HESI PN EXIT EXAM VERSION 4 (V4)
2026/2027 | NGN-STYLE PRACTICE
QUESTIONS, VERIFIED ANSWERS &
DETAILED RATIONALES | A+ STUDY GUIDE |
JUST RELEASED PDF
HESI PN EXIT EXAM V4 (2026/2027) – NGN-STYLE PRACTICE QUESTIONS
Document Overview:
• Comprehensive question study guide designed for exam readiness with verified
answers, detailed rationales, and NGN-style formatting to mirror actual HESI PN
EXIT exam conditions • Use these questions for progressive learning: review weak
areas, focus on rationales to understand "why," and time yourself to build test-
taking stamina and confidence
QUESTION 1
A patient with diabetes mellitus type 2 is admitted to the unit. Which of the
following laboratory values would indicate the need for immediate
intervention?
A) Fasting blood glucose of 110 mg/dL
B) HbA1c of 7.5%
C) Random blood glucose of 450 mg/dL
D) Fasting blood glucose of 100 mg/dL
E) Postprandial glucose of 140 mg/dL
CORRECT ANSWER: C) Random blood glucose of 450 mg/dL
RATIONALE: A random blood glucose of 450 mg/dL is critically elevated and
requires immediate intervention to prevent diabetic ketoacidosis (DKA) or
hyperosmolar hyperglycemic state (HHS). This level indicates severe hyperglycemia.
A fasting glucose of 110 mg/dL is acceptable for diabetics; HbA1c of 7.5% is within
target range for most diabetic patients; fasting glucose of 100 mg/dL is normal to
,slightly elevated; postprandial glucose of 140 mg/dL is acceptable. Immediate
intervention includes IV fluids, insulin therapy, and electrolyte monitoring.
QUESTION 2
A nurse is caring for a 72-year-old male patient admitted with acute
myocardial infarction (MI). Which assessment finding would require the most
immediate nursing intervention?
A) Blood pressure of 132/88 mmHg
B) Chest pain rated 8/10 unrelieved by nitroglycerin
C) Heart rate of 88 beats per minute
D) Respiratory rate of 18 breaths per minute
E) Temperature of 37.2°C (99°F)
CORRECT ANSWER: B) Chest pain rated 8/10 unrelieved by nitroglycerin
RATIONALE: Chest pain unrelieved by nitroglycerin in an MI patient indicates
ongoing myocardial ischemia and requires immediate intervention. This could
indicate progression of infarction or complications. Immediate actions include
administering additional analgesics (possibly morphine), notifying the provider, and
ensuring continuous cardiac monitoring. The other vital signs are within normal
limits and do not indicate acute distress requiring immediate intervention. Pain
control is essential to reduce anxiety and oxygen demand on the compromised
myocardium.
QUESTION 3
A patient receiving chemotherapy complains of severe nausea and vomiting.
Which nursing action is most appropriate initially?
A) Encourage the patient to eat small frequent meals
B) Administer prescribed antiemetic 30 minutes before meals
,C) Position the patient upright after meals
D) Provide ice chips and cold beverages
E) Withhold all oral intake for 4 hours
CORRECT ANSWER: B) Administer prescribed antiemetic 30 minutes before
meals
RATIONALE: Administering antiemetics prophylactically (before nausea occurs) is
more effective than treating established nausea. Giving the medication 30 minutes
before meals allows time for the drug to take effect. Chemotherapy-induced
nausea and vomiting (CINV) is better prevented than treated. Encouraging eating
before medication is ineffective; ice chips and cold beverages may trigger nausea;
withholding oral intake is unnecessary and compromises nutrition; positioning is
helpful but doesn't address the underlying problem. Antiemetics work best when
administered preventively rather than reactively.
QUESTION 4
A patient with chronic kidney disease stage 4 has a serum potassium level of
6.2 mEq/L. Which dietary instruction should the nurse provide?
A) Increase intake of bananas and orange juice
B) Restrict potassium-containing foods such as potatoes and tomatoes
C) Consume only fresh fruits and vegetables
D) Increase protein intake to maintain muscle mass
E) Drink at least 3 liters of fluid daily
CORRECT ANSWER: B) Restrict potassium-containing foods such as potatoes
and tomatoes
RATIONALE: Hyperkalemia in CKD stage 4 requires dietary potassium restriction
because the kidneys cannot effectively excrete potassium. High-potassium foods
like bananas, orange juice, potatoes, and tomatoes must be limited. A serum
potassium of 6.2 mEq/L (normal 3.5-5.0) is dangerously elevated and increases risk
, of cardiac dysrhythmias. Options A and C would worsen hyperkalemia; increased
protein may increase potassium load; excessive fluid intake may worsen fluid
retention. Dietary restriction of potassium is a key management strategy in
advanced CKD.
QUESTION 5
A nurse is assessing a patient with COPD who is experiencing an acute
exacerbation. Which finding would indicate respiratory acidosis?
A) pH 7.45, PaCO2 32 mmHg, HCO3- 24 mEq/L
B) pH 7.32, PaCO2 55 mmHg, HCO3- 24 mEq/L
C) pH 7.48, PaCO2 40 mmHg, HCO3- 28 mEq/L
D) pH 7.38, PaCO2 45 mmHg, HCO3- 26 mEq/L
E) pH 7.42, PaCO2 38 mmHg, HCO3- 22 mEq/L
CORRECT ANSWER: B) pH 7.32, PaCO2 55 mmHg, HCO3- 24 mEq/L
RATIONALE: Respiratory acidosis is characterized by low pH (<7.35) and elevated
PaCO2 (>45 mmHg). Option B shows pH of 7.32 (acidic) and PaCO2 of 55 mmHg
(high CO2 retention). In COPD exacerbation, patients cannot effectively eliminate
CO2, leading to hypercapnia and acidosis. Option A shows respiratory alkalosis;
Option C shows metabolic alkalosis; Options D and E are normal values.
Recognizing this acid-base disturbance is crucial for appropriate interventions such
as oxygen therapy and respiratory support.
QUESTION 6
A patient post-operative day 1 from abdominal surgery has a temperature of
38.5°C (101.3°F) and reports incisional pain rated 7/10. The surgical site shows
some erythema and drainage. Which nursing action is priority?
A) Apply warm compresses to the incision
2026/2027 | NGN-STYLE PRACTICE
QUESTIONS, VERIFIED ANSWERS &
DETAILED RATIONALES | A+ STUDY GUIDE |
JUST RELEASED PDF
HESI PN EXIT EXAM V4 (2026/2027) – NGN-STYLE PRACTICE QUESTIONS
Document Overview:
• Comprehensive question study guide designed for exam readiness with verified
answers, detailed rationales, and NGN-style formatting to mirror actual HESI PN
EXIT exam conditions • Use these questions for progressive learning: review weak
areas, focus on rationales to understand "why," and time yourself to build test-
taking stamina and confidence
QUESTION 1
A patient with diabetes mellitus type 2 is admitted to the unit. Which of the
following laboratory values would indicate the need for immediate
intervention?
A) Fasting blood glucose of 110 mg/dL
B) HbA1c of 7.5%
C) Random blood glucose of 450 mg/dL
D) Fasting blood glucose of 100 mg/dL
E) Postprandial glucose of 140 mg/dL
CORRECT ANSWER: C) Random blood glucose of 450 mg/dL
RATIONALE: A random blood glucose of 450 mg/dL is critically elevated and
requires immediate intervention to prevent diabetic ketoacidosis (DKA) or
hyperosmolar hyperglycemic state (HHS). This level indicates severe hyperglycemia.
A fasting glucose of 110 mg/dL is acceptable for diabetics; HbA1c of 7.5% is within
target range for most diabetic patients; fasting glucose of 100 mg/dL is normal to
,slightly elevated; postprandial glucose of 140 mg/dL is acceptable. Immediate
intervention includes IV fluids, insulin therapy, and electrolyte monitoring.
QUESTION 2
A nurse is caring for a 72-year-old male patient admitted with acute
myocardial infarction (MI). Which assessment finding would require the most
immediate nursing intervention?
A) Blood pressure of 132/88 mmHg
B) Chest pain rated 8/10 unrelieved by nitroglycerin
C) Heart rate of 88 beats per minute
D) Respiratory rate of 18 breaths per minute
E) Temperature of 37.2°C (99°F)
CORRECT ANSWER: B) Chest pain rated 8/10 unrelieved by nitroglycerin
RATIONALE: Chest pain unrelieved by nitroglycerin in an MI patient indicates
ongoing myocardial ischemia and requires immediate intervention. This could
indicate progression of infarction or complications. Immediate actions include
administering additional analgesics (possibly morphine), notifying the provider, and
ensuring continuous cardiac monitoring. The other vital signs are within normal
limits and do not indicate acute distress requiring immediate intervention. Pain
control is essential to reduce anxiety and oxygen demand on the compromised
myocardium.
QUESTION 3
A patient receiving chemotherapy complains of severe nausea and vomiting.
Which nursing action is most appropriate initially?
A) Encourage the patient to eat small frequent meals
B) Administer prescribed antiemetic 30 minutes before meals
,C) Position the patient upright after meals
D) Provide ice chips and cold beverages
E) Withhold all oral intake for 4 hours
CORRECT ANSWER: B) Administer prescribed antiemetic 30 minutes before
meals
RATIONALE: Administering antiemetics prophylactically (before nausea occurs) is
more effective than treating established nausea. Giving the medication 30 minutes
before meals allows time for the drug to take effect. Chemotherapy-induced
nausea and vomiting (CINV) is better prevented than treated. Encouraging eating
before medication is ineffective; ice chips and cold beverages may trigger nausea;
withholding oral intake is unnecessary and compromises nutrition; positioning is
helpful but doesn't address the underlying problem. Antiemetics work best when
administered preventively rather than reactively.
QUESTION 4
A patient with chronic kidney disease stage 4 has a serum potassium level of
6.2 mEq/L. Which dietary instruction should the nurse provide?
A) Increase intake of bananas and orange juice
B) Restrict potassium-containing foods such as potatoes and tomatoes
C) Consume only fresh fruits and vegetables
D) Increase protein intake to maintain muscle mass
E) Drink at least 3 liters of fluid daily
CORRECT ANSWER: B) Restrict potassium-containing foods such as potatoes
and tomatoes
RATIONALE: Hyperkalemia in CKD stage 4 requires dietary potassium restriction
because the kidneys cannot effectively excrete potassium. High-potassium foods
like bananas, orange juice, potatoes, and tomatoes must be limited. A serum
potassium of 6.2 mEq/L (normal 3.5-5.0) is dangerously elevated and increases risk
, of cardiac dysrhythmias. Options A and C would worsen hyperkalemia; increased
protein may increase potassium load; excessive fluid intake may worsen fluid
retention. Dietary restriction of potassium is a key management strategy in
advanced CKD.
QUESTION 5
A nurse is assessing a patient with COPD who is experiencing an acute
exacerbation. Which finding would indicate respiratory acidosis?
A) pH 7.45, PaCO2 32 mmHg, HCO3- 24 mEq/L
B) pH 7.32, PaCO2 55 mmHg, HCO3- 24 mEq/L
C) pH 7.48, PaCO2 40 mmHg, HCO3- 28 mEq/L
D) pH 7.38, PaCO2 45 mmHg, HCO3- 26 mEq/L
E) pH 7.42, PaCO2 38 mmHg, HCO3- 22 mEq/L
CORRECT ANSWER: B) pH 7.32, PaCO2 55 mmHg, HCO3- 24 mEq/L
RATIONALE: Respiratory acidosis is characterized by low pH (<7.35) and elevated
PaCO2 (>45 mmHg). Option B shows pH of 7.32 (acidic) and PaCO2 of 55 mmHg
(high CO2 retention). In COPD exacerbation, patients cannot effectively eliminate
CO2, leading to hypercapnia and acidosis. Option A shows respiratory alkalosis;
Option C shows metabolic alkalosis; Options D and E are normal values.
Recognizing this acid-base disturbance is crucial for appropriate interventions such
as oxygen therapy and respiratory support.
QUESTION 6
A patient post-operative day 1 from abdominal surgery has a temperature of
38.5°C (101.3°F) and reports incisional pain rated 7/10. The surgical site shows
some erythema and drainage. Which nursing action is priority?
A) Apply warm compresses to the incision
