HESI PN EXIT EXAM NGN COMPREHENSIVE PRACTICE EXAM | STUDY GUIDE |
TESTBANK | PRACTICE QUESTIONS & ANSWERS | EXAM PREPARATION |
CERTIFICATION EXAM | LATEST UPDATE 2026/2027 | ADVANCED REVIEW
Examiner:
Elsevier HESI (Health Education Systems Incorporated)
## TABLE OF CONTENTS
1. Foundations of Practical Nursing
2. Adult Medical-Surgical Nursing
3. Pharmacology and Medication Safety
4. Maternal-Newborn Nursing
5. Pediatric Nursing
6. Mental Health Nursing
7. Leadership, Delegation, and Prioritization
8. Clinical Judgment (Next Generation Nursing)
9. Infection Prevention and Safety
10. Professional Practice and Patient Education
## DESCRIPTION
This comprehensive practice exam is designed to help Practical Nursing students
prepare for a PN Exit examination by reinforcing concepts commonly emphasized
across PN curricula, nursing textbooks, study guides, and educational review
materials. The questions emphasize clinical judgment, prioritization, patient safety,
pharmacology, medical-surgical nursing, maternal-child care, mental health, and
professional practice using complex scenario-based formats similar in style to
advanced nursing review resources. Each question includes a detailed rationale to
strengthen critical thinking and clinical decision-making rather than memorization.
These original practice questions are intended solely as a study aid and educational
resource. They are not actual examination questions and are not reproduced from any
official examination. They are designed to promote deeper understanding of nursing
concepts that support success on comprehensive PN exit assessments.
,QUESTION 1.
A practical nurse is caring for a client admitted with community-acquired
pneumonia. Four hours after admission, the client becomes increasingly restless,
has an oxygen saturation of 86% on 2 L/min via nasal cannula, respiratory rate of
32/min, and is using accessory muscles. Which action should the nurse take first?
A. Increase oxygen per protocol and reassess the client.
B. Administer the prescribed antibiotic immediately.
C. Encourage the client to perform incentive spirometry.
D. Document the findings and notify the provider after reassessment.
🔴 Correct Answer: A. Increase oxygen per protocol and reassess the client
🔵 Explanation: Airway and breathing take priority when a client demonstrates signs
of acute respiratory compromise. Increasing supplemental oxygen according to
protocol addresses immediate hypoxemia while the nurse continues assessment and
prepares to notify the provider. Antibiotics are important but do not correct
immediate oxygenation deficits. Incentive spirometry is inappropriate during severe
respiratory distress, and delaying intervention for documentation could worsen the
client's condition.
QUESTION 2.
A client with heart failure reports increasing fatigue and gains 2.5 kg (5.5 lb) within
3 days. Which assessment finding most strongly indicates worsening fluid overload?
A. Dry mucous membranes
B. Bilateral crackles in the lung bases
C. Heart rate of 62/min
D. Blood glucose of 126 mg/dL
🔴 Correct Answer: B. Bilateral crackles in the lung bases
🔵 Explanation: Crackles indicate pulmonary fluid accumulation resulting from
worsening heart failure and require prompt evaluation. Weight gain and fatigue
further support fluid retention. Dry mucous membranes suggest dehydration rather
,than overload, while the heart rate and blood glucose do not specifically indicate
worsening heart failure.
QUESTION 3.
A nurse prepares to administer regular insulin and notices the client's blood glucose
is 58 mg/dL. The client is awake, alert, and able to swallow. What is the nurse's
priority action?
A. Administer insulin as prescribed.
B. Notify the healthcare provider before intervening.
C. Provide 15 g of rapid-acting carbohydrate.
D. Recheck glucose in 2 hours.
🔴 Correct Answer: C. Provide 15 g of rapid-acting carbohydrate
🔵 Explanation: A conscious client with symptomatic or confirmed hypoglycemia
should receive approximately 15 g of rapid-acting carbohydrate immediately. Insulin
should be withheld until glucose normalizes. Delaying treatment to notify the
provider or waiting several hours to reassess could allow hypoglycemia to worsen.
QUESTION 4.
A client receiving IV vancomycin develops flushing of the face, itching, and mild
hypotension during the infusion. Which nursing interpretation is most appropriate?
A. The client is experiencing Red Man syndrome related to rapid infusion.
B. The client has developed septic shock.
C. The medication has successfully reached therapeutic levels.
D. The findings indicate acute renal failure.
🔴 Correct Answer: A. The client is experiencing Red Man syndrome related to
rapid infusion
🔵 Explanation: Red Man syndrome is an infusion-related reaction commonly
associated with rapid administration of vancomycin and presents with flushing,
, pruritus, and hypotension. Slowing the infusion and notifying the provider are
appropriate interventions. Septic shock and renal failure present differently, and
therapeutic drug levels do not produce this characteristic reaction.
QUESTION 5.
A postoperative client suddenly reports shortness of breath, pleuritic chest pain,
and anxiety. Which complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Myocardial infarction
D. Pneumothorax
🔴 Correct Answer: B. Pulmonary embolism
🔵 Explanation: Sudden dyspnea, pleuritic chest pain, and anxiety following surgery
are classic findings associated with pulmonary embolism. Immediate assessment and
emergency intervention are required. Atelectasis typically develops more gradually,
while myocardial infarction and pneumothorax have different characteristic clinical
findings.
QUESTION 6.
A nurse is preparing discharge teaching for a client prescribed warfarin. Which
statement by the client indicates correct understanding?
A. "I'll stop taking the medication when I feel better."
B. "I'll maintain a consistent intake of foods containing vitamin K."
C. "I'll avoid having my INR monitored regularly."
D. "I'll take aspirin for headaches unless instructed otherwise."
🔴 Correct Answer: B. I'll maintain a consistent intake of foods containing
vitamin K.
TESTBANK | PRACTICE QUESTIONS & ANSWERS | EXAM PREPARATION |
CERTIFICATION EXAM | LATEST UPDATE 2026/2027 | ADVANCED REVIEW
Examiner:
Elsevier HESI (Health Education Systems Incorporated)
## TABLE OF CONTENTS
1. Foundations of Practical Nursing
2. Adult Medical-Surgical Nursing
3. Pharmacology and Medication Safety
4. Maternal-Newborn Nursing
5. Pediatric Nursing
6. Mental Health Nursing
7. Leadership, Delegation, and Prioritization
8. Clinical Judgment (Next Generation Nursing)
9. Infection Prevention and Safety
10. Professional Practice and Patient Education
## DESCRIPTION
This comprehensive practice exam is designed to help Practical Nursing students
prepare for a PN Exit examination by reinforcing concepts commonly emphasized
across PN curricula, nursing textbooks, study guides, and educational review
materials. The questions emphasize clinical judgment, prioritization, patient safety,
pharmacology, medical-surgical nursing, maternal-child care, mental health, and
professional practice using complex scenario-based formats similar in style to
advanced nursing review resources. Each question includes a detailed rationale to
strengthen critical thinking and clinical decision-making rather than memorization.
These original practice questions are intended solely as a study aid and educational
resource. They are not actual examination questions and are not reproduced from any
official examination. They are designed to promote deeper understanding of nursing
concepts that support success on comprehensive PN exit assessments.
,QUESTION 1.
A practical nurse is caring for a client admitted with community-acquired
pneumonia. Four hours after admission, the client becomes increasingly restless,
has an oxygen saturation of 86% on 2 L/min via nasal cannula, respiratory rate of
32/min, and is using accessory muscles. Which action should the nurse take first?
A. Increase oxygen per protocol and reassess the client.
B. Administer the prescribed antibiotic immediately.
C. Encourage the client to perform incentive spirometry.
D. Document the findings and notify the provider after reassessment.
🔴 Correct Answer: A. Increase oxygen per protocol and reassess the client
🔵 Explanation: Airway and breathing take priority when a client demonstrates signs
of acute respiratory compromise. Increasing supplemental oxygen according to
protocol addresses immediate hypoxemia while the nurse continues assessment and
prepares to notify the provider. Antibiotics are important but do not correct
immediate oxygenation deficits. Incentive spirometry is inappropriate during severe
respiratory distress, and delaying intervention for documentation could worsen the
client's condition.
QUESTION 2.
A client with heart failure reports increasing fatigue and gains 2.5 kg (5.5 lb) within
3 days. Which assessment finding most strongly indicates worsening fluid overload?
A. Dry mucous membranes
B. Bilateral crackles in the lung bases
C. Heart rate of 62/min
D. Blood glucose of 126 mg/dL
🔴 Correct Answer: B. Bilateral crackles in the lung bases
🔵 Explanation: Crackles indicate pulmonary fluid accumulation resulting from
worsening heart failure and require prompt evaluation. Weight gain and fatigue
further support fluid retention. Dry mucous membranes suggest dehydration rather
,than overload, while the heart rate and blood glucose do not specifically indicate
worsening heart failure.
QUESTION 3.
A nurse prepares to administer regular insulin and notices the client's blood glucose
is 58 mg/dL. The client is awake, alert, and able to swallow. What is the nurse's
priority action?
A. Administer insulin as prescribed.
B. Notify the healthcare provider before intervening.
C. Provide 15 g of rapid-acting carbohydrate.
D. Recheck glucose in 2 hours.
🔴 Correct Answer: C. Provide 15 g of rapid-acting carbohydrate
🔵 Explanation: A conscious client with symptomatic or confirmed hypoglycemia
should receive approximately 15 g of rapid-acting carbohydrate immediately. Insulin
should be withheld until glucose normalizes. Delaying treatment to notify the
provider or waiting several hours to reassess could allow hypoglycemia to worsen.
QUESTION 4.
A client receiving IV vancomycin develops flushing of the face, itching, and mild
hypotension during the infusion. Which nursing interpretation is most appropriate?
A. The client is experiencing Red Man syndrome related to rapid infusion.
B. The client has developed septic shock.
C. The medication has successfully reached therapeutic levels.
D. The findings indicate acute renal failure.
🔴 Correct Answer: A. The client is experiencing Red Man syndrome related to
rapid infusion
🔵 Explanation: Red Man syndrome is an infusion-related reaction commonly
associated with rapid administration of vancomycin and presents with flushing,
, pruritus, and hypotension. Slowing the infusion and notifying the provider are
appropriate interventions. Septic shock and renal failure present differently, and
therapeutic drug levels do not produce this characteristic reaction.
QUESTION 5.
A postoperative client suddenly reports shortness of breath, pleuritic chest pain,
and anxiety. Which complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Myocardial infarction
D. Pneumothorax
🔴 Correct Answer: B. Pulmonary embolism
🔵 Explanation: Sudden dyspnea, pleuritic chest pain, and anxiety following surgery
are classic findings associated with pulmonary embolism. Immediate assessment and
emergency intervention are required. Atelectasis typically develops more gradually,
while myocardial infarction and pneumothorax have different characteristic clinical
findings.
QUESTION 6.
A nurse is preparing discharge teaching for a client prescribed warfarin. Which
statement by the client indicates correct understanding?
A. "I'll stop taking the medication when I feel better."
B. "I'll maintain a consistent intake of foods containing vitamin K."
C. "I'll avoid having my INR monitored regularly."
D. "I'll take aspirin for headaches unless instructed otherwise."
🔴 Correct Answer: B. I'll maintain a consistent intake of foods containing
vitamin K.
