NGN PN HESI Exam Actual Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100% Verified – Pass Guaranteed
A+ Graded
EXAM INFORMATION
Total Questions: 55
Recommended Time: 82 Minutes
Passing Threshold: 80%
Exam Format: Multiple Choice Questions (MCQs)
Question Style: Scenario-Based, Applied, and Professional Decision-Making Questions
Difficulty Level: Dynamically Determined Based on Exam Scope
==============================
SECTION 1: Clinical Judgment and Prioritization
Question 1: A practical nurse receives report on four clients. Which client requires
immediate assessment?
A. A client with a blood pressure of 142/88 mmHg who reports a mild headache
B. A client with a heart rate of 52 beats per minute who is asymptomatic
C. A client with a respiratory rate of 28 breaths per minute and oxygen saturation of 89%
on room air
D. A client with a temperature of 101.2 degrees Fahrenheit who has been receiving
antibiotics for 24 hours
Correct Answer: C
Rationale: A respiratory rate of 28 with an oxygen saturation of 89% indicates significant
respiratory compromise and hypoxemia. This client is at risk for respiratory failure and
requires immediate intervention. The other clients are stable or have expected findings
that do not require immediate action.
,Question 2: During morning rounds, the practical nurse identifies the following clients.
Which client should the nurse assess first?
A. A postoperative client on day two whose surgical dressing has a small amount of
serosanguineous drainage
B. A client with heart failure who has gained 1.5 pounds since yesterday and has
crackles in the lung bases
C. A client with type 2 diabetes whose fasting blood glucose is 148 mg/dL
D. A client with a nasogastric tube who has 40 mL of greenish drainage in the past four
hours
Correct Answer: B
Rationale: The client with heart failure who has gained 1.5 pounds in one day with new
crackles in the lung bases is showing signs of fluid volume overload and potential
pulmonary edema. This requires immediate assessment to prevent respiratory distress.
Weight gain with crackles indicates worsening heart failure.
Question 3: The practical nurse is caring for a group of clients. Which task is
appropriate to delegate to unlicensed assistive personnel (UAP)?
A. Assessing a client for signs of postoperative infection
B. Measuring and recording intake and output for a client with renal failure
C. Administering oral medications to a client with pneumonia
D. Teaching a newly diagnosed diabetic client about foot care
Correct Answer: B
Rationale: Measuring and recording intake and output is a task that can be delegated to
UAP because it does not require nursing judgment or clinical decision-making.
Assessment, medication administration, and client education are within the scope of
licensed nursing practice and cannot be delegated to UAP.
, Question 4: A practical nurse enters a client's room and finds the client unresponsive,
not breathing, and without a pulse. After calling for help and initiating CPR, what is the
next priority action?
A. Inserting an oropharyngeal airway
B. Applying the automated external defibrillator (AED)
C. Establishing intravenous access
D. Administering epinephrine
Correct Answer: B
Rationale: According to the American Heart Association BLS guidelines, after initiating
CPR and calling for help, the next priority is to apply the AED as soon as it is available.
Early defibrillation is the most effective intervention for ventricular fibrillation or
pulseless ventricular tachycardia. The AED should be applied without delay.
Question 5: The practical nurse is reviewing laboratory results for four clients. Which
result requires immediate notification of the healthcare provider?
A. A client with chronic kidney disease whose potassium level is 5.8 mEq/L
B. A client with anemia whose hemoglobin is 10.2 g/dL
C. A client with diabetes whose HbA1c is 7.8%
D. A client with heart failure whose BNP is 450 pg/mL
Correct Answer: A
Rationale: A potassium level of 5.8 mEq/L is critically elevated and places the client at
risk for life-threatening cardiac dysrhythmias. This requires immediate notification of
the healthcare provider for intervention. Normal potassium is 3.5 to 5.0 mEq/L. Levels
above 6.0 mEq/L can cause peaked T waves, widened QRS complexes, and cardiac
arrest.
Questions with Detailed Rationales | 100% Verified – Pass Guaranteed
A+ Graded
EXAM INFORMATION
Total Questions: 55
Recommended Time: 82 Minutes
Passing Threshold: 80%
Exam Format: Multiple Choice Questions (MCQs)
Question Style: Scenario-Based, Applied, and Professional Decision-Making Questions
Difficulty Level: Dynamically Determined Based on Exam Scope
==============================
SECTION 1: Clinical Judgment and Prioritization
Question 1: A practical nurse receives report on four clients. Which client requires
immediate assessment?
A. A client with a blood pressure of 142/88 mmHg who reports a mild headache
B. A client with a heart rate of 52 beats per minute who is asymptomatic
C. A client with a respiratory rate of 28 breaths per minute and oxygen saturation of 89%
on room air
D. A client with a temperature of 101.2 degrees Fahrenheit who has been receiving
antibiotics for 24 hours
Correct Answer: C
Rationale: A respiratory rate of 28 with an oxygen saturation of 89% indicates significant
respiratory compromise and hypoxemia. This client is at risk for respiratory failure and
requires immediate intervention. The other clients are stable or have expected findings
that do not require immediate action.
,Question 2: During morning rounds, the practical nurse identifies the following clients.
Which client should the nurse assess first?
A. A postoperative client on day two whose surgical dressing has a small amount of
serosanguineous drainage
B. A client with heart failure who has gained 1.5 pounds since yesterday and has
crackles in the lung bases
C. A client with type 2 diabetes whose fasting blood glucose is 148 mg/dL
D. A client with a nasogastric tube who has 40 mL of greenish drainage in the past four
hours
Correct Answer: B
Rationale: The client with heart failure who has gained 1.5 pounds in one day with new
crackles in the lung bases is showing signs of fluid volume overload and potential
pulmonary edema. This requires immediate assessment to prevent respiratory distress.
Weight gain with crackles indicates worsening heart failure.
Question 3: The practical nurse is caring for a group of clients. Which task is
appropriate to delegate to unlicensed assistive personnel (UAP)?
A. Assessing a client for signs of postoperative infection
B. Measuring and recording intake and output for a client with renal failure
C. Administering oral medications to a client with pneumonia
D. Teaching a newly diagnosed diabetic client about foot care
Correct Answer: B
Rationale: Measuring and recording intake and output is a task that can be delegated to
UAP because it does not require nursing judgment or clinical decision-making.
Assessment, medication administration, and client education are within the scope of
licensed nursing practice and cannot be delegated to UAP.
, Question 4: A practical nurse enters a client's room and finds the client unresponsive,
not breathing, and without a pulse. After calling for help and initiating CPR, what is the
next priority action?
A. Inserting an oropharyngeal airway
B. Applying the automated external defibrillator (AED)
C. Establishing intravenous access
D. Administering epinephrine
Correct Answer: B
Rationale: According to the American Heart Association BLS guidelines, after initiating
CPR and calling for help, the next priority is to apply the AED as soon as it is available.
Early defibrillation is the most effective intervention for ventricular fibrillation or
pulseless ventricular tachycardia. The AED should be applied without delay.
Question 5: The practical nurse is reviewing laboratory results for four clients. Which
result requires immediate notification of the healthcare provider?
A. A client with chronic kidney disease whose potassium level is 5.8 mEq/L
B. A client with anemia whose hemoglobin is 10.2 g/dL
C. A client with diabetes whose HbA1c is 7.8%
D. A client with heart failure whose BNP is 450 pg/mL
Correct Answer: A
Rationale: A potassium level of 5.8 mEq/L is critically elevated and places the client at
risk for life-threatening cardiac dysrhythmias. This requires immediate notification of
the healthcare provider for intervention. Normal potassium is 3.5 to 5.0 mEq/L. Levels
above 6.0 mEq/L can cause peaked T waves, widened QRS complexes, and cardiac
arrest.
