HESI PN EXIT EXAM MASTER
BLUEPRINT 2024 150 CORRECT
VERIFIED ANSWERS GRADE
A+ MATERIAL | INSTANT
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1. The practical nurse (PN) is collecting data from a client
who has a history of chronic obstructive pulmonary
disease (COPD) and is experiencing acute shortness of
breath. Which clinical finding should the PN report to the
charge nurse immediately as a sign of impending
respiratory failure?
A) A productive cough yielding a moderate amount of
thick, white sputum.
B) An oxygen saturation level fluctuating between 89%
and 91% on room air.
C) Increased use of accessory muscles, intercostal
retractions, and paradoxical chest wall movement.
D) Auscultation of bilateral expiratory wheezes throughout
the lower lung fields.
Correct Answer: C) Increased use of accessory
muscles, intercostal retractions, and paradoxical
chest wall movement.
Rationale: Paradoxical chest wall movement and
severe retractions indicate respiratory muscle exhaustion
and impending respiratory failure, which require
immediate medical intervention. Clients with COPD
routinely exhibit oxygen saturations around 90% and
, expiratory wheezes, which are expected manifestations of
their chronic disease state.
2. A client diagnosed with Type 2 diabetes mellitus is
prescribed subcutaneous insulin glargine daily at bedtime.
Which information should the PN emphasize when
reinforcing teaching with this client regarding this
medication?
A) The medication should be mixed in the same syringe
with short-acting regular insulin to reduce the number of
daily injections.
B) The insulin should be administered only when the pre-
meal blood glucose reading exceeds 200 mg/dL.
C) This medication has a continuous, peakless action
profile over 24 hours and should be taken at the same time
every day.
D) Vigorous massaged of the injection site is necessary
immediately after administration to accelerate absorption.
Correct Answer: C) This medication has a
continuous, peakless action profile over 24 hours
and should be taken at the same time every day.
Rationale: Insulin glargine is a long-acting insulin
with a peakless duration of action lasting approximately
24 hours. Because it provides a steady baseline level of
insulin, it must never be mixed in the same syringe with
any other insulin and should be administered consistently
at the same time daily.
3. The PN is caring for a client who is recovering from a
subtotal thyroidectomy. Which clinical manifestation
should the PN monitor for closely to detect accidental
parathyroid gland damage or removal?
A) Severe generalized muscle atrophy and
hyperpigmentation of the skin surfaces.
B) Profuse diaphoresis, bradycardia, and a sudden drop in
core body temperature.
, C) Intermittent numbness and tingling of the fingers,
muscle twitching, and a positive Chvostek's sign.
D) Significant weight gain accompanied by increased
lethargy and a coarse hair texture.
Correct Answer: C) Intermittent numbness and
tingling of the fingers, muscle twitching, and a
positive Chvostek's sign.
Rationale: Accidental removal or injury to the
parathyroid glands during a thyroidectomy causes
hypoparathyroidism, leading to severe hypocalcaemia.
Early clinical indicators include neuromuscular
irritability, perioral numbness, tingling in the
extremities, and a positive Chvostek's or Trousseau's sign.
4. A client who is 2 days postoperative following an open
cholecystectomy refuses to ambulate or perform deep-
breathing exercises because of severe abdominal pain.
Which action should the PN implement first?
A) Administer the prescribed PRN opioid analgesic
medication and re-evaluate the pain level in 30 to 45
minutes before attempting any physical activity.
B) Document the client's non-compliance in the electronic
medical record and notify the attending surgeon during
afternoon rounds.
C) Explain to the client that failing to ambulate will result
in a prolonged hospital stay and increase the risk of deep
vein thrombosis.
D) Instruct the client's family members to gently assist the
client out of bed onto the bedside chair without further
delay.
Correct Answer: A) Administer the prescribed
PRN opioid analgesic medication and re-evaluate
the pain level in 30 to 45 minutes before
attempting any physical activity.
Rationale: Uncontrolled postoperative pain prevents
, the client from participating in vital recovery tasks like
ambulation and incentive spirometry, increasing the risk
of atelectasis and pneumonia. Medicating the client first
ensures pain control, making subsequent physical
movement tolerable and safe.
5. The PN is assigned to care for a client who has a chest tube
connected to a water-seal drainage system. While assisting
the client from the bed to a wheelchair, the PN notes that
the chest tube has accidentally become disconnected from
the drainage collection system. Which immediate action
should the PN take?
A) Clamp the chest tube close to the client's chest wall
using padded hemostats to block air movement.
B) Submerge the distal end of the disconnected chest tube
in a bottle of sterile water to re-establish a water seal.
C) Cover the insertion site completely with a tight,
occlusive petroleum gauze dressing tape.
D) Raise the drainage collection system above the level of
the client's chest to drain remaining fluids.
Correct Answer: B) Submerge the disconnected
distal end of the chest tube in a bottle of sterile
water to re-establish a water seal.
Rationale: If a chest tube becomes disconnected from
its system, placing the distal end of the tube 1 to 2 inches
into a container of sterile saline or water creates an
emergency water seal. This prevents atmospheric air
from entering the pleural space, reducing the risk of a
tension pneumothorax while a new drainage system is
prepared.
6. The PN is monitoring a client who is receiving a
continuous intravenous infusion of magnesium sulfate for
preeclampsia. Which finding should the PN report to the
charge nurse immediately as an indicator of magnesium
toxicity?
BLUEPRINT 2024 150 CORRECT
VERIFIED ANSWERS GRADE
A+ MATERIAL | INSTANT
DOWNLOAD | 100% PASS
GUARANTEE
1. The practical nurse (PN) is collecting data from a client
who has a history of chronic obstructive pulmonary
disease (COPD) and is experiencing acute shortness of
breath. Which clinical finding should the PN report to the
charge nurse immediately as a sign of impending
respiratory failure?
A) A productive cough yielding a moderate amount of
thick, white sputum.
B) An oxygen saturation level fluctuating between 89%
and 91% on room air.
C) Increased use of accessory muscles, intercostal
retractions, and paradoxical chest wall movement.
D) Auscultation of bilateral expiratory wheezes throughout
the lower lung fields.
Correct Answer: C) Increased use of accessory
muscles, intercostal retractions, and paradoxical
chest wall movement.
Rationale: Paradoxical chest wall movement and
severe retractions indicate respiratory muscle exhaustion
and impending respiratory failure, which require
immediate medical intervention. Clients with COPD
routinely exhibit oxygen saturations around 90% and
, expiratory wheezes, which are expected manifestations of
their chronic disease state.
2. A client diagnosed with Type 2 diabetes mellitus is
prescribed subcutaneous insulin glargine daily at bedtime.
Which information should the PN emphasize when
reinforcing teaching with this client regarding this
medication?
A) The medication should be mixed in the same syringe
with short-acting regular insulin to reduce the number of
daily injections.
B) The insulin should be administered only when the pre-
meal blood glucose reading exceeds 200 mg/dL.
C) This medication has a continuous, peakless action
profile over 24 hours and should be taken at the same time
every day.
D) Vigorous massaged of the injection site is necessary
immediately after administration to accelerate absorption.
Correct Answer: C) This medication has a
continuous, peakless action profile over 24 hours
and should be taken at the same time every day.
Rationale: Insulin glargine is a long-acting insulin
with a peakless duration of action lasting approximately
24 hours. Because it provides a steady baseline level of
insulin, it must never be mixed in the same syringe with
any other insulin and should be administered consistently
at the same time daily.
3. The PN is caring for a client who is recovering from a
subtotal thyroidectomy. Which clinical manifestation
should the PN monitor for closely to detect accidental
parathyroid gland damage or removal?
A) Severe generalized muscle atrophy and
hyperpigmentation of the skin surfaces.
B) Profuse diaphoresis, bradycardia, and a sudden drop in
core body temperature.
, C) Intermittent numbness and tingling of the fingers,
muscle twitching, and a positive Chvostek's sign.
D) Significant weight gain accompanied by increased
lethargy and a coarse hair texture.
Correct Answer: C) Intermittent numbness and
tingling of the fingers, muscle twitching, and a
positive Chvostek's sign.
Rationale: Accidental removal or injury to the
parathyroid glands during a thyroidectomy causes
hypoparathyroidism, leading to severe hypocalcaemia.
Early clinical indicators include neuromuscular
irritability, perioral numbness, tingling in the
extremities, and a positive Chvostek's or Trousseau's sign.
4. A client who is 2 days postoperative following an open
cholecystectomy refuses to ambulate or perform deep-
breathing exercises because of severe abdominal pain.
Which action should the PN implement first?
A) Administer the prescribed PRN opioid analgesic
medication and re-evaluate the pain level in 30 to 45
minutes before attempting any physical activity.
B) Document the client's non-compliance in the electronic
medical record and notify the attending surgeon during
afternoon rounds.
C) Explain to the client that failing to ambulate will result
in a prolonged hospital stay and increase the risk of deep
vein thrombosis.
D) Instruct the client's family members to gently assist the
client out of bed onto the bedside chair without further
delay.
Correct Answer: A) Administer the prescribed
PRN opioid analgesic medication and re-evaluate
the pain level in 30 to 45 minutes before
attempting any physical activity.
Rationale: Uncontrolled postoperative pain prevents
, the client from participating in vital recovery tasks like
ambulation and incentive spirometry, increasing the risk
of atelectasis and pneumonia. Medicating the client first
ensures pain control, making subsequent physical
movement tolerable and safe.
5. The PN is assigned to care for a client who has a chest tube
connected to a water-seal drainage system. While assisting
the client from the bed to a wheelchair, the PN notes that
the chest tube has accidentally become disconnected from
the drainage collection system. Which immediate action
should the PN take?
A) Clamp the chest tube close to the client's chest wall
using padded hemostats to block air movement.
B) Submerge the distal end of the disconnected chest tube
in a bottle of sterile water to re-establish a water seal.
C) Cover the insertion site completely with a tight,
occlusive petroleum gauze dressing tape.
D) Raise the drainage collection system above the level of
the client's chest to drain remaining fluids.
Correct Answer: B) Submerge the disconnected
distal end of the chest tube in a bottle of sterile
water to re-establish a water seal.
Rationale: If a chest tube becomes disconnected from
its system, placing the distal end of the tube 1 to 2 inches
into a container of sterile saline or water creates an
emergency water seal. This prevents atmospheric air
from entering the pleural space, reducing the risk of a
tension pneumothorax while a new drainage system is
prepared.
6. The PN is monitoring a client who is receiving a
continuous intravenous infusion of magnesium sulfate for
preeclampsia. Which finding should the PN report to the
charge nurse immediately as an indicator of magnesium
toxicity?
