Elsevier Health Sciences
Q 0051 NP ISEH
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ELSEVIER
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HESI Exit Examination · Practical Nursing
A D V A N C I N G H E A LT H C A R E T H R O U G H K N O W L E D G E
EST. 1880
Comprehensive HESI PN Exit Exam: 1500 Questions &
Rationales
M E D I C A L-S U R G I C A L · P H A R M A CO LO G Y · M AT E R N A L- N E W B O R N · P E D I AT R I C · M E N TA L H E A LT H ·
P R O F E SS I O N A L P R A C T I C E
INSTITUTION Elsevier Health Sciences / HESI Testing COURSE CODE PN-HESI-1500-2026
PROGRAM Practical Nursing (PN) · NCLEX-PN ACADEMIC YEAR
Preparation
EXAM TITLE Comprehensive HESI PN Exit — 1500 TOTAL QUESTIONS 50 Questions (Sample Set)
Questions & Rationales
COURSE TITLE Practical Nursing Exit Readiness · Clinical FORMAT Multiple Choice — Select the Single Best
Judgment & Safe Practice Answer
EXAMINATION INSTRUCTIONS
▸ This sample set represents 50 questions from the comprehensive 1500-question HESI PN Exit Exam bank.
▸ Questions span all PN content areas: medical-surgical, pharmacology, maternal-newborn, pediatric, mental health, and professional
practice.
▸ Select the single best answer for each question based on NCLEX-PN test plan and HESI Exit Exam standards.
▸ Correct answers and detailed clinical rationales appear below each question for comprehensive exam preparation.
▸ All rationales emphasize the "why" behind correct answers—critical for developing clinical judgment.
CLINICAL REASONING · NURSING INTERVENTIONS · PHARMACOLOGY · Questions
PATHOPHYSIOLOGY · PROFESSIONAL PRACTICE 1 – 50
1. What step of the injection technique should the PN reteach for subcutaneous insulin administration?
A. Selecting the same site used for the previous injection
B. Rotating the injection site
C. Using a 90-degree angle for all injections
D. Massaging the site after injection
CORRECT ANSWER B. Rotating the injection site
RATIONALE The PN should reteach the client to rotate the injection site to a different location than the one used for the
previous dose. Systematic rotation within the same anatomical region for each time of day prevents
lipohypertrophy—fatty lumps that impair insulin absorption. Using the exact same spot repeatedly compromises
glycemic control.
,2. What action should the PN take when observing a UAP counting a client's radial pulse?
A. Instruct the UAP to use the carotid site instead
B. Confirm the accuracy of the pulse rate obtained by the UAP
C. Document the pulse rate reported by the UAP without verification
D. Discipline the UAP for performing the task incorrectly
CORRECT ANSWER B. Confirm the accuracy of the pulse rate obtained by the UAP
RATIONALE The PN retains accountability for delegated tasks. When observing a UAP's technique, the PN should first verify the
accuracy of the obtained measurement before documenting or acting on it. If the technique is incorrect, the PN
should then demonstrate the correct procedure. The radial pulse is the appropriate site for routine pulse checks in
adults.
3. What should the PN implement first for an infant with a heel stick glucose level of 40 mg/dL?
A. Administer intravenous dextrose bolus
B. Begin frequent feedings of breast milk or formula
C. Transfer the infant to the NICU immediately
D. Wait 4 hours and recheck the glucose level
CORRECT ANSWER B. Begin frequent feedings of breast milk or formula
RATIONALE For a newborn with borderline hypoglycemia (glucose 40 mg/dL, threshold typically <40–45 mg/dL), the first-line
intervention is early and frequent oral feedings to provide glucose substrate. IV dextrose is reserved for severe
hypoglycemia or when feedings are ineffective. NICU transfer is premature without attempting feeding first.
Waiting delays necessary treatment.
4. How many mL total oral and IV intake should the PN document for a client consuming 8 oz of broth, 4 oz of apple juice,
4 oz of gelatin, and 1 banana, along with 1 liter of IV fluid?
A. 1180 mL
B. 1280 mL
C. 1380 mL
D. 1480 mL
CORRECT ANSWER D. 1480 mL
RATIONALE Oral intake: broth 8 oz × 30 mL = 240 mL; apple juice 4 oz × 30 = 120 mL; gelatin 4 oz × 30 = 120 mL; banana is solid
(not counted). Total oral = 480 mL. IV intake = 1000 mL (1 liter). Total intake = 480 + 1000 = 1480 mL. Only liquids
and foods that become liquid at room temperature (gelatin, ice cream) are counted as fluid intake.
, 5. How should the PN respond when asked to administer medication from an unlabeled syringe?
A. "Sure, I'll administer it right away."
B. "I am not comfortable doing that. Is there something else I can do to help you?"
C. "You should be reported for unsafe practice immediately."
D. Administer the medication without comment to maintain team harmony
CORRECT ANSWER B. "I am not comfortable doing that. Is there something else I can do to help you?"
RATIONALE This assertive (not aggressive) response refuses the unsafe practice while maintaining collegiality by offering
alternative help. Administering an unlabeled, unverified medication violates the "rights" of medication
administration—the nurse who administers must verify the medication. An aggressive response damages
teamwork. Administering without question endangers the client.
6. Which client care tasks can the PN assign to the UAP?
A. Administering oral medications
B. Emptying bedside drainage unit and obtaining a post-voided residual (PVR) volume
C. Developing the nursing care plan
D. Performing initial client admission assessment
CORRECT ANSWER B. Emptying bedside drainage unit and obtaining a post-voided residual (PVR) volume
RATIONALE UAPs can perform routine, non-sterile tasks with predictable outcomes: emptying drainage units, measuring
output, and obtaining specimens. Medication administration, care plan development, and initial assessments
require nursing judgment and cannot be delegated. Note: some facilities may restrict PVR measurement to
licensed staff—always follow facility-specific delegation policies.
7. What intervention should the PN reinforce for a client with pruritus?
A. Apply alcohol-based lotions to dry the skin
B. Keep fingernails trimmed short
C. Scratch the area vigorously to relieve itching
D. Apply heat packs to the pruritic area
CORRECT ANSWER B. Keep fingernails trimmed short
RATIONALE Short, smooth fingernails minimize excoriation (skin breakdown) from scratching. Even with the best intentions,
clients will scratch pruritic areas—trimmed nails reduce the trauma. Alcohol-based products further dry and
irritate the skin. Scratching damages the skin barrier. Heat often intensifies itching by increasing blood flow and
histamine release.
Q 0051 NP ISEH
+
ELSEVIER
+
HESI Exit Examination · Practical Nursing
A D V A N C I N G H E A LT H C A R E T H R O U G H K N O W L E D G E
EST. 1880
Comprehensive HESI PN Exit Exam: 1500 Questions &
Rationales
M E D I C A L-S U R G I C A L · P H A R M A CO LO G Y · M AT E R N A L- N E W B O R N · P E D I AT R I C · M E N TA L H E A LT H ·
P R O F E SS I O N A L P R A C T I C E
INSTITUTION Elsevier Health Sciences / HESI Testing COURSE CODE PN-HESI-1500-2026
PROGRAM Practical Nursing (PN) · NCLEX-PN ACADEMIC YEAR
Preparation
EXAM TITLE Comprehensive HESI PN Exit — 1500 TOTAL QUESTIONS 50 Questions (Sample Set)
Questions & Rationales
COURSE TITLE Practical Nursing Exit Readiness · Clinical FORMAT Multiple Choice — Select the Single Best
Judgment & Safe Practice Answer
EXAMINATION INSTRUCTIONS
▸ This sample set represents 50 questions from the comprehensive 1500-question HESI PN Exit Exam bank.
▸ Questions span all PN content areas: medical-surgical, pharmacology, maternal-newborn, pediatric, mental health, and professional
practice.
▸ Select the single best answer for each question based on NCLEX-PN test plan and HESI Exit Exam standards.
▸ Correct answers and detailed clinical rationales appear below each question for comprehensive exam preparation.
▸ All rationales emphasize the "why" behind correct answers—critical for developing clinical judgment.
CLINICAL REASONING · NURSING INTERVENTIONS · PHARMACOLOGY · Questions
PATHOPHYSIOLOGY · PROFESSIONAL PRACTICE 1 – 50
1. What step of the injection technique should the PN reteach for subcutaneous insulin administration?
A. Selecting the same site used for the previous injection
B. Rotating the injection site
C. Using a 90-degree angle for all injections
D. Massaging the site after injection
CORRECT ANSWER B. Rotating the injection site
RATIONALE The PN should reteach the client to rotate the injection site to a different location than the one used for the
previous dose. Systematic rotation within the same anatomical region for each time of day prevents
lipohypertrophy—fatty lumps that impair insulin absorption. Using the exact same spot repeatedly compromises
glycemic control.
,2. What action should the PN take when observing a UAP counting a client's radial pulse?
A. Instruct the UAP to use the carotid site instead
B. Confirm the accuracy of the pulse rate obtained by the UAP
C. Document the pulse rate reported by the UAP without verification
D. Discipline the UAP for performing the task incorrectly
CORRECT ANSWER B. Confirm the accuracy of the pulse rate obtained by the UAP
RATIONALE The PN retains accountability for delegated tasks. When observing a UAP's technique, the PN should first verify the
accuracy of the obtained measurement before documenting or acting on it. If the technique is incorrect, the PN
should then demonstrate the correct procedure. The radial pulse is the appropriate site for routine pulse checks in
adults.
3. What should the PN implement first for an infant with a heel stick glucose level of 40 mg/dL?
A. Administer intravenous dextrose bolus
B. Begin frequent feedings of breast milk or formula
C. Transfer the infant to the NICU immediately
D. Wait 4 hours and recheck the glucose level
CORRECT ANSWER B. Begin frequent feedings of breast milk or formula
RATIONALE For a newborn with borderline hypoglycemia (glucose 40 mg/dL, threshold typically <40–45 mg/dL), the first-line
intervention is early and frequent oral feedings to provide glucose substrate. IV dextrose is reserved for severe
hypoglycemia or when feedings are ineffective. NICU transfer is premature without attempting feeding first.
Waiting delays necessary treatment.
4. How many mL total oral and IV intake should the PN document for a client consuming 8 oz of broth, 4 oz of apple juice,
4 oz of gelatin, and 1 banana, along with 1 liter of IV fluid?
A. 1180 mL
B. 1280 mL
C. 1380 mL
D. 1480 mL
CORRECT ANSWER D. 1480 mL
RATIONALE Oral intake: broth 8 oz × 30 mL = 240 mL; apple juice 4 oz × 30 = 120 mL; gelatin 4 oz × 30 = 120 mL; banana is solid
(not counted). Total oral = 480 mL. IV intake = 1000 mL (1 liter). Total intake = 480 + 1000 = 1480 mL. Only liquids
and foods that become liquid at room temperature (gelatin, ice cream) are counted as fluid intake.
, 5. How should the PN respond when asked to administer medication from an unlabeled syringe?
A. "Sure, I'll administer it right away."
B. "I am not comfortable doing that. Is there something else I can do to help you?"
C. "You should be reported for unsafe practice immediately."
D. Administer the medication without comment to maintain team harmony
CORRECT ANSWER B. "I am not comfortable doing that. Is there something else I can do to help you?"
RATIONALE This assertive (not aggressive) response refuses the unsafe practice while maintaining collegiality by offering
alternative help. Administering an unlabeled, unverified medication violates the "rights" of medication
administration—the nurse who administers must verify the medication. An aggressive response damages
teamwork. Administering without question endangers the client.
6. Which client care tasks can the PN assign to the UAP?
A. Administering oral medications
B. Emptying bedside drainage unit and obtaining a post-voided residual (PVR) volume
C. Developing the nursing care plan
D. Performing initial client admission assessment
CORRECT ANSWER B. Emptying bedside drainage unit and obtaining a post-voided residual (PVR) volume
RATIONALE UAPs can perform routine, non-sterile tasks with predictable outcomes: emptying drainage units, measuring
output, and obtaining specimens. Medication administration, care plan development, and initial assessments
require nursing judgment and cannot be delegated. Note: some facilities may restrict PVR measurement to
licensed staff—always follow facility-specific delegation policies.
7. What intervention should the PN reinforce for a client with pruritus?
A. Apply alcohol-based lotions to dry the skin
B. Keep fingernails trimmed short
C. Scratch the area vigorously to relieve itching
D. Apply heat packs to the pruritic area
CORRECT ANSWER B. Keep fingernails trimmed short
RATIONALE Short, smooth fingernails minimize excoriation (skin breakdown) from scratching. Even with the best intentions,
clients will scratch pruritic areas—trimmed nails reduce the trauma. Alcohol-based products further dry and
irritate the skin. Scratching damages the skin barrier. Heat often intensifies itching by increasing blood flow and
histamine release.
