HESI PN EXIT EXAM 2026/2027 | 200
PRACTICE QUESTIONS & ANSWERS WITH
RATIONALES | NCLEX-PN PRACTICAL
NURSING PREP | newest!
Questions 1–25: Management of Care & Safety
1. The practical nurse receives report on four clients. Which client should be assessed
first?
A. Client with chronic arthritis reporting pain of 5/10
B. Client awaiting routine discharge instructions
C. Client with COPD who has new-onset confusion and an oxygen saturation of 84%
D. Client requesting assistance with bathing
Answer: C. Client with COPD who has new-onset confusion and an oxygen saturation of
84%.
Rationale: Acute hypoxemia with a change in mental status indicates possible respiratory
compromise and requires immediate assessment.
2. Which task is most appropriate for the practical nurse to assign to unlicensed
assistive personnel (UAP)?
A. Assessing a newly admitted client
B. Teaching a client how to use an incentive spirometer
C. Measuring intake and output for a stable client
D. Evaluating a client's response to pain medication
Answer: C. Measuring intake and output for a stable client.
Rationale: Routine measurement of intake and output is within UAP responsibilities when the
client is stable and the task does not require nursing judgment.
3. A client refuses a prescribed medication. What should the practical nurse do first?
A. Document the refusal and leave the room
B. Ask the client why the medication is being refused
C. Notify the healthcare provider immediately
D. Tell the client the medication is required
Answer: B. Ask the client why the medication is being refused.
Rationale: The nurse should first determine the client's reason for refusal and provide
appropriate information before taking further action.
4. Which action demonstrates appropriate infection-control practice?
A. Recapping a used needle with two hands
,B. Wearing gloves instead of performing hand hygiene
C. Performing hand hygiene before and after client contact
D. Reusing disposable equipment after wiping it with alcohol
Answer: C. Performing hand hygiene before and after client contact.
Rationale: Hand hygiene is a fundamental infection-prevention measure and should be
performed at appropriate points of care.
5. A client is identified as being at high risk for falls. Which intervention is most
appropriate?
A. Keep all four side rails raised
B. Place frequently used items within reach
C. Keep the bed in the highest position
D. Encourage the client to walk independently
Answer: B. Place frequently used items within reach.
Rationale: Keeping needed items within reach reduces unnecessary attempts to get out of bed
and helps prevent falls.
6. Which client should the practical nurse see first?
A. Client with a temperature of 37.5°C (99.5°F)
B. Client requesting a snack
C. Client with sudden unilateral weakness and slurred speech
D. Client with chronic back pain
Answer: C. Client with sudden unilateral weakness and slurred speech.
Rationale: These findings suggest an acute neurologic event such as stroke and require
immediate assessment.
7. Which action protects client confidentiality?
A. Discussing client information in the elevator
B. Leaving the medical record open at the nurses' station
C. Sharing information only with members of the healthcare team who need it
D. Giving a client's diagnosis to a visiting friend
Answer: C. Sharing information only with members of the healthcare team who need it.
Rationale: Confidential health information should be disclosed only to authorized individuals
involved in the client's care.
8. A client becomes angry about a delay in medication administration. Which response
is best?
A. "You need to calm down."
B. "There is nothing I can do."
C. "I can see that the delay is frustrating. Let me check the status of your medication."
D. "Everyone has to wait."
,Answer: C. "I can see that the delay is frustrating. Let me check the status of your
medication."
Rationale: Acknowledging the client's feelings and offering an appropriate action promotes
therapeutic communication.
9. Which action should the nurse take when a medication error occurs?
A. Hide the error if the client has no symptoms
B. Document only that the medication was given
C. Assess the client and follow facility reporting procedures
D. Ask another nurse to document the error
Answer: C. Assess the client and follow facility reporting procedures.
Rationale: Client safety is the priority after a medication error. The nurse should assess the
client, notify appropriate personnel, and complete required documentation.
10. Which client assignment is most appropriate for a practical nurse?
A. Client requiring initial assessment of septic shock
B. Stable client receiving routine postoperative care
C. Client requiring complex admission assessment
D. Client with rapidly changing neurologic status
Answer: B. Stable client receiving routine postoperative care.
Rationale: Practical nurses commonly care for clients with stable, predictable conditions
according to their scope of practice and facility policy.
11. A client with a newly inserted central line develops sudden shortness of breath.
What is the priority action?
A. Offer oral fluids
B. Place the client flat
C. Assess respiratory status and notify the appropriate provider
D. Encourage ambulation
Answer: C. Assess respiratory status and notify the appropriate provider.
Rationale: Sudden respiratory symptoms after central-line insertion may indicate a serious
complication such as pneumothorax.
12. Which action is appropriate when transferring a client from bed to wheelchair?
A. Leave wheelchair brakes unlocked
B. Place the wheelchair on the client's weaker side
C. Lock the wheelchair brakes before transfer
D. Pull the client by the arms
Answer: C. Lock the wheelchair brakes before transfer.
Rationale: Securing the wheelchair prevents movement during transfer and reduces injury
risk.
, 13. A client asks about information contained in another client's medical record. What
should the nurse say?
A. "I can tell you if you are family."
B. "That information is confidential."
C. "Ask the physician."
D. "You can look at the chart yourself."
Answer: B. "That information is confidential."
Rationale: Client records are protected health information and cannot be disclosed without
appropriate authorization.
14. Which intervention is most important for a client at risk for aspiration?
A. Keep the client flat after meals
B. Encourage rapid eating
C. Position the client upright during meals
D. Give thin liquids to every client
Answer: C. Position the client upright during meals.
Rationale: Upright positioning promotes safer swallowing and decreases aspiration risk.
15. A nurse discovers that a client's identification band is missing. What should the
nurse do?
A. Give medications based on room number
B. Ask another client who the person is
C. Replace the identification band using approved identification procedures
D. Skip identification because the nurse knows the client
Answer: C. Replace the identification band using approved identification procedures.
Rationale: Proper identification is required before medications, treatments, procedures, and
other care.
16. Which action is appropriate when using a mechanical lift?
A. Use it without checking the equipment
B. Follow manufacturer and facility instructions
C. Allow the client to stand while suspended
D. Leave the client unattended
Answer: B. Follow manufacturer and facility instructions.
Rationale: Mechanical lifts require correct procedures and equipment checks to ensure client
and staff safety.
17. Which statement indicates correct understanding of advance directives?
A. They allow nurses to prescribe medications.
B. They communicate a client's healthcare wishes.
C. They replace informed consent for every procedure.
D. They are required for every hospital admission.
PRACTICE QUESTIONS & ANSWERS WITH
RATIONALES | NCLEX-PN PRACTICAL
NURSING PREP | newest!
Questions 1–25: Management of Care & Safety
1. The practical nurse receives report on four clients. Which client should be assessed
first?
A. Client with chronic arthritis reporting pain of 5/10
B. Client awaiting routine discharge instructions
C. Client with COPD who has new-onset confusion and an oxygen saturation of 84%
D. Client requesting assistance with bathing
Answer: C. Client with COPD who has new-onset confusion and an oxygen saturation of
84%.
Rationale: Acute hypoxemia with a change in mental status indicates possible respiratory
compromise and requires immediate assessment.
2. Which task is most appropriate for the practical nurse to assign to unlicensed
assistive personnel (UAP)?
A. Assessing a newly admitted client
B. Teaching a client how to use an incentive spirometer
C. Measuring intake and output for a stable client
D. Evaluating a client's response to pain medication
Answer: C. Measuring intake and output for a stable client.
Rationale: Routine measurement of intake and output is within UAP responsibilities when the
client is stable and the task does not require nursing judgment.
3. A client refuses a prescribed medication. What should the practical nurse do first?
A. Document the refusal and leave the room
B. Ask the client why the medication is being refused
C. Notify the healthcare provider immediately
D. Tell the client the medication is required
Answer: B. Ask the client why the medication is being refused.
Rationale: The nurse should first determine the client's reason for refusal and provide
appropriate information before taking further action.
4. Which action demonstrates appropriate infection-control practice?
A. Recapping a used needle with two hands
,B. Wearing gloves instead of performing hand hygiene
C. Performing hand hygiene before and after client contact
D. Reusing disposable equipment after wiping it with alcohol
Answer: C. Performing hand hygiene before and after client contact.
Rationale: Hand hygiene is a fundamental infection-prevention measure and should be
performed at appropriate points of care.
5. A client is identified as being at high risk for falls. Which intervention is most
appropriate?
A. Keep all four side rails raised
B. Place frequently used items within reach
C. Keep the bed in the highest position
D. Encourage the client to walk independently
Answer: B. Place frequently used items within reach.
Rationale: Keeping needed items within reach reduces unnecessary attempts to get out of bed
and helps prevent falls.
6. Which client should the practical nurse see first?
A. Client with a temperature of 37.5°C (99.5°F)
B. Client requesting a snack
C. Client with sudden unilateral weakness and slurred speech
D. Client with chronic back pain
Answer: C. Client with sudden unilateral weakness and slurred speech.
Rationale: These findings suggest an acute neurologic event such as stroke and require
immediate assessment.
7. Which action protects client confidentiality?
A. Discussing client information in the elevator
B. Leaving the medical record open at the nurses' station
C. Sharing information only with members of the healthcare team who need it
D. Giving a client's diagnosis to a visiting friend
Answer: C. Sharing information only with members of the healthcare team who need it.
Rationale: Confidential health information should be disclosed only to authorized individuals
involved in the client's care.
8. A client becomes angry about a delay in medication administration. Which response
is best?
A. "You need to calm down."
B. "There is nothing I can do."
C. "I can see that the delay is frustrating. Let me check the status of your medication."
D. "Everyone has to wait."
,Answer: C. "I can see that the delay is frustrating. Let me check the status of your
medication."
Rationale: Acknowledging the client's feelings and offering an appropriate action promotes
therapeutic communication.
9. Which action should the nurse take when a medication error occurs?
A. Hide the error if the client has no symptoms
B. Document only that the medication was given
C. Assess the client and follow facility reporting procedures
D. Ask another nurse to document the error
Answer: C. Assess the client and follow facility reporting procedures.
Rationale: Client safety is the priority after a medication error. The nurse should assess the
client, notify appropriate personnel, and complete required documentation.
10. Which client assignment is most appropriate for a practical nurse?
A. Client requiring initial assessment of septic shock
B. Stable client receiving routine postoperative care
C. Client requiring complex admission assessment
D. Client with rapidly changing neurologic status
Answer: B. Stable client receiving routine postoperative care.
Rationale: Practical nurses commonly care for clients with stable, predictable conditions
according to their scope of practice and facility policy.
11. A client with a newly inserted central line develops sudden shortness of breath.
What is the priority action?
A. Offer oral fluids
B. Place the client flat
C. Assess respiratory status and notify the appropriate provider
D. Encourage ambulation
Answer: C. Assess respiratory status and notify the appropriate provider.
Rationale: Sudden respiratory symptoms after central-line insertion may indicate a serious
complication such as pneumothorax.
12. Which action is appropriate when transferring a client from bed to wheelchair?
A. Leave wheelchair brakes unlocked
B. Place the wheelchair on the client's weaker side
C. Lock the wheelchair brakes before transfer
D. Pull the client by the arms
Answer: C. Lock the wheelchair brakes before transfer.
Rationale: Securing the wheelchair prevents movement during transfer and reduces injury
risk.
, 13. A client asks about information contained in another client's medical record. What
should the nurse say?
A. "I can tell you if you are family."
B. "That information is confidential."
C. "Ask the physician."
D. "You can look at the chart yourself."
Answer: B. "That information is confidential."
Rationale: Client records are protected health information and cannot be disclosed without
appropriate authorization.
14. Which intervention is most important for a client at risk for aspiration?
A. Keep the client flat after meals
B. Encourage rapid eating
C. Position the client upright during meals
D. Give thin liquids to every client
Answer: C. Position the client upright during meals.
Rationale: Upright positioning promotes safer swallowing and decreases aspiration risk.
15. A nurse discovers that a client's identification band is missing. What should the
nurse do?
A. Give medications based on room number
B. Ask another client who the person is
C. Replace the identification band using approved identification procedures
D. Skip identification because the nurse knows the client
Answer: C. Replace the identification band using approved identification procedures.
Rationale: Proper identification is required before medications, treatments, procedures, and
other care.
16. Which action is appropriate when using a mechanical lift?
A. Use it without checking the equipment
B. Follow manufacturer and facility instructions
C. Allow the client to stand while suspended
D. Leave the client unattended
Answer: B. Follow manufacturer and facility instructions.
Rationale: Mechanical lifts require correct procedures and equipment checks to ensure client
and staff safety.
17. Which statement indicates correct understanding of advance directives?
A. They allow nurses to prescribe medications.
B. They communicate a client's healthcare wishes.
C. They replace informed consent for every procedure.
D. They are required for every hospital admission.
