HESI PN Comprehensive Nursing Exam | ACTUAL
EXAM | Complete Questions & Verified Answers |
Latest Update | Already Graded A
1. A postoperative client has a prescription for morphine 4 mg IV q4h PRN for pain.
The medication is supplied as morphine 2 mg/mL. How many mL should the PN
administer?
A. 0.5 mL
B. 2 mL
C. 4 mL
D. 8 mL
Correct Answer: B. 2 mL
Rationale: Desired dose 4 mg ÷ concentration 2 mg/mL = 2 mL. Choice A is
under-dosed, C and D exceed the ordered dose.
2. The PN is caring for a client with a new colostomy. Which observation indicates
that the stoma is healthy?
A. Pale pink color
B. Dark red color
C. Beefy red color
D. Bluish-purple color
,Correct Answer: C. Beefy red color
Rationale: A beefy red stoma indicates adequate blood supply. Pale pink suggests
anemia, dark red may indicate venous congestion, and bluish-purple indicates ischemia.
3. A client receiving heparin therapy has an aPTT of 96 seconds (control 30–40
seconds). What is the PN’s priority action?
A. Stop the heparin infusion immediately
B. Reduce the rate by 50 mL/h
C. Continue the current rate
D. Obtain a PT/INR
Correct Answer: A. Stop the heparin infusion immediately
Rationale: APTT > 70 seconds places the client at high risk for bleeding; stopping the
infusion is the first step. Reducing rate is premature without provider consultation, and
PT/INR monitors warfarin, not heparin.
4. The PN is assisting with a sterile dressing change. Which action contaminates
the sterile field?
A. Holding the sterile package 2 cm above the field
B. Placing sterile gloves on after opening the package
C. Reaching 15 cm (6 in) over the field to obtain supplies
D. Using the 2.5 cm (1 in) border to handle the drape
Correct Answer: C. Reaching 15 cm (6 in) over the field to obtain supplies
,Rationale: Any part of the body or clothing that crosses above the sterile field
contaminates it. The 1-inch border is unsterile, but reaching over the field is a direct
contamination.
5. A 2-day-old newborn’s bilirubin level is 18 mg/dL. The PN anticipates which
intervention?
A. Phototherapy
B. Exchange transfusion
C. IV fluid bolus
D. Oral glucose water
Correct Answer: A. Phototherapy
Rationale: Levels ≥ 15 mg/dL in term infants warrant phototherapy. Exchange
transfusion is reserved for levels > 25 mg/dL or clinical deterioration. Glucose water is
contraindicated.
6. The PN is teaching a client with heart failure about daily weights. Which
statement indicates understanding?
A. “I will weigh myself naked every morning after voiding.”
B. “I will weigh myself at the same time each evening.”
C. “A 1-pound gain in a week is concerning.”
D. “I will call the provider for a 3-pound gain in 2 days.”
Correct Answer: A. “I will weigh myself naked every morning after voiding.”
, Rationale: Consistent morning weights after voiding provide the most accurate trend. A
2–3 lb (1–1.4 kg) gain in 24–48 h is reportable, not weekly.
7. A client with schizophrenia states, “The FBI put a chip in my brain.” The PN’s best
response is:
A. “That must feel frightening.”
B. “The FBI is not interested in you.”
C. “Tell me more about the chip.”
D. “Let’s talk about something else.”
Correct Answer: A. “That must feel frightening.”
Rationale: Acknowledging the client’s feelings builds trust without reinforcing the
delusion. Arguing or asking for details strengthens the false belief.
8. The PN receives shift report on four clients. Which client should be assessed
first?
A. COPD client with O₂ saturation 89% on 2 L NC
B. Post–laparoscopic cholecystectomy client requesting pain medication
C. Diabetic client with blood glucose 220 mg/dL 2 h after dinner
D. Radial catheterization client with weak pedal pulses
Correct Answer: D. Radial catheterization client with weak pedal pulses
Rationale: Weak pedal pulses suggest acute limb ischemia, a time-sensitive
complication. The other clients are stable within expected parameters.
EXAM | Complete Questions & Verified Answers |
Latest Update | Already Graded A
1. A postoperative client has a prescription for morphine 4 mg IV q4h PRN for pain.
The medication is supplied as morphine 2 mg/mL. How many mL should the PN
administer?
A. 0.5 mL
B. 2 mL
C. 4 mL
D. 8 mL
Correct Answer: B. 2 mL
Rationale: Desired dose 4 mg ÷ concentration 2 mg/mL = 2 mL. Choice A is
under-dosed, C and D exceed the ordered dose.
2. The PN is caring for a client with a new colostomy. Which observation indicates
that the stoma is healthy?
A. Pale pink color
B. Dark red color
C. Beefy red color
D. Bluish-purple color
,Correct Answer: C. Beefy red color
Rationale: A beefy red stoma indicates adequate blood supply. Pale pink suggests
anemia, dark red may indicate venous congestion, and bluish-purple indicates ischemia.
3. A client receiving heparin therapy has an aPTT of 96 seconds (control 30–40
seconds). What is the PN’s priority action?
A. Stop the heparin infusion immediately
B. Reduce the rate by 50 mL/h
C. Continue the current rate
D. Obtain a PT/INR
Correct Answer: A. Stop the heparin infusion immediately
Rationale: APTT > 70 seconds places the client at high risk for bleeding; stopping the
infusion is the first step. Reducing rate is premature without provider consultation, and
PT/INR monitors warfarin, not heparin.
4. The PN is assisting with a sterile dressing change. Which action contaminates
the sterile field?
A. Holding the sterile package 2 cm above the field
B. Placing sterile gloves on after opening the package
C. Reaching 15 cm (6 in) over the field to obtain supplies
D. Using the 2.5 cm (1 in) border to handle the drape
Correct Answer: C. Reaching 15 cm (6 in) over the field to obtain supplies
,Rationale: Any part of the body or clothing that crosses above the sterile field
contaminates it. The 1-inch border is unsterile, but reaching over the field is a direct
contamination.
5. A 2-day-old newborn’s bilirubin level is 18 mg/dL. The PN anticipates which
intervention?
A. Phototherapy
B. Exchange transfusion
C. IV fluid bolus
D. Oral glucose water
Correct Answer: A. Phototherapy
Rationale: Levels ≥ 15 mg/dL in term infants warrant phototherapy. Exchange
transfusion is reserved for levels > 25 mg/dL or clinical deterioration. Glucose water is
contraindicated.
6. The PN is teaching a client with heart failure about daily weights. Which
statement indicates understanding?
A. “I will weigh myself naked every morning after voiding.”
B. “I will weigh myself at the same time each evening.”
C. “A 1-pound gain in a week is concerning.”
D. “I will call the provider for a 3-pound gain in 2 days.”
Correct Answer: A. “I will weigh myself naked every morning after voiding.”
, Rationale: Consistent morning weights after voiding provide the most accurate trend. A
2–3 lb (1–1.4 kg) gain in 24–48 h is reportable, not weekly.
7. A client with schizophrenia states, “The FBI put a chip in my brain.” The PN’s best
response is:
A. “That must feel frightening.”
B. “The FBI is not interested in you.”
C. “Tell me more about the chip.”
D. “Let’s talk about something else.”
Correct Answer: A. “That must feel frightening.”
Rationale: Acknowledging the client’s feelings builds trust without reinforcing the
delusion. Arguing or asking for details strengthens the false belief.
8. The PN receives shift report on four clients. Which client should be assessed
first?
A. COPD client with O₂ saturation 89% on 2 L NC
B. Post–laparoscopic cholecystectomy client requesting pain medication
C. Diabetic client with blood glucose 220 mg/dL 2 h after dinner
D. Radial catheterization client with weak pedal pulses
Correct Answer: D. Radial catheterization client with weak pedal pulses
Rationale: Weak pedal pulses suggest acute limb ischemia, a time-sensitive
complication. The other clients are stable within expected parameters.
