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
001 Traditional MC
A client with COPD is receiving O₂ at 5 L/min via nasal cannula. The client becomes
increasingly somnolent and his PaCO₂ rises from 55 to 72 mm Hg. Which action should
the PN implement first?
A. Increase O₂ to 6 L/min
B. Obtain a stat ABG
C. Notify the RN/provider immediately
D. Place the client in high-Fowler position
Correct Answer: C
Rationale: High-flow O₂ in COPD clients can blunt the hypoxic respiratory drive, leading
to acute CO₂ narcosis. The PN must immediately alert the RN/provider to titrate O₂ to
SpO₂ 88–92%. Increasing O₂ further worsens hypoventilation; positioning and repeat
ABG are secondary to provider notification.
002 Traditional MC
The LPN is delegating tasks on a medical floor. Which task should the PN retain?
A. Measuring vital signs on a stable post-op client
B. Recording intake and output
,C. Performing finger-stick glucose checks
D. Ambulating a client with a new PCA pump
Correct Answer: C
Rationale: Finger-stick glucose monitoring requires clinical judgment and cannot be
delegated to UAP. Vital signs, I&O, and ambulation of stable clients are within UAP
scope under RN/LPN supervision.
003 Matrix (NGN) – Select all that apply
The PN is caring for a client with a stage III sacral pressure injury. Which interventions
reduce injury progression? (Select 3)
☐ Turn q2h
☐ Keep head of bed <30°
☐ Massage around ulcer
☐ Use donut cushion
☐ Apply moisture-barrier cream
Correct Scoring: 3 points total
Correct Selections: Turn q2h, Keep head of bed <30°, Apply moisture-barrier cream
Rationale: Regular repositioning and low head-of-bed decrease shear/friction; barrier
creams protect perilesional skin. Massage and donut cushions increase tissue ischemia
and are contraindicated.
004 Traditional MC
A postpartum client receiving magnesium sulfate 2 g/h IV has DTRs 1+, respiratory rate
10/min, and urine output 15 mL/h. What is the PN’s priority action?
,A. Slow the infusion to 1 g/h
B. Administer IV calcium gluconate
C. Stop the infusion and call the RN/provider
D. Encourage oral fluids
Correct Answer: C
Rationale: Respiratory depression (<12/min), absent DTRs, and oliguria signal
magnesium toxicity. The PN must stop the infusion immediately and obtain an antidote
order. Calcium gluconate is given only after provider contact.
005 Bow-tie (NGN) – Place the steps in order to manage a witnessed airway
obstruction in an adult.
A. Deliver 30 chest compressions
B. Check consciousness
C. Open mouth and look for object
D. Give 2 ventilation breaths
E. Perform Heimlich if breathing absent
Correct Sequence: B → E → C → A → D
Rationale: Follow AHA BLS sequence: assess responsiveness → Heimlich (if no
cough/breath) → look/remove object → compressions if unresponsive → attempt
ventilations.
006-008 Case Study (NGN) – Pediatric Asthma
, A 4-year-old with asthma is brought to the clinic. Parents report increased wheezing for
2 days, reliever use every 3 hours, and nighttime awakening. SpO₂ 92%, RR 32, peak flow
60% personal best.
Q006: Which finding indicates moderate exacerbation?
A. SpO₂ 92%
B. RR 32
C. Peak flow 60%
D. Nighttime awakening
Correct Answer: C
Rationale: Peak flow 50–80% personal best defines moderate asthma exacerbation per
NAEPP. SpO₂ <92% and RR >30 suggest severe; nighttime awakening is a trigger history,
not severity index.
Q007: The provider orders albuterol 2.5 mg nebulizer and oral prednisolone 1 mg/kg.
The PN should evaluate therapeutic response in:
A. 15 minutes
B. 30 minutes
C. 1 hour
D. 4 hours
Correct Answer: A
Rationale: Short-acting beta-agonists peak within 5–15 minutes; reassess respiratory
rate, SpO₂, and peak flow to decide further bronchodilator dosing.
Q008: After 3 nebulizer treatments, peak flow is 78% and the child tolerates PO fluids.
Which discharge instruction is most appropriate?
A. Continue albuterol PRN only
B. Use spacer for all inhaled meds
WITH NGN | ACTUAL EXAM Complete Exam
Questions & Correct Verified Answers | Latest 2025
/ 2026 Update | Already Graded A
001 Traditional MC
A client with COPD is receiving O₂ at 5 L/min via nasal cannula. The client becomes
increasingly somnolent and his PaCO₂ rises from 55 to 72 mm Hg. Which action should
the PN implement first?
A. Increase O₂ to 6 L/min
B. Obtain a stat ABG
C. Notify the RN/provider immediately
D. Place the client in high-Fowler position
Correct Answer: C
Rationale: High-flow O₂ in COPD clients can blunt the hypoxic respiratory drive, leading
to acute CO₂ narcosis. The PN must immediately alert the RN/provider to titrate O₂ to
SpO₂ 88–92%. Increasing O₂ further worsens hypoventilation; positioning and repeat
ABG are secondary to provider notification.
002 Traditional MC
The LPN is delegating tasks on a medical floor. Which task should the PN retain?
A. Measuring vital signs on a stable post-op client
B. Recording intake and output
,C. Performing finger-stick glucose checks
D. Ambulating a client with a new PCA pump
Correct Answer: C
Rationale: Finger-stick glucose monitoring requires clinical judgment and cannot be
delegated to UAP. Vital signs, I&O, and ambulation of stable clients are within UAP
scope under RN/LPN supervision.
003 Matrix (NGN) – Select all that apply
The PN is caring for a client with a stage III sacral pressure injury. Which interventions
reduce injury progression? (Select 3)
☐ Turn q2h
☐ Keep head of bed <30°
☐ Massage around ulcer
☐ Use donut cushion
☐ Apply moisture-barrier cream
Correct Scoring: 3 points total
Correct Selections: Turn q2h, Keep head of bed <30°, Apply moisture-barrier cream
Rationale: Regular repositioning and low head-of-bed decrease shear/friction; barrier
creams protect perilesional skin. Massage and donut cushions increase tissue ischemia
and are contraindicated.
004 Traditional MC
A postpartum client receiving magnesium sulfate 2 g/h IV has DTRs 1+, respiratory rate
10/min, and urine output 15 mL/h. What is the PN’s priority action?
,A. Slow the infusion to 1 g/h
B. Administer IV calcium gluconate
C. Stop the infusion and call the RN/provider
D. Encourage oral fluids
Correct Answer: C
Rationale: Respiratory depression (<12/min), absent DTRs, and oliguria signal
magnesium toxicity. The PN must stop the infusion immediately and obtain an antidote
order. Calcium gluconate is given only after provider contact.
005 Bow-tie (NGN) – Place the steps in order to manage a witnessed airway
obstruction in an adult.
A. Deliver 30 chest compressions
B. Check consciousness
C. Open mouth and look for object
D. Give 2 ventilation breaths
E. Perform Heimlich if breathing absent
Correct Sequence: B → E → C → A → D
Rationale: Follow AHA BLS sequence: assess responsiveness → Heimlich (if no
cough/breath) → look/remove object → compressions if unresponsive → attempt
ventilations.
006-008 Case Study (NGN) – Pediatric Asthma
, A 4-year-old with asthma is brought to the clinic. Parents report increased wheezing for
2 days, reliever use every 3 hours, and nighttime awakening. SpO₂ 92%, RR 32, peak flow
60% personal best.
Q006: Which finding indicates moderate exacerbation?
A. SpO₂ 92%
B. RR 32
C. Peak flow 60%
D. Nighttime awakening
Correct Answer: C
Rationale: Peak flow 50–80% personal best defines moderate asthma exacerbation per
NAEPP. SpO₂ <92% and RR >30 suggest severe; nighttime awakening is a trigger history,
not severity index.
Q007: The provider orders albuterol 2.5 mg nebulizer and oral prednisolone 1 mg/kg.
The PN should evaluate therapeutic response in:
A. 15 minutes
B. 30 minutes
C. 1 hour
D. 4 hours
Correct Answer: A
Rationale: Short-acting beta-agonists peak within 5–15 minutes; reassess respiratory
rate, SpO₂, and peak flow to decide further bronchodilator dosing.
Q008: After 3 nebulizer treatments, peak flow is 78% and the child tolerates PO fluids.
Which discharge instruction is most appropriate?
A. Continue albuterol PRN only
B. Use spacer for all inhaled meds
