PN HESI EXIT V1 & V2
Latest Practice Exam
221 Real Exam Questions and Correct Answers
Aligned with current HESI PN Exit Examination Blueprint
NCLEX-PN Test Plan Standards | Clinical Judgment Frameworks
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Format: 80% Scenario-Based | 20% Direct Recall w/ Calculation Integration
Practical Nursing Education | Comprehensive Rationales | PN Scope of Practice Complete Exam | 221 Questions | V1 & V2 Coverage
,PN HESI EXIT V1 & V2 | 221-Question Practice Exam Aligned with NCLEX-PN Test Plan
PN HESI EXIT V1 & V2 PRACTICE EXAM
221 Real Exam Questions and Correct Answers — Latest Edition
Aligned with the current HESI PN Exit Examination Blueprint and the NCLEX-PN Test Plan Standards
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Format: 80% Scenario-Based | 20% Direct Recall with Calculation Integration
Frameworks Integrated: ABCs, Maslow's Hierarchy, Safety, Least Restrictive, ADPIE, and PN Scope of
Practice
SECTION 1
Section 1: Safe and Effective Care Environment — Management of Care
Focus: Advocacy, Delegation, Prioritization, Continuity of Care, & Legal/Ethical Practice (Q1–Q25)
Q1: A PN is caring for four clients. Which client should the PN assess FIRST?
A. A client with a systolic blood pressure of 145 mm Hg who is scheduled for discharge
B. A client who is 4 hours postoperative and has not voided since surgery
C. A client with chronic heart failure reporting new-onset shortness of breath [CORRECT]
D. A client requesting pain medication for incisional pain rated 6/10
Correct Answer: C
Rationale: New-onset shortness of breath in a heart failure client suggests possible pulmonary edema, an
ABC threat requiring immediate evaluation. The ABC framework (Airway, Breathing, Circulation) always
takes priority over elimination, pain, or stable chronic findings. The postoperative client who has not
voided requires monitoring but is not in acute distress; the hypertensive and pain clients are stable by
comparison. Test-taking strategy: identify the client with an acute change in breathing status.
Q2: The RN delegates care of four clients to a PN and a UAP. Which client should the PN
assign to the UAP?
A. A client admitted 2 hours ago with acute GI bleeding who is receiving IV fluids
B. A client who is 1 day postoperative from a hip replacement and needs assistance with
ambulation
C. A stable client requiring routine vital signs, intake and output, and ambulation to the
bathroom [CORRECT]
D. A client with new-onset atrial fibrillation receiving a continuous IV heparin infusion
Correct Answer: C
Rationale: The UAP scope of practice includes routine care such as measuring vital signs on stable clients,
recording intake and output, and ambulating stable clients. The GI bleed client is unstable and requires
ongoing assessment; the postoperative hip replacement client requires PN-level assessment during initial
ambulation; the heparin infusion client requires ongoing RN/PN assessment for bleeding and infusion
rate. Delegation must match the UAP's defined, non-complex scope. Test-taking strategy: match task
complexity to the UAP scope of practice.
Page 2 | HESI PN Exit V1 & V2 Practice Exam
,PN HESI EXIT V1 & V2 | 221-Question Practice Exam Aligned with NCLEX-PN Test Plan
Q3: A client scheduled for an elective cholecystectomy refuses to sign the surgical consent
after the surgeon has explained the procedure. Which action should the PN take NEXT?
A. Witness the consent and document the client's verbal agreement
B. Notify the surgeon and document that the client refused the procedure [CORRECT]
C. Explain the risks of not having the surgery and ask the client to sign
D. Ask a family member to sign the consent on the client's behalf
Correct Answer: B
Rationale: Informed consent is the surgeon's responsibility, and the client has the legal right to refuse.
The PN's role is to notify the surgeon of the refusal and document accurately; coercing or allowing family
to sign violates autonomy. Witnessing consent the client refused, or having family sign for a competent
adult, is illegal. Test-taking strategy: when a competent adult refuses, document the refusal and notify the
provider.
Q4: Which action by a PN requires IMMEDIATE intervention by the charge nurse?
A. The PN delegates measurement of vital signs to a UAP for a stable postoperative client
B. The PN administers a PRN dose of acetaminophen to a client with a mild headache
C. The PN discontinues a client's IV antibiotic infusion 30 minutes early to administer the
next dose on time [CORRECT]
D. The PN educates a client about low-sodium diet before discharge
Correct Answer: C
Rationale: Discontinuing an IV antibiotic infusion early alters the prescribed dosing schedule and
compromises therapeutic drug levels, requiring provider notification and a new order. Delegating vital
signs to a UAP for a stable client, administering a PRN medication, and providing discharge education are
all within the PN scope. Test-taking strategy: identify the action that violates the rights of medication
administration and requires provider clarification.
Q5: A PN is preparing to administer a scheduled medication when the client states, "I don't
want to take that pill; it makes me dizzy." Which response demonstrates advocacy?
A. "I will hold this dose and notify your provider of your symptom." [CORRECT]
B. "You need to take this medication because it was prescribed by your doctor."
C. "Dizziness is normal; try to take it with food next time."
D. "I will document that you refused your medication."
Correct Answer: A
Rationale: Advocacy means protecting the client's right to refuse while ensuring the provider is informed
so alternative therapy can be considered. Holding the dose, notifying the provider, and documenting
accurately is the correct sequence. Forcing the medication, minimizing symptoms, or merely
documenting refusal without provider notification fail the advocacy role. Test-taking strategy: select the
response that respects client autonomy and communicates with the provider.
Page 3 | HESI PN Exit V1 & V2 Practice Exam
, PN HESI EXIT V1 & V2 | 221-Question Practice Exam Aligned with NCLEX-PN Test Plan
Q6: Which task is appropriate for the PN to delegate to a UAP when caring for a client with a
stage 3 sacral pressure injury?
A. Measuring and documenting the size of the wound bed
B. Repositioning the client every 2 hours using a turn schedule [CORRECT]
C. Applying a hydrocolloid dressing to the wound bed
D. Educating the family about wound care at home
Correct Answer: B
Rationale: Repositioning a stable client on a turn schedule is within the UAP scope and supports pressure
injury prevention. Wound measurement, dressing changes, and discharge education require PN/RN
assessment and clinical judgment. Test-taking strategy: select the task that is routine, repetitive, and has a
predictable outcome.
Q7: A client is transferred from the ICU to the medical-surgical unit. The receiving PN
should implement which action FIRST to ensure continuity of care?
A. Review the transfer summary and reconcile current medications with the prior order list
[CORRECT]
B. Notify the family that the client has been transferred
C. Complete a head-to-toe assessment focused on stability of vital signs
D. Schedule the client's follow-up appointments before discharge
Correct Answer: A
Rationale: Medication reconciliation at every transition of care is a National Patient Safety Goal and the
first step in continuity of care. Without reconciling medications, the PN risks duplicating, omitting, or
interacting drugs. Assessment and family notification follow, and follow-up scheduling occurs closer to
discharge. Test-taking strategy: prioritize actions that prevent errors at transitions of care.
Q8: A PN discovers that a UAP measured a client's blood pressure but did not record it.
Which action by the PN is MOST appropriate?
A. Reprimand the UAP in front of the client and other staff
B. Remind the UAP of documentation expectations and have the UAP re-measure and
document [CORRECT]
C. Document the value from memory and notify the charge nurse
D. Ignore the omission because the vital signs were normal
Correct Answer: B
Rationale: Direct, private feedback about professional expectations plus re-measurement ensures
accurate data while preserving the UAP's dignity. Reprimanding publicly violates professional conduct;
documenting from memory violates accuracy; ignoring the omission perpetuates unsafe practice.
Test-taking strategy: select the action that ensures accurate documentation and supports staff
accountability.
Page 4 | HESI PN Exit V1 & V2 Practice Exam
Latest Practice Exam
221 Real Exam Questions and Correct Answers
Aligned with current HESI PN Exit Examination Blueprint
NCLEX-PN Test Plan Standards | Clinical Judgment Frameworks
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Format: 80% Scenario-Based | 20% Direct Recall w/ Calculation Integration
Practical Nursing Education | Comprehensive Rationales | PN Scope of Practice Complete Exam | 221 Questions | V1 & V2 Coverage
,PN HESI EXIT V1 & V2 | 221-Question Practice Exam Aligned with NCLEX-PN Test Plan
PN HESI EXIT V1 & V2 PRACTICE EXAM
221 Real Exam Questions and Correct Answers — Latest Edition
Aligned with the current HESI PN Exit Examination Blueprint and the NCLEX-PN Test Plan Standards
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Format: 80% Scenario-Based | 20% Direct Recall with Calculation Integration
Frameworks Integrated: ABCs, Maslow's Hierarchy, Safety, Least Restrictive, ADPIE, and PN Scope of
Practice
SECTION 1
Section 1: Safe and Effective Care Environment — Management of Care
Focus: Advocacy, Delegation, Prioritization, Continuity of Care, & Legal/Ethical Practice (Q1–Q25)
Q1: A PN is caring for four clients. Which client should the PN assess FIRST?
A. A client with a systolic blood pressure of 145 mm Hg who is scheduled for discharge
B. A client who is 4 hours postoperative and has not voided since surgery
C. A client with chronic heart failure reporting new-onset shortness of breath [CORRECT]
D. A client requesting pain medication for incisional pain rated 6/10
Correct Answer: C
Rationale: New-onset shortness of breath in a heart failure client suggests possible pulmonary edema, an
ABC threat requiring immediate evaluation. The ABC framework (Airway, Breathing, Circulation) always
takes priority over elimination, pain, or stable chronic findings. The postoperative client who has not
voided requires monitoring but is not in acute distress; the hypertensive and pain clients are stable by
comparison. Test-taking strategy: identify the client with an acute change in breathing status.
Q2: The RN delegates care of four clients to a PN and a UAP. Which client should the PN
assign to the UAP?
A. A client admitted 2 hours ago with acute GI bleeding who is receiving IV fluids
B. A client who is 1 day postoperative from a hip replacement and needs assistance with
ambulation
C. A stable client requiring routine vital signs, intake and output, and ambulation to the
bathroom [CORRECT]
D. A client with new-onset atrial fibrillation receiving a continuous IV heparin infusion
Correct Answer: C
Rationale: The UAP scope of practice includes routine care such as measuring vital signs on stable clients,
recording intake and output, and ambulating stable clients. The GI bleed client is unstable and requires
ongoing assessment; the postoperative hip replacement client requires PN-level assessment during initial
ambulation; the heparin infusion client requires ongoing RN/PN assessment for bleeding and infusion
rate. Delegation must match the UAP's defined, non-complex scope. Test-taking strategy: match task
complexity to the UAP scope of practice.
Page 2 | HESI PN Exit V1 & V2 Practice Exam
,PN HESI EXIT V1 & V2 | 221-Question Practice Exam Aligned with NCLEX-PN Test Plan
Q3: A client scheduled for an elective cholecystectomy refuses to sign the surgical consent
after the surgeon has explained the procedure. Which action should the PN take NEXT?
A. Witness the consent and document the client's verbal agreement
B. Notify the surgeon and document that the client refused the procedure [CORRECT]
C. Explain the risks of not having the surgery and ask the client to sign
D. Ask a family member to sign the consent on the client's behalf
Correct Answer: B
Rationale: Informed consent is the surgeon's responsibility, and the client has the legal right to refuse.
The PN's role is to notify the surgeon of the refusal and document accurately; coercing or allowing family
to sign violates autonomy. Witnessing consent the client refused, or having family sign for a competent
adult, is illegal. Test-taking strategy: when a competent adult refuses, document the refusal and notify the
provider.
Q4: Which action by a PN requires IMMEDIATE intervention by the charge nurse?
A. The PN delegates measurement of vital signs to a UAP for a stable postoperative client
B. The PN administers a PRN dose of acetaminophen to a client with a mild headache
C. The PN discontinues a client's IV antibiotic infusion 30 minutes early to administer the
next dose on time [CORRECT]
D. The PN educates a client about low-sodium diet before discharge
Correct Answer: C
Rationale: Discontinuing an IV antibiotic infusion early alters the prescribed dosing schedule and
compromises therapeutic drug levels, requiring provider notification and a new order. Delegating vital
signs to a UAP for a stable client, administering a PRN medication, and providing discharge education are
all within the PN scope. Test-taking strategy: identify the action that violates the rights of medication
administration and requires provider clarification.
Q5: A PN is preparing to administer a scheduled medication when the client states, "I don't
want to take that pill; it makes me dizzy." Which response demonstrates advocacy?
A. "I will hold this dose and notify your provider of your symptom." [CORRECT]
B. "You need to take this medication because it was prescribed by your doctor."
C. "Dizziness is normal; try to take it with food next time."
D. "I will document that you refused your medication."
Correct Answer: A
Rationale: Advocacy means protecting the client's right to refuse while ensuring the provider is informed
so alternative therapy can be considered. Holding the dose, notifying the provider, and documenting
accurately is the correct sequence. Forcing the medication, minimizing symptoms, or merely
documenting refusal without provider notification fail the advocacy role. Test-taking strategy: select the
response that respects client autonomy and communicates with the provider.
Page 3 | HESI PN Exit V1 & V2 Practice Exam
, PN HESI EXIT V1 & V2 | 221-Question Practice Exam Aligned with NCLEX-PN Test Plan
Q6: Which task is appropriate for the PN to delegate to a UAP when caring for a client with a
stage 3 sacral pressure injury?
A. Measuring and documenting the size of the wound bed
B. Repositioning the client every 2 hours using a turn schedule [CORRECT]
C. Applying a hydrocolloid dressing to the wound bed
D. Educating the family about wound care at home
Correct Answer: B
Rationale: Repositioning a stable client on a turn schedule is within the UAP scope and supports pressure
injury prevention. Wound measurement, dressing changes, and discharge education require PN/RN
assessment and clinical judgment. Test-taking strategy: select the task that is routine, repetitive, and has a
predictable outcome.
Q7: A client is transferred from the ICU to the medical-surgical unit. The receiving PN
should implement which action FIRST to ensure continuity of care?
A. Review the transfer summary and reconcile current medications with the prior order list
[CORRECT]
B. Notify the family that the client has been transferred
C. Complete a head-to-toe assessment focused on stability of vital signs
D. Schedule the client's follow-up appointments before discharge
Correct Answer: A
Rationale: Medication reconciliation at every transition of care is a National Patient Safety Goal and the
first step in continuity of care. Without reconciling medications, the PN risks duplicating, omitting, or
interacting drugs. Assessment and family notification follow, and follow-up scheduling occurs closer to
discharge. Test-taking strategy: prioritize actions that prevent errors at transitions of care.
Q8: A PN discovers that a UAP measured a client's blood pressure but did not record it.
Which action by the PN is MOST appropriate?
A. Reprimand the UAP in front of the client and other staff
B. Remind the UAP of documentation expectations and have the UAP re-measure and
document [CORRECT]
C. Document the value from memory and notify the charge nurse
D. Ignore the omission because the vital signs were normal
Correct Answer: B
Rationale: Direct, private feedback about professional expectations plus re-measurement ensures
accurate data while preserving the UAP's dignity. Reprimanding publicly violates professional conduct;
documenting from memory violates accuracy; ignoring the omission perpetuates unsafe practice.
Test-taking strategy: select the action that ensures accurate documentation and supports staff
accountability.
Page 4 | HESI PN Exit V1 & V2 Practice Exam
