HESI PN Exit Exam NGN 2025–2026 | Actual
Exam-Based Questions with Verified
Correct Answers & Rationales | Graded
A+ Premium Study Bank
Question 1
,A practical nurse (PN) is reinforcing discharge instructions for a client
diagnosed with chronic heart failure who is prescribed furosemide. Which
statement by the client indicates a need for further teaching?
A. "I will weigh myself every morning before breakfast."
B. "I will call the doctor if I gain more than 3 pounds in one day."
C. "I will use a salt substitute to flavor my dinners."
D. "I will take my medication early in the day."
Answer: C. "I will use a salt substitute to flavor my dinners."
Explanation: Salt substitutes frequently contain high amounts of potassium
chloride. While clients taking furosemide lose potassium, they should not use
salt substitutes without consulting their provider due to the risk of
unpredictable potassium spikes or interactions with other medications (like
ACE inhibitors). Instead, they should consume natural potassium-rich foods.
Weighing daily (Option A), reporting sudden weight gains (Option B), and
taking diuretics early to prevent nocturia (Option D) are correct actions.
Question 2
The practical nurse (PN) is monitoring a client who returned to the nursing unit
2 hours ago following a subtotal thyroidectomy. The client complains of
tingling around the mouth and muscle twitching in the hand. Which action
should the PN take first?
A. Assess the client's surgical dressing for hemorrhage.
B. Check the client's serum calcium level and notify the charge nurse.
C. Encourage the client to perform deep-breathing exercises.
D. Check the client's vital signs and lower the head of the bed.
,Answer: B. Check the client's serum calcium level and notify the charge
nurse.
Explanation: Tingling around the mouth (perioral paresthesia) and muscle
twitching (positive Trousseau's or Chvostek's sign) are classic symptoms of
hypocalcemia. This is a known risk following thyroidectomy due to accidental
damage or removal of the parathyroid glands. Hypocalcemia can lead to
laryngospasm and seizures, requiring immediate intervention. While
assessing for bleeding (Option A) is important post-thyroidectomy, it does not
address the neuromuscular symptoms presented.
Question 3
A resident in a long-term care facility who has a history of type 2 diabetes
mellitus is found confused, sweaty, and trembling. Which action should the
practical nurse (PN) implement immediately?
A. Administer 10 units of regular insulin subcutaneously.
B. Check the client's blood glucose level using a glucometer.
C. Offer the client 4 ounces (120 mL) of orange juice.
D. Call for an emergency medical transfer to the hospital.
Answer: B. Check the client's blood glucose level using a glucometer.
Explanation: The client is exhibiting signs of hypoglycemia (confusion,
diaphoresis, tremors). The immediate priority is to verify the blood glucose
level to confirm hypoglycemia. If a glucometer is not instantly available,
treating for hypoglycemia safely (Option C) is appropriate, but protocol
mandates checking the level first to guide treatment. Giving insulin (Option
A) would worsen the hypoglycemia and could be fatal.
, Question 4
The practical nurse (PN) is reviewing the medical records of four clients on a
medical-surgical unit. Which client should the PN identify as being at the
highest risk for developing deep vein thrombosis (DVT)?
A. A 35-year-old client who is 1 day postoperative following an appendectomy.
B. A 72-year-old client with a fractured hip who has been on bed rest for 3 days.
C. A 50-year-old client with controlled hypertension who walks the halls daily.
D. A 22-year-old client admitted for dehydration who is receiving intravenous
fluids.
Answer: B. A 72-year-old client with a fractured hip who has been on bed rest
for 3 days.
Explanation: The risk of DVT increases significantly with advanced age,
orthopedic trauma (fractured hip), and prolonged immobility (bed rest for 3
days), matching Virchow's triad (stasis of blood flow, endothelial injury, and
hypercoagulability). Option A has a minor surgery and lower age. Option C is
active. Option D has temporary dehydration which is being corrected.
Question 5
The practical nurse (PN) is caring for a client who is receiving a continuous
intravenous infusion of heparin for a pulmonary embolism. Which laboratory
value should the PN monitor to evaluate the therapeutic effectiveness of the
heparin infusion?
Exam-Based Questions with Verified
Correct Answers & Rationales | Graded
A+ Premium Study Bank
Question 1
,A practical nurse (PN) is reinforcing discharge instructions for a client
diagnosed with chronic heart failure who is prescribed furosemide. Which
statement by the client indicates a need for further teaching?
A. "I will weigh myself every morning before breakfast."
B. "I will call the doctor if I gain more than 3 pounds in one day."
C. "I will use a salt substitute to flavor my dinners."
D. "I will take my medication early in the day."
Answer: C. "I will use a salt substitute to flavor my dinners."
Explanation: Salt substitutes frequently contain high amounts of potassium
chloride. While clients taking furosemide lose potassium, they should not use
salt substitutes without consulting their provider due to the risk of
unpredictable potassium spikes or interactions with other medications (like
ACE inhibitors). Instead, they should consume natural potassium-rich foods.
Weighing daily (Option A), reporting sudden weight gains (Option B), and
taking diuretics early to prevent nocturia (Option D) are correct actions.
Question 2
The practical nurse (PN) is monitoring a client who returned to the nursing unit
2 hours ago following a subtotal thyroidectomy. The client complains of
tingling around the mouth and muscle twitching in the hand. Which action
should the PN take first?
A. Assess the client's surgical dressing for hemorrhage.
B. Check the client's serum calcium level and notify the charge nurse.
C. Encourage the client to perform deep-breathing exercises.
D. Check the client's vital signs and lower the head of the bed.
,Answer: B. Check the client's serum calcium level and notify the charge
nurse.
Explanation: Tingling around the mouth (perioral paresthesia) and muscle
twitching (positive Trousseau's or Chvostek's sign) are classic symptoms of
hypocalcemia. This is a known risk following thyroidectomy due to accidental
damage or removal of the parathyroid glands. Hypocalcemia can lead to
laryngospasm and seizures, requiring immediate intervention. While
assessing for bleeding (Option A) is important post-thyroidectomy, it does not
address the neuromuscular symptoms presented.
Question 3
A resident in a long-term care facility who has a history of type 2 diabetes
mellitus is found confused, sweaty, and trembling. Which action should the
practical nurse (PN) implement immediately?
A. Administer 10 units of regular insulin subcutaneously.
B. Check the client's blood glucose level using a glucometer.
C. Offer the client 4 ounces (120 mL) of orange juice.
D. Call for an emergency medical transfer to the hospital.
Answer: B. Check the client's blood glucose level using a glucometer.
Explanation: The client is exhibiting signs of hypoglycemia (confusion,
diaphoresis, tremors). The immediate priority is to verify the blood glucose
level to confirm hypoglycemia. If a glucometer is not instantly available,
treating for hypoglycemia safely (Option C) is appropriate, but protocol
mandates checking the level first to guide treatment. Giving insulin (Option
A) would worsen the hypoglycemia and could be fatal.
, Question 4
The practical nurse (PN) is reviewing the medical records of four clients on a
medical-surgical unit. Which client should the PN identify as being at the
highest risk for developing deep vein thrombosis (DVT)?
A. A 35-year-old client who is 1 day postoperative following an appendectomy.
B. A 72-year-old client with a fractured hip who has been on bed rest for 3 days.
C. A 50-year-old client with controlled hypertension who walks the halls daily.
D. A 22-year-old client admitted for dehydration who is receiving intravenous
fluids.
Answer: B. A 72-year-old client with a fractured hip who has been on bed rest
for 3 days.
Explanation: The risk of DVT increases significantly with advanced age,
orthopedic trauma (fractured hip), and prolonged immobility (bed rest for 3
days), matching Virchow's triad (stasis of blood flow, endothelial injury, and
hypercoagulability). Option A has a minor surgery and lower age. Option C is
active. Option D has temporary dehydration which is being corrected.
Question 5
The practical nurse (PN) is caring for a client who is receiving a continuous
intravenous infusion of heparin for a pulmonary embolism. Which laboratory
value should the PN monitor to evaluate the therapeutic effectiveness of the
heparin infusion?
