HESI PN EXIT EXAM 2026: 800+ NGN PRACTICE
QUESTIONS & RATIONALES – GUARANTEED NCLEX-
PN PASS (A+ VERIFIED)
HESI PN Exit Exam 2026 – 800+ NGN-Style Questions with Detailed Rationales! Conquer the
HESI PN Exit and ace the NCLEX-PN with this comprehensive, up-to-date test bank. Featuring
Next Generation NCLEX (NGN) unfolding case studies, stand-alone items, and traditional
multiple-choice questions. Each question includes a bolded correct answer and a thorough
Rationale explaining the "why." Covers pharmacology, med-surg, maternal-child, mental
health, and critical care. Includes 800+ Q&As covering high-yield topics like fluid/electrolytes,
cardiac, respiratory, and prioritization. Created by experienced nurse educators. Instant digital
download. Boost your confidence, identify weak areas, and pass on your first attempt! Perfect
for Chamberlain, Rasmussen, Concorde, Fortis, and Herzing students. Get your A+ today!
,1. A client with chronic obstructive pulmonary disease (COPD) has an arterial blood gas (ABG)
result showing pH 7.31, PaCO2 58 mmHg, HCO3 24 mEq/L. The nurse interprets this as which
acid-base imbalance?
a) Metabolic acidosis
b) Metabolic alkalosis
c) Respiratory acidosis
d) Respiratory alkalosis
Correct Answer: c) Respiratory acidosis
Rationale: The pH is below 7.35, indicating acidosis. The PaCO2 is elevated above 45 mmHg,
indicating a respiratory cause. The HCO3 is normal at 24 mEq/L, meaning there is no renal
compensation yet. In COPD, clients retain CO2 due to inadequate ventilation, leading to
respiratory acidosis.
2. A postoperative client reports sudden chest pain, shortness of breath, and hemoptysis. The
nurse notes tachycardia and tachypnea. Which condition should the nurse suspect first?
a) Atelectasis
b) Pulmonary embolism
c) Pneumothorax
d) Wound infection
Correct Answer: b) Pulmonary embolism
Rationale: The classic triad of sudden chest pain, shortness of breath, and hemoptysis, along
with tachycardia and tachypnea, strongly suggests a pulmonary embolism (PE). Postoperative
clients are at high risk for venous thromboembolism due to immobility and surgical
hypercoagulability. Atelectasis typically presents with low-grade fever and crackles;
pneumothorax presents with absent breath sounds; wound infection would have localized
signs.
3. A client with type 1 diabetes mellitus is found unresponsive. The nurse notes dry skin, fruity
breath odor, and Kussmaul respirations. Which intervention should the nurse anticipate?
a) IV push of 50% dextrose
b) IV infusion of regular insulin and normal saline
c) Subcutaneous glucagon
d) Oral glucose gel
,Correct Answer: b) IV infusion of regular insulin and normal saline
Rationale: The clinical presentation of unresponsiveness, fruity breath, dry skin, and Kussmaul
respirations is classic for diabetic ketoacidosis (DKA). DKA requires aggressive fluid
resuscitation with normal saline and IV regular insulin to lower blood glucose and correct
dehydration. Options A and C are used for hypoglycemia; option D is inappropriate for an
unresponsive client.
4. The nurse is assessing a client with cirrhosis who has asterixis. What does this finding
indicate?
a) Portal hypertension
b) Hepatic encephalopathy
c) Esophageal varices
d) Splenomegaly
Correct Answer: b) Hepatic encephalopathy
Rationale: Asterixis, also known as liver flap, is a tremor of the hands when the wrists are
extended. It is a hallmark sign of hepatic encephalopathy, which results from the liver's
inability to clear ammonia and other neurotoxins from the blood. Portal hypertension, varices,
and splenomegaly are complications of cirrhosis but do not directly cause asterixis.
5. A client with heart failure is prescribed furosemide. Which laboratory value should the nurse
monitor most closely?
a) Serum sodium
b) Serum potassium
c) Serum calcium
d) Serum magnesium
Correct Answer: b) Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant potassium wasting in the distal
tubule. Hypokalemia is a common and potentially dangerous side effect that can precipitate
cardiac arrhythmias, especially in clients taking digoxin. While sodium, calc ium, and
magnesium may also be affected, potassium monitoring is the highest priority.
, 6. A client who is 6 hours post-gastrectomy has a nasogastric (NG) tube set to low intermittent
suction. The nurse notes scant sanguineous drainage. Which action is most appropriate?
a) Irrigate the NG tube with sterile saline
b) Reposition the NG tube and advance it 2 cm
c) Document the finding as expected
d) Notify the healthcare provider immediately
Correct Answer: c) Document the finding as expected
Rationale: In the immediate postoperative period after gastrectomy, scant sanguineous
(bloody) drainage from the NG tube is a normal and expected finding. The NG tube is used to
decompress the stomach and prevent distension. Irrigation should only be done with a specific
order; repositioning can cause injury; there is no need to notify the provider for this expected
finding.
7. A nurse is providing discharge teaching to a client with a new colostomy. Which statement by
the client indicates a need for further teaching?
a) "I will need to avoid gas-forming foods like beans and broccoli."
b) "I should change the ostomy pouch only when it becomes loose or leaks."
c) "I will inspect the stoma daily for color changes or swelling."
d) "I can take a shower with the pouch on or off."
Correct Answer: b) "I should change the ostomy pouch only when it becomes loose or leaks."
Rationale: Ostomy pouches should be changed routinely every 3 to 7 days, even if they are not
leaking, to maintain skin integrity and prevent breakdown. Waiting until leakage occurs
increases the risk of peristomal skin irritation. The other statements are correct: gas-forming
foods should be limited; stoma assessment is essential; and showering with or without the
pouch is safe.
8. A client with major depressive disorder is prescribed phenelzine. Which food item should the
nurse instruct the client to avoid?
a) Apples and bananas
b) Aged cheese and red wine
c) Chicken and fish
d) Rice and pasta
QUESTIONS & RATIONALES – GUARANTEED NCLEX-
PN PASS (A+ VERIFIED)
HESI PN Exit Exam 2026 – 800+ NGN-Style Questions with Detailed Rationales! Conquer the
HESI PN Exit and ace the NCLEX-PN with this comprehensive, up-to-date test bank. Featuring
Next Generation NCLEX (NGN) unfolding case studies, stand-alone items, and traditional
multiple-choice questions. Each question includes a bolded correct answer and a thorough
Rationale explaining the "why." Covers pharmacology, med-surg, maternal-child, mental
health, and critical care. Includes 800+ Q&As covering high-yield topics like fluid/electrolytes,
cardiac, respiratory, and prioritization. Created by experienced nurse educators. Instant digital
download. Boost your confidence, identify weak areas, and pass on your first attempt! Perfect
for Chamberlain, Rasmussen, Concorde, Fortis, and Herzing students. Get your A+ today!
,1. A client with chronic obstructive pulmonary disease (COPD) has an arterial blood gas (ABG)
result showing pH 7.31, PaCO2 58 mmHg, HCO3 24 mEq/L. The nurse interprets this as which
acid-base imbalance?
a) Metabolic acidosis
b) Metabolic alkalosis
c) Respiratory acidosis
d) Respiratory alkalosis
Correct Answer: c) Respiratory acidosis
Rationale: The pH is below 7.35, indicating acidosis. The PaCO2 is elevated above 45 mmHg,
indicating a respiratory cause. The HCO3 is normal at 24 mEq/L, meaning there is no renal
compensation yet. In COPD, clients retain CO2 due to inadequate ventilation, leading to
respiratory acidosis.
2. A postoperative client reports sudden chest pain, shortness of breath, and hemoptysis. The
nurse notes tachycardia and tachypnea. Which condition should the nurse suspect first?
a) Atelectasis
b) Pulmonary embolism
c) Pneumothorax
d) Wound infection
Correct Answer: b) Pulmonary embolism
Rationale: The classic triad of sudden chest pain, shortness of breath, and hemoptysis, along
with tachycardia and tachypnea, strongly suggests a pulmonary embolism (PE). Postoperative
clients are at high risk for venous thromboembolism due to immobility and surgical
hypercoagulability. Atelectasis typically presents with low-grade fever and crackles;
pneumothorax presents with absent breath sounds; wound infection would have localized
signs.
3. A client with type 1 diabetes mellitus is found unresponsive. The nurse notes dry skin, fruity
breath odor, and Kussmaul respirations. Which intervention should the nurse anticipate?
a) IV push of 50% dextrose
b) IV infusion of regular insulin and normal saline
c) Subcutaneous glucagon
d) Oral glucose gel
,Correct Answer: b) IV infusion of regular insulin and normal saline
Rationale: The clinical presentation of unresponsiveness, fruity breath, dry skin, and Kussmaul
respirations is classic for diabetic ketoacidosis (DKA). DKA requires aggressive fluid
resuscitation with normal saline and IV regular insulin to lower blood glucose and correct
dehydration. Options A and C are used for hypoglycemia; option D is inappropriate for an
unresponsive client.
4. The nurse is assessing a client with cirrhosis who has asterixis. What does this finding
indicate?
a) Portal hypertension
b) Hepatic encephalopathy
c) Esophageal varices
d) Splenomegaly
Correct Answer: b) Hepatic encephalopathy
Rationale: Asterixis, also known as liver flap, is a tremor of the hands when the wrists are
extended. It is a hallmark sign of hepatic encephalopathy, which results from the liver's
inability to clear ammonia and other neurotoxins from the blood. Portal hypertension, varices,
and splenomegaly are complications of cirrhosis but do not directly cause asterixis.
5. A client with heart failure is prescribed furosemide. Which laboratory value should the nurse
monitor most closely?
a) Serum sodium
b) Serum potassium
c) Serum calcium
d) Serum magnesium
Correct Answer: b) Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant potassium wasting in the distal
tubule. Hypokalemia is a common and potentially dangerous side effect that can precipitate
cardiac arrhythmias, especially in clients taking digoxin. While sodium, calc ium, and
magnesium may also be affected, potassium monitoring is the highest priority.
, 6. A client who is 6 hours post-gastrectomy has a nasogastric (NG) tube set to low intermittent
suction. The nurse notes scant sanguineous drainage. Which action is most appropriate?
a) Irrigate the NG tube with sterile saline
b) Reposition the NG tube and advance it 2 cm
c) Document the finding as expected
d) Notify the healthcare provider immediately
Correct Answer: c) Document the finding as expected
Rationale: In the immediate postoperative period after gastrectomy, scant sanguineous
(bloody) drainage from the NG tube is a normal and expected finding. The NG tube is used to
decompress the stomach and prevent distension. Irrigation should only be done with a specific
order; repositioning can cause injury; there is no need to notify the provider for this expected
finding.
7. A nurse is providing discharge teaching to a client with a new colostomy. Which statement by
the client indicates a need for further teaching?
a) "I will need to avoid gas-forming foods like beans and broccoli."
b) "I should change the ostomy pouch only when it becomes loose or leaks."
c) "I will inspect the stoma daily for color changes or swelling."
d) "I can take a shower with the pouch on or off."
Correct Answer: b) "I should change the ostomy pouch only when it becomes loose or leaks."
Rationale: Ostomy pouches should be changed routinely every 3 to 7 days, even if they are not
leaking, to maintain skin integrity and prevent breakdown. Waiting until leakage occurs
increases the risk of peristomal skin irritation. The other statements are correct: gas-forming
foods should be limited; stoma assessment is essential; and showering with or without the
pouch is safe.
8. A client with major depressive disorder is prescribed phenelzine. Which food item should the
nurse instruct the client to avoid?
a) Apples and bananas
b) Aged cheese and red wine
c) Chicken and fish
d) Rice and pasta
