PN HESI Exit Exam 2026/2027 Actual Exam | Real
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Safe and Effective Care Environment – Management of Care
Q1: An LPN is working on a medical-surgical unit. Which of the following tasks is appropriate
for the LPN to delegate to a CNA?
A. Administering oral medications to a stable patient
B. Obtaining vital signs on a patient 2 hours post-operative [CORRECT]
C. Assessing a patient's wound for signs of infection
D. Teaching a patient how to use an incentive spirometer
Correct Answer: B
Rationale: Obtaining routine vital signs on stable patients is within the CNA's scope of practice
and can be delegated by the LPN. Option A (medication administration) requires licensure and
cannot be delegated to UAP. Option C (wound assessment) requires nursing judgment and is the
responsibility of the licensed nurse. Option D (patient teaching) requires nursing knowledge and
cannot be delegated to UAP.
Q2 (Delegation): The LPN is caring for a client with a staged pressure injury on the sacrum.
Which action should the LPN delegate to the Unlicensed Assistive Personnel (UAP)?
A. Measuring the dimensions of the wound
B. Applying a hydrocolloid dressing to the wound
C. Repositioning the client every 2 hours [CORRECT]
D. Notifying the physician of changes in drainage
Correct Answer: C
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Rationale: Repositioning a client is a standard nursing intervention that falls within the UAP
scope of practice. Wound measurement (A) and dressing application (B) require assessment and
sterile technique skills reserved for the licensed nurse. Notifying the physician (D) is an RN
responsibility involving clinical judgment and communication.
Q3 (Delegation): An LPN is assigned to care for four clients. Which client should the LPN assess
first?
A. A client requesting pain medication for a headache
B. A client with pneumonia who is confused and restless [CORRECT]
C. A client scheduled for discharge who needs teaching
D. A client with diabetes requesting a bedtime snack
Correct Answer: B
Rationale: Confusion and restlessness in a client with pneumonia may indicate hypoxia, a
potential emergency requiring immediate assessment. This client takes priority using the ABCs
(Airway, Breathing, Circulation) framework. Options A, C, and D are important but not
emergent.
Q4: A client is scheduled for a total hip arthroplasty. The LPN reviews the informed consent
form and finds it is signed but the client still has questions. What is the LPN's best action?
A. Witness the signature and proceed with pre-operative preparation
B. Answer the client's questions based on the procedure manual
C. Notify the Registered Nurse (RN) or surgeon to answer the client's questions [CORRECT]
D. Cancel the surgery until the client is sedated
Correct Answer: C
Rationale: While LPNs can witness signatures, they cannot provide the detailed information
required for informed consent (provider responsibility). If the client has unanswered questions,
the consent is not valid. The LPN must notify the RN or surgeon to speak with the client.
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Q5: Which of the following incidents requires the completion of an incident report? (Select all
that apply).
[A] A visitor slips in the hallway near the nurse's station. [CORRECT]
[B] A nurse administers a vaccine to the wrong client. [CORRECT]
[C] A client refuses to take their scheduled medication.
[D] A client falls while attempting to get out of bed. [CORRECT]
[E] A staff member takes a scheduled break.
Correct Answer: A, B, D
Rationale: Incident reports are required for any unusual or unexpected occurrence that results in
or could result in harm to a client, visitor, or staff. Slips/falls (A, D) and medication errors (B)
are reportable events. A client refusing medication (C) is a client right, not an incident, though it
requires documentation. Scheduled breaks (E) are routine.
Safe and Effective Care Environment – Safety and Infection Control
Q6: The LPN is caring for a client on contact precautions for Methicillin-resistant
Staphylococcus aureus (MRSA). Which personal protective equipment (PPE) is required when
entering the room?
A. N95 respirator and gown
B. Gown and gloves [CORRECT]
C. Goggles and face shield
D. Gloves only
Correct Answer: B
Rationale: Contact precautions require a gown and gloves to prevent the transmission of
pathogens via direct contact. An N95 respirator (A) is for airborne precautions. Goggles (C) are
for splatter risks.
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Q7 (Ordered Response): The LPN is donning personal protective equipment (PPE) to care for a
client on isolation precautions. Arrange the following steps in the correct order for putting on
PPE.
Put on gloves.
Put on the gown.
Apply the mask or respirator.
Perform hand hygiene.
Put on goggles or face shield.
Correct Answer: 4, 2, 3, 5, 1
Rationale: The correct sequence for donning PPE is: 1. Hand hygiene (4), 2. Gown (2), 3. Mask
or respirator (3), 4. Goggles or face shield (5), 5. Gloves (1). This order ensures the gown covers
the torso, the mask is secured before eye protection, and gloves are put on last to cover the gown
cuffs.
Q8: A client is receiving oxygen via nasal cannula at 4 L/min. Which safety intervention is
priority for the LPN to implement?
A. Posting a "No Smoking" sign on the door [CORRECT]
B. Keeping the client in a high Fowler's position
C. Applying petroleum jelly to the client's nares
D. Checking the oxygen flow rate every 8 hours
Correct Answer: A
Rationale: Oxygen supports combustion. Posting a "No Smoking" sign is a critical safety
intervention to prevent fire. Petroleum jelly (C) should be avoided as it is flammable and can
cause lipoid pneumonia.
Q9: The LPN enters a client's room and finds the client unresponsive with a fire in the trash can.
Which action should the LPN take first?
A. Pull the fire alarm