PN HESI EXIT EXAM 2026 | HESI PN EXIT EXAM
WITH NGN ACTUAL COMPLETE EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS WITH
RELIABLE RATIONALES PLUS ANSWER KEY
LATEST 2026-2027 UPDATED VERSION ALREADY
GRADED A+ (HESI PN EXIT EXAM)
Good Luck
1. A client with chronic obstructive pulmonary disease (COPD) reports
increasing dyspnea and a productive cough with green sputum. Which
action should the practical nurse (PN) take first?
A. Administer an antipyretic
B. Obtain a sputum culture
C. Encourage increased fluid intake
D. Assess oxygen saturation
D. Assess oxygen saturation
Rationale: The priority is to evaluate oxygenation status, as hypoxia can
rapidly become life-threatening in COPD exacerbation. Obtaining cultures
, and encouraging fluids are important but secondary to ensuring adequate
oxygenation.
2. A client is admitted with heart failure and has 3+ pitting edema in both
lower extremities. Which nursing intervention is most important to include
in the plan of care?
A. Restrict sodium intake
B. Elevate the legs above heart level
C. Measure abdominal girth daily
D. Apply antiembolism stockings
A. Restrict sodium intake
Rationale: Sodium restriction is a cornerstone of heart failure
management to reduce fluid retention. Elevation of legs helps but does
not address the underlying fluid overload. Daily weights, not abdominal
girth, are more specific for fluid status.
3. A client receiving furosemide 40 mg IV push develops muscle weakness and
a heart rate of 48 bpm. The PN suspects which electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
B. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss,
leading to hypokalemia. Manifestations include muscle weakness,
bradycardia, and cardiac dysrhythmias. Hyperkalemia would cause
peaked T waves and possibly tachycardia.
4. A client 2 days post-cholecystectomy reports sudden sharp right upper
quadrant pain, nausea, and vomiting. Vital signs: T 101.2°F (38.4°C), HR 110,
BP 100/60. The PN should suspect which complication?
A. Pulmonary embolism
B. Wound dehiscence
C. Bile leak or retained stone
D. Pancreatitis
C. Bile leak or retained stone
, Rationale: Post-cholecystectomy, sudden return of RUQ pain with fever
and tachycardia suggests a bile leak or retained common bile duct stone.
This requires immediate medical evaluation and possible endoscopic
retrograde cholangiopancreatography (ERCP).
5. A client with diabetes mellitus type 2 has a fasting blood glucose of 220
mg/dL. Which statement by the client indicates a need for further
teaching?
A. “I can skip breakfast if my glucose is high.”
B. “I should check my feet daily for cuts.”
C. “Exercise helps lower my blood sugar.”
D. “I take my metformin with meals.”
A. “I can skip breakfast if my glucose is high.”
Rationale: Skipping meals can lead to hypoglycemia or rebound
hyperglycemia and disrupts glucose control. Clients should eat regular
meals and adjust medication as directed by the provider. The other
statements are correct.
Pharmacology
6. The PN is administering digoxin to a client. Which assessment finding
requires holding the dose and notifying the healthcare provider?
A. Blood pressure 140/90 mmHg
B. Apical pulse 54 bpm
C. Respiratory rate 20/min
D. Temperature 99.5°F (37.5°C)
B. Apical pulse 54 bpm
Rationale: Digoxin can cause bradycardia. Standard practice is to hold the
dose if the apical pulse is below 60 bpm and notify the provider. The other
vital signs are not directly contraindicated.
7. A client with a history of asthma is prescribed propranolol for hypertension.
What is the PN’s priority concern?
A. Hyperglycemia
B. Bronchospasm
C. Tachycardia
D. Urinary retention
, B. Bronchospasm
Rationale: Propranolol is a nonselective beta-blocker that can cause
bronchoconstriction by blocking beta-2 receptors in the lungs. It is
contraindicated in asthma. The client should be monitored for wheezing
and respiratory distress.
8. The PN is teaching a client about warfarin therapy. Which statement by the
client indicates understanding?
A. “I should use a soft-bristle toothbrush.”
B. “I can take aspirin for headaches.”
C. “I will eat more green leafy vegetables.”
D. “I should double the dose if I miss one.”
A. “I should use a soft-bristle toothbrush.”
Rationale: Warfarin increases bleeding risk; a soft-bristle toothbrush
reduces gum trauma. Aspirin potentiates bleeding, green leafy vegetables
(vitamin K) can reduce warfarin’s effect, and doses should never be
doubled.
9. A client is receiving gentamicin IV. Which laboratory value should the PN
monitor most closely for toxicity?
A. Creatinine and BUN
B. Hemoglobin and hematocrit
C. Bilirubin and ALT
D. Serum glucose
A. Creatinine and BUN
Rationale: Aminoglycosides like gentamicin are nephrotoxic and ototoxic.
Kidney function tests (creatinine, BUN) should be monitored closely. Peak
and trough levels may also be ordered.
10.A client on lithium carbonate reports fine hand tremors, thirst, and
polyuria. What is the PN’s best action?
A. Hold the lithium and notify the provider
B. Encourage increased fluid intake and report symptoms
C. Administer an anticholinergic as needed
D. Restrict sodium intake
B. Encourage increased fluid intake and report symptoms
WITH NGN ACTUAL COMPLETE EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS WITH
RELIABLE RATIONALES PLUS ANSWER KEY
LATEST 2026-2027 UPDATED VERSION ALREADY
GRADED A+ (HESI PN EXIT EXAM)
Good Luck
1. A client with chronic obstructive pulmonary disease (COPD) reports
increasing dyspnea and a productive cough with green sputum. Which
action should the practical nurse (PN) take first?
A. Administer an antipyretic
B. Obtain a sputum culture
C. Encourage increased fluid intake
D. Assess oxygen saturation
D. Assess oxygen saturation
Rationale: The priority is to evaluate oxygenation status, as hypoxia can
rapidly become life-threatening in COPD exacerbation. Obtaining cultures
, and encouraging fluids are important but secondary to ensuring adequate
oxygenation.
2. A client is admitted with heart failure and has 3+ pitting edema in both
lower extremities. Which nursing intervention is most important to include
in the plan of care?
A. Restrict sodium intake
B. Elevate the legs above heart level
C. Measure abdominal girth daily
D. Apply antiembolism stockings
A. Restrict sodium intake
Rationale: Sodium restriction is a cornerstone of heart failure
management to reduce fluid retention. Elevation of legs helps but does
not address the underlying fluid overload. Daily weights, not abdominal
girth, are more specific for fluid status.
3. A client receiving furosemide 40 mg IV push develops muscle weakness and
a heart rate of 48 bpm. The PN suspects which electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
B. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss,
leading to hypokalemia. Manifestations include muscle weakness,
bradycardia, and cardiac dysrhythmias. Hyperkalemia would cause
peaked T waves and possibly tachycardia.
4. A client 2 days post-cholecystectomy reports sudden sharp right upper
quadrant pain, nausea, and vomiting. Vital signs: T 101.2°F (38.4°C), HR 110,
BP 100/60. The PN should suspect which complication?
A. Pulmonary embolism
B. Wound dehiscence
C. Bile leak or retained stone
D. Pancreatitis
C. Bile leak or retained stone
, Rationale: Post-cholecystectomy, sudden return of RUQ pain with fever
and tachycardia suggests a bile leak or retained common bile duct stone.
This requires immediate medical evaluation and possible endoscopic
retrograde cholangiopancreatography (ERCP).
5. A client with diabetes mellitus type 2 has a fasting blood glucose of 220
mg/dL. Which statement by the client indicates a need for further
teaching?
A. “I can skip breakfast if my glucose is high.”
B. “I should check my feet daily for cuts.”
C. “Exercise helps lower my blood sugar.”
D. “I take my metformin with meals.”
A. “I can skip breakfast if my glucose is high.”
Rationale: Skipping meals can lead to hypoglycemia or rebound
hyperglycemia and disrupts glucose control. Clients should eat regular
meals and adjust medication as directed by the provider. The other
statements are correct.
Pharmacology
6. The PN is administering digoxin to a client. Which assessment finding
requires holding the dose and notifying the healthcare provider?
A. Blood pressure 140/90 mmHg
B. Apical pulse 54 bpm
C. Respiratory rate 20/min
D. Temperature 99.5°F (37.5°C)
B. Apical pulse 54 bpm
Rationale: Digoxin can cause bradycardia. Standard practice is to hold the
dose if the apical pulse is below 60 bpm and notify the provider. The other
vital signs are not directly contraindicated.
7. A client with a history of asthma is prescribed propranolol for hypertension.
What is the PN’s priority concern?
A. Hyperglycemia
B. Bronchospasm
C. Tachycardia
D. Urinary retention
, B. Bronchospasm
Rationale: Propranolol is a nonselective beta-blocker that can cause
bronchoconstriction by blocking beta-2 receptors in the lungs. It is
contraindicated in asthma. The client should be monitored for wheezing
and respiratory distress.
8. The PN is teaching a client about warfarin therapy. Which statement by the
client indicates understanding?
A. “I should use a soft-bristle toothbrush.”
B. “I can take aspirin for headaches.”
C. “I will eat more green leafy vegetables.”
D. “I should double the dose if I miss one.”
A. “I should use a soft-bristle toothbrush.”
Rationale: Warfarin increases bleeding risk; a soft-bristle toothbrush
reduces gum trauma. Aspirin potentiates bleeding, green leafy vegetables
(vitamin K) can reduce warfarin’s effect, and doses should never be
doubled.
9. A client is receiving gentamicin IV. Which laboratory value should the PN
monitor most closely for toxicity?
A. Creatinine and BUN
B. Hemoglobin and hematocrit
C. Bilirubin and ALT
D. Serum glucose
A. Creatinine and BUN
Rationale: Aminoglycosides like gentamicin are nephrotoxic and ototoxic.
Kidney function tests (creatinine, BUN) should be monitored closely. Peak
and trough levels may also be ordered.
10.A client on lithium carbonate reports fine hand tremors, thirst, and
polyuria. What is the PN’s best action?
A. Hold the lithium and notify the provider
B. Encourage increased fluid intake and report symptoms
C. Administer an anticholinergic as needed
D. Restrict sodium intake
B. Encourage increased fluid intake and report symptoms
