EXAM SERIES
LPN/LVN HESI Exit Exam
Evaluation – Elsevier HESI
Practical Nursing Exit
Examination
Comprehensive Exam — Questions and Answers
100 Questions
with Answers and Complete Rationales
01 Scenario-based and direct multiple-choice questions
02 Answers with explanatory rationales
03 Organized by practical nursing client-need competencies
04 Complete questions and answers
2026 EDITION
Questions and Answers • Complete Rationales
, Examination Instructions
This examination contains 100 multiple-choice questions assessing practical and vocational nursing
competencies within the LPN/LVN scope of practice. Each question has one best answer.
Section 1: Safe and Effective Care Environment and Coordinated Care (Questions 1–25)
Section 2: Health Promotion, Psychosocial Integrity, and Basic Care (Questions 26–50)
Section 3: Physiological Integrity and Reduction of Risk Potential (Questions 51–80)
Section 4: Pharmacological and Parenteral Therapies (Questions 81–100)
Select the single best option (A, B, C, or D). Rationales are provided after each answer to reinforce
clinical reasoning.
Section 1 — Safe and Effective Care Environment and Coordinated Care
Questions 1–25 address scope of practice, delegation, prioritization, safety, infection control, and
collaboration with the registered nurse and interdisciplinary team.
Q1. An LPN/LVN is caring for four assigned clients. Which client should the practical nurse
assess first?
A. A client requesting pain medication two hours after a total knee replacement
B. A client with a respiratory rate of 28 and an oxygen saturation of 90% on room air
C. A client who is upset about a delayed diagnostic test
D. A client needing education on discharge wound care
Correct Answer: B. A client with a respiratory rate of 28 and an oxygen saturation of 90% on room
air
Using the airway, breathing, circulation (ABC) framework, the client with respiratory compromise is the
highest priority. Tachypnea and hypoxemia suggest impending respiratory distress and require
immediate assessment and notification of the RN or provider. The other clients have needs that are
important but not immediately life-threatening.
Q2. Which task is most appropriate for the LPN/LVN to delegate to an experienced unlicensed
assistive personnel (UAP)?
A. Reinforcing teaching about a newly prescribed insulin regimen
B. Measuring intake and output for a client receiving IV diuretics
C. Assessing a stage 2 pressure injury for signs of infection
D. Evaluating a client’s response to a new antihypertensive medication
Correct Answer: B. Measuring intake and output for a client receiving IV diuretics
Measuring intake and output is a routine, noninvasive task within the UAP scope and does not require
clinical judgment. Teaching, wound assessment, and evaluation of medication effectiveness all require
nursing knowledge and must be performed by licensed nursing personnel.
,Q3. A client on a medical-surgical unit tells the practical nurse, “I want to leave now. I do not want
to stay here anymore.” The client was admitted voluntarily for treatment of pneumonia. What is
the practical nurse’s best initial action?
A. Physically prevent the client from leaving the unit
B. Notify the registered nurse and document the client’s statement
C. Tell the client that leaving would be against medical advice and dangerous
D. Sedate the client to prevent elopement
Correct Answer: B. Notify the registered nurse and document the client’s statement
A voluntarily admitted client has the right to leave, although leaving against medical advice may be
discussed. The LPN/LVN should immediately notify the RN, who can collaborate with the provider,
discuss risks with the client, and initiate the against-medical-advice process if needed. Physical
restraint or sedation is inappropriate and could constitute false imprisonment or battery.
Q4. The RN assigns the LPN/LVN to care for a client who was admitted two hours ago with acute
myocardial infarction and is receiving a nitroglycerin infusion. Which action by the LPN/LVN is
most appropriate?
A. Accept the assignment and monitor the client closely
B. Request that the assignment be reassigned to an RN because the client is unstable
C. Administer the infusion and titrate the dose based on chest pain
D. Discharge teaching about nitroglycerin use
Correct Answer: B. Request that the assignment be reassigned to an RN because the client is
unstable
Clients who are unstable, require continuous assessment, or need titration of vasoactive medications
are outside the LPN/LVN scope of practice. The practical nurse should communicate concerns to the
RN and request reassignment. Accepting an inappropriate assignment could compromise client safety
and exceed scope.
Q5. Which principle of standard precautions should the LPN/LVN apply to every client encounter?
A. Wear gloves only when contact with blood is anticipated
B. Perform hand hygiene before and after every client contact
C. Don a gown only when entering an isolation room
D. Reserve masks for clients with confirmed airborne disease
Correct Answer: B. Perform hand hygiene before and after every client contact
Standard precautions are based on the principle that all body fluids and clients may carry transmissible
pathogens. Hand hygiene before and after each contact is the single most effective infection control
measure and is required regardless of the client’s diagnosis.
, Q6. A UAP reports that a client’s surgical dressing has a small amount of serosanguineous
drainage. What should the LPN/LVN do first?
A. Reassure the UAP that serosanguineous drainage is always expected
B. Personally assess the dressing and the client’s vital signs
C. Remove the dressing immediately to inspect the incision
D. Ask the UAP to reinforce the dressing and reassess in four hours
Correct Answer: B. Personally assess the dressing and the client’s vital signs
The LPN/LVN remains responsible for evaluating findings reported by UAP. Personal assessment of
the dressing and vital signs allows the practical nurse to determine whether the drainage is expected
or indicates complications such as dehiscence or infection. Directing the UAP to reinforce without
assessment could delay detection of a problem.
Q7. Which action demonstrates that the LPN/LVN understands informed consent?
A. Explaining the surgical procedure in detail before the surgeon arrives
B. Witnessing the client’s signature after the provider has explained the procedure
C. Telling the client that the procedure is low risk and safe
D. Asking the client to sign the form even though the client has unanswered questions
Correct Answer: B. Witnessing the client’s signature after the provider has explained the
procedure
The LPN/LVN may witness the client’s signature on a consent form, confirming that the client signed
voluntarily. The provider is responsible for explaining the procedure, risks, benefits, and alternatives. If
the client has unanswered questions, the LPN/LVN should notify the provider rather than proceeding
with the consent process.
Q8. A client falls while trying to ambulate to the bathroom unassisted. After ensuring the client is
safe, what should the LPN/LVN do next?
A. Document the fall in the medical record and complete an incident report
B. Wait until the end of the shift to document so the details are clearer
C. Document only that the client had an unwitnessed event
D. Document in the medical record that an incident report was filed
Correct Answer: A. Document the fall in the medical record and complete an incident report
The client’s clinical status, assessment findings, notifications, and interventions should be documented
factually in the medical record. A separate incident report is completed for quality improvement. The
incident report itself should not be referenced in the medical record, and documentation should occur
promptly without delay.
LPN/LVN HESI Exit Exam
Evaluation – Elsevier HESI
Practical Nursing Exit
Examination
Comprehensive Exam — Questions and Answers
100 Questions
with Answers and Complete Rationales
01 Scenario-based and direct multiple-choice questions
02 Answers with explanatory rationales
03 Organized by practical nursing client-need competencies
04 Complete questions and answers
2026 EDITION
Questions and Answers • Complete Rationales
, Examination Instructions
This examination contains 100 multiple-choice questions assessing practical and vocational nursing
competencies within the LPN/LVN scope of practice. Each question has one best answer.
Section 1: Safe and Effective Care Environment and Coordinated Care (Questions 1–25)
Section 2: Health Promotion, Psychosocial Integrity, and Basic Care (Questions 26–50)
Section 3: Physiological Integrity and Reduction of Risk Potential (Questions 51–80)
Section 4: Pharmacological and Parenteral Therapies (Questions 81–100)
Select the single best option (A, B, C, or D). Rationales are provided after each answer to reinforce
clinical reasoning.
Section 1 — Safe and Effective Care Environment and Coordinated Care
Questions 1–25 address scope of practice, delegation, prioritization, safety, infection control, and
collaboration with the registered nurse and interdisciplinary team.
Q1. An LPN/LVN is caring for four assigned clients. Which client should the practical nurse
assess first?
A. A client requesting pain medication two hours after a total knee replacement
B. A client with a respiratory rate of 28 and an oxygen saturation of 90% on room air
C. A client who is upset about a delayed diagnostic test
D. A client needing education on discharge wound care
Correct Answer: B. A client with a respiratory rate of 28 and an oxygen saturation of 90% on room
air
Using the airway, breathing, circulation (ABC) framework, the client with respiratory compromise is the
highest priority. Tachypnea and hypoxemia suggest impending respiratory distress and require
immediate assessment and notification of the RN or provider. The other clients have needs that are
important but not immediately life-threatening.
Q2. Which task is most appropriate for the LPN/LVN to delegate to an experienced unlicensed
assistive personnel (UAP)?
A. Reinforcing teaching about a newly prescribed insulin regimen
B. Measuring intake and output for a client receiving IV diuretics
C. Assessing a stage 2 pressure injury for signs of infection
D. Evaluating a client’s response to a new antihypertensive medication
Correct Answer: B. Measuring intake and output for a client receiving IV diuretics
Measuring intake and output is a routine, noninvasive task within the UAP scope and does not require
clinical judgment. Teaching, wound assessment, and evaluation of medication effectiveness all require
nursing knowledge and must be performed by licensed nursing personnel.
,Q3. A client on a medical-surgical unit tells the practical nurse, “I want to leave now. I do not want
to stay here anymore.” The client was admitted voluntarily for treatment of pneumonia. What is
the practical nurse’s best initial action?
A. Physically prevent the client from leaving the unit
B. Notify the registered nurse and document the client’s statement
C. Tell the client that leaving would be against medical advice and dangerous
D. Sedate the client to prevent elopement
Correct Answer: B. Notify the registered nurse and document the client’s statement
A voluntarily admitted client has the right to leave, although leaving against medical advice may be
discussed. The LPN/LVN should immediately notify the RN, who can collaborate with the provider,
discuss risks with the client, and initiate the against-medical-advice process if needed. Physical
restraint or sedation is inappropriate and could constitute false imprisonment or battery.
Q4. The RN assigns the LPN/LVN to care for a client who was admitted two hours ago with acute
myocardial infarction and is receiving a nitroglycerin infusion. Which action by the LPN/LVN is
most appropriate?
A. Accept the assignment and monitor the client closely
B. Request that the assignment be reassigned to an RN because the client is unstable
C. Administer the infusion and titrate the dose based on chest pain
D. Discharge teaching about nitroglycerin use
Correct Answer: B. Request that the assignment be reassigned to an RN because the client is
unstable
Clients who are unstable, require continuous assessment, or need titration of vasoactive medications
are outside the LPN/LVN scope of practice. The practical nurse should communicate concerns to the
RN and request reassignment. Accepting an inappropriate assignment could compromise client safety
and exceed scope.
Q5. Which principle of standard precautions should the LPN/LVN apply to every client encounter?
A. Wear gloves only when contact with blood is anticipated
B. Perform hand hygiene before and after every client contact
C. Don a gown only when entering an isolation room
D. Reserve masks for clients with confirmed airborne disease
Correct Answer: B. Perform hand hygiene before and after every client contact
Standard precautions are based on the principle that all body fluids and clients may carry transmissible
pathogens. Hand hygiene before and after each contact is the single most effective infection control
measure and is required regardless of the client’s diagnosis.
, Q6. A UAP reports that a client’s surgical dressing has a small amount of serosanguineous
drainage. What should the LPN/LVN do first?
A. Reassure the UAP that serosanguineous drainage is always expected
B. Personally assess the dressing and the client’s vital signs
C. Remove the dressing immediately to inspect the incision
D. Ask the UAP to reinforce the dressing and reassess in four hours
Correct Answer: B. Personally assess the dressing and the client’s vital signs
The LPN/LVN remains responsible for evaluating findings reported by UAP. Personal assessment of
the dressing and vital signs allows the practical nurse to determine whether the drainage is expected
or indicates complications such as dehiscence or infection. Directing the UAP to reinforce without
assessment could delay detection of a problem.
Q7. Which action demonstrates that the LPN/LVN understands informed consent?
A. Explaining the surgical procedure in detail before the surgeon arrives
B. Witnessing the client’s signature after the provider has explained the procedure
C. Telling the client that the procedure is low risk and safe
D. Asking the client to sign the form even though the client has unanswered questions
Correct Answer: B. Witnessing the client’s signature after the provider has explained the
procedure
The LPN/LVN may witness the client’s signature on a consent form, confirming that the client signed
voluntarily. The provider is responsible for explaining the procedure, risks, benefits, and alternatives. If
the client has unanswered questions, the LPN/LVN should notify the provider rather than proceeding
with the consent process.
Q8. A client falls while trying to ambulate to the bathroom unassisted. After ensuring the client is
safe, what should the LPN/LVN do next?
A. Document the fall in the medical record and complete an incident report
B. Wait until the end of the shift to document so the details are clearer
C. Document only that the client had an unwitnessed event
D. Document in the medical record that an incident report was filed
Correct Answer: A. Document the fall in the medical record and complete an incident report
The client’s clinical status, assessment findings, notifications, and interventions should be documented
factually in the medical record. A separate incident report is completed for quality improvement. The
incident report itself should not be referenced in the medical record, and documentation should occur
promptly without delay.
