HESI PN Exit V5 Exam with NGN
Questions and Answers With rationales
2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
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1. A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen via nasal cannula at 2 L/min. The client asks the
nurse why the oxygen flow cannot be increased. Which response by
the nurse is best?
A) "Higher oxygen levels will cause you to hyperventilate."
B) "Increased oxygen can depress your respiratory drive."
C) "Your lungs cannot absorb oxygen at higher flow rates."
D) "High oxygen concentrations can be toxic to your lung tissue."
Answer: B
Rationale: In clients with COPD, the respiratory drive is often
hypoxia-driven rather than carbon dioxide-driven. Administering
high concentrations of oxygen can eliminate their hypoxic drive,
leading to hypoventilation, CO2 retention, and respiratory failure.
The flow should generally be kept between 1-3 L/min unless
otherwise prescribed.
2. The nurse is caring for a client receiving digoxin. Which of the
following findings would indicate digoxin toxicity and require the
nurse to withhold the medication?
A) Heart rate of 62 bpm
B) Serum potassium level of 4.0 mEq/L
C) Sudden onset of yellow-tinged vision
D) Blood pressure of 118/76 mmHg
Answer: C
Rationale: Yellow-tinged vision (yellow halos around objects) is a
classic neurological/visual sign of digoxin toxicity. Other signs
include bradycardia (HR < 60), nausea, vomiting, and arrhythmias. A
,heart rate of 62 is on the lower end but is not the most definitive
sign of toxicity compared to visual changes.
3. A client with pre-eclampsia is receiving magnesium sulfate. Which
of the following assessment findings indicates the client is
experiencing magnesium toxicity?
A) Deep tendon reflexes of +2
B) Respiratory rate of 12 breaths/min
C) Urine output of 40 mL/hr
D) Absent deep tendon reflexes
Answer: D
Rationale: Magnesium sulfate can cause central nervous system
depression. Signs of toxicity include absent deep tendon reflexes,
respiratory rate less than 12 breaths/min, and urine output less
than 30 mL/hr. The antidote is calcium gluconate.
4. A client with schizophrenia is experiencing command auditory
hallucinations telling them to harm others. Which intervention is the
nurse's priority?
A) Encourage the client to listen to music to distract from the voices.
B) Administer a prescribed PRN antipsychotic medication.
C) Ensure the safety of the client and others on the unit.
D) Explore the content of the hallucinations with the client.
Answer: C
Rationale: When a client is experiencing command hallucinations,
especially those directing harm to self or others, the priority is
always safety. The nurse must first ensure the environment is safe
for the client and others before implementing other interventions
like medication or distraction.
5. A client is admitted with a diagnosis of acute pancreatitis. Which
of the following assessment findings does the nurse expect?
, A) Severe, constant epigastric pain radiating to the back
B) Right upper quadrant pain that worsens after a fatty meal
C) Sharp, localized pain in the left lower quadrant
D) Burning epigastric pain relieved by eating food
Answer: A
Rationale: Acute pancreatitis typically presents with severe,
constant, deep epigastric pain that often radiates to the back. It is
frequently accompanied by nausea, vomiting, and elevated amylase
and lipase levels. RUQ pain after a fatty meal is typical of
cholecystitis. Burning pain relieved by food is typical of a duodenal
ulcer.
6. The nurse is preparing to administer morning medications to a
client. Which of the following medications should the nurse hold and
clarify with the provider?
A) Metformin for a client with a blood glucose of 150 mg/dL
B) Enalapril for a client with a blood pressure of 140/88 mmHg
C) Furosemide for a client with a serum potassium level of 3.1
mEq/L
D) Levothyroxine for a client with a heart rate of 80 bpm
Answer: C
Rationale: Furosemide is a loop diuretic that causes potassium loss.
The client's potassium level is already critically low (normal is 3.5-
5.0 mEq/L). Administering furosemide could cause severe
hypokalemia, leading to life-threatening cardiac arrhythmias. The
nurse must hold the medication and clarify with the provider.
7. A client with a history of heart failure is admitted with shortness
of breath and peripheral edema. The nurse notes the client's jugular
vein distention (JVD) is elevated. Which physiological process best
explains this finding?
A) Decreased right atrial pressure
Questions and Answers With rationales
2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
1. A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen via nasal cannula at 2 L/min. The client asks the
nurse why the oxygen flow cannot be increased. Which response by
the nurse is best?
A) "Higher oxygen levels will cause you to hyperventilate."
B) "Increased oxygen can depress your respiratory drive."
C) "Your lungs cannot absorb oxygen at higher flow rates."
D) "High oxygen concentrations can be toxic to your lung tissue."
Answer: B
Rationale: In clients with COPD, the respiratory drive is often
hypoxia-driven rather than carbon dioxide-driven. Administering
high concentrations of oxygen can eliminate their hypoxic drive,
leading to hypoventilation, CO2 retention, and respiratory failure.
The flow should generally be kept between 1-3 L/min unless
otherwise prescribed.
2. The nurse is caring for a client receiving digoxin. Which of the
following findings would indicate digoxin toxicity and require the
nurse to withhold the medication?
A) Heart rate of 62 bpm
B) Serum potassium level of 4.0 mEq/L
C) Sudden onset of yellow-tinged vision
D) Blood pressure of 118/76 mmHg
Answer: C
Rationale: Yellow-tinged vision (yellow halos around objects) is a
classic neurological/visual sign of digoxin toxicity. Other signs
include bradycardia (HR < 60), nausea, vomiting, and arrhythmias. A
,heart rate of 62 is on the lower end but is not the most definitive
sign of toxicity compared to visual changes.
3. A client with pre-eclampsia is receiving magnesium sulfate. Which
of the following assessment findings indicates the client is
experiencing magnesium toxicity?
A) Deep tendon reflexes of +2
B) Respiratory rate of 12 breaths/min
C) Urine output of 40 mL/hr
D) Absent deep tendon reflexes
Answer: D
Rationale: Magnesium sulfate can cause central nervous system
depression. Signs of toxicity include absent deep tendon reflexes,
respiratory rate less than 12 breaths/min, and urine output less
than 30 mL/hr. The antidote is calcium gluconate.
4. A client with schizophrenia is experiencing command auditory
hallucinations telling them to harm others. Which intervention is the
nurse's priority?
A) Encourage the client to listen to music to distract from the voices.
B) Administer a prescribed PRN antipsychotic medication.
C) Ensure the safety of the client and others on the unit.
D) Explore the content of the hallucinations with the client.
Answer: C
Rationale: When a client is experiencing command hallucinations,
especially those directing harm to self or others, the priority is
always safety. The nurse must first ensure the environment is safe
for the client and others before implementing other interventions
like medication or distraction.
5. A client is admitted with a diagnosis of acute pancreatitis. Which
of the following assessment findings does the nurse expect?
, A) Severe, constant epigastric pain radiating to the back
B) Right upper quadrant pain that worsens after a fatty meal
C) Sharp, localized pain in the left lower quadrant
D) Burning epigastric pain relieved by eating food
Answer: A
Rationale: Acute pancreatitis typically presents with severe,
constant, deep epigastric pain that often radiates to the back. It is
frequently accompanied by nausea, vomiting, and elevated amylase
and lipase levels. RUQ pain after a fatty meal is typical of
cholecystitis. Burning pain relieved by food is typical of a duodenal
ulcer.
6. The nurse is preparing to administer morning medications to a
client. Which of the following medications should the nurse hold and
clarify with the provider?
A) Metformin for a client with a blood glucose of 150 mg/dL
B) Enalapril for a client with a blood pressure of 140/88 mmHg
C) Furosemide for a client with a serum potassium level of 3.1
mEq/L
D) Levothyroxine for a client with a heart rate of 80 bpm
Answer: C
Rationale: Furosemide is a loop diuretic that causes potassium loss.
The client's potassium level is already critically low (normal is 3.5-
5.0 mEq/L). Administering furosemide could cause severe
hypokalemia, leading to life-threatening cardiac arrhythmias. The
nurse must hold the medication and clarify with the provider.
7. A client with a history of heart failure is admitted with shortness
of breath and peripheral edema. The nurse notes the client's jugular
vein distention (JVD) is elevated. Which physiological process best
explains this finding?
A) Decreased right atrial pressure
