut at 0700
C. Insulin glargine 18 units subcut BID
D. Insulin aspart 4 units subcut AC breakfast
Correct Answer: C
Rationale: Glargine is long-acting and prescribed once daily; BID dosing (C) is unsafe
and should be clarified. The other orders (A, B, D) are appropriate.
6
A client with COPD has an oxygen saturation of 82% on room air. Which oxygen
delivery device is appropriate for the PN to apply?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 6 L/min
C. Simple face mask at 10 L/min
D. Venturi mask at 24% (4 L/min)
Correct Answer: D
Rationale: COPD clients are at risk for hypoventilation with high oxygen; controlled
low-flow via Venturi mask (D) targets 88–92% saturation. High-flow devices (A, B, C)
can suppress hypoxic drive.
7
A postoperative client has a prescription for morphine 10 mg IV q4h PRN. The PN notes
a respiratory rate of 8 breaths/min. What is the first action?
A. Administer naloxone 0.4 mg IV
B. Apply oxygen via non-rebreather
C. Stimulate the client and call the RN
,D. Document the finding and reassess in 30 minutes
Correct Answer: C
Rationale: Stimulating may temporarily increase respirations; the RN must be notified
immediately for further orders. Naloxone (A) requires an order or protocol. Oxygen (B) is
adjunctive. Delayed reassessment (D) is unsafe.
8
A newborn’s blood glucose is 35 mg/dL. Which intervention should the PN perform first?
A. Feed the baby formula or breast milk
B. Obtain a repeat heel-stick
C. Administer IV dextrose 10%
D. Place the newborn under a radiant warmer
Correct Answer: A
Rationale: Early feeding (A) is the least invasive first step for asymptomatic
hypoglycemia. Repeat stick (B) delays treatment. IV dextrose (C) is for symptomatic or
persistent hypoglycemia. Warmer (D) addresses temperature, not glucose.
9
A client with depression is started on sertraline. Which finding requires immediate
intervention?
A. Mood improvement after 1 week
B. Reports of insomnia
C. Expressing suicidal ideation with plan
D. Decreased appetite
Correct Answer: C
Rationale: Suicidal ideation with plan (C) is an emergency requiring immediate
intervention. Mood improvement (A) is expected. Insomnia (B) and appetite change (D)
are common side effects to monitor, not immediate emergencies.
10
A client has a nasogastric tube connected to low intermittent suction. The PN notes the
output is 1200 mL in 4 hours. Which action is priority?
A. Document the output
B. Assess for signs of dehydration
C. Clamp the tube and notify the RN
D. Irrigate the tube with saline
Correct Answer: C
Rationale: Excessive output can lead to fluid/electrolyte imbalance; clamping the tube
and notifying the RN (C) prevents further loss while awaiting orders. Documentation (A)
and assessment (B) are ongoing. Irrigation (D) is unnecessary unless blocked.
11
A client with a chest tube has no bubbling in the water-seal chamber and tidaling is
absent. Which interpretation is correct?
, A. The lung has re-expanded or the tube is kinked
B. There is an air leak
C. The suction is too high
D. The system is functioning normally
Correct Answer: A
Rationale: Absence of bubbling and tidaling may indicate lung re-expansion (desired) or
an obstruction/kink (undesired) and requires assessment. Bubbling (B) would indicate
air leak. High suction (C) is unrelated.
12
A 6-month-old infant is to receive digoxin 0.5 mL PO. Which action by the PN is
appropriate?
A. Mix the medication in the baby’s formula
B. Use a 3 mL syringe to measure the dose
C. Administer the medication rapidly to prevent spitting
D. Measure using a household teaspoon
Correct Answer: B
Rationale: A 3 mL oral syringe provides accurate measurement. Mixing with formula (A)
is discouraged because the full dose may not be taken. Rapid administration (C)
increases gagging risk. Household teaspoons (D) are inaccurate.
13
A client with diabetes has a blood glucose of 48 mg/dL and is conscious but diaphoretic.
Which action should the PN take?
A. Give 4 oz orange juice
B. Administer 1 mg glucagon IM
C. Start an IV of D5W
D. Recheck glucose in 4 hours
Correct Answer: A
Rationale: Conscious hypoglycemia is treated with 15 g fast-acting carbohydrate (4 oz
juice = ~15 g). Glucagon (B) is for unconscious clients or inability to swallow. IV
dextrose (C) requires an order. Rechecking (D) should occur in 15 minutes.
14
A client with a C. difficile infection has frequent loose stools. Which isolation precaution
is appropriate?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Protective environment
Correct Answer: A
