Pass the 2026 HESI PN Exit Exam with
Questions, NGN-Style Questions & Case
Scenarios | (100% Guarantee Pass)
SECTION 1: Medical-Surgical Nursing
1. Q: A client is admitted to the postoperative surgical unit with two chest tubes
after a left lobectomy. The PN observes that the chest tube system is set at a
suction of 20 cm water pressure, with tidaling during respirations and bubbling
present. What action should the PN take?
A) Clamp the chest tube to see if the activity stops
B) Notify the registered nurse of a malfunction
C) Maintain system integrity to promote lung reexpansion
D) Apply a partially occlusive dressing to the chest insertion site
Answer: C
Rationale: Tidaling (fluctuations with respirations) and bubbling in the suction chamber
are normal findings indicating proper function. Maintaining a closed and intact system
ensures continued lung reexpansion and prevents complications such as
pneumothorax. Clamping is contraindicated due to risk of tension pneumothorax .
2. Q: A client is admitted with pneumonia. Which intervention should the PN
implement to prevent complications?
A) Encourage energy conservation with complete bed rest
B) Restrict PO and intravenous fluids
C) Encourage mobilization and ambulation
D) Provide humidified oxygen per nasal cannula
Answer: C
Rationale: Mobilization prevents complications like atelectasis and promotes lung
expansion in pneumonia. Bed rest and fluid restriction would not prevent respiratory
complications .
,3. Q: A client with acute pancreatitis reports severe, piercing abdominal pain
and has an elevated serum amylase. Which additional information is most
likely?
A) Abdominal pain decreases when lying supine
B) Pain lasts an hour and leaves the abdomen tender
C) Right upper quadrant pain refers to the right scapula
D) Drinks alcohol until intoxicated at least twice weekly
Answer: D
Rationale: Heavy alcohol use is a common cause of acute pancreatitis, correlating with
the clinical presentation of severe abdominal pain and elevated serum amylase .
4. Q: The practical nurse (PN) observes two unlicensed assistive personnel
(UAP) turning an older client who had a hip arthroplasty with prosthesis
placement four hours ago. Which observation by the PN indicates that the
UAPs need additional information about the turning procedure?
A) The UAPs keep their backs straight and knees bent when moving the client
B) A turning sheet is used under the client for turning and repositioning
C) An abduction pillow is placed between the client's legs when positioned
D) The client is told to keep both legs straight and together while turning
Answer: D
Rationale: After hip arthroplasty, the affected leg should be kept abducted to prevent
dislocation. Telling the client to keep both legs straight and together indicates the UAPs
need additional teaching. An abduction pillow between the legs is correct. Use of a
turning sheet and proper body mechanics are correct .
5. Q: Which client finding should the practical nurse (PN) report to the
registered nurse (RN) immediately?
A) Ineffective pain management was reported while using morphine PCA
B) Inability to void 4 hours after discontinuing an indwelling catheter
C) Oral ice chips for 30 minutes were eaten after vomiting postoperatively
D) Coffee-ground secretions draining via nasogastric tube suction
Answer: D
Rationale: Coffee-ground secretions indicate upper gastrointestinal bleeding and
,require immediate reporting to the RN. The other findings, while concerning, are not as
immediately life-threatening .
6. Q: A client receiving a blood transfusion 15 minutes after starting complains
of itchy skin and appears flushed. What is the PN's first action?
A) Apply lotion to the skin
B) Stop the transfusion immediately
C) Slow the infusion rate
D) Administer diphenhydramine
Answer: B
Rationale: Flushing and itching are signs of a transfusion reaction. The PN should stop
the transfusion immediately, maintain IV access with normal saline, and notify the RN.
This is a life-threatening emergency .
7. Q: During the immediate postoperative period following total hip
replacement surgery, which intervention is most important?
A) Encourage the client to use a walker or cane when ambulating
B) Keep the client's hip aligned with knees abducted
C) Teach the client to sit on the side of the bed before standing
D) Monitor urinary flow via an indwelling catheter
Answer: B
Rationale: Maintaining proper hip alignment and abduction reduces risk of hip
dislocation, a common and serious complication post-hip replacement. Early
ambulation and mobility aids are important but follow after initial precautions .
8. Q: An elderly male client taking psychotropic medications has uncontrollable
hand movements and excessive eye blinking. Which information from his
medical record should the PN review?
A) Prescription for lorazepam
B) History of Parkinson's disease
, C) Screening for tardive dyskinesia
D) Recent urine drug screen report
Answer: C
Rationale: Tardive dyskinesia is a movement disorder caused by long-term use of
psychotropic medications. Reviewing prior screenings helps assess risk and plan care .
SECTION 2: Fundamentals of Nursing
9. Q: A client's daughter phones the charge nurse to report that the night
LPN/LVN did not provide good care for her mother. What response should the
nurse make?
A) Reassure the daughter that the mother will get better care
B) Tell the daughter to talk to the unit's nurse manager
C) Ask for a description of what happened during the night
D) Explain that all staff are doing the best they can
Answer: C
Rationale: Gathering specific information about the concern allows the nurse to assess
the situation objectively and address it appropriately .
10. Q: The PN is observing a newly hired PN who is preparing to administer a
liquid medication via a client's feeding tube system using the wrong procedure.
What action should the PN take?
A) Demonstrate how to administer medication via a feeding tube
B) Confirm that the medication is only administered once daily
C) Report the error to the unit manager immediately
D) Offer to assist in calculating the rate of flow for the mixture
Answer: A
Rationale: When observing incorrect procedure, the PN should demonstrate the correct
technique to ensure safe practice and prevent medication errors .
Questions, NGN-Style Questions & Case
Scenarios | (100% Guarantee Pass)
SECTION 1: Medical-Surgical Nursing
1. Q: A client is admitted to the postoperative surgical unit with two chest tubes
after a left lobectomy. The PN observes that the chest tube system is set at a
suction of 20 cm water pressure, with tidaling during respirations and bubbling
present. What action should the PN take?
A) Clamp the chest tube to see if the activity stops
B) Notify the registered nurse of a malfunction
C) Maintain system integrity to promote lung reexpansion
D) Apply a partially occlusive dressing to the chest insertion site
Answer: C
Rationale: Tidaling (fluctuations with respirations) and bubbling in the suction chamber
are normal findings indicating proper function. Maintaining a closed and intact system
ensures continued lung reexpansion and prevents complications such as
pneumothorax. Clamping is contraindicated due to risk of tension pneumothorax .
2. Q: A client is admitted with pneumonia. Which intervention should the PN
implement to prevent complications?
A) Encourage energy conservation with complete bed rest
B) Restrict PO and intravenous fluids
C) Encourage mobilization and ambulation
D) Provide humidified oxygen per nasal cannula
Answer: C
Rationale: Mobilization prevents complications like atelectasis and promotes lung
expansion in pneumonia. Bed rest and fluid restriction would not prevent respiratory
complications .
,3. Q: A client with acute pancreatitis reports severe, piercing abdominal pain
and has an elevated serum amylase. Which additional information is most
likely?
A) Abdominal pain decreases when lying supine
B) Pain lasts an hour and leaves the abdomen tender
C) Right upper quadrant pain refers to the right scapula
D) Drinks alcohol until intoxicated at least twice weekly
Answer: D
Rationale: Heavy alcohol use is a common cause of acute pancreatitis, correlating with
the clinical presentation of severe abdominal pain and elevated serum amylase .
4. Q: The practical nurse (PN) observes two unlicensed assistive personnel
(UAP) turning an older client who had a hip arthroplasty with prosthesis
placement four hours ago. Which observation by the PN indicates that the
UAPs need additional information about the turning procedure?
A) The UAPs keep their backs straight and knees bent when moving the client
B) A turning sheet is used under the client for turning and repositioning
C) An abduction pillow is placed between the client's legs when positioned
D) The client is told to keep both legs straight and together while turning
Answer: D
Rationale: After hip arthroplasty, the affected leg should be kept abducted to prevent
dislocation. Telling the client to keep both legs straight and together indicates the UAPs
need additional teaching. An abduction pillow between the legs is correct. Use of a
turning sheet and proper body mechanics are correct .
5. Q: Which client finding should the practical nurse (PN) report to the
registered nurse (RN) immediately?
A) Ineffective pain management was reported while using morphine PCA
B) Inability to void 4 hours after discontinuing an indwelling catheter
C) Oral ice chips for 30 minutes were eaten after vomiting postoperatively
D) Coffee-ground secretions draining via nasogastric tube suction
Answer: D
Rationale: Coffee-ground secretions indicate upper gastrointestinal bleeding and
,require immediate reporting to the RN. The other findings, while concerning, are not as
immediately life-threatening .
6. Q: A client receiving a blood transfusion 15 minutes after starting complains
of itchy skin and appears flushed. What is the PN's first action?
A) Apply lotion to the skin
B) Stop the transfusion immediately
C) Slow the infusion rate
D) Administer diphenhydramine
Answer: B
Rationale: Flushing and itching are signs of a transfusion reaction. The PN should stop
the transfusion immediately, maintain IV access with normal saline, and notify the RN.
This is a life-threatening emergency .
7. Q: During the immediate postoperative period following total hip
replacement surgery, which intervention is most important?
A) Encourage the client to use a walker or cane when ambulating
B) Keep the client's hip aligned with knees abducted
C) Teach the client to sit on the side of the bed before standing
D) Monitor urinary flow via an indwelling catheter
Answer: B
Rationale: Maintaining proper hip alignment and abduction reduces risk of hip
dislocation, a common and serious complication post-hip replacement. Early
ambulation and mobility aids are important but follow after initial precautions .
8. Q: An elderly male client taking psychotropic medications has uncontrollable
hand movements and excessive eye blinking. Which information from his
medical record should the PN review?
A) Prescription for lorazepam
B) History of Parkinson's disease
, C) Screening for tardive dyskinesia
D) Recent urine drug screen report
Answer: C
Rationale: Tardive dyskinesia is a movement disorder caused by long-term use of
psychotropic medications. Reviewing prior screenings helps assess risk and plan care .
SECTION 2: Fundamentals of Nursing
9. Q: A client's daughter phones the charge nurse to report that the night
LPN/LVN did not provide good care for her mother. What response should the
nurse make?
A) Reassure the daughter that the mother will get better care
B) Tell the daughter to talk to the unit's nurse manager
C) Ask for a description of what happened during the night
D) Explain that all staff are doing the best they can
Answer: C
Rationale: Gathering specific information about the concern allows the nurse to assess
the situation objectively and address it appropriately .
10. Q: The PN is observing a newly hired PN who is preparing to administer a
liquid medication via a client's feeding tube system using the wrong procedure.
What action should the PN take?
A) Demonstrate how to administer medication via a feeding tube
B) Confirm that the medication is only administered once daily
C) Report the error to the unit manager immediately
D) Offer to assist in calculating the rate of flow for the mixture
Answer: A
Rationale: When observing incorrect procedure, the PN should demonstrate the correct
technique to ensure safe practice and prevent medication errors .
