HESI PN EXIT EXAM ULTIMATE PREP REAL
PRACTICE QUESTIONS WITH IN-DEPTH
RATIONALES
Master your upcoming nursing exams with this premium, high-
yield study package containing over realistic practice questions
designed to mirror the actual exam format. Every question
features a distinct italicized answer and an in-depth, bold-
italicized clinical rationale to sharpen your critical thinking and
test-taking endurance. Secure the ultimate resource to
confidently pass your exam on the very first attempt and
accelerate your journey toward becoming a licensed practical
nurse.
Q1. A practical nurse (PN) receives report on four
clients at the start of the shift. Which client should
the nurse assess first?
A) A client with a history of heart failure who has 2+
pitting edema in the lower extremities.
B) A client who underwent an abdominal
hysterectomy 2 days ago and reports a pain level of
5 out of 10.
C) A client who is 2 hours post-bronchoscopy and
has an absent gag reflex.
D) A client with type 2 diabetes mellitus whose
fasting blood glucose is 140 mg/dL.
Answer: C
,Rationale: An absent gag reflex post-bronchoscopy
places the client at a critical risk for aspiration and
airway obstruction. Following the ABC (Airway,
Breathing, Circulation) framework, airway safety is
the absolute priority. Lower extremity edema is
chronic in heart failure, moderate post-operative
pain is expected, and a blood glucose of 140 mg/dL
is stable; none of these present an immediate life
threat.
Q2. The PN is monitoring a client receiving a
continuous intravenous heparin infusion. Which
assessment finding requires immediate notification
to the registered nurse (RN)?
A) Mild bruising at the peripheral IV insertion site.
B) An activated partial thromboplastin time (aPTT)
that is 2 times the control value.
C) A platelet count of 180,000/mm³.
D) Active epistaxis and bleeding gums when
brushing teeth.
Answer: D
Rationale: Epistaxis (nosebleeds) and bleeding
gums are clear indicators of systemic bleeding,
which is a major adverse effect of heparin therapy.
Mild bruising at the IV site is a common localized
,finding. An aPTT of 2 times the control is within the
therapeutic range (1.5 to 2.5 times control). A
platelet count of 180,000/mm³ is normal (150,000–
450,000/mm³).
Q3. A 4-year-old child is admitted to the pediatric
unit with a confirmed diagnosis of rubeola
(measles). Which transmission-based precaution
should the PN initiate?
A) Standard precautions only
B) Contact precautions
C) Droplet precautions
D) Airborne precautions
Answer: D
Rationale: Rubeola (measles) is a highly contagious
viral infection transmitted via small-particle
aerosols that remain suspended in the air.
Therefore, airborne precautions (including a
negative-pressure room and N95 respirator use)
are required. Droplet precautions are insufficient,
and contact precautions do not prevent inhalation of
airborne viral particles.
Q4. A client diagnosed with major depressive
disorder tells the PN, "I am a complete failure to my
, family. I just wish I wasn't here anymore." Which
response by the nurse is therapeutic?
A) "You have a beautiful family and so much to live
for, don't say that."
B) "Are you thinking about killing yourself or
planning to harm yourself?"
C) "Don't worry, things will definitely get better if
you give it some time."
D) "Let’s focus on something positive today, like
your upcoming visitors."
Answer: B
Rationale: When a client expresses feelings of
worthlessness and suicidal ideation, the nurse must
directly and explicitly assess for the presence of
suicidal intent or a plan. Reassurance, dismissive
platitudes, or changing the subject are non-
therapeutic blocks that minimize the client's
feelings and compromise safety.
Q5. The PN is reviewing the laboratory results of a
client with type 1 diabetes mellitus who is admitted
with suspected diabetic ketoacidosis (DKA). Which
clinical finding should the nurse expect?
A) Blood glucose of 90 mg/dL and bradycardia
B) Kussmaul respirations and deep, rapid breathing
PRACTICE QUESTIONS WITH IN-DEPTH
RATIONALES
Master your upcoming nursing exams with this premium, high-
yield study package containing over realistic practice questions
designed to mirror the actual exam format. Every question
features a distinct italicized answer and an in-depth, bold-
italicized clinical rationale to sharpen your critical thinking and
test-taking endurance. Secure the ultimate resource to
confidently pass your exam on the very first attempt and
accelerate your journey toward becoming a licensed practical
nurse.
Q1. A practical nurse (PN) receives report on four
clients at the start of the shift. Which client should
the nurse assess first?
A) A client with a history of heart failure who has 2+
pitting edema in the lower extremities.
B) A client who underwent an abdominal
hysterectomy 2 days ago and reports a pain level of
5 out of 10.
C) A client who is 2 hours post-bronchoscopy and
has an absent gag reflex.
D) A client with type 2 diabetes mellitus whose
fasting blood glucose is 140 mg/dL.
Answer: C
,Rationale: An absent gag reflex post-bronchoscopy
places the client at a critical risk for aspiration and
airway obstruction. Following the ABC (Airway,
Breathing, Circulation) framework, airway safety is
the absolute priority. Lower extremity edema is
chronic in heart failure, moderate post-operative
pain is expected, and a blood glucose of 140 mg/dL
is stable; none of these present an immediate life
threat.
Q2. The PN is monitoring a client receiving a
continuous intravenous heparin infusion. Which
assessment finding requires immediate notification
to the registered nurse (RN)?
A) Mild bruising at the peripheral IV insertion site.
B) An activated partial thromboplastin time (aPTT)
that is 2 times the control value.
C) A platelet count of 180,000/mm³.
D) Active epistaxis and bleeding gums when
brushing teeth.
Answer: D
Rationale: Epistaxis (nosebleeds) and bleeding
gums are clear indicators of systemic bleeding,
which is a major adverse effect of heparin therapy.
Mild bruising at the IV site is a common localized
,finding. An aPTT of 2 times the control is within the
therapeutic range (1.5 to 2.5 times control). A
platelet count of 180,000/mm³ is normal (150,000–
450,000/mm³).
Q3. A 4-year-old child is admitted to the pediatric
unit with a confirmed diagnosis of rubeola
(measles). Which transmission-based precaution
should the PN initiate?
A) Standard precautions only
B) Contact precautions
C) Droplet precautions
D) Airborne precautions
Answer: D
Rationale: Rubeola (measles) is a highly contagious
viral infection transmitted via small-particle
aerosols that remain suspended in the air.
Therefore, airborne precautions (including a
negative-pressure room and N95 respirator use)
are required. Droplet precautions are insufficient,
and contact precautions do not prevent inhalation of
airborne viral particles.
Q4. A client diagnosed with major depressive
disorder tells the PN, "I am a complete failure to my
, family. I just wish I wasn't here anymore." Which
response by the nurse is therapeutic?
A) "You have a beautiful family and so much to live
for, don't say that."
B) "Are you thinking about killing yourself or
planning to harm yourself?"
C) "Don't worry, things will definitely get better if
you give it some time."
D) "Let’s focus on something positive today, like
your upcoming visitors."
Answer: B
Rationale: When a client expresses feelings of
worthlessness and suicidal ideation, the nurse must
directly and explicitly assess for the presence of
suicidal intent or a plan. Reassurance, dismissive
platitudes, or changing the subject are non-
therapeutic blocks that minimize the client's
feelings and compromise safety.
Q5. The PN is reviewing the laboratory results of a
client with type 1 diabetes mellitus who is admitted
with suspected diabetic ketoacidosis (DKA). Which
clinical finding should the nurse expect?
A) Blood glucose of 90 mg/dL and bradycardia
B) Kussmaul respirations and deep, rapid breathing
