HESI PN Medical-Surgical Nursing
Final Exam Review
50 Practice Questions with Correct Answers and Rationales
Practical/Vocational Nursing (PN/VN) Program Assessment
Safe & Effective Care | Health Promotion | Psychosocial Integrity
Data Collection | Pharmacological Therapies | Physiological Adaptation
2026/2027 Edition
NGN-Integrated | Aligned with NCSBN CJMM for PN Scope
, HESI PN Med-Surg Final Exam Review
HESI PN Medical-Surgical Nursing Final Exam Review
50 Practice Questions with Correct Answers and Rationales
Aligned with Elsevier HESI PN Blueprint and NCSBN NCLEX-PN Detailed Test Plan
Domain 1: Safe and Effective Care Environment (Questions 1-10)
Question 1
A PN is caring for a patient diagnosed with Clostridioides difficile infection. Which type of
isolation precautions should the PN implement?
A) Airborne precautions with N95 respirator
B) Standard precautions only
C) Droplet precautions with surgical mask
D) Contact precautions with gown and gloves
Correct Answer: D) Contact precautions with gown and gloves
Rationale: Contact precautions are required for C. difficile because the spores are transmitted
via direct and indirect contact with contaminated surfaces, equipment, and hands.
Handwashing with soap and water is essential because alcohol-based hand sanitizers do not
kill C. difficile spores. Airborne and droplet precautions are not indicated for this organism.
Question 2
A PN is assigned to care for four patients. Which task is most appropriate for the PN to delegate to
a UAP?
A) Measuring intake and output for a stable postoperative patient
B) Administering oral medications to a patient with diabetes
C) Assessing a patient who reports new-onset chest pain
D) Performing an initial admission assessment on a new patient
Correct Answer: A) Measuring intake and output for a stable postoperative patient
Rationale: Measuring intake and output is a routine, predictable task that falls within the UAP
scope of practice. The PN remains responsible for supervising and validating the data.
Medication administration, patient assessment, and admission assessments require nursing
education and licensure and cannot be delegated to a UAP. The PN must always evaluate and
report findings to the RN.
Question 3
A patient with active pulmonary tuberculosis is admitted to the medical unit. Which action by the
PN is most important to prevent transmission?
A) Place the patient in a room with negative-pressure airflow
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, HESI PN Med-Surg Final Exam Review
B) Wear a surgical mask when entering the patient room
C) Use contact precautions with gown and gloves
D) Keep the patient door open for frequent observation
Correct Answer: A) Place the patient in a room with negative-pressure airflow
Rationale: Pulmonary TB requires airborne precautions, including a negative-pressure
airborne infection isolation room (AIIR). The PN should wear an N95 respirator, not a surgical
mask, when entering the room. Contact precautions and keeping the door open are
inappropriate for an airborne pathogen and would increase the risk of transmission to other
patients and staff.
Question 4
A PN enters a patient room and finds the patient unresponsive with no palpable pulse. What is the
first action the PN should take?
A) Document the time of discovery and notify the charge nurse
B) Check the patient airway and give two rescue breaths
C) Call the RN and wait for further instructions
D) Begin chest compressions immediately and call for help
Correct Answer: D) Begin chest compressions immediately and call for help
Rationale: When a patient is unresponsive with no pulse, the PN should immediately begin
chest compressions and activate the emergency response system. Delaying compressions to
call the RN first would compromise patient survival. Basic Life Support (BLS) protocols
prioritize immediate initiation of high-quality CPR. The PN documents and provides a full
report after the emergency is managed.
Question 5
A PN is preparing to administer medications to a patient. Which action best demonstrates the right
of documentation?
A) Documenting medications before administering them to save time
B) Writing documentation in pencil so corrections can be made easily
C) Documenting at the end of the shift for all medications given
D) Documenting immediately after administering each medication
Correct Answer: D) Documenting immediately after administering each medication
Rationale: Medications should be documented immediately after administration to ensure
accuracy and prevent errors. Pre-documenting (charting before giving) is unsafe because it
assumes the medication was given. End-of-shift documentation increases the risk of omissions
and errors. All documentation should be in permanent ink with proper error correction
methods, never in pencil.
Question 6
Page 3
Final Exam Review
50 Practice Questions with Correct Answers and Rationales
Practical/Vocational Nursing (PN/VN) Program Assessment
Safe & Effective Care | Health Promotion | Psychosocial Integrity
Data Collection | Pharmacological Therapies | Physiological Adaptation
2026/2027 Edition
NGN-Integrated | Aligned with NCSBN CJMM for PN Scope
, HESI PN Med-Surg Final Exam Review
HESI PN Medical-Surgical Nursing Final Exam Review
50 Practice Questions with Correct Answers and Rationales
Aligned with Elsevier HESI PN Blueprint and NCSBN NCLEX-PN Detailed Test Plan
Domain 1: Safe and Effective Care Environment (Questions 1-10)
Question 1
A PN is caring for a patient diagnosed with Clostridioides difficile infection. Which type of
isolation precautions should the PN implement?
A) Airborne precautions with N95 respirator
B) Standard precautions only
C) Droplet precautions with surgical mask
D) Contact precautions with gown and gloves
Correct Answer: D) Contact precautions with gown and gloves
Rationale: Contact precautions are required for C. difficile because the spores are transmitted
via direct and indirect contact with contaminated surfaces, equipment, and hands.
Handwashing with soap and water is essential because alcohol-based hand sanitizers do not
kill C. difficile spores. Airborne and droplet precautions are not indicated for this organism.
Question 2
A PN is assigned to care for four patients. Which task is most appropriate for the PN to delegate to
a UAP?
A) Measuring intake and output for a stable postoperative patient
B) Administering oral medications to a patient with diabetes
C) Assessing a patient who reports new-onset chest pain
D) Performing an initial admission assessment on a new patient
Correct Answer: A) Measuring intake and output for a stable postoperative patient
Rationale: Measuring intake and output is a routine, predictable task that falls within the UAP
scope of practice. The PN remains responsible for supervising and validating the data.
Medication administration, patient assessment, and admission assessments require nursing
education and licensure and cannot be delegated to a UAP. The PN must always evaluate and
report findings to the RN.
Question 3
A patient with active pulmonary tuberculosis is admitted to the medical unit. Which action by the
PN is most important to prevent transmission?
A) Place the patient in a room with negative-pressure airflow
Page 2
, HESI PN Med-Surg Final Exam Review
B) Wear a surgical mask when entering the patient room
C) Use contact precautions with gown and gloves
D) Keep the patient door open for frequent observation
Correct Answer: A) Place the patient in a room with negative-pressure airflow
Rationale: Pulmonary TB requires airborne precautions, including a negative-pressure
airborne infection isolation room (AIIR). The PN should wear an N95 respirator, not a surgical
mask, when entering the room. Contact precautions and keeping the door open are
inappropriate for an airborne pathogen and would increase the risk of transmission to other
patients and staff.
Question 4
A PN enters a patient room and finds the patient unresponsive with no palpable pulse. What is the
first action the PN should take?
A) Document the time of discovery and notify the charge nurse
B) Check the patient airway and give two rescue breaths
C) Call the RN and wait for further instructions
D) Begin chest compressions immediately and call for help
Correct Answer: D) Begin chest compressions immediately and call for help
Rationale: When a patient is unresponsive with no pulse, the PN should immediately begin
chest compressions and activate the emergency response system. Delaying compressions to
call the RN first would compromise patient survival. Basic Life Support (BLS) protocols
prioritize immediate initiation of high-quality CPR. The PN documents and provides a full
report after the emergency is managed.
Question 5
A PN is preparing to administer medications to a patient. Which action best demonstrates the right
of documentation?
A) Documenting medications before administering them to save time
B) Writing documentation in pencil so corrections can be made easily
C) Documenting at the end of the shift for all medications given
D) Documenting immediately after administering each medication
Correct Answer: D) Documenting immediately after administering each medication
Rationale: Medications should be documented immediately after administration to ensure
accuracy and prevent errors. Pre-documenting (charting before giving) is unsafe because it
assumes the medication was given. End-of-shift documentation increases the risk of omissions
and errors. All documentation should be in permanent ink with proper error correction
methods, never in pencil.
Question 6
Page 3
