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HESI PN EXIT EXAM V2 | Advanced & Mixed Difficulty | 100%
Pass Guaranteed | Graded A+
1. A practical nurse (PN) is caring for a client who is 1 day post-operative following a total
hip arthroplasty. The client is receiving morphine via a patient-controlled analgesia
(PCA) pump. The PN notes that the client's respiratory rate is 8 breaths per minute and
they are difficult to arouse. What is the priority nursing action?
A. Administer naloxone (Narcan) per protocol.
B. Increase the PCA basal rate.
C. Place the client in a high-Fowler's position.
D. Document the findings and continue to monitor.
☑ Correct Answer: A
☑ Explanation: A respiratory rate of 8 breaths per minute and altered level of
consciousness are signs of opioid-induced respiratory depression. The priority action is to
administer naloxone, the opioid antagonist, to reverse the respiratory depression. Increasing the
PCA rate would worsen the situation. Positioning alone will not reverse the respiratory
depression. Continuing to monitor without intervention is unsafe.
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2. A client with a diagnosis of heart failure is prescribed furosemide (Lasix) 40 mg IV push.
Which of the following laboratory values should the PN monitor closely before
administering this medication?
A. Serum sodium
B. Serum potassium
C. Serum creatinine
D. Serum calcium
☑ Correct Answer: B
☑ Explanation: Furosemide is a loop diuretic that causes potassium excretion.
Hypokalemia is a significant side effect and can lead to cardiac arrhythmias. Monitoring serum
potassium before administration is critical. While sodium, creatinine, and calcium levels may be
affected, potassium is the most critical for immediate safety.
3. An older adult client is admitted with a diagnosis of dehydration. The PN is inserting an
IV catheter. Which of the following sites is the most appropriate for the PN to use?
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A. The non-dominant hand
B. The dominant hand
C. The antecubital fossa
D. The cephalic vein in the forearm
☑ Correct Answer: D
☑ Explanation: The cephalic vein in the forearm is a preferred site for IV insertion in older
adults as it provides good access and is less likely to interfere with mobility. The antecubital
fossa is often used but may limit arm movement. The dominant hand should be avoided to
preserve function. The non-dominant hand is an option, but the forearm is generally preferred
for comfort and stability.
4. A client is receiving a blood transfusion of packed red blood cells (PRBCs). Fifteen
minutes after the infusion starts, the client reports itching and hives. What is the priority
action by the PN?
A. Slow the infusion rate.
B. Administer diphenhydramine (Benadryl) as prescribed.
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C. Stop the infusion and notify the primary care provider.
D. Continue the infusion and monitor the client closely.
☑ Correct Answer: C
☑ Explanation: Itching and hives are signs of a mild allergic reaction to the blood
transfusion. The priority action is to stop the infusion immediately to prevent a more severe
reaction, then notify the provider. Slowing the infusion or continuing it is unsafe. Antihistamines
may be given, but only after the infusion is stopped and the provider is notified.
5. A client with diabetes mellitus type 2 is prescribed metformin (Glucophage). The PN is
providing teaching about this medication. Which of the following statements by the
client indicates a need for further teaching?
A. "I should take this medication with meals."
B. "I need to report any muscle pain or weakness to my doctor."
C. "This medication may cause me to gain weight."
D. "I should avoid drinking large amounts of alcohol."
☑ Correct Answer: C
HESI PN EXIT EXAM V2 | Advanced & Mixed Difficulty | 100%
Pass Guaranteed | Graded A+
1. A practical nurse (PN) is caring for a client who is 1 day post-operative following a total
hip arthroplasty. The client is receiving morphine via a patient-controlled analgesia
(PCA) pump. The PN notes that the client's respiratory rate is 8 breaths per minute and
they are difficult to arouse. What is the priority nursing action?
A. Administer naloxone (Narcan) per protocol.
B. Increase the PCA basal rate.
C. Place the client in a high-Fowler's position.
D. Document the findings and continue to monitor.
☑ Correct Answer: A
☑ Explanation: A respiratory rate of 8 breaths per minute and altered level of
consciousness are signs of opioid-induced respiratory depression. The priority action is to
administer naloxone, the opioid antagonist, to reverse the respiratory depression. Increasing the
PCA rate would worsen the situation. Positioning alone will not reverse the respiratory
depression. Continuing to monitor without intervention is unsafe.
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2. A client with a diagnosis of heart failure is prescribed furosemide (Lasix) 40 mg IV push.
Which of the following laboratory values should the PN monitor closely before
administering this medication?
A. Serum sodium
B. Serum potassium
C. Serum creatinine
D. Serum calcium
☑ Correct Answer: B
☑ Explanation: Furosemide is a loop diuretic that causes potassium excretion.
Hypokalemia is a significant side effect and can lead to cardiac arrhythmias. Monitoring serum
potassium before administration is critical. While sodium, creatinine, and calcium levels may be
affected, potassium is the most critical for immediate safety.
3. An older adult client is admitted with a diagnosis of dehydration. The PN is inserting an
IV catheter. Which of the following sites is the most appropriate for the PN to use?
, 3
A. The non-dominant hand
B. The dominant hand
C. The antecubital fossa
D. The cephalic vein in the forearm
☑ Correct Answer: D
☑ Explanation: The cephalic vein in the forearm is a preferred site for IV insertion in older
adults as it provides good access and is less likely to interfere with mobility. The antecubital
fossa is often used but may limit arm movement. The dominant hand should be avoided to
preserve function. The non-dominant hand is an option, but the forearm is generally preferred
for comfort and stability.
4. A client is receiving a blood transfusion of packed red blood cells (PRBCs). Fifteen
minutes after the infusion starts, the client reports itching and hives. What is the priority
action by the PN?
A. Slow the infusion rate.
B. Administer diphenhydramine (Benadryl) as prescribed.
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C. Stop the infusion and notify the primary care provider.
D. Continue the infusion and monitor the client closely.
☑ Correct Answer: C
☑ Explanation: Itching and hives are signs of a mild allergic reaction to the blood
transfusion. The priority action is to stop the infusion immediately to prevent a more severe
reaction, then notify the provider. Slowing the infusion or continuing it is unsafe. Antihistamines
may be given, but only after the infusion is stopped and the provider is notified.
5. A client with diabetes mellitus type 2 is prescribed metformin (Glucophage). The PN is
providing teaching about this medication. Which of the following statements by the
client indicates a need for further teaching?
A. "I should take this medication with meals."
B. "I need to report any muscle pain or weakness to my doctor."
C. "This medication may cause me to gain weight."
D. "I should avoid drinking large amounts of alcohol."
☑ Correct Answer: C
