HESI PN EXIT EXAM V1-7 PRACTICE NURSING DIPLOMA,
VANCOUVER ISLAND UNIVERSITY (2025/2026) – ACTUAL
NGN FORMAT WITH VERIFIED QUESTIONS AND 100%
CORRECT ANSWER KEYS
CORE DOMAINS
Fundamentals of Nursing and Patient Safety
Medical-Surgical Nursing Across the Lifespan
Pharmacology and Medication Safety
Maternal-Newborn Nursing
Pediatric Nursing
Mental Health Nursing
Leadership, Delegation, and Prioritization
Ethical and Legal Nursing Practice
INTRODUCTION
This comprehensive examination is designed for practical nursing students
preparing for the HESI PN Exit Exam at Vancouver Island University. It
mirrors the actual NGN format with 100 verified multiple-choice questions
covering fundamentals, medical-surgical, pharmacology, maternal-
newborn, pediatric, mental health, leadership, and ethics. Each question
includes a detailed rationale to reinforce clinical judgment and evidence-
based practice. The guide emphasizes real-world application, prioritization,
and safe decision-making to ensure readiness for the NCLEX-PN and
professional practice.
SECTION ONE: QUESTIONS 1–100
1. The practical nurse enters a male client's room to administer
routine morning medications, but the client is on the phone. Which
action is best for the PN to take?
A. Ask another nurse to go back with the medication when the client's
phone call ends
B. Wait for the client to excuse himself from the telephone conversation and
observe the client taking the medication
,C. Return the medication to the client's drawer on the medication cart and
document the client refused the dose
D. Leave the medication at the bedside with a glass of water and ask the
client to take it when finished
B. Wait for the client to excuse himself from the telephone conversation
and observe the client taking the medication
RATIONALE: The nurse must witness the client taking the medication
to ensure it was taken as prescribed. Leaving medication unattended or
relying on another nurse compromises patient safety and proper
documentation.
2. A disoriented resident in a long-term care facility has no
identification band or picture. What is the best action for the PN to
take before administering medications?
A. Ask a regular staff member to confirm the resident's identity
B. Hold the medication until a family member arrives
C. Reorient the resident to name, place, and situation
D. Confirm the room and bed numbers match the medication record
D. Confirm the room and bed numbers match the medication record
RATIONALE: Confirming multiple identifiers, including room and bed
number per facility policy, is essential to ensure patient safety before
medication administration. Reliance solely on staff or family confirmation
risks error.
3. A client is admitted to the postoperative surgical unit with chest
tubes after a left lobectomy. The PN observes that the chambers are
set at the prescribed suction of 20 cm water pressure and tidalizing
occurs with respirations and bubbling. What action should the PN
implement?
A. Clamp the chest tube to see if bubbling stops
B. Document the findings as normal and continue monitoring
C. Notify the healthcare provider immediately
D. Increase the suction to 30 cm water pressure
, B. Document the findings as normal and continue monitoring
RATIONALE: Tidaling (fluctuation) with respirations and gentle bubbling
in the water seal chamber are expected findings in a functioning chest tube
drainage system. Clamping the tube or increasing suction without an order
is unsafe.
4. A client's daughter phones the charge nurse to report that the night
LPN/LVN did not provide good care for her mother. What response
should the nurse make?
A. Reassure the daughter that the mother will get better care
B. Tell the daughter to talk to the unit's nurse manager
C. Ask for a description of what happened during the night
D. Explain that all staff are doing the best they can
C. Ask for a description of what happened during the night
RATIONALE: Gathering specific information about the concern allows
the nurse to assess the situation objectively and address it appropriately.
This demonstrates active listening and a commitment to quality
improvement.
5. A hospitalized toddler recovering from a sickle cell crisis holds a
toy and says "mine." According to Erikson's theory, this behavior
demonstrates which developmental stage?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
B. Autonomy vs. Shame and Doubt
RATIONALE: The toddler's behavior reflects the autonomy vs. shame
and doubt stage (ages 1-3), where asserting ownership is part of
developing independence.
6. A client is admitted with pneumonia. Which intervention should the
LPN/LVN implement to prevent complications?
, A. Encourage energy conservation with complete bed rest
B. Restrict PO and intravenous fluids
C. Encourage mobilization and ambulation
D. Provide humidified oxygen per nasal cannula
C. Encourage mobilization and ambulation
RATIONALE: Mobilization prevents complications like atelectasis and
promotes lung expansion in pneumonia.
7. The LPN/LVN is preparing to administer cefazolin 600 mg IM every 6
hours. The vial is labeled "Cefazolin 1 gram, add 2 mL sterile water for
injection." How many mL should the nurse administer?
A. 1.2 mL
B. 1.8 mL
C. 2.0 mL
D. 2.4 mL
A. 1.2 mL
RATIONALE: Reconstituting 1 g (1000 mg) with 2 mL yields 500
mg/mL. For 600 mg: (600 mg ÷ 500 mg/mL) = 1.2 mL per dose.
8. A female client presents to the emergency department stating she
was raped last night. Which question is most important for the nurse
to ask?
A. Does she know the person who raped her?
B. Has she taken a bath since the rape occurred?
C. Did she report the rape to the police department?
D. Is the place where she lives a safe place?
B. Has she taken a bath since the rape occurred?
RATIONALE: Bathing may destroy forensic evidence critical for
investigation, making this the priority question.
9. A 3-year-old is admitted with bacterial meningitis and
hydrocephalus. Which finding suggests increased intracranial
pressure (ICP)?
VANCOUVER ISLAND UNIVERSITY (2025/2026) – ACTUAL
NGN FORMAT WITH VERIFIED QUESTIONS AND 100%
CORRECT ANSWER KEYS
CORE DOMAINS
Fundamentals of Nursing and Patient Safety
Medical-Surgical Nursing Across the Lifespan
Pharmacology and Medication Safety
Maternal-Newborn Nursing
Pediatric Nursing
Mental Health Nursing
Leadership, Delegation, and Prioritization
Ethical and Legal Nursing Practice
INTRODUCTION
This comprehensive examination is designed for practical nursing students
preparing for the HESI PN Exit Exam at Vancouver Island University. It
mirrors the actual NGN format with 100 verified multiple-choice questions
covering fundamentals, medical-surgical, pharmacology, maternal-
newborn, pediatric, mental health, leadership, and ethics. Each question
includes a detailed rationale to reinforce clinical judgment and evidence-
based practice. The guide emphasizes real-world application, prioritization,
and safe decision-making to ensure readiness for the NCLEX-PN and
professional practice.
SECTION ONE: QUESTIONS 1–100
1. The practical nurse enters a male client's room to administer
routine morning medications, but the client is on the phone. Which
action is best for the PN to take?
A. Ask another nurse to go back with the medication when the client's
phone call ends
B. Wait for the client to excuse himself from the telephone conversation and
observe the client taking the medication
,C. Return the medication to the client's drawer on the medication cart and
document the client refused the dose
D. Leave the medication at the bedside with a glass of water and ask the
client to take it when finished
B. Wait for the client to excuse himself from the telephone conversation
and observe the client taking the medication
RATIONALE: The nurse must witness the client taking the medication
to ensure it was taken as prescribed. Leaving medication unattended or
relying on another nurse compromises patient safety and proper
documentation.
2. A disoriented resident in a long-term care facility has no
identification band or picture. What is the best action for the PN to
take before administering medications?
A. Ask a regular staff member to confirm the resident's identity
B. Hold the medication until a family member arrives
C. Reorient the resident to name, place, and situation
D. Confirm the room and bed numbers match the medication record
D. Confirm the room and bed numbers match the medication record
RATIONALE: Confirming multiple identifiers, including room and bed
number per facility policy, is essential to ensure patient safety before
medication administration. Reliance solely on staff or family confirmation
risks error.
3. A client is admitted to the postoperative surgical unit with chest
tubes after a left lobectomy. The PN observes that the chambers are
set at the prescribed suction of 20 cm water pressure and tidalizing
occurs with respirations and bubbling. What action should the PN
implement?
A. Clamp the chest tube to see if bubbling stops
B. Document the findings as normal and continue monitoring
C. Notify the healthcare provider immediately
D. Increase the suction to 30 cm water pressure
, B. Document the findings as normal and continue monitoring
RATIONALE: Tidaling (fluctuation) with respirations and gentle bubbling
in the water seal chamber are expected findings in a functioning chest tube
drainage system. Clamping the tube or increasing suction without an order
is unsafe.
4. A client's daughter phones the charge nurse to report that the night
LPN/LVN did not provide good care for her mother. What response
should the nurse make?
A. Reassure the daughter that the mother will get better care
B. Tell the daughter to talk to the unit's nurse manager
C. Ask for a description of what happened during the night
D. Explain that all staff are doing the best they can
C. Ask for a description of what happened during the night
RATIONALE: Gathering specific information about the concern allows
the nurse to assess the situation objectively and address it appropriately.
This demonstrates active listening and a commitment to quality
improvement.
5. A hospitalized toddler recovering from a sickle cell crisis holds a
toy and says "mine." According to Erikson's theory, this behavior
demonstrates which developmental stage?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
B. Autonomy vs. Shame and Doubt
RATIONALE: The toddler's behavior reflects the autonomy vs. shame
and doubt stage (ages 1-3), where asserting ownership is part of
developing independence.
6. A client is admitted with pneumonia. Which intervention should the
LPN/LVN implement to prevent complications?
, A. Encourage energy conservation with complete bed rest
B. Restrict PO and intravenous fluids
C. Encourage mobilization and ambulation
D. Provide humidified oxygen per nasal cannula
C. Encourage mobilization and ambulation
RATIONALE: Mobilization prevents complications like atelectasis and
promotes lung expansion in pneumonia.
7. The LPN/LVN is preparing to administer cefazolin 600 mg IM every 6
hours. The vial is labeled "Cefazolin 1 gram, add 2 mL sterile water for
injection." How many mL should the nurse administer?
A. 1.2 mL
B. 1.8 mL
C. 2.0 mL
D. 2.4 mL
A. 1.2 mL
RATIONALE: Reconstituting 1 g (1000 mg) with 2 mL yields 500
mg/mL. For 600 mg: (600 mg ÷ 500 mg/mL) = 1.2 mL per dose.
8. A female client presents to the emergency department stating she
was raped last night. Which question is most important for the nurse
to ask?
A. Does she know the person who raped her?
B. Has she taken a bath since the rape occurred?
C. Did she report the rape to the police department?
D. Is the place where she lives a safe place?
B. Has she taken a bath since the rape occurred?
RATIONALE: Bathing may destroy forensic evidence critical for
investigation, making this the priority question.
9. A 3-year-old is admitted with bacterial meningitis and
hydrocephalus. Which finding suggests increased intracranial
pressure (ICP)?
