1
2026 HESI PN EXIT EXAM V7 | Advanced/Hard/Mixed
Difficulty | Comprehensive Practical Nursing Review | 100%
Pass Guaranteed | Graded A+
1. The practical nurse is caring for a client who is 12 hours post-operative following a total hip
arthroplasty. Which action is most important to prevent dislocation of the new joint?
A. Place a pillow between the client's legs when turning
B. Keep the client in a supine position with the hip flexed to 90 degrees
C. Encourage the client to cross the legs at the ankles
D. Position the client on the affected side for comfort
☑ Correct Answer: A
☑ Explanation: Placing a pillow between the client's legs when turning maintains
abduction and prevents adduction, which is crucial to prevent dislocation of a new hip joint. Hip
flexion should be limited to less than 90 degrees. Crossing the legs and positioning on the
affected side increase the risk of dislocation.
2. A client with a history of alcohol use disorder is admitted with severe withdrawal
symptoms. Which medication should the practical nurse anticipate administering to prevent
,2
complications?
A. Haloperidol
B. Lorazepam
C. Naltrexone
D. Disulfiram
☑ Correct Answer: B
☑ Explanation: Lorazepam, a benzodiazepine, is the drug of choice for managing alcohol
withdrawal to prevent seizures and delirium tremens. Haloperidol may be used for agitation but
does not prevent withdrawal seizures. Naltrexone and disulfiram are used for maintaining
sobriety, not for acute withdrawal.
3. The practical nurse is assessing a client with a suspected pulmonary embolism. Which
finding is most characteristic of this condition?
A. Sudden onset of pleuritic chest pain and dyspnea
B. Gradual onset of productive cough
C. Hemoptysis and bradycardia
D. Wheezing and tachypnea
,3
☑ Correct Answer: A
☑ Explanation: Sudden onset of pleuritic chest pain, dyspnea, and tachycardia are classic
signs of a pulmonary embolism. Productive cough is more indicative of infection. Hemoptysis
may occur but bradycardia is not a typical finding; tachycardia is more common. Wheezing is
more characteristic of asthma or COPD.
4. A client who is pregnant at 38 weeks gestation presents to the labor and delivery unit with
contractions every 5 minutes. The practical nurse notes the client's blood pressure is 150/96
mmHg. Which additional finding indicates preeclampsia?
A. Weight gain of 2 pounds in the past week
B. Urine protein of 300 mg/24 hours
C. Heart rate of 90 beats per minute
D. Hemoglobin level of 11 g/dL
☑ Correct Answer: B
☑ Explanation: Proteinuria (≥ 300 mg in a 24-hour urine collection) along with
, 4
hypertension is a hallmark of preeclampsia. Weight gain of 2 pounds in a week is common in
late pregnancy. Tachycardia and mild anemia are not specific indicators of preeclampsia.
5. The practical nurse is preparing to administer an intramuscular injection of meperidine to a
client in pain. Which action is correct?
A. Use the Z-track technique to prevent leakage
B. Aspirate before injection to ensure no blood return
C. Inject into the deltoid muscle for rapid absorption
D. Massage the site after injection
☑ Correct Answer: A
☑ Explanation: The Z-track technique is recommended for intramuscular injections of
medications that are irritating to tissues, such as meperidine, to prevent leakage into
subcutaneous tissue. Aspiration is not recommended for many IM injections due to updated
guidelines. The ventrogluteal or vastus lateralis sites are preferred over the deltoid for IM
injections. Massaging the site may cause irritation.
2026 HESI PN EXIT EXAM V7 | Advanced/Hard/Mixed
Difficulty | Comprehensive Practical Nursing Review | 100%
Pass Guaranteed | Graded A+
1. The practical nurse is caring for a client who is 12 hours post-operative following a total hip
arthroplasty. Which action is most important to prevent dislocation of the new joint?
A. Place a pillow between the client's legs when turning
B. Keep the client in a supine position with the hip flexed to 90 degrees
C. Encourage the client to cross the legs at the ankles
D. Position the client on the affected side for comfort
☑ Correct Answer: A
☑ Explanation: Placing a pillow between the client's legs when turning maintains
abduction and prevents adduction, which is crucial to prevent dislocation of a new hip joint. Hip
flexion should be limited to less than 90 degrees. Crossing the legs and positioning on the
affected side increase the risk of dislocation.
2. A client with a history of alcohol use disorder is admitted with severe withdrawal
symptoms. Which medication should the practical nurse anticipate administering to prevent
,2
complications?
A. Haloperidol
B. Lorazepam
C. Naltrexone
D. Disulfiram
☑ Correct Answer: B
☑ Explanation: Lorazepam, a benzodiazepine, is the drug of choice for managing alcohol
withdrawal to prevent seizures and delirium tremens. Haloperidol may be used for agitation but
does not prevent withdrawal seizures. Naltrexone and disulfiram are used for maintaining
sobriety, not for acute withdrawal.
3. The practical nurse is assessing a client with a suspected pulmonary embolism. Which
finding is most characteristic of this condition?
A. Sudden onset of pleuritic chest pain and dyspnea
B. Gradual onset of productive cough
C. Hemoptysis and bradycardia
D. Wheezing and tachypnea
,3
☑ Correct Answer: A
☑ Explanation: Sudden onset of pleuritic chest pain, dyspnea, and tachycardia are classic
signs of a pulmonary embolism. Productive cough is more indicative of infection. Hemoptysis
may occur but bradycardia is not a typical finding; tachycardia is more common. Wheezing is
more characteristic of asthma or COPD.
4. A client who is pregnant at 38 weeks gestation presents to the labor and delivery unit with
contractions every 5 minutes. The practical nurse notes the client's blood pressure is 150/96
mmHg. Which additional finding indicates preeclampsia?
A. Weight gain of 2 pounds in the past week
B. Urine protein of 300 mg/24 hours
C. Heart rate of 90 beats per minute
D. Hemoglobin level of 11 g/dL
☑ Correct Answer: B
☑ Explanation: Proteinuria (≥ 300 mg in a 24-hour urine collection) along with
, 4
hypertension is a hallmark of preeclampsia. Weight gain of 2 pounds in a week is common in
late pregnancy. Tachycardia and mild anemia are not specific indicators of preeclampsia.
5. The practical nurse is preparing to administer an intramuscular injection of meperidine to a
client in pain. Which action is correct?
A. Use the Z-track technique to prevent leakage
B. Aspirate before injection to ensure no blood return
C. Inject into the deltoid muscle for rapid absorption
D. Massage the site after injection
☑ Correct Answer: A
☑ Explanation: The Z-track technique is recommended for intramuscular injections of
medications that are irritating to tissues, such as meperidine, to prevent leakage into
subcutaneous tissue. Aspiration is not recommended for many IM injections due to updated
guidelines. The ventrogluteal or vastus lateralis sites are preferred over the deltoid for IM
injections. Massaging the site may cause irritation.
