HESI PN EXIT
V1 – V7 EXAM
NCLEX (NGN), Case-based Scenarios,
Actual Qs & Ans to Pass the Exam
THIS HESI PN EXIT CONSISTS OF
❖Each Exam has 75 Qs and Ans
❖ multiple-choice questions (MCQs)** with four options
(A–D), answers, and detailed rationales aligned with
HESI PN Exit Exam 2025 standards.
❖ Some questions are flagged as **NCLEX-style (NGN)**, and
relevant **case studies/vitals** are integrated where applicable.
,Table of Contents
HESI PN EXIT V1 EXAM .................................................. 2
HESI PN EXIT V2 EXAM ................................................ 54
HESI PN EXIT V3 EXAM .............................................. 108
HESI PN EXIT V4 EXAM .............................................. 162
HESI PN EXIT V5 EXAM .............................................. 217
HESI PN EXIT V6 EXAM .............................................. 259
HESI PN EXIT V7 EXAM .............................................. 299
HESI PN EXIT V1 EXAM
### 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 with the client and let him take it when he finishes
the conversation
Answer: B. Wait for the client to excuse himself from the telephone
conversation and observe the client taking the medication
Rationale:
Medication administration requires verification of the “five rights,” including
observing the client actually take the medication for safety and
documentation. Interrupting a phone call can be disrespectful, but it is
important to wait until the client is free to safely administer meds. Leaving
meds unattended or documenting refusal without client’s consent violates
safety protocols.
---
### 2.
A client is admitted to the postoperative surgical unit with two chest tubes
after a left lobectomy. The PN observes that the chest tube system is set at
a suction of 20 cm water pressure, with tidaling during respirations and
bubbling present. What action should the PN take?
A. Clamp the chest tube to see if the activity stops
B. Notify the registered nurse of a malfunction
C. Maintain system integrity to promote lung reexpansion
D. Apply a partially occlusive dressing to the chest insertion site
Answer: C. Maintain system integrity to promote lung reexpansion
Rationale:
,Tidaling (fluctuations with respirations) and bubbling in the suction chamber
are normal findings indicating proper function. Maintaining a closed and
intact system ensures continued lung reexpansion and prevents
complications such as pneumothorax. Clamping is contraindicated due to risk
of tension pneumothorax.
---
### 3. (NCLEX NGN - Case-Based Scenario)
A mother calls the clinic about her 9-month-old child diagnosed with RSV
yesterday. She asks if it is okay to take the baby to a friend’s child’s first
birthday party tomorrow. What is the best response?
A. Do not expose other children as RSV is very contagious even without
direct contact
B. The child will no longer be contagious and no precautions are needed
C. The child can be around other children but should wear a mask
D. Make sure no children under 5 months are near the infected child
Answer: A. Do not expose other children as RSV is very contagious even
without direct contact
Rationale:
RSV is highly contagious and easily transmitted via respiratory droplet and
indirect contact, particularly in infants and young children. The virus can
spread even before symptoms appear, so avoiding exposure at group events
helps control transmission.
---
### 4.
,A Korean female exchange student admitted with acute abdominal pain
answers questions easily but looks away when asked about sexual activity.
What should the PN do?
A. Omit this section of the assessment
B. Ask if she would prefer an interpreter to ask this question
C. Reword the question in case the client did not understand
D. Observe the client’s response when asked different questions
Answer: D. Observe the client’s response when asked different questions
Rationale:
Nonverbal cues may indicate cultural discomfort or embarrassment.
Observing reactions to other questions can help determine if discomfort is
specific to sexual topics or if further cultural sensitivity/intervention is
needed. Forcing the question or omitting it prematurely may impair
assessment accuracy.
---
### 5.
During the immediate postoperative period following total hip replacement
surgery, which intervention is most important?
A. Encourage the client to use a walker or cane when ambulating
B. Keep the client’s hip aligned with knees abducted
C. Teach the client to sit on the side of the bed before standing
D. Monitor urinary flow via an indwelling catheter
Answer: B. Keep the client’s hip aligned with knees abducted
Rationale:
,Maintaining proper hip alignment and abduction reduces risk of hip
dislocation, a common and serious complication post-hip replacement. Early
ambulation and mobility aids are important but follow after initial
precautions.
---
### 6.
A client confides to the PN that he has been using herbal supplements
instead of prescribed hypertension medications. What is the PN’s best initial
response?
A. Ask the client’s reasons for using herbal supplements instead of
prescription drugs
B. Reinforce that the healthcare provider prescribed medications with a
purpose
C. Have the client describe the complications of uncontrolled high blood
pressure
D. Explain the risks of using herbs instead of prescribed medications
Answer: A. Ask the client’s reasons for using herbal supplements instead of
prescription drugs
Rationale:
Begin with open, nonjudgmental communication to understand the client’s
beliefs and motivations, establishing trust before teaching. This patient-
centered approach encourages collaboration in care planning.
---
### 7.
,A disoriented resident in a long-term care facility has no ID band or picture.
What is the best action for the PN 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 number match the medication record
Answer: D. Confirm the room and bed number 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.
---
### 8. (Vital Signs / Case-Based Scenario)
An adult client weighing 150 pounds with 40% total body surface area burns
has been admitted. Which finding requires immediate reporting?
A. Poor appetite and refusal to eat
B. Systolic blood pressure of 102 mmHg
C. Painful moaning and crying
D. Urine output of 20 ml/hr
Answer: D. Urine output of 20 ml/hr
Rationale:
,Adequate urine output (>30 ml/hr) is a key indicator of adequate renal
perfusion and fluid status after burns. Output of 20 ml/hr signals
hypovolemia/shock and requires immediate intervention.
---
### 9.
A 12-year-old child begins a blood transfusion with an infusion pump. Fifteen
minutes after starting, he complains of itchy skin and appears flushed. What
is the PN’s first action?
A. Apply lotion to the skin
B. Stop the transfusion immediately
C. Inspect the infusion site
D. Obtain vital signs
Answer: B. Stop the transfusion immediately
Rationale:
Signs of allergic or hemolytic transfusion reactions require immediate
cessation of the transfusion to prevent worsening complications. Further
assessment follows.
---
### 10.
During skin assessment, the PN notes a 0.7 cm crusted lesion on an older
adult’s forehead. What is the best action?
A. Report the lesion to the healthcare provider
B. Cover the lesion with a clear, occlusive dressing
,C. Apply a warm compress to remove the crust
D. Explain this is a normal skin change in aging
Answer: A. Report the lesion to the healthcare provider
Rationale:
Crusted lesions can indicate skin cancer or infection and require professional
evaluation. Do not attempt removal or dismiss as normal without
assessment.
---
### 11.
An elderly male client taking psychotropic meds has uncontrollable hand
movements and excessive eye blinking. Which information from his medical
record should the PN review?
A. Prescription for lorazepam
B. History of Parkinson’s disease
C. Screening for tardive dyskinesia
D. Recent urine drug screen report
Answer: C. Screening for tardive dyskinesia
Rationale:
Tardive dyskinesia is a movement disorder caused by long-term use of
psychotropic medications. Reviewing prior screenings helps assess risk and
plan care.
### 11.
, While taking the vital signs of an older male client who takes psychotropic
medications, the PN notes uncontrollable hand movements and excessive
blinking of the eyes. Which information in the client’s medical record should
the PN review?
A. Prescription for lorazepam
B. History of Parkinson’s disease
C. Screening for tardive dyskinesia
D. Recent urine drug screen report
Answer: B. History of Parkinson’s disease
Rationale:
Involuntary movements and excessive blinking may be extrapyramidal
symptoms typical in clients with Parkinson’s disease. Psychotropic
medications can worsen these symptoms. Reviewing the history of
Parkinson’s helps the PN evaluate whether these movements relate to the
disease or medication side effects. Screening for tardive dyskinesia is also
important but secondary to knowing if Parkinson’s exists.
---
### 12.
The PN is caring for an elderly female client who reports, "When I sneeze, I
wet my pants." After discussing the complaint with the charge nurse, the PN
plans to reinforce teaching about Kegel exercises. Which muscles are
involved in these exercises?
A. Pectoral muscles
B. Buttock muscles
C. Abdominal muscles
V1 – V7 EXAM
NCLEX (NGN), Case-based Scenarios,
Actual Qs & Ans to Pass the Exam
THIS HESI PN EXIT CONSISTS OF
❖Each Exam has 75 Qs and Ans
❖ multiple-choice questions (MCQs)** with four options
(A–D), answers, and detailed rationales aligned with
HESI PN Exit Exam 2025 standards.
❖ Some questions are flagged as **NCLEX-style (NGN)**, and
relevant **case studies/vitals** are integrated where applicable.
,Table of Contents
HESI PN EXIT V1 EXAM .................................................. 2
HESI PN EXIT V2 EXAM ................................................ 54
HESI PN EXIT V3 EXAM .............................................. 108
HESI PN EXIT V4 EXAM .............................................. 162
HESI PN EXIT V5 EXAM .............................................. 217
HESI PN EXIT V6 EXAM .............................................. 259
HESI PN EXIT V7 EXAM .............................................. 299
HESI PN EXIT V1 EXAM
### 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 with the client and let him take it when he finishes
the conversation
Answer: B. Wait for the client to excuse himself from the telephone
conversation and observe the client taking the medication
Rationale:
Medication administration requires verification of the “five rights,” including
observing the client actually take the medication for safety and
documentation. Interrupting a phone call can be disrespectful, but it is
important to wait until the client is free to safely administer meds. Leaving
meds unattended or documenting refusal without client’s consent violates
safety protocols.
---
### 2.
A client is admitted to the postoperative surgical unit with two chest tubes
after a left lobectomy. The PN observes that the chest tube system is set at
a suction of 20 cm water pressure, with tidaling during respirations and
bubbling present. What action should the PN take?
A. Clamp the chest tube to see if the activity stops
B. Notify the registered nurse of a malfunction
C. Maintain system integrity to promote lung reexpansion
D. Apply a partially occlusive dressing to the chest insertion site
Answer: C. Maintain system integrity to promote lung reexpansion
Rationale:
,Tidaling (fluctuations with respirations) and bubbling in the suction chamber
are normal findings indicating proper function. Maintaining a closed and
intact system ensures continued lung reexpansion and prevents
complications such as pneumothorax. Clamping is contraindicated due to risk
of tension pneumothorax.
---
### 3. (NCLEX NGN - Case-Based Scenario)
A mother calls the clinic about her 9-month-old child diagnosed with RSV
yesterday. She asks if it is okay to take the baby to a friend’s child’s first
birthday party tomorrow. What is the best response?
A. Do not expose other children as RSV is very contagious even without
direct contact
B. The child will no longer be contagious and no precautions are needed
C. The child can be around other children but should wear a mask
D. Make sure no children under 5 months are near the infected child
Answer: A. Do not expose other children as RSV is very contagious even
without direct contact
Rationale:
RSV is highly contagious and easily transmitted via respiratory droplet and
indirect contact, particularly in infants and young children. The virus can
spread even before symptoms appear, so avoiding exposure at group events
helps control transmission.
---
### 4.
,A Korean female exchange student admitted with acute abdominal pain
answers questions easily but looks away when asked about sexual activity.
What should the PN do?
A. Omit this section of the assessment
B. Ask if she would prefer an interpreter to ask this question
C. Reword the question in case the client did not understand
D. Observe the client’s response when asked different questions
Answer: D. Observe the client’s response when asked different questions
Rationale:
Nonverbal cues may indicate cultural discomfort or embarrassment.
Observing reactions to other questions can help determine if discomfort is
specific to sexual topics or if further cultural sensitivity/intervention is
needed. Forcing the question or omitting it prematurely may impair
assessment accuracy.
---
### 5.
During the immediate postoperative period following total hip replacement
surgery, which intervention is most important?
A. Encourage the client to use a walker or cane when ambulating
B. Keep the client’s hip aligned with knees abducted
C. Teach the client to sit on the side of the bed before standing
D. Monitor urinary flow via an indwelling catheter
Answer: B. Keep the client’s hip aligned with knees abducted
Rationale:
,Maintaining proper hip alignment and abduction reduces risk of hip
dislocation, a common and serious complication post-hip replacement. Early
ambulation and mobility aids are important but follow after initial
precautions.
---
### 6.
A client confides to the PN that he has been using herbal supplements
instead of prescribed hypertension medications. What is the PN’s best initial
response?
A. Ask the client’s reasons for using herbal supplements instead of
prescription drugs
B. Reinforce that the healthcare provider prescribed medications with a
purpose
C. Have the client describe the complications of uncontrolled high blood
pressure
D. Explain the risks of using herbs instead of prescribed medications
Answer: A. Ask the client’s reasons for using herbal supplements instead of
prescription drugs
Rationale:
Begin with open, nonjudgmental communication to understand the client’s
beliefs and motivations, establishing trust before teaching. This patient-
centered approach encourages collaboration in care planning.
---
### 7.
,A disoriented resident in a long-term care facility has no ID band or picture.
What is the best action for the PN 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 number match the medication record
Answer: D. Confirm the room and bed number 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.
---
### 8. (Vital Signs / Case-Based Scenario)
An adult client weighing 150 pounds with 40% total body surface area burns
has been admitted. Which finding requires immediate reporting?
A. Poor appetite and refusal to eat
B. Systolic blood pressure of 102 mmHg
C. Painful moaning and crying
D. Urine output of 20 ml/hr
Answer: D. Urine output of 20 ml/hr
Rationale:
,Adequate urine output (>30 ml/hr) is a key indicator of adequate renal
perfusion and fluid status after burns. Output of 20 ml/hr signals
hypovolemia/shock and requires immediate intervention.
---
### 9.
A 12-year-old child begins a blood transfusion with an infusion pump. Fifteen
minutes after starting, he complains of itchy skin and appears flushed. What
is the PN’s first action?
A. Apply lotion to the skin
B. Stop the transfusion immediately
C. Inspect the infusion site
D. Obtain vital signs
Answer: B. Stop the transfusion immediately
Rationale:
Signs of allergic or hemolytic transfusion reactions require immediate
cessation of the transfusion to prevent worsening complications. Further
assessment follows.
---
### 10.
During skin assessment, the PN notes a 0.7 cm crusted lesion on an older
adult’s forehead. What is the best action?
A. Report the lesion to the healthcare provider
B. Cover the lesion with a clear, occlusive dressing
,C. Apply a warm compress to remove the crust
D. Explain this is a normal skin change in aging
Answer: A. Report the lesion to the healthcare provider
Rationale:
Crusted lesions can indicate skin cancer or infection and require professional
evaluation. Do not attempt removal or dismiss as normal without
assessment.
---
### 11.
An elderly male client taking psychotropic meds has uncontrollable hand
movements and excessive eye blinking. Which information from his medical
record should the PN review?
A. Prescription for lorazepam
B. History of Parkinson’s disease
C. Screening for tardive dyskinesia
D. Recent urine drug screen report
Answer: C. Screening for tardive dyskinesia
Rationale:
Tardive dyskinesia is a movement disorder caused by long-term use of
psychotropic medications. Reviewing prior screenings helps assess risk and
plan care.
### 11.
, While taking the vital signs of an older male client who takes psychotropic
medications, the PN notes uncontrollable hand movements and excessive
blinking of the eyes. Which information in the client’s medical record should
the PN review?
A. Prescription for lorazepam
B. History of Parkinson’s disease
C. Screening for tardive dyskinesia
D. Recent urine drug screen report
Answer: B. History of Parkinson’s disease
Rationale:
Involuntary movements and excessive blinking may be extrapyramidal
symptoms typical in clients with Parkinson’s disease. Psychotropic
medications can worsen these symptoms. Reviewing the history of
Parkinson’s helps the PN evaluate whether these movements relate to the
disease or medication side effects. Screening for tardive dyskinesia is also
important but secondary to knowing if Parkinson’s exists.
---
### 12.
The PN is caring for an elderly female client who reports, "When I sneeze, I
wet my pants." After discussing the complaint with the charge nurse, the PN
plans to reinforce teaching about Kegel exercises. Which muscles are
involved in these exercises?
A. Pectoral muscles
B. Buttock muscles
C. Abdominal muscles
