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HESI LPN-ADN MOBILITY ACTUAL EXAM
PREP 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK |NEW AND REVISED
1. A client with chronic kidney disease (CKD) has a serum potassium of 6.2
mEq/L. Which intervention should the LPN implement first after notifying the
RN?
A. Administer sodium polystyrene sulfonate as ordered
B. Place the client on a cardiac monitor
C. Restrict all oral fluids for 8 hours
D. Encourage intake of high-carbohydrate foods
B. Place the client on a cardiac monitor
*Rationale: Hyperkalemia (K+ >5.5) can cause life-threatening dysrhythmias.
Cardiac monitoring is the priority to detect changes such as peaked T waves or
ventricular fibrillation. Sodium polystyrene sulfonate is a treatment but not the
first action before ensuring cardiac safety.*
2. A postoperative client reports sudden onset of chest pain and dyspnea. The
oxygen saturation is 88% on room air. What is the priority nursing action?
A. Administer PRN morphine sulfate
B. Raise the head of the bed to 90 degrees
C. Prepare for an electrocardiogram (ECG)
D. Apply a sequential compression device
B. Raise the head of the bed to 90 degrees
Rationale: This presentation suggests a pulmonary embolism. High Fowler’s
position optimizes lung expansion and oxygenation, improving saturation while
further interventions are initiated. Morphine may be given later for pain/
anxiety, but positioning is immediate.
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3. A client with type 1 diabetes mellitus is found diaphoretic, confused, and
tachycardic. Which action should the LPN take first?
A. Administer 15g of fast-acting carbohydrates
B. Check blood glucose level
C. Give 0.5 mg of glucagon intramuscularly
D. Start an IV line of normal saline
B. Check blood glucose level
Rationale: While symptoms suggest hypoglycemia, the LPN must verify the blood
glucose level before treatment to avoid giving glucose to a hyperglycemic client.
The "treat first, then check" rule applies only if a glucose meter is unavailable
or the patient is unconscious.
4. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which
task is appropriate for the LPN to delegate?
A. Perform the initial admission assessment on a new client
B. Reinsert a nasogastric tube that has become dislodged
C. Measure orthostatic blood pressures on a stable client
D. Evaluate the effectiveness of a client’s pain medication
C. Measure orthostatic blood pressures on a stable client
Rationale: Delegation follows the rule that stable, predictable tasks with no
expected complication can be assigned to UAP. Assessment, evaluation, and
invasive procedures (NG tube) remain with the licensed nurse.
5. A client receiving a blood transfusion develops chills, fever, and lower back
pain. What is the LPN’s priority action?
A. Slow the infusion rate to 10 mL/hour
B. Stop the transfusion immediately
C. Administer acetaminophen as ordered
D. Notify the healthcare provider
B. Stop the transfusion immediately
Rationale: These symptoms indicate an acute hemolytic transfusion reaction.
The priority is to stop the transfusion to prevent further destruction of RBCs,
then maintain IV line with saline, notify the provider, and send blood bag to lab.
6. Which clinical finding in a client with bacterial meningitis requires immediate
intervention by the LPN?
A. Complaints of severe headache and photophobia
B. Positive Kernig’s and Brudzinski’s signs
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C. Petechial rash on the trunk and extremities
D. Temperature of 38.8°C (101.8°F)
C. Petechial rash on the trunk and extremities
Rationale: A petechial rash in meningitis suggests Neisseria meningitidis and
indicates disseminated intravascular coagulation (DIC) or septic shock. This is a
medical emergency requiring rapid antibiotics and supportive care.
7. A client is prescribed furosemide 40 mg IV push. Which laboratory value should
the LPN review prior to administration?
A. Serum calcium
B. Serum sodium
C. Serum potassium
D. Serum creatinine
C. Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting.
Hypokalemia increases risk of digoxin toxicity and cardiac dysrhythmias. The
nurse must check potassium levels before and during therapy.
8. During a home visit, an older adult client reports taking multiple over-the-
counter (OTC) sleep aids and laxatives daily. What is the LPN’s best response?
A. “Using OTC products is generally safe as long as you follow package
directions.”
B. “You should stop all OTC medications immediately and flush them down the
toilet.”
C. “Let’s review all your medications together, including OTC products, to check
for interactions.”
D. “These products are fine, but try to use the brand name consistently.”
C. “Let’s review all your medications together, including OTC products, to
check for interactions.”
Rationale: Older adults are at high risk for polypharmacy, adverse reactions,
and drug interactions. The nurse should perform a comprehensive medication
reconciliation including OTC, herbal, and prescription drugs.
9. A client with heart failure has an order for digoxin 0.25 mg daily. The apical
pulse is 52 bpm and irregular. Which action should the LPN take?
A. Administer the medication as ordered
B. Hold the medication and notify the RN/ provider
C. Give half the dose and recheck the pulse in 1 hour
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D. Apply oxygen at 2 L/min and then administer digoxin
B. Hold the medication and notify the RN/ provider
*Rationale: Digoxin is withheld if the apical pulse is <60 bpm in an adult (or
<70 in an infant/ child) or if the rhythm is irregular, as this may indicate digoxin
toxicity or worsening heart failure.*
10. A client is admitted with carbon monoxide poisoning. Which intervention is
most important for the LPN to implement?
A. Administer 100% oxygen via non-rebreather mask
B. Draw arterial blood gases
C. Prepare for hyperbaric oxygen therapy
D. Place the client in a supine position
A. Administer 100% oxygen via non-rebreather mask
*Rationale: High-flow oxygen rapidly displaces carbon monoxide from
hemoglobin, reducing half-life from 4-6 hours to 90 minutes. This is the
immediate priority while preparing for possible hyperbaric oxygen.*
11. The LPN is caring for a client with a chest tube to water seal drainage for a
pneumothorax. Which finding requires immediate action?
A. Continuous bubbling in the water seal chamber
B. Fluctuation (tidaling) in the water seal chamber with respiration
C. 100 mL of serosanguinous drainage in the collection chamber
D. Crepitus palpated around the insertion site
A. Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling indicates an air leak (often from a loose
connection or chest wall opening). Tidaling is normal. Crepitus (subcutaneous
emphysema) should be monitored but is not immediately life-threatening.
12. A client with major depressive disorder refuses to get out of bed or eat. Which
statement by the LPN is most therapeutic?
A. “You need to eat something or you will become even weaker.”
B. “I will sit here with you for 10 minutes while you drink this milkshake.”
C. “Why don’t you want to get up today? Tell me the reason.”
D. “Your family is very worried about you. Please try to eat.”
B. “I will sit here with you for 10 minutes while you drink this milkshake.”
Rationale: This statement offers presence, structure, and a small, achievable
goal without pressure or judgment. Avoid “why” questions (client may not know)
and guilt-inducing statements.
HESI LPN-ADN MOBILITY ACTUAL EXAM
PREP 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK |NEW AND REVISED
1. A client with chronic kidney disease (CKD) has a serum potassium of 6.2
mEq/L. Which intervention should the LPN implement first after notifying the
RN?
A. Administer sodium polystyrene sulfonate as ordered
B. Place the client on a cardiac monitor
C. Restrict all oral fluids for 8 hours
D. Encourage intake of high-carbohydrate foods
B. Place the client on a cardiac monitor
*Rationale: Hyperkalemia (K+ >5.5) can cause life-threatening dysrhythmias.
Cardiac monitoring is the priority to detect changes such as peaked T waves or
ventricular fibrillation. Sodium polystyrene sulfonate is a treatment but not the
first action before ensuring cardiac safety.*
2. A postoperative client reports sudden onset of chest pain and dyspnea. The
oxygen saturation is 88% on room air. What is the priority nursing action?
A. Administer PRN morphine sulfate
B. Raise the head of the bed to 90 degrees
C. Prepare for an electrocardiogram (ECG)
D. Apply a sequential compression device
B. Raise the head of the bed to 90 degrees
Rationale: This presentation suggests a pulmonary embolism. High Fowler’s
position optimizes lung expansion and oxygenation, improving saturation while
further interventions are initiated. Morphine may be given later for pain/
anxiety, but positioning is immediate.
,2|Page
3. A client with type 1 diabetes mellitus is found diaphoretic, confused, and
tachycardic. Which action should the LPN take first?
A. Administer 15g of fast-acting carbohydrates
B. Check blood glucose level
C. Give 0.5 mg of glucagon intramuscularly
D. Start an IV line of normal saline
B. Check blood glucose level
Rationale: While symptoms suggest hypoglycemia, the LPN must verify the blood
glucose level before treatment to avoid giving glucose to a hyperglycemic client.
The "treat first, then check" rule applies only if a glucose meter is unavailable
or the patient is unconscious.
4. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which
task is appropriate for the LPN to delegate?
A. Perform the initial admission assessment on a new client
B. Reinsert a nasogastric tube that has become dislodged
C. Measure orthostatic blood pressures on a stable client
D. Evaluate the effectiveness of a client’s pain medication
C. Measure orthostatic blood pressures on a stable client
Rationale: Delegation follows the rule that stable, predictable tasks with no
expected complication can be assigned to UAP. Assessment, evaluation, and
invasive procedures (NG tube) remain with the licensed nurse.
5. A client receiving a blood transfusion develops chills, fever, and lower back
pain. What is the LPN’s priority action?
A. Slow the infusion rate to 10 mL/hour
B. Stop the transfusion immediately
C. Administer acetaminophen as ordered
D. Notify the healthcare provider
B. Stop the transfusion immediately
Rationale: These symptoms indicate an acute hemolytic transfusion reaction.
The priority is to stop the transfusion to prevent further destruction of RBCs,
then maintain IV line with saline, notify the provider, and send blood bag to lab.
6. Which clinical finding in a client with bacterial meningitis requires immediate
intervention by the LPN?
A. Complaints of severe headache and photophobia
B. Positive Kernig’s and Brudzinski’s signs
,3|Page
C. Petechial rash on the trunk and extremities
D. Temperature of 38.8°C (101.8°F)
C. Petechial rash on the trunk and extremities
Rationale: A petechial rash in meningitis suggests Neisseria meningitidis and
indicates disseminated intravascular coagulation (DIC) or septic shock. This is a
medical emergency requiring rapid antibiotics and supportive care.
7. A client is prescribed furosemide 40 mg IV push. Which laboratory value should
the LPN review prior to administration?
A. Serum calcium
B. Serum sodium
C. Serum potassium
D. Serum creatinine
C. Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting.
Hypokalemia increases risk of digoxin toxicity and cardiac dysrhythmias. The
nurse must check potassium levels before and during therapy.
8. During a home visit, an older adult client reports taking multiple over-the-
counter (OTC) sleep aids and laxatives daily. What is the LPN’s best response?
A. “Using OTC products is generally safe as long as you follow package
directions.”
B. “You should stop all OTC medications immediately and flush them down the
toilet.”
C. “Let’s review all your medications together, including OTC products, to check
for interactions.”
D. “These products are fine, but try to use the brand name consistently.”
C. “Let’s review all your medications together, including OTC products, to
check for interactions.”
Rationale: Older adults are at high risk for polypharmacy, adverse reactions,
and drug interactions. The nurse should perform a comprehensive medication
reconciliation including OTC, herbal, and prescription drugs.
9. A client with heart failure has an order for digoxin 0.25 mg daily. The apical
pulse is 52 bpm and irregular. Which action should the LPN take?
A. Administer the medication as ordered
B. Hold the medication and notify the RN/ provider
C. Give half the dose and recheck the pulse in 1 hour
, 4|Page
D. Apply oxygen at 2 L/min and then administer digoxin
B. Hold the medication and notify the RN/ provider
*Rationale: Digoxin is withheld if the apical pulse is <60 bpm in an adult (or
<70 in an infant/ child) or if the rhythm is irregular, as this may indicate digoxin
toxicity or worsening heart failure.*
10. A client is admitted with carbon monoxide poisoning. Which intervention is
most important for the LPN to implement?
A. Administer 100% oxygen via non-rebreather mask
B. Draw arterial blood gases
C. Prepare for hyperbaric oxygen therapy
D. Place the client in a supine position
A. Administer 100% oxygen via non-rebreather mask
*Rationale: High-flow oxygen rapidly displaces carbon monoxide from
hemoglobin, reducing half-life from 4-6 hours to 90 minutes. This is the
immediate priority while preparing for possible hyperbaric oxygen.*
11. The LPN is caring for a client with a chest tube to water seal drainage for a
pneumothorax. Which finding requires immediate action?
A. Continuous bubbling in the water seal chamber
B. Fluctuation (tidaling) in the water seal chamber with respiration
C. 100 mL of serosanguinous drainage in the collection chamber
D. Crepitus palpated around the insertion site
A. Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling indicates an air leak (often from a loose
connection or chest wall opening). Tidaling is normal. Crepitus (subcutaneous
emphysema) should be monitored but is not immediately life-threatening.
12. A client with major depressive disorder refuses to get out of bed or eat. Which
statement by the LPN is most therapeutic?
A. “You need to eat something or you will become even weaker.”
B. “I will sit here with you for 10 minutes while you drink this milkshake.”
C. “Why don’t you want to get up today? Tell me the reason.”
D. “Your family is very worried about you. Please try to eat.”
B. “I will sit here with you for 10 minutes while you drink this milkshake.”
Rationale: This statement offers presence, structure, and a small, achievable
goal without pressure or judgment. Avoid “why” questions (client may not know)
and guilt-inducing statements.
