PN HESI EXIT EXAM V1 NEWEST 2026
ACTUAL EXAM| ELSEVIER HESI PN EXIT
EXAM V1
2026 Exam · 199 Questions · With Rationales
ati. PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1
Question: 1 of 199
A client with chronic kidney disease stage 4 is admitted with hyperkalemia (K+ 6.2 mEq/L). The nurse reviews
the electronic health record and notes the client is scheduled for dialysis tomorrow. Which intervention should
A. Administer sodium polystyrene sulfonate orally.
B. Prepare for immediate hemodialysis.
C. Administer intravenous calcium gluconate.
D. Administer albuterol via nebulizer.
PREVIOUS CONTINUE
A client with chronic kidney disease stage 4 is admitted with hyperkalemia (K+ 6.2 mEq/L).
The nurse reviews the electronic health record and notes the client is scheduled for
dialysis tomorrow. Which intervention should the nurse initiate first?
A. Administer sodium polystyrene sulfonate orally.
B. Prepare for immediate hemodialysis.
(Correct) C. Administer intravenous calcium gluconate.
D. Administer albuterol via nebulizer.
Correct Answer: C
Intravenous calcium gluconate is given first to protect the heart from life-threatening arrhythmias by stabilizing
the myocardial membrane. Sodium polystyrene sulfonate works slowly, dialysis is not immediate, and albuterol
is a temporary measure to shift potassium into cells but does not protect the heart.
Page 1 | PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1 2026
, PN HESI EXIT EXAM V1 NEWEST 2026
ACTUAL EXAM| ELSEVIER HESI PN EXIT
EXAM V1
2026 Exam · 199 Questions · With Rationales
ati. PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1
Question: 2 of 199
A client receiving continuous intravenous heparin for deep vein thrombosis has an activated partial
thromboplastin time (aPTT) of 98 seconds (therapeutic range 60-80 seconds). Which action should the nurse
A. Increase the heparin infusion rate by 2 units/kg/hr.
B. Decrease the heparin infusion rate by 2 units/kg/hr.
C. Administer protamine sulfate per protocol.
D. Discontinue the heparin infusion immediately.
PREVIOUS CONTINUE
A client receiving continuous intravenous heparin for deep vein thrombosis has an
activated partial thromboplastin time (aPTT) of 98 seconds (therapeutic range 60-80
seconds). Which action should the nurse take?
A. Increase the heparin infusion rate by 2 units/kg/hr.
(Correct) B. Decrease the heparin infusion rate by 2 units/kg/hr.
C. Administer protamine sulfate per protocol.
D. Discontinue the heparin infusion immediately.
Correct Answer: B
The aPTT is above therapeutic range, indicating increased bleeding risk. Decreasing the infusion rate is
appropriate to bring aPTT back into range. Protamine sulfate is used for severe bleeding or reversal, not for
moderate elevation. Discontinuing abruptly may cause rebound thrombosis.
Page 2 | PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1 2026
, PN HESI EXIT EXAM V1 NEWEST 2026
ACTUAL EXAM| ELSEVIER HESI PN EXIT
EXAM V1
2026 Exam · 199 Questions · With Rationales
ati. PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1
Question: 3 of 199
A nurse is caring for a client with a chest tube connected to a dry suction water seal drainage system. The
nurse observes continuous bubbling in the water seal chamber. What is the priority nursing action?
A. Clamp the chest tube near the insertion site.
B. Check the tubing for air leaks.
C. Increase the suction pressure.
D. Notify the healthcare provider immediately.
PREVIOUS CONTINUE
A nurse is caring for a client with a chest tube connected to a dry suction water seal
drainage system. The nurse observes continuous bubbling in the water seal chamber.
What is the priority nursing action?
A. Clamp the chest tube near the insertion site.
(Correct) B. Check the tubing for air leaks.
C. Increase the suction pressure.
D. Notify the healthcare provider immediately.
Correct Answer: B
Continuous bubbling in the water seal chamber indicates an air leak in the system, which must be located and
corrected. Clamping is dangerous as it can cause tension pneumothorax. Increasing suction does not fix the
leak. Notification may be needed after assessment, but checking for leaks is the priority.
Page 3 | PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1 2026
, PN HESI EXIT EXAM V1 NEWEST 2026
ACTUAL EXAM| ELSEVIER HESI PN EXIT
EXAM V1
2026 Exam · 199 Questions · With Rationales
ati. PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1
Question: 4 of 199
A nurse is assessing a client with suspected meningitis. Which finding is most indicative of meningeal
irritation?
A. Positive Babinski sign.
B. Brudzinski's sign.
C. Decorticate posturing.
D. Nystagmus.
PREVIOUS CONTINUE
A nurse is assessing a client with suspected meningitis. Which finding is most indicative
of meningeal irritation?
A. Positive Babinski sign.
(Correct) B. Brudzinski's sign.
C. Decorticate posturing.
D. Nystagmus.
Correct Answer: B
Brudzinski's sign (flexion of hips and knees with passive neck flexion) is a classic sign of meningeal irritation.
Babinski sign indicates upper motor neuron lesion, decorticate posturing suggests severe brain injury, and
nystagmus is associated with cerebellar or vestibular dysfunction.
Page 4 | PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1 2026
ACTUAL EXAM| ELSEVIER HESI PN EXIT
EXAM V1
2026 Exam · 199 Questions · With Rationales
ati. PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1
Question: 1 of 199
A client with chronic kidney disease stage 4 is admitted with hyperkalemia (K+ 6.2 mEq/L). The nurse reviews
the electronic health record and notes the client is scheduled for dialysis tomorrow. Which intervention should
A. Administer sodium polystyrene sulfonate orally.
B. Prepare for immediate hemodialysis.
C. Administer intravenous calcium gluconate.
D. Administer albuterol via nebulizer.
PREVIOUS CONTINUE
A client with chronic kidney disease stage 4 is admitted with hyperkalemia (K+ 6.2 mEq/L).
The nurse reviews the electronic health record and notes the client is scheduled for
dialysis tomorrow. Which intervention should the nurse initiate first?
A. Administer sodium polystyrene sulfonate orally.
B. Prepare for immediate hemodialysis.
(Correct) C. Administer intravenous calcium gluconate.
D. Administer albuterol via nebulizer.
Correct Answer: C
Intravenous calcium gluconate is given first to protect the heart from life-threatening arrhythmias by stabilizing
the myocardial membrane. Sodium polystyrene sulfonate works slowly, dialysis is not immediate, and albuterol
is a temporary measure to shift potassium into cells but does not protect the heart.
Page 1 | PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1 2026
, PN HESI EXIT EXAM V1 NEWEST 2026
ACTUAL EXAM| ELSEVIER HESI PN EXIT
EXAM V1
2026 Exam · 199 Questions · With Rationales
ati. PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1
Question: 2 of 199
A client receiving continuous intravenous heparin for deep vein thrombosis has an activated partial
thromboplastin time (aPTT) of 98 seconds (therapeutic range 60-80 seconds). Which action should the nurse
A. Increase the heparin infusion rate by 2 units/kg/hr.
B. Decrease the heparin infusion rate by 2 units/kg/hr.
C. Administer protamine sulfate per protocol.
D. Discontinue the heparin infusion immediately.
PREVIOUS CONTINUE
A client receiving continuous intravenous heparin for deep vein thrombosis has an
activated partial thromboplastin time (aPTT) of 98 seconds (therapeutic range 60-80
seconds). Which action should the nurse take?
A. Increase the heparin infusion rate by 2 units/kg/hr.
(Correct) B. Decrease the heparin infusion rate by 2 units/kg/hr.
C. Administer protamine sulfate per protocol.
D. Discontinue the heparin infusion immediately.
Correct Answer: B
The aPTT is above therapeutic range, indicating increased bleeding risk. Decreasing the infusion rate is
appropriate to bring aPTT back into range. Protamine sulfate is used for severe bleeding or reversal, not for
moderate elevation. Discontinuing abruptly may cause rebound thrombosis.
Page 2 | PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1 2026
, PN HESI EXIT EXAM V1 NEWEST 2026
ACTUAL EXAM| ELSEVIER HESI PN EXIT
EXAM V1
2026 Exam · 199 Questions · With Rationales
ati. PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1
Question: 3 of 199
A nurse is caring for a client with a chest tube connected to a dry suction water seal drainage system. The
nurse observes continuous bubbling in the water seal chamber. What is the priority nursing action?
A. Clamp the chest tube near the insertion site.
B. Check the tubing for air leaks.
C. Increase the suction pressure.
D. Notify the healthcare provider immediately.
PREVIOUS CONTINUE
A nurse is caring for a client with a chest tube connected to a dry suction water seal
drainage system. The nurse observes continuous bubbling in the water seal chamber.
What is the priority nursing action?
A. Clamp the chest tube near the insertion site.
(Correct) B. Check the tubing for air leaks.
C. Increase the suction pressure.
D. Notify the healthcare provider immediately.
Correct Answer: B
Continuous bubbling in the water seal chamber indicates an air leak in the system, which must be located and
corrected. Clamping is dangerous as it can cause tension pneumothorax. Increasing suction does not fix the
leak. Notification may be needed after assessment, but checking for leaks is the priority.
Page 3 | PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1 2026
, PN HESI EXIT EXAM V1 NEWEST 2026
ACTUAL EXAM| ELSEVIER HESI PN EXIT
EXAM V1
2026 Exam · 199 Questions · With Rationales
ati. PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1
Question: 4 of 199
A nurse is assessing a client with suspected meningitis. Which finding is most indicative of meningeal
irritation?
A. Positive Babinski sign.
B. Brudzinski's sign.
C. Decorticate posturing.
D. Nystagmus.
PREVIOUS CONTINUE
A nurse is assessing a client with suspected meningitis. Which finding is most indicative
of meningeal irritation?
A. Positive Babinski sign.
(Correct) B. Brudzinski's sign.
C. Decorticate posturing.
D. Nystagmus.
Correct Answer: B
Brudzinski's sign (flexion of hips and knees with passive neck flexion) is a classic sign of meningeal irritation.
Babinski sign indicates upper motor neuron lesion, decorticate posturing suggests severe brain injury, and
nystagmus is associated with cerebellar or vestibular dysfunction.
Page 4 | PN HESI EXIT EXAM V1 NEWEST 2026 ACTUAL EXAM| ELSEVIER HESI PN EXIT EXAM V1 2026
