HESI PN Exit Exam Practice
Questions and Answers - Walden
University (Latest 2026/2027 Update)
Complete Q&A with Verified Answers
HESI PN Exit Exam Practice Questions and | Comprehensive
Examination
HESI PN Exit Exam Practice Questions and Answers -
Walden University (Latest 2026/2027 Update) Complete Q&A
with Verified Answers and Detailed Rationales A+ Grade
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI PN Exit Exam Practice Questions and
Answers - Walden University (Latest 2026/2027 Update)
Complete Q&A with Verified Answers and Detailed Rationales
A+ Grade. Every item uses a focused exam stem, four response
options, a keyed response, and a clear rationale, making it
easier to understand the subject, spot distractors, and build real
exam confidence.
Page 1
, Question 1
A client receiving continuous IV heparin for venous thromboembolism has an
aPTT of 98 seconds (control 30 seconds). Which action should the PN
anticipate?
A. Continue the infusion and recheck aPTT in 6 hours.
B. Hold the infusion and prepare to administer protamine sulfate.
C. Administer vitamin K subcutaneously.
D. Increase the infusion rate to maintain therapeutic range.
Correct Answer: B - Hold the infusion and prepare to administer
protamine sulfate.
RATIONALE
A therapeutic aPTT is typically 1.5-2.5 times control (about 45-75
seconds); 98 seconds indicates supratherapeutic anticoagulation. The
PN should hold the heparin and anticipate protamine sulfate as the
antidote. Vitamin K reverses warfarin, and continuing or increasing
the infusion risks hemorrhage.
Question 2
Which finding most strongly indicates impending lithium toxicity in a client
maintained on lithium carbonate?
A. Serum lithium level of 0.6 mEq/L
B. Fine hand tremor and polyuria
C. Coarse hand tremor with ataxia and vomiting
D. Mild thirst and increased urination
Correct Answer: C - Coarse hand tremor with ataxia and
vomiting
Page 2
, RATIONALE
Coarse tremor, ataxia, vomiting, and confusion signal
moderate-to-severe lithium toxicity (levels typically >1.5 mEq/L).
Fine tremor and polyuria are expected therapeutic side effects at levels
0.6-1.2 mEq/L. The other options represent normal findings or
therapeutic effects.
Question 3
A postpartum client who is breastfeeding reports unilateral breast pain,
redness, and flu-like symptoms. Which instruction is most appropriate?
A. Discontinue breastfeeding on the affected breast until symptoms
resolve.
B. Apply warm compresses and continue emptying the affected breast.
C. Apply ice packs before feedings to reduce inflammation.
D. Pump and discard milk from the affected breast for 48 hours.
Correct Answer: B - Apply warm compresses and continue
emptying the affected breast.
RATIONALE
Mastitis management includes continued milk removal (feeding or
pumping), warm compresses before feeds, and analgesics.
Discontinuing breastfeeding or discarding milk can worsen
engorgement and does not hasten resolution. Ice is used after feeds for
comfort, not before.
Question 4
A client with a new colostomy has a stoma that is dark purple and dry. Which
action should the PN take first?
A. Apply a transparent dressing over the stoma.
B. Document the finding as normal and reassess in 24 hours.
C. Notify the provider immediately.
D. Irrigate the stoma with sterile saline.
Page 3
, Correct Answer: C - Notify the provider immediately.
RATIONALE
A healthy stoma is pink to red, moist, and shiny. A dark purple, dry
stoma indicates ischemia/necrosis and requires immediate provider
notification. Applying a dressing or irrigating does not address the
underlying vascular compromise and delays intervention.
Question 5
Which statement by a client prescribed metformin indicates a need for further
teaching?
A. I will take this with meals to reduce stomach upset.
B. I should report muscle pain or unusual fatigue.
C. I can skip my dose on days I plan to drink alcohol.
D. I will have my kidney function checked regularly.
Correct Answer: C - I can skip my dose on days I plan to drink
alcohol.
RATIONALE
Metformin should be avoided with excessive alcohol due to increased
risk of lactic acidosis; skipping a dose does not make alcohol safe.
Taking with meals, monitoring for lactic acidosis symptoms (myalgia,
fatigue), and periodic renal function testing are correct. Option C
reflects a dangerous misconception.
Question 6
A nurse is calculating a pediatric dose. The order is for 15 mg/kg/day divided
every 8 hours. The child weighs 22 lb. The medication is available as 100 mg/5
mL. How many mL will the nurse administer per dose? (Round to the nearest
tenth.)
A. 2.5 mL
B. 5.0 mL
Page 4
Questions and Answers - Walden
University (Latest 2026/2027 Update)
Complete Q&A with Verified Answers
HESI PN Exit Exam Practice Questions and | Comprehensive
Examination
HESI PN Exit Exam Practice Questions and Answers -
Walden University (Latest 2026/2027 Update) Complete Q&A
with Verified Answers and Detailed Rationales A+ Grade
INTRODUCTION
This document is an important and very helpful preparation
resource for HESI PN Exit Exam Practice Questions and
Answers - Walden University (Latest 2026/2027 Update)
Complete Q&A with Verified Answers and Detailed Rationales
A+ Grade. Every item uses a focused exam stem, four response
options, a keyed response, and a clear rationale, making it
easier to understand the subject, spot distractors, and build real
exam confidence.
Page 1
, Question 1
A client receiving continuous IV heparin for venous thromboembolism has an
aPTT of 98 seconds (control 30 seconds). Which action should the PN
anticipate?
A. Continue the infusion and recheck aPTT in 6 hours.
B. Hold the infusion and prepare to administer protamine sulfate.
C. Administer vitamin K subcutaneously.
D. Increase the infusion rate to maintain therapeutic range.
Correct Answer: B - Hold the infusion and prepare to administer
protamine sulfate.
RATIONALE
A therapeutic aPTT is typically 1.5-2.5 times control (about 45-75
seconds); 98 seconds indicates supratherapeutic anticoagulation. The
PN should hold the heparin and anticipate protamine sulfate as the
antidote. Vitamin K reverses warfarin, and continuing or increasing
the infusion risks hemorrhage.
Question 2
Which finding most strongly indicates impending lithium toxicity in a client
maintained on lithium carbonate?
A. Serum lithium level of 0.6 mEq/L
B. Fine hand tremor and polyuria
C. Coarse hand tremor with ataxia and vomiting
D. Mild thirst and increased urination
Correct Answer: C - Coarse hand tremor with ataxia and
vomiting
Page 2
, RATIONALE
Coarse tremor, ataxia, vomiting, and confusion signal
moderate-to-severe lithium toxicity (levels typically >1.5 mEq/L).
Fine tremor and polyuria are expected therapeutic side effects at levels
0.6-1.2 mEq/L. The other options represent normal findings or
therapeutic effects.
Question 3
A postpartum client who is breastfeeding reports unilateral breast pain,
redness, and flu-like symptoms. Which instruction is most appropriate?
A. Discontinue breastfeeding on the affected breast until symptoms
resolve.
B. Apply warm compresses and continue emptying the affected breast.
C. Apply ice packs before feedings to reduce inflammation.
D. Pump and discard milk from the affected breast for 48 hours.
Correct Answer: B - Apply warm compresses and continue
emptying the affected breast.
RATIONALE
Mastitis management includes continued milk removal (feeding or
pumping), warm compresses before feeds, and analgesics.
Discontinuing breastfeeding or discarding milk can worsen
engorgement and does not hasten resolution. Ice is used after feeds for
comfort, not before.
Question 4
A client with a new colostomy has a stoma that is dark purple and dry. Which
action should the PN take first?
A. Apply a transparent dressing over the stoma.
B. Document the finding as normal and reassess in 24 hours.
C. Notify the provider immediately.
D. Irrigate the stoma with sterile saline.
Page 3
, Correct Answer: C - Notify the provider immediately.
RATIONALE
A healthy stoma is pink to red, moist, and shiny. A dark purple, dry
stoma indicates ischemia/necrosis and requires immediate provider
notification. Applying a dressing or irrigating does not address the
underlying vascular compromise and delays intervention.
Question 5
Which statement by a client prescribed metformin indicates a need for further
teaching?
A. I will take this with meals to reduce stomach upset.
B. I should report muscle pain or unusual fatigue.
C. I can skip my dose on days I plan to drink alcohol.
D. I will have my kidney function checked regularly.
Correct Answer: C - I can skip my dose on days I plan to drink
alcohol.
RATIONALE
Metformin should be avoided with excessive alcohol due to increased
risk of lactic acidosis; skipping a dose does not make alcohol safe.
Taking with meals, monitoring for lactic acidosis symptoms (myalgia,
fatigue), and periodic renal function testing are correct. Option C
reflects a dangerous misconception.
Question 6
A nurse is calculating a pediatric dose. The order is for 15 mg/kg/day divided
every 8 hours. The child weighs 22 lb. The medication is available as 100 mg/5
mL. How many mL will the nurse administer per dose? (Round to the nearest
tenth.)
A. 2.5 mL
B. 5.0 mL
Page 4
