PN HESI EXIT EXAM V1 – 150 Questions with
Verified Answers 2026/2027 Updated | Elsevier HESI
PN Exit Exam
Section 1: Fundamentals of Nursing & Patient Safety (Q1-Q10)
Q1. 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 return later
- b. Wait for the client to finish the call and observe medication intake
- c. Return medication and document refusal
- d. Leave medication at bedside
Rationale: Medication administration requires verification of the five rights and direct observation
of ingestion. Waiting respects the client while maintaining safety.
Q2. A confused long-term care resident has no ID band. What should the PN do before giving
medication?
- a. Ask staff to confirm identity
- b. Wait for family
✅
- c. Reorient the resident
- d. Verify room and bed number
Rationale: Facility-approved identifiers must be used to confirm identity. Room and bed number
provide objective verification.
Q3. An elderly client who is 12 hours postoperative suddenly becomes agitated, staggers out
into the corridor, and demands to be set free. Which intervention is best?
✅
- a. Notify HCP and request restraints
- b. Raise side rails and notify family to come sit with the client
- c. Administer narcotic antagonist
- d. Instruct UAP to check every 15 minutes
Rationale: Family presence provides reorientation and comfort. Restraints should be a last
resort.
Q4. The PN is charting vital signs and realizes an error has been made. What should the PN
do?
,- a. Draw one line through the entry and insert correct information ✅
- b. Chart correct information in the column
- c. Obliterate the entry and insert correct information
- d. Notify charge nurse
Rationale: The correct method for correcting a charting error is to strike through with a single
line, then write the correct information.
Q5. While providing oral care for an unconscious client, the PN positions the client laterally.
Which intervention is best?
✅
- a. Swab oral cavity with washcloth
- b. Use oral swabs with normal saline
- c. Provide Yankauer tip for oral suction
- d. Support head with small pillow
Rationale: Oral swabs moistened with normal saline effectively clean the mouth without causing
trauma.
Q6. A client with two chest tubes after a left lobectomy has tidaling and bubbling in the suction
chamber. What should the PN do?
- a. Clamp the chest tube
✅
- b. Notify the RN immediately
- c. Maintain the system as is
- d. Apply an occlusive dressing
Rationale: Tidaling and gentle bubbling in the suction chamber are normal findings indicating
proper function.
Q7. A client is diagnosed with acute myocardial infarction (MI). Which lab value should the PN
✅
anticipate to be the first to elevate?
- a. Elevated troponin
- b. Elevated CK-MB
- c. Prolonged PT
- d. Elevated BUN and creatinine
Rationale: Troponin is the most sensitive and specific cardiac marker for MI, elevating within 3-4
hours of myocardial injury.
Q8. A client with emphysema who is oxygen-dependent lives alone. Which finding should
prompt the PN to consult the RN case manager?
✅
- a. Pulse oximetry 91% on 2 L/min oxygen
- b. Weight loss of 5 pounds since last monthly visit
- c. Needs to increase oxygen at night
- d. Dirty dishes and clothing scattered around home
,Rationale: Weight loss of 5 pounds in 1 month is a concern. Clients with COPD need additional
calorie intake because they are using energy to breathe.
Q9. A client with small cell carcinoma of the lung has developed SIADH. Which outcome finding
is the priority?
- a. Reduced peripheral edema
- b. Urinary output of at least 70 mL/hr
✅
- c. Decrease in urine osmolarity
- d. Serum sodium level of 137 mEq/L
Rationale: SIADH causes fluid retention and hyponatremia. Normalization of serum sodium is
the most important outcome.
Q10. An elderly client with a history of cardiac disease is confused, complaining of muscle
cramps, and has vomited twice. Vitals: BP 130/70, P-47, R-18. Which medication should the PN
be MOST concerned about?
- a. Warfarin
- b. Ibuprofen
✅
- c. Nitroglycerine
- d. Digitalis
Rationale: Elderly clients are particularly susceptible to digitalis toxicity. Toxicity can cause
anorexia, nausea, vomiting, diarrhea, headache, muscle cramps, and fatigue.
Section 2: Medical-Surgical Nursing (Q11-Q30)
Q11. The home health PN is visiting a client with a pacemaker placed 6 months ago. Which
symptom complaint would be indicative of pacemaker failure?
- a. Facial flushing
- b. Nausea
✅
- c. Pounding headache
- d. Feelings of dizziness
Rationale: Dizziness may occur as the result of a decreased heart rate, leading to decreased
cardiac output as a result of pacemaker failure.
Q12. A client status post-femoral rod placement surgery suddenly complains of chest pain,
becomes SOB, pale, and diaphoretic. Vitals: BP 100/80, HR 110, RR 36. What nursing action
should the PN take next?
- a. Provide paper bag for hyperventilation
- b. Administer PRN analgesic
, ✅
- c. Lower head of bed and raise feet
- d. Apply oxygen at 2 L per nasal cannula
Rationale: The PN should immediately provide oxygen while performing further assessment.
Pulmonary embolism and pneumothorax are risks associated with major surgery.
Q13. A client with a history of left-sided heart failure is receiving furosemide (Lasix). Which
assessment finding indicates the medication is effective?
✅
- a. Weight gain of 2 lbs
- b. Decreased peripheral edema
- c. Crackles in lung bases
- d. Increased jugular vein distention
Rationale: Furosemide is a loop diuretic used to reduce fluid volume. Decreased peripheral
edema indicates the medication is effectively reducing fluid overload.
Q14. A client with COPD has an SpO2 of 88% on room air. Which oxygen delivery method is
safest?
✅
- a. Non-rebreather mask at 15 L/min
- b. Nasal cannula at 2 L/min
- c. Simple face mask at 8 L/min
- d. Venturi mask at 50% FiO2
Rationale: In COPD, high oxygen levels may suppress the hypoxic drive. Low-flow oxygen via
nasal cannula (1-2 L/min) is recommended.
Q15. A client with a new colostomy asks about dietary changes. Which food should the PN
recommend to reduce odor?
✅
- a. Eggs
- b. Yogurt
- c. Onions
- d. Garlic
Rationale: Yogurt (probiotics) can reduce ostomy odor. Eggs, onions, garlic, fish, and asparagus
increase odor.
Q16. A client with a tracheostomy tube suddenly develops respiratory distress. The PN attempts
to pass a suction catheter but meets resistance. The priority intervention is to:
✅
- a. Instill 5 mL of normal saline
- b. Remove the inner cannula and attempt to suction the outer cannula
- c. Notify the provider immediately
- d. Increase suction pressure
Verified Answers 2026/2027 Updated | Elsevier HESI
PN Exit Exam
Section 1: Fundamentals of Nursing & Patient Safety (Q1-Q10)
Q1. 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 return later
- b. Wait for the client to finish the call and observe medication intake
- c. Return medication and document refusal
- d. Leave medication at bedside
Rationale: Medication administration requires verification of the five rights and direct observation
of ingestion. Waiting respects the client while maintaining safety.
Q2. A confused long-term care resident has no ID band. What should the PN do before giving
medication?
- a. Ask staff to confirm identity
- b. Wait for family
✅
- c. Reorient the resident
- d. Verify room and bed number
Rationale: Facility-approved identifiers must be used to confirm identity. Room and bed number
provide objective verification.
Q3. An elderly client who is 12 hours postoperative suddenly becomes agitated, staggers out
into the corridor, and demands to be set free. Which intervention is best?
✅
- a. Notify HCP and request restraints
- b. Raise side rails and notify family to come sit with the client
- c. Administer narcotic antagonist
- d. Instruct UAP to check every 15 minutes
Rationale: Family presence provides reorientation and comfort. Restraints should be a last
resort.
Q4. The PN is charting vital signs and realizes an error has been made. What should the PN
do?
,- a. Draw one line through the entry and insert correct information ✅
- b. Chart correct information in the column
- c. Obliterate the entry and insert correct information
- d. Notify charge nurse
Rationale: The correct method for correcting a charting error is to strike through with a single
line, then write the correct information.
Q5. While providing oral care for an unconscious client, the PN positions the client laterally.
Which intervention is best?
✅
- a. Swab oral cavity with washcloth
- b. Use oral swabs with normal saline
- c. Provide Yankauer tip for oral suction
- d. Support head with small pillow
Rationale: Oral swabs moistened with normal saline effectively clean the mouth without causing
trauma.
Q6. A client with two chest tubes after a left lobectomy has tidaling and bubbling in the suction
chamber. What should the PN do?
- a. Clamp the chest tube
✅
- b. Notify the RN immediately
- c. Maintain the system as is
- d. Apply an occlusive dressing
Rationale: Tidaling and gentle bubbling in the suction chamber are normal findings indicating
proper function.
Q7. A client is diagnosed with acute myocardial infarction (MI). Which lab value should the PN
✅
anticipate to be the first to elevate?
- a. Elevated troponin
- b. Elevated CK-MB
- c. Prolonged PT
- d. Elevated BUN and creatinine
Rationale: Troponin is the most sensitive and specific cardiac marker for MI, elevating within 3-4
hours of myocardial injury.
Q8. A client with emphysema who is oxygen-dependent lives alone. Which finding should
prompt the PN to consult the RN case manager?
✅
- a. Pulse oximetry 91% on 2 L/min oxygen
- b. Weight loss of 5 pounds since last monthly visit
- c. Needs to increase oxygen at night
- d. Dirty dishes and clothing scattered around home
,Rationale: Weight loss of 5 pounds in 1 month is a concern. Clients with COPD need additional
calorie intake because they are using energy to breathe.
Q9. A client with small cell carcinoma of the lung has developed SIADH. Which outcome finding
is the priority?
- a. Reduced peripheral edema
- b. Urinary output of at least 70 mL/hr
✅
- c. Decrease in urine osmolarity
- d. Serum sodium level of 137 mEq/L
Rationale: SIADH causes fluid retention and hyponatremia. Normalization of serum sodium is
the most important outcome.
Q10. An elderly client with a history of cardiac disease is confused, complaining of muscle
cramps, and has vomited twice. Vitals: BP 130/70, P-47, R-18. Which medication should the PN
be MOST concerned about?
- a. Warfarin
- b. Ibuprofen
✅
- c. Nitroglycerine
- d. Digitalis
Rationale: Elderly clients are particularly susceptible to digitalis toxicity. Toxicity can cause
anorexia, nausea, vomiting, diarrhea, headache, muscle cramps, and fatigue.
Section 2: Medical-Surgical Nursing (Q11-Q30)
Q11. The home health PN is visiting a client with a pacemaker placed 6 months ago. Which
symptom complaint would be indicative of pacemaker failure?
- a. Facial flushing
- b. Nausea
✅
- c. Pounding headache
- d. Feelings of dizziness
Rationale: Dizziness may occur as the result of a decreased heart rate, leading to decreased
cardiac output as a result of pacemaker failure.
Q12. A client status post-femoral rod placement surgery suddenly complains of chest pain,
becomes SOB, pale, and diaphoretic. Vitals: BP 100/80, HR 110, RR 36. What nursing action
should the PN take next?
- a. Provide paper bag for hyperventilation
- b. Administer PRN analgesic
, ✅
- c. Lower head of bed and raise feet
- d. Apply oxygen at 2 L per nasal cannula
Rationale: The PN should immediately provide oxygen while performing further assessment.
Pulmonary embolism and pneumothorax are risks associated with major surgery.
Q13. A client with a history of left-sided heart failure is receiving furosemide (Lasix). Which
assessment finding indicates the medication is effective?
✅
- a. Weight gain of 2 lbs
- b. Decreased peripheral edema
- c. Crackles in lung bases
- d. Increased jugular vein distention
Rationale: Furosemide is a loop diuretic used to reduce fluid volume. Decreased peripheral
edema indicates the medication is effectively reducing fluid overload.
Q14. A client with COPD has an SpO2 of 88% on room air. Which oxygen delivery method is
safest?
✅
- a. Non-rebreather mask at 15 L/min
- b. Nasal cannula at 2 L/min
- c. Simple face mask at 8 L/min
- d. Venturi mask at 50% FiO2
Rationale: In COPD, high oxygen levels may suppress the hypoxic drive. Low-flow oxygen via
nasal cannula (1-2 L/min) is recommended.
Q15. A client with a new colostomy asks about dietary changes. Which food should the PN
recommend to reduce odor?
✅
- a. Eggs
- b. Yogurt
- c. Onions
- d. Garlic
Rationale: Yogurt (probiotics) can reduce ostomy odor. Eggs, onions, garlic, fish, and asparagus
increase odor.
Q16. A client with a tracheostomy tube suddenly develops respiratory distress. The PN attempts
to pass a suction catheter but meets resistance. The priority intervention is to:
✅
- a. Instill 5 mL of normal saline
- b. Remove the inner cannula and attempt to suction the outer cannula
- c. Notify the provider immediately
- d. Increase suction pressure
