HESI PN EXIT EXAM WITH NGN V1-V7 |
ACTUAL EXAM | ACTUAL QUESTIONS &
ANSWERS | LATEST 2026/2027 | 100%
VERIFIED.
Core Domains
• Fundamentals of Nursing and Patient Safety
• Medical-Surgical Nursing and Chronic Illness Management
• Maternal-Newborn and Pediatric Nursing
• Mental Health Nursing and Psychosocial Integrity
• Pharmacology and Medication Administration
• Nutrition, Fluid, and Electrolyte Balance
• Infection Control and Antimicrobial Stewardship
• Prioritization, Delegation, and Clinical Judgment
Introduction
The HESI PN Exit Exam with Next Generation NCLEX (NGN) is a
comprehensive assessment designed to evaluate the clinical judgment and
nursing knowledge of practical nursing students prior to graduation. This
exam assesses competencies across fundamentals, medical-surgical, maternal-
newborn, pediatric, and mental health nursing. The NGN format emphasizes
clinical reasoning through case studies, extended multiple-choice, and
prioritization scenarios. The exam tests application of the nursing process,
patient safety, and evidence-based practice. Emphasis is placed on decision-
making, communication, and safe delegation to ensure readiness for entry-
level practical nursing practice.
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is assessing a client with heart failure who reports increased
shortness of breath and fatigue. The nurse notes bilateral crackles in the lung
bases and 2+ pitting edema in the lower extremities. Which intervention
should the nurse implement first?
A. Administer furosemide as prescribed
B. Place the client in high Fowler's position
C. Obtain a stat 12-lead ECG
D. Restrict the client's fluid intake
Correct answer: B. Place the client in high Fowler's position
RATIONALE: Positioning the client in high Fowler's position promotes
lung expansion and improves oxygenation by reducing venous return and
decreasing pulmonary congestion. This is an immediate, non-invasive
intervention that should be performed before administering medications or
obtaining diagnostics .
Question 2
A practical nurse (PN) is caring for a client receiving digoxin. Which
assessment finding should the PN report to the registered nurse (RN)
immediately?
A. Apical pulse of 58 beats per minute
B. Blood pressure of 118/76 mm Hg
C. Serum potassium level of 4.0 mEq/L
D. Respiratory rate of 18 breaths per minute
Correct answer: A. Apical pulse of 58 beats per minute
RATIONALE: Digoxin should be withheld if the apical pulse is below 60
beats per minute in adults. The PN must notify the RN before administering
,the medication to prevent digoxin toxicity and potential life-threatening
dysrhythmias .
Question 3
A client with type 1 diabetes mellitus is found unresponsive with a blood
glucose level of 42 mg/dL. Which action should the PN take first?
A. Administer glucagon intramuscularly as prescribed
B. Start an intravenous line for dextrose administration
C. Place the client in a side-lying position
D. Obtain a repeat blood glucose reading
Correct answer: A. Administer glucagon intramuscularly as prescribed
RATIONALE: For an unresponsive client with hypoglycemia, glucagon
should be administered intramuscularly or subcutaneously as prescribed.
Oral glucose is contraindicated due to aspiration risk. This is a life-
threatening emergency requiring immediate intervention .
Question 4
A nurse is caring for a client with a new colostomy. Which finding requires
immediate intervention?
A. Stoma is pink and moist
B. Small amount of bleeding at the stoma site
C. Stoma is dark purple and dry
D. Output is liquid to semi-formed
Correct answer: C. Stoma is dark purple and dry
RATIONALE: A dark purple or black, dry stoma indicates ischemia or
necrosis of the stoma tissue. This requires immediate notification of the
, healthcare provider as it may indicate compromised blood supply requiring
surgical intervention .
Question 5
A client is admitted with a suspected pulmonary embolism. Which
assessment finding is most concerning?
A. Sudden onset of dyspnea and pleuritic chest pain
B. Mild fatigue with activity
C. Low-grade fever of 100.2°F
D. Productive cough with clear sputum
Correct answer: A. Sudden onset of dyspnea and pleuritic chest pain
RATIONALE: Sudden onset of dyspnea and pleuritic chest pain is the
classic presentation of pulmonary embolism, a life-threatening emergency
requiring immediate intervention. The PN should report this to the RN
immediately .
Question 6
A nurse is preparing to administer a blood transfusion. Which action should
the nurse take first?
A. Obtain informed consent
B. Verify the blood product with another nurse
C. Assess baseline vital signs
D. Prime the blood administration tubing
Correct answer: C. Assess baseline vital signs
RATIONALE: Baseline vital signs must be obtained prior to initiating a
blood transfusion to establish a comparison point for detecting transfusion
reactions. This is the first step in the transfusion process .
ACTUAL EXAM | ACTUAL QUESTIONS &
ANSWERS | LATEST 2026/2027 | 100%
VERIFIED.
Core Domains
• Fundamentals of Nursing and Patient Safety
• Medical-Surgical Nursing and Chronic Illness Management
• Maternal-Newborn and Pediatric Nursing
• Mental Health Nursing and Psychosocial Integrity
• Pharmacology and Medication Administration
• Nutrition, Fluid, and Electrolyte Balance
• Infection Control and Antimicrobial Stewardship
• Prioritization, Delegation, and Clinical Judgment
Introduction
The HESI PN Exit Exam with Next Generation NCLEX (NGN) is a
comprehensive assessment designed to evaluate the clinical judgment and
nursing knowledge of practical nursing students prior to graduation. This
exam assesses competencies across fundamentals, medical-surgical, maternal-
newborn, pediatric, and mental health nursing. The NGN format emphasizes
clinical reasoning through case studies, extended multiple-choice, and
prioritization scenarios. The exam tests application of the nursing process,
patient safety, and evidence-based practice. Emphasis is placed on decision-
making, communication, and safe delegation to ensure readiness for entry-
level practical nursing practice.
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is assessing a client with heart failure who reports increased
shortness of breath and fatigue. The nurse notes bilateral crackles in the lung
bases and 2+ pitting edema in the lower extremities. Which intervention
should the nurse implement first?
A. Administer furosemide as prescribed
B. Place the client in high Fowler's position
C. Obtain a stat 12-lead ECG
D. Restrict the client's fluid intake
Correct answer: B. Place the client in high Fowler's position
RATIONALE: Positioning the client in high Fowler's position promotes
lung expansion and improves oxygenation by reducing venous return and
decreasing pulmonary congestion. This is an immediate, non-invasive
intervention that should be performed before administering medications or
obtaining diagnostics .
Question 2
A practical nurse (PN) is caring for a client receiving digoxin. Which
assessment finding should the PN report to the registered nurse (RN)
immediately?
A. Apical pulse of 58 beats per minute
B. Blood pressure of 118/76 mm Hg
C. Serum potassium level of 4.0 mEq/L
D. Respiratory rate of 18 breaths per minute
Correct answer: A. Apical pulse of 58 beats per minute
RATIONALE: Digoxin should be withheld if the apical pulse is below 60
beats per minute in adults. The PN must notify the RN before administering
,the medication to prevent digoxin toxicity and potential life-threatening
dysrhythmias .
Question 3
A client with type 1 diabetes mellitus is found unresponsive with a blood
glucose level of 42 mg/dL. Which action should the PN take first?
A. Administer glucagon intramuscularly as prescribed
B. Start an intravenous line for dextrose administration
C. Place the client in a side-lying position
D. Obtain a repeat blood glucose reading
Correct answer: A. Administer glucagon intramuscularly as prescribed
RATIONALE: For an unresponsive client with hypoglycemia, glucagon
should be administered intramuscularly or subcutaneously as prescribed.
Oral glucose is contraindicated due to aspiration risk. This is a life-
threatening emergency requiring immediate intervention .
Question 4
A nurse is caring for a client with a new colostomy. Which finding requires
immediate intervention?
A. Stoma is pink and moist
B. Small amount of bleeding at the stoma site
C. Stoma is dark purple and dry
D. Output is liquid to semi-formed
Correct answer: C. Stoma is dark purple and dry
RATIONALE: A dark purple or black, dry stoma indicates ischemia or
necrosis of the stoma tissue. This requires immediate notification of the
, healthcare provider as it may indicate compromised blood supply requiring
surgical intervention .
Question 5
A client is admitted with a suspected pulmonary embolism. Which
assessment finding is most concerning?
A. Sudden onset of dyspnea and pleuritic chest pain
B. Mild fatigue with activity
C. Low-grade fever of 100.2°F
D. Productive cough with clear sputum
Correct answer: A. Sudden onset of dyspnea and pleuritic chest pain
RATIONALE: Sudden onset of dyspnea and pleuritic chest pain is the
classic presentation of pulmonary embolism, a life-threatening emergency
requiring immediate intervention. The PN should report this to the RN
immediately .
Question 6
A nurse is preparing to administer a blood transfusion. Which action should
the nurse take first?
A. Obtain informed consent
B. Verify the blood product with another nurse
C. Assess baseline vital signs
D. Prime the blood administration tubing
Correct answer: C. Assess baseline vital signs
RATIONALE: Baseline vital signs must be obtained prior to initiating a
blood transfusion to establish a comparison point for detecting transfusion
reactions. This is the first step in the transfusion process .
