PN HESI Exit Exam V1 -Comprehensive Study Guide &
NCLEX-PN Practice Pack (Latest 2026)
Pass your Practical Nursing exit assessment on your very first attempt with this
comprehensive study pack designed for the PN HESI Exit Exam V1. This high-yield
resource details critical nursing interventions, fundamental pharmacological principles,
pediatric and adult medical-surgical care, and priority delegation rules. Eliminate testing
anxiety and master high-stakes Next-Generation NCLEX (NGN) style items using
realistic clinical vignettes modeled directly after the official HESI blueprint.
QUESTION 1
A client with heart failure is prescribed furosemide. Which assessment finding indicates
the medication is effective?
A) Weight gain of 2 pounds in 24 hours
B) Decreased peripheral edema
C) Heart rate of 100 bpm
D) Blood pressure of 150/90 mmHg
Answer: B
Rationale: Furosemide is a loop diuretic used to reduce fluid overload. A decrease in
peripheral edema indicates the medication is effectively removing excess fluid.
QUESTION 2
A nurse is providing discharge teaching to a client with a new colostomy. Which
statement by the client indicates understanding?
A) "I will change the pouch only when it leaks."
B) "I will clean the stoma with alcohol wipes."
,C) "I will cut the wafer to fit snugly around the stoma."
D) "I can resume a regular diet immediately."
Answer: C
Rationale: The wafer should be cut to fit snugly around the stoma to prevent skin
breakdown and leakage. The pouch should be changed regularly, not only when it leaks.
QUESTION 3
A client with diabetes mellitus is receiving insulin lispro. When should the nurse
administer this medication?
A) 30 minutes before a meal
B) 1 hour before a meal
C) Immediately before or within 15 minutes after starting a meal
D) At bedtime
Answer: C
Rationale: Insulin lispro is a rapid-acting insulin that should be given immediately before
or within 15 minutes after starting a meal to match the onset of action with glucose
absorption.
QUESTION 4
A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which
finding requires immediate intervention?
A) Oxygen saturation of 88%
B) Respiratory rate of 22 breaths/min
C) Use of accessory muscles to breathe
D) Cough with clear sputum
Answer: C
Rationale: Use of accessory muscles indicates respiratory distress and requires immediate
,intervention. An oxygen saturation of 88% is concerning but accessory muscle use is a
more urgent sign of impending respiratory failure.
QUESTION 5
A client is prescribed warfarin. Which laboratory value should the nurse monitor to
evaluate therapeutic effectiveness?
A) aPTT
B) INR
C) Platelet count
D) Hemoglobin
Answer: B
Rationale: The International Normalized Ratio (INR) is used to monitor warfarin therapy.
The therapeutic range is typically 2-3 for most indications.
QUESTION 6
A client with a history of seizures is prescribed phenytoin. Which side effect should the
nurse teach the client to report?
A) Drowsiness
B) Gingival hyperplasia
C) Dry mouth
D) Constipation
Answer: B
Rationale: Gingival hyperplasia (overgrowth of gum tissue) is a common side effect of
phenytoin and requires good oral hygiene and dental follow-up.
, QUESTION 7
A nurse is caring for a client who is 2 days post-operative following abdominal surgery.
The client reports sudden, sharp pain in the calf. What is the nurse's priority action?
A) Administer prescribed pain medication
B) Massage the calf
C) Apply a warm compress
D) Notify the healthcare provider immediately
Answer: D
Rationale: Sudden calf pain may indicate a deep vein thrombosis (DVT). The healthcare
provider should be notified immediately. Massaging the leg is contraindicated as it could
dislodge a clot.
QUESTION 8
A client with major depressive disorder is prescribed fluoxetine. Which instruction
should the nurse include?
A) "You will feel better within 24 hours."
B) "This medication may cause weight gain."
C) "It may take 4-6 weeks to see therapeutic effects."
D) "You can stop taking this medication when you feel better."
Answer: C
Rationale: SSRIs like fluoxetine take 4-6 weeks to reach full therapeutic effect. Clients
should be educated about this delay to promote adherence.
QUESTION 9
A client with acute pancreatitis is NPO. Which finding indicates the client is experiencing
a complication?
NCLEX-PN Practice Pack (Latest 2026)
Pass your Practical Nursing exit assessment on your very first attempt with this
comprehensive study pack designed for the PN HESI Exit Exam V1. This high-yield
resource details critical nursing interventions, fundamental pharmacological principles,
pediatric and adult medical-surgical care, and priority delegation rules. Eliminate testing
anxiety and master high-stakes Next-Generation NCLEX (NGN) style items using
realistic clinical vignettes modeled directly after the official HESI blueprint.
QUESTION 1
A client with heart failure is prescribed furosemide. Which assessment finding indicates
the medication is effective?
A) Weight gain of 2 pounds in 24 hours
B) Decreased peripheral edema
C) Heart rate of 100 bpm
D) Blood pressure of 150/90 mmHg
Answer: B
Rationale: Furosemide is a loop diuretic used to reduce fluid overload. A decrease in
peripheral edema indicates the medication is effectively removing excess fluid.
QUESTION 2
A nurse is providing discharge teaching to a client with a new colostomy. Which
statement by the client indicates understanding?
A) "I will change the pouch only when it leaks."
B) "I will clean the stoma with alcohol wipes."
,C) "I will cut the wafer to fit snugly around the stoma."
D) "I can resume a regular diet immediately."
Answer: C
Rationale: The wafer should be cut to fit snugly around the stoma to prevent skin
breakdown and leakage. The pouch should be changed regularly, not only when it leaks.
QUESTION 3
A client with diabetes mellitus is receiving insulin lispro. When should the nurse
administer this medication?
A) 30 minutes before a meal
B) 1 hour before a meal
C) Immediately before or within 15 minutes after starting a meal
D) At bedtime
Answer: C
Rationale: Insulin lispro is a rapid-acting insulin that should be given immediately before
or within 15 minutes after starting a meal to match the onset of action with glucose
absorption.
QUESTION 4
A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which
finding requires immediate intervention?
A) Oxygen saturation of 88%
B) Respiratory rate of 22 breaths/min
C) Use of accessory muscles to breathe
D) Cough with clear sputum
Answer: C
Rationale: Use of accessory muscles indicates respiratory distress and requires immediate
,intervention. An oxygen saturation of 88% is concerning but accessory muscle use is a
more urgent sign of impending respiratory failure.
QUESTION 5
A client is prescribed warfarin. Which laboratory value should the nurse monitor to
evaluate therapeutic effectiveness?
A) aPTT
B) INR
C) Platelet count
D) Hemoglobin
Answer: B
Rationale: The International Normalized Ratio (INR) is used to monitor warfarin therapy.
The therapeutic range is typically 2-3 for most indications.
QUESTION 6
A client with a history of seizures is prescribed phenytoin. Which side effect should the
nurse teach the client to report?
A) Drowsiness
B) Gingival hyperplasia
C) Dry mouth
D) Constipation
Answer: B
Rationale: Gingival hyperplasia (overgrowth of gum tissue) is a common side effect of
phenytoin and requires good oral hygiene and dental follow-up.
, QUESTION 7
A nurse is caring for a client who is 2 days post-operative following abdominal surgery.
The client reports sudden, sharp pain in the calf. What is the nurse's priority action?
A) Administer prescribed pain medication
B) Massage the calf
C) Apply a warm compress
D) Notify the healthcare provider immediately
Answer: D
Rationale: Sudden calf pain may indicate a deep vein thrombosis (DVT). The healthcare
provider should be notified immediately. Massaging the leg is contraindicated as it could
dislodge a clot.
QUESTION 8
A client with major depressive disorder is prescribed fluoxetine. Which instruction
should the nurse include?
A) "You will feel better within 24 hours."
B) "This medication may cause weight gain."
C) "It may take 4-6 weeks to see therapeutic effects."
D) "You can stop taking this medication when you feel better."
Answer: C
Rationale: SSRIs like fluoxetine take 4-6 weeks to reach full therapeutic effect. Clients
should be educated about this delay to promote adherence.
QUESTION 9
A client with acute pancreatitis is NPO. Which finding indicates the client is experiencing
a complication?
