HESI PN EXIT EXAM COMPREHENSIVE
PRACTICE QUESTIONS AND ANSWERS
1. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse notes the client’s oxygen saturation is 88%. Which action should
the nurse take first?
A. Increase the oxygen flow to 4 L/min
B. Notify the healthcare provider immediately
C. Assess the client’s respiratory rate and effort
D. Place the client in a Trendelenburg position
Answer: C
Conceptual Explanation: Assessment is the first step of the nursing process. For a COPD
client, an O2 saturation of 88-92% is often acceptable, but the nurse must first assess the
clinical status before intervening or notifying the provider.
2. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which intervention should the nurse implement to prevent dislocation?
A. Keep the affected leg adducted
,B. Encourage the client to cross their legs when sitting
C. Place an abductor pillow between the client’s legs
D. Maintain the hip in a flexed position greater than 90 degrees
Answer: C
Conceptual Explanation: To prevent hip dislocation post-arthroplasty, the hip should be
maintained in abduction. Adduction, crossing legs, and flexion beyond 90 degrees increase
the risk of dislocation.
3. A client is prescribed digoxin 0.25 mg daily. Which assessment finding should the nurse
identify as a primary sign of digoxin toxicity?
A. Visual disturbances such as yellow halos
B. Hypertension
C. Tachycardia
D. Increased appetite
Answer: A
Conceptual Explanation: Common signs of digoxin toxicity include visual changes
(yellow/green halos), nausea, vomiting, and bradycardia.
4. A nurse is preparing to administer regular insulin and NPH insulin in the same syringe.
Which action should the nurse take first?
A. Draw up the NPH insulin first
, B. Mix the two insulins by shaking the vials
C. Inject air into the regular insulin vial
D. Inject air into the NPH insulin vial
Answer: D
Conceptual Explanation: The correct sequence for mixing insulin is to inject air into the
NPH (cloudy), then air into the regular (clear), then draw up regular, then draw up NPH.
Air into NPH is the first step.
5. A client with type 1 diabetes mellitus reports feeling shaky, sweaty, and hungry. What is
the priority nursing action?
A. Check the client’s blood glucose level
B. Administer a dose of regular insulin
C. Call the healthcare provider
D. Offer a complex carbohydrate snack
Answer: A
Conceptual Explanation: The symptoms suggest hypoglycemia. The nurse should verify
the blood glucose level immediately to determine the severity before treating.
6. Which of the following findings should the nurse expect in a client diagnosed with Grave’s
disease?
A. Exophthalmos
PRACTICE QUESTIONS AND ANSWERS
1. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse notes the client’s oxygen saturation is 88%. Which action should
the nurse take first?
A. Increase the oxygen flow to 4 L/min
B. Notify the healthcare provider immediately
C. Assess the client’s respiratory rate and effort
D. Place the client in a Trendelenburg position
Answer: C
Conceptual Explanation: Assessment is the first step of the nursing process. For a COPD
client, an O2 saturation of 88-92% is often acceptable, but the nurse must first assess the
clinical status before intervening or notifying the provider.
2. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which intervention should the nurse implement to prevent dislocation?
A. Keep the affected leg adducted
,B. Encourage the client to cross their legs when sitting
C. Place an abductor pillow between the client’s legs
D. Maintain the hip in a flexed position greater than 90 degrees
Answer: C
Conceptual Explanation: To prevent hip dislocation post-arthroplasty, the hip should be
maintained in abduction. Adduction, crossing legs, and flexion beyond 90 degrees increase
the risk of dislocation.
3. A client is prescribed digoxin 0.25 mg daily. Which assessment finding should the nurse
identify as a primary sign of digoxin toxicity?
A. Visual disturbances such as yellow halos
B. Hypertension
C. Tachycardia
D. Increased appetite
Answer: A
Conceptual Explanation: Common signs of digoxin toxicity include visual changes
(yellow/green halos), nausea, vomiting, and bradycardia.
4. A nurse is preparing to administer regular insulin and NPH insulin in the same syringe.
Which action should the nurse take first?
A. Draw up the NPH insulin first
, B. Mix the two insulins by shaking the vials
C. Inject air into the regular insulin vial
D. Inject air into the NPH insulin vial
Answer: D
Conceptual Explanation: The correct sequence for mixing insulin is to inject air into the
NPH (cloudy), then air into the regular (clear), then draw up regular, then draw up NPH.
Air into NPH is the first step.
5. A client with type 1 diabetes mellitus reports feeling shaky, sweaty, and hungry. What is
the priority nursing action?
A. Check the client’s blood glucose level
B. Administer a dose of regular insulin
C. Call the healthcare provider
D. Offer a complex carbohydrate snack
Answer: A
Conceptual Explanation: The symptoms suggest hypoglycemia. The nurse should verify
the blood glucose level immediately to determine the severity before treating.
6. Which of the following findings should the nurse expect in a client diagnosed with Grave’s
disease?
A. Exophthalmos
