HESI PN Comprehensive Nursing Exam | ACTUAL
EXAM | Complete Questions & Verified Answers |
Latest Update | Already Graded A
1. A postoperative client who received morphine 10 minutes ago suddenly becomes
very sleepy and respirations drop to 8 breaths/min. What is the PN’s priority
action?
A. Document the response and continue to monitor
B. Apply oxygen via nasal cannula at 2 L/min
C. Attempt to arouse the client and prepare naloxone
D. Lower the head of the bed and raise the knee gatch
Correct Answer: C
Rationale: Respiratory depression is the most life-threatening adverse effect of opioids.
The PN must first attempt to arouse the client to confirm level of sedation and then
prepare the opioid antagonist naloxone per protocol. Option A delays rescue; Option B is
secondary; Option D would worsen respiratory status.
2. A client receiving a unit of packed RBCs reports chills and flank pain 20 minutes
after the infusion starts. Vital signs are: T 38.9 °C, BP 90/50 mm Hg, HR 110.
What should the PN do first?
A. Slow the infusion to 50 mL/h
B. Stop the transfusion and maintain IV access with normal saline
,C. Administer acetaminophen per PRN order
D. Notify the blood bank to recheck the unit
Correct Answer: B
Rationale: Classic signs of acute hemolytic reaction mandate immediate
discontinuation of the blood and keeping the IV line open with normal saline. Remaining
actions follow per protocol but stopping the infusion is priority.
3. The PN is assigned four clients. Which client should the PN see first?
A. A client 6 h post-appendectomy with a BP 118/78 and reports pain 4/10
B. A client with pneumonia who is due for scheduled oral antibiotics in 30 min
C. A client with COPD whose pulse oximeter reads 86% on 2 L nasal cannula
D. A client with a stage II pressure injury needing a dressing change
Correct Answer: C
Rationale: Oxygen saturation of 86% indicates significant hypoxemia and requires
immediate assessment/intervention. Other clients have stable or non-urgent needs.
4. A newborn boy is uncircumcised. The mother asks how to clean the penis during
diaper changes. The PN should instruct:
A. Retract the foreskin gently and cleanse with antiseptic wipes
B. Clean only what is seen; do not retract the foreskin
C. Apply petroleum jelly to the glans at each diaper change
D. Force the foreskin back to prevent adhesions
,Correct Answer: B
Rationale: The foreskin of an infant is normally non-retractile; forcing retraction causes
trauma and future adhesions. Gentle external cleansing is sufficient.
5. A client is prescribed metformin 500 mg PO twice daily for newly diagnosed type
2 diabetes. Which statement by the client indicates understanding?
A. “I should skip the dose if I am not eating breakfast.”
B. “I need to stop this drug 2 days before any CT scan with contrast.”
C. “It may turn my urine orange.”
D. “I should take it on an empty stomach to increase absorption.”
Correct Answer: B
Rationale: Metformin must be withheld 48 h before and after IV iodinated contrast to
reduce risk of lactic acidosis. It is taken with meals to reduce GI upset; orange urine is
not associated.
6. The PN is preparing to administer digoxin 0.25 mg PO. The apical pulse is 58
beats/min. What is the PN’s best action?
A. Give the drug and recheck the pulse in 1 h
B. Hold the dose and notify the charge nurse
C. Administer half the dose now and half in 6 h
D. Recheck the radial pulse for 30 s and proceed if regular
Correct Answer: B
, Rationale: Digoxin is held for apical pulse <60 beats/min in adults to avoid bradycardic
toxicity. The charge nurse or prescriber must be informed before any dose change.
7. A 4-year-old with cystic fibrosis receives pancreatic enzymes. When should the
PN instruct the parents to give the capsules?
A. With meals and snacks
B. Only before breakfast
C. At bedtime to decrease night stools
D. 2 h after meals to enhance absorption
Correct Answer: A
Rationale: Pancreatic enzymes must be given with every meal and snack to allow proper
digestion of nutrients and reduce steatorrhea.
8. A client on lithium carbonate has a serum level of 2.0 mEq/L. The PN should
expect which priority order?
A. Give the next dose as scheduled
B. Encourage 3 L of fluid daily
C. Hold lithium and obtain repeat level
D. Administer sodium tablets
Correct Answer: C
Rationale: Therapeutic lithium range is 0.6–1.2 mEq/L; 2.0 mEq/L indicates toxicity
requiring immediate dose withholding and provider notification.
EXAM | Complete Questions & Verified Answers |
Latest Update | Already Graded A
1. A postoperative client who received morphine 10 minutes ago suddenly becomes
very sleepy and respirations drop to 8 breaths/min. What is the PN’s priority
action?
A. Document the response and continue to monitor
B. Apply oxygen via nasal cannula at 2 L/min
C. Attempt to arouse the client and prepare naloxone
D. Lower the head of the bed and raise the knee gatch
Correct Answer: C
Rationale: Respiratory depression is the most life-threatening adverse effect of opioids.
The PN must first attempt to arouse the client to confirm level of sedation and then
prepare the opioid antagonist naloxone per protocol. Option A delays rescue; Option B is
secondary; Option D would worsen respiratory status.
2. A client receiving a unit of packed RBCs reports chills and flank pain 20 minutes
after the infusion starts. Vital signs are: T 38.9 °C, BP 90/50 mm Hg, HR 110.
What should the PN do first?
A. Slow the infusion to 50 mL/h
B. Stop the transfusion and maintain IV access with normal saline
,C. Administer acetaminophen per PRN order
D. Notify the blood bank to recheck the unit
Correct Answer: B
Rationale: Classic signs of acute hemolytic reaction mandate immediate
discontinuation of the blood and keeping the IV line open with normal saline. Remaining
actions follow per protocol but stopping the infusion is priority.
3. The PN is assigned four clients. Which client should the PN see first?
A. A client 6 h post-appendectomy with a BP 118/78 and reports pain 4/10
B. A client with pneumonia who is due for scheduled oral antibiotics in 30 min
C. A client with COPD whose pulse oximeter reads 86% on 2 L nasal cannula
D. A client with a stage II pressure injury needing a dressing change
Correct Answer: C
Rationale: Oxygen saturation of 86% indicates significant hypoxemia and requires
immediate assessment/intervention. Other clients have stable or non-urgent needs.
4. A newborn boy is uncircumcised. The mother asks how to clean the penis during
diaper changes. The PN should instruct:
A. Retract the foreskin gently and cleanse with antiseptic wipes
B. Clean only what is seen; do not retract the foreskin
C. Apply petroleum jelly to the glans at each diaper change
D. Force the foreskin back to prevent adhesions
,Correct Answer: B
Rationale: The foreskin of an infant is normally non-retractile; forcing retraction causes
trauma and future adhesions. Gentle external cleansing is sufficient.
5. A client is prescribed metformin 500 mg PO twice daily for newly diagnosed type
2 diabetes. Which statement by the client indicates understanding?
A. “I should skip the dose if I am not eating breakfast.”
B. “I need to stop this drug 2 days before any CT scan with contrast.”
C. “It may turn my urine orange.”
D. “I should take it on an empty stomach to increase absorption.”
Correct Answer: B
Rationale: Metformin must be withheld 48 h before and after IV iodinated contrast to
reduce risk of lactic acidosis. It is taken with meals to reduce GI upset; orange urine is
not associated.
6. The PN is preparing to administer digoxin 0.25 mg PO. The apical pulse is 58
beats/min. What is the PN’s best action?
A. Give the drug and recheck the pulse in 1 h
B. Hold the dose and notify the charge nurse
C. Administer half the dose now and half in 6 h
D. Recheck the radial pulse for 30 s and proceed if regular
Correct Answer: B
, Rationale: Digoxin is held for apical pulse <60 beats/min in adults to avoid bradycardic
toxicity. The charge nurse or prescriber must be informed before any dose change.
7. A 4-year-old with cystic fibrosis receives pancreatic enzymes. When should the
PN instruct the parents to give the capsules?
A. With meals and snacks
B. Only before breakfast
C. At bedtime to decrease night stools
D. 2 h after meals to enhance absorption
Correct Answer: A
Rationale: Pancreatic enzymes must be given with every meal and snack to allow proper
digestion of nutrients and reduce steatorrhea.
8. A client on lithium carbonate has a serum level of 2.0 mEq/L. The PN should
expect which priority order?
A. Give the next dose as scheduled
B. Encourage 3 L of fluid daily
C. Hold lithium and obtain repeat level
D. Administer sodium tablets
Correct Answer: C
Rationale: Therapeutic lithium range is 0.6–1.2 mEq/L; 2.0 mEq/L indicates toxicity
requiring immediate dose withholding and provider notification.
