HESI PN EXIT EXAM PN HESI EXIT EXAM 2026/2027
Practical/Vocational Nursing Exit Exam (HESI) | Key Domains: Safe & Effective Care
Environment (Safety, Infection Control, Coordinated Care), Health Promotion &
Maintenance, Psychosocial Integrity, Basic Care & Comfort, Pharmacological Therapies,
Reduction of Risk Potential, and Physiological Adaptation | Expert-Aligned Structure | HESI
Exit Exam Format
Introduction
This structured HESI PN Exit Exam for 2026/2027 provides a comprehensive set of
exam-style questions with correct answers and rationales designed to predict NCLEX-PN
readiness. It emphasizes the application of nursing knowledge within the scope of practice
for the Licensed Practical/Vocational Nurse, focusing on safe patient care, accurate data
collection, medication administration, and recognizing findings that must be reported.
Exam Structure:
● Comprehensive HESI PN Exit Exam: (150 QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the LPN/LVN's appropriate action within their scope, the foundational principle
of care, the rationale for a specific observation or intervention, and why alternative options
are outside the PN's scope, unsafe, or represent an incorrect delegation of tasks.
Comprehensive HESI PN Exit Exam (150 Questions)
,1. A client with type 2 diabetes is prescribed metformin. Which statement by the
client indicates understanding of the medication teaching?
A. “I will stop taking this if I feel nauseated.”
B. “I can take this with my evening meal only.”
C. “I should call my doctor if I develop muscle pain or weakness.”
D. “This medication will make me gain weight.”
Rationale: Metformin can rarely cause lactic acidosis, which presents with muscle pain,
weakness, and malaise. The client should report these symptoms immediately. Nausea is
common initially but not a reason to stop (A). Metformin is usually taken with meals, often
twice daily (B). It is weight-neutral or may cause mild weight loss (D).
2. An LPN is assigned to care for a client with a new colostomy. Which action is within
the LPN’s scope of practice?
A. Teaching the client how to irrigate the colostomy
B. Changing the colostomy pouch and assessing stoma appearance
C. Determining the need for a new appliance based on skin breakdown
, D. Developing a long-term ostomy care plan
Rationale: Changing the pouch and assessing the stoma (color, moisture, size) are
routine tasks within the LPN scope. Initial teaching (A), complex assessment for skin
breakdown requiring plan changes (C), and care planning (D) are RN responsibilities.
3. A client reports sudden onset of shortness of breath and chest pain after
abdominal surgery. The LPN should first:
A. Administer PRN oxygen via nasal cannula
B. Elevate the head of the bed
C. Notify the RN or physician immediately
D. Obtain vital signs including oxygen saturation
Rationale: Sudden dyspnea and chest pain post-op suggest pulmonary embolism—a
life-threatening emergency. While obtaining vitals (D) and positioning (B) are supportive, the
LPN must immediately notify the RN or provider because rapid intervention is critical.
Oxygen (A) may be given per protocol, but notification takes priority.
4. Which finding in a client with heart failure requires immediate reporting to the
RN?
A. Weight gain of 1 lb in 24 hours
, B. Mild ankle edema
C. Respiratory rate of 28 breaths/min with crackles in lung bases
D. Fatigue with ambulation
Rationale: Tachypnea and crackles indicate worsening pulmonary congestion and
possible acute decompensation. This requires prompt intervention. Weight gain of 1 lb (A)
is not significant; 2–3 lbs/day is concerning. Mild edema (B) and fatigue (D) are chronic
manifestations.
5. A client is receiving IV potassium chloride. The LPN notes the IV site is red,
swollen, and painful. The best action is to:
A. Slow the infusion rate
B. Apply warm compresses
C. Stop the infusion and notify the RN
D. Flush the line with normal saline
Rationale: Signs of phlebitis or infiltration require stopping the infusion
immediately—especially with potassium, which is highly irritating—and notifying the
RN. Continuing (A, D) or applying heat (B) could worsen tissue damage.
Practical/Vocational Nursing Exit Exam (HESI) | Key Domains: Safe & Effective Care
Environment (Safety, Infection Control, Coordinated Care), Health Promotion &
Maintenance, Psychosocial Integrity, Basic Care & Comfort, Pharmacological Therapies,
Reduction of Risk Potential, and Physiological Adaptation | Expert-Aligned Structure | HESI
Exit Exam Format
Introduction
This structured HESI PN Exit Exam for 2026/2027 provides a comprehensive set of
exam-style questions with correct answers and rationales designed to predict NCLEX-PN
readiness. It emphasizes the application of nursing knowledge within the scope of practice
for the Licensed Practical/Vocational Nurse, focusing on safe patient care, accurate data
collection, medication administration, and recognizing findings that must be reported.
Exam Structure:
● Comprehensive HESI PN Exit Exam: (150 QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the LPN/LVN's appropriate action within their scope, the foundational principle
of care, the rationale for a specific observation or intervention, and why alternative options
are outside the PN's scope, unsafe, or represent an incorrect delegation of tasks.
Comprehensive HESI PN Exit Exam (150 Questions)
,1. A client with type 2 diabetes is prescribed metformin. Which statement by the
client indicates understanding of the medication teaching?
A. “I will stop taking this if I feel nauseated.”
B. “I can take this with my evening meal only.”
C. “I should call my doctor if I develop muscle pain or weakness.”
D. “This medication will make me gain weight.”
Rationale: Metformin can rarely cause lactic acidosis, which presents with muscle pain,
weakness, and malaise. The client should report these symptoms immediately. Nausea is
common initially but not a reason to stop (A). Metformin is usually taken with meals, often
twice daily (B). It is weight-neutral or may cause mild weight loss (D).
2. An LPN is assigned to care for a client with a new colostomy. Which action is within
the LPN’s scope of practice?
A. Teaching the client how to irrigate the colostomy
B. Changing the colostomy pouch and assessing stoma appearance
C. Determining the need for a new appliance based on skin breakdown
, D. Developing a long-term ostomy care plan
Rationale: Changing the pouch and assessing the stoma (color, moisture, size) are
routine tasks within the LPN scope. Initial teaching (A), complex assessment for skin
breakdown requiring plan changes (C), and care planning (D) are RN responsibilities.
3. A client reports sudden onset of shortness of breath and chest pain after
abdominal surgery. The LPN should first:
A. Administer PRN oxygen via nasal cannula
B. Elevate the head of the bed
C. Notify the RN or physician immediately
D. Obtain vital signs including oxygen saturation
Rationale: Sudden dyspnea and chest pain post-op suggest pulmonary embolism—a
life-threatening emergency. While obtaining vitals (D) and positioning (B) are supportive, the
LPN must immediately notify the RN or provider because rapid intervention is critical.
Oxygen (A) may be given per protocol, but notification takes priority.
4. Which finding in a client with heart failure requires immediate reporting to the
RN?
A. Weight gain of 1 lb in 24 hours
, B. Mild ankle edema
C. Respiratory rate of 28 breaths/min with crackles in lung bases
D. Fatigue with ambulation
Rationale: Tachypnea and crackles indicate worsening pulmonary congestion and
possible acute decompensation. This requires prompt intervention. Weight gain of 1 lb (A)
is not significant; 2–3 lbs/day is concerning. Mild edema (B) and fatigue (D) are chronic
manifestations.
5. A client is receiving IV potassium chloride. The LPN notes the IV site is red,
swollen, and painful. The best action is to:
A. Slow the infusion rate
B. Apply warm compresses
C. Stop the infusion and notify the RN
D. Flush the line with normal saline
Rationale: Signs of phlebitis or infiltration require stopping the infusion
immediately—especially with potassium, which is highly irritating—and notifying the
RN. Continuing (A, D) or applying heat (B) could worsen tissue damage.
