1
HESI PN Comprehensive Exit
Exam (2025/2026) – Actual
Exam Questions with Correct
Answers and Rationales |
Graded A+
Pharmacology (Questions 1–30)
Question 1
A practical nurse (PN) is preparing to administer lisinopril to a client with hypertension. Which
assessment is the priority before administration?
A. Blood glucose
B. Blood pressure
C. Heart rate
D. Respiratory rate
Correct Answer:
B. Blood pressure
Rationale: Lisinopril, an ACE inhibitor, lowers blood pressure. Assessing blood pressure ensures
it is not too low (e.g., <90/60 mmHg), which could cause hypotension. Other assessments are
secondary.
Question 2
A client is prescribed furosemide 40 mg IV for heart failure. What should the PN monitor?
A. Serum potassium
B. Blood glucose
C. INR
D. Platelet count
Correct Answer:
A. Serum potassium
, 2
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, leading to arrhythmias.
Monitoring potassium levels is critical. Other labs are less relevant to furosemide’s effects.
Question 3 (Select All That Apply)
Which client education points should the PN include for a client starting warfarin? Select all that
apply.
A. Avoid green leafy vegetables
B. Report unusual bleeding
C. Take with grapefruit juice
D. Monitor for bruising
E. Increase alcohol intake
Correct Answers:
A. Avoid green leafy vegetables
B. Report unusual bleeding
D. Monitor for bruising
Rationale: Warfarin, an anticoagulant, is affected by vitamin K-rich foods (e.g., green leafy
vegetables) and requires monitoring for bleeding or bruising. Grapefruit juice and alcohol can
interfere with warfarin metabolism or increase bleeding risk.
Question 4
A client on morphine reports constipation. What should the PN recommend?
A. Increase fiber intake
B. Reduce fluid intake
C. Stop the medication
D. Take an antacid
Correct Answer:
A. Increase fiber intake
Rationale: Morphine, an opioid, causes constipation due to decreased gastrointestinal motility.
Increasing fiber and fluids helps manage this side effect. Stopping the medication or using
antacids is inappropriate.
Question 5
A client is prescribed digoxin. What should the PN check before administration?
A. Apical pulse
B. Blood pressure
C. Blood glucose
D. Respiratory rate
Correct Answer:
A. Apical pulse
, 3
Rationale: Digoxin slows heart rate. Checking the apical pulse (holding if <60 bpm) prevents
toxicity. Other assessments are secondary for digoxin administration.
Question 6
A client overdoses on acetaminophen. What is the antidote?
A. Naloxone
B. Acetylcysteine
C. Flumazenil
D. Protamine sulfate
Correct Answer:
B. Acetylcysteine
Rationale: Acetylcysteine prevents liver damage in acetaminophen overdose by restoring
glutathione. Other options are antidotes for different drugs (e.g., naloxone for opioids).
Question 7
A client on metformin reports nausea. What should the PN recommend?
A. Take with food
B. Stop the medication
C. Increase the dose
D. Take at bedtime
Correct Answer:
A. Take with food
Rationale: Metformin, a biguanide, causes gastrointestinal upset, which is reduced by taking it
with food. Stopping or increasing the dose is inappropriate without provider input.
Question 8 (Select All That Apply)
Which side effects should the PN monitor for a client on prednisone? Select all that apply.
A. Hyperglycemia
B. Weight gain
C. Hypotension
D. Osteoporosis
E. Insomnia
Correct Answers:
A. Hyperglycemia
B. Weight gain
D. Osteoporosis
E. Insomnia
, 4
Rationale: Prednisone, a corticosteroid, causes hyperglycemia, weight gain, osteoporosis, and
insomnia due to its metabolic and anti-inflammatory effects. Hypotension is not typical;
hypertension is more common.
Question 9
A client is prescribed albuterol for asthma. Which side effect should the PN monitor?
A. Tremors
B. Bradycardia
C. Hypotension
D. Hyperglycemia
Correct Answer:
A. Tremors
Rationale: Albuterol, a beta-2 agonist, causes tremors due to stimulation of skeletal muscle
receptors. Other options are not typical side effects.
Question 10
A PN is administering heparin subcutaneously. What should the PN do?
A. Aspirate before injection
B. Massage the site after injection
C. Use a 25-gauge needle
D. Inject at a 90-degree angle
Correct Answer:
C. Use a 25-gauge needle
Rationale: Heparin is administered subcutaneously with a small-gauge needle (25–26 gauge) at a
45–90-degree angle, without aspiration or massage, to prevent bleeding or bruising.
Question 11
A client on phenytoin reports gingival hyperplasia. What should the PN recommend?
A. Stop the medication
B. Encourage good oral hygiene
C. Administer an antibiotic
D. Ignore the symptom
Correct Answer:
B. Encourage good oral hygiene
Rationale: Gingival hyperplasia is a common phenytoin side effect, managed with good oral
hygiene. Stopping the medication or antibiotics is inappropriate without provider guidance.
Question 12
A client is prescribed levothyroxine. Which instruction should the PN provide?
A. Take with grapefruit juice
HESI PN Comprehensive Exit
Exam (2025/2026) – Actual
Exam Questions with Correct
Answers and Rationales |
Graded A+
Pharmacology (Questions 1–30)
Question 1
A practical nurse (PN) is preparing to administer lisinopril to a client with hypertension. Which
assessment is the priority before administration?
A. Blood glucose
B. Blood pressure
C. Heart rate
D. Respiratory rate
Correct Answer:
B. Blood pressure
Rationale: Lisinopril, an ACE inhibitor, lowers blood pressure. Assessing blood pressure ensures
it is not too low (e.g., <90/60 mmHg), which could cause hypotension. Other assessments are
secondary.
Question 2
A client is prescribed furosemide 40 mg IV for heart failure. What should the PN monitor?
A. Serum potassium
B. Blood glucose
C. INR
D. Platelet count
Correct Answer:
A. Serum potassium
, 2
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, leading to arrhythmias.
Monitoring potassium levels is critical. Other labs are less relevant to furosemide’s effects.
Question 3 (Select All That Apply)
Which client education points should the PN include for a client starting warfarin? Select all that
apply.
A. Avoid green leafy vegetables
B. Report unusual bleeding
C. Take with grapefruit juice
D. Monitor for bruising
E. Increase alcohol intake
Correct Answers:
A. Avoid green leafy vegetables
B. Report unusual bleeding
D. Monitor for bruising
Rationale: Warfarin, an anticoagulant, is affected by vitamin K-rich foods (e.g., green leafy
vegetables) and requires monitoring for bleeding or bruising. Grapefruit juice and alcohol can
interfere with warfarin metabolism or increase bleeding risk.
Question 4
A client on morphine reports constipation. What should the PN recommend?
A. Increase fiber intake
B. Reduce fluid intake
C. Stop the medication
D. Take an antacid
Correct Answer:
A. Increase fiber intake
Rationale: Morphine, an opioid, causes constipation due to decreased gastrointestinal motility.
Increasing fiber and fluids helps manage this side effect. Stopping the medication or using
antacids is inappropriate.
Question 5
A client is prescribed digoxin. What should the PN check before administration?
A. Apical pulse
B. Blood pressure
C. Blood glucose
D. Respiratory rate
Correct Answer:
A. Apical pulse
, 3
Rationale: Digoxin slows heart rate. Checking the apical pulse (holding if <60 bpm) prevents
toxicity. Other assessments are secondary for digoxin administration.
Question 6
A client overdoses on acetaminophen. What is the antidote?
A. Naloxone
B. Acetylcysteine
C. Flumazenil
D. Protamine sulfate
Correct Answer:
B. Acetylcysteine
Rationale: Acetylcysteine prevents liver damage in acetaminophen overdose by restoring
glutathione. Other options are antidotes for different drugs (e.g., naloxone for opioids).
Question 7
A client on metformin reports nausea. What should the PN recommend?
A. Take with food
B. Stop the medication
C. Increase the dose
D. Take at bedtime
Correct Answer:
A. Take with food
Rationale: Metformin, a biguanide, causes gastrointestinal upset, which is reduced by taking it
with food. Stopping or increasing the dose is inappropriate without provider input.
Question 8 (Select All That Apply)
Which side effects should the PN monitor for a client on prednisone? Select all that apply.
A. Hyperglycemia
B. Weight gain
C. Hypotension
D. Osteoporosis
E. Insomnia
Correct Answers:
A. Hyperglycemia
B. Weight gain
D. Osteoporosis
E. Insomnia
, 4
Rationale: Prednisone, a corticosteroid, causes hyperglycemia, weight gain, osteoporosis, and
insomnia due to its metabolic and anti-inflammatory effects. Hypotension is not typical;
hypertension is more common.
Question 9
A client is prescribed albuterol for asthma. Which side effect should the PN monitor?
A. Tremors
B. Bradycardia
C. Hypotension
D. Hyperglycemia
Correct Answer:
A. Tremors
Rationale: Albuterol, a beta-2 agonist, causes tremors due to stimulation of skeletal muscle
receptors. Other options are not typical side effects.
Question 10
A PN is administering heparin subcutaneously. What should the PN do?
A. Aspirate before injection
B. Massage the site after injection
C. Use a 25-gauge needle
D. Inject at a 90-degree angle
Correct Answer:
C. Use a 25-gauge needle
Rationale: Heparin is administered subcutaneously with a small-gauge needle (25–26 gauge) at a
45–90-degree angle, without aspiration or massage, to prevent bleeding or bruising.
Question 11
A client on phenytoin reports gingival hyperplasia. What should the PN recommend?
A. Stop the medication
B. Encourage good oral hygiene
C. Administer an antibiotic
D. Ignore the symptom
Correct Answer:
B. Encourage good oral hygiene
Rationale: Gingival hyperplasia is a common phenytoin side effect, managed with good oral
hygiene. Stopping the medication or antibiotics is inappropriate without provider guidance.
Question 12
A client is prescribed levothyroxine. Which instruction should the PN provide?
A. Take with grapefruit juice
