HESI PN EXIT EXAM V3 – Practical Nursing Comprehensive
Exit Exam | Advanced Practice Questions with Detailed
Rationales | Graded A+
1. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via nasal
cannula. Which assessment finding indicates the client is experiencing oxygen toxicity?
A. Productive cough with green sputum
B. Substernal chest pain and paresthesias
C. Decreased level of consciousness
D. Increased respiratory rate
☑ Correct Answer: B
☑ Explanation: Oxygen toxicity manifests as substernal chest pain, paresthesias, and dyspnea. A
productive cough (A) may indicate infection. Decreased LOC (C) and increased respiratory rate (D) are not
specific to oxygen toxicity.
2. A client is prescribed digoxin for heart failure. Which assessment finding indicates digoxin toxicity?
A. Heart rate of 72 beats/min
B. Blood pressure of 130/80 mmHg
,C. Nausea, vomiting, and visual disturbances
D. Respiratory rate of 18 breaths/min
☑ Correct Answer: C
☑ Explanation: Nausea, vomiting, anorexia, and visual disturbances (yellow-green halos, blurred
vision) are classic signs of digoxin toxicity. Options A, B, and D are within normal limits.
3. A client with diabetes mellitus type 1 is admitted with diabetic ketoacidosis (DKA). Which
laboratory finding is expected with this diagnosis?
A. Serum pH 7.45
B. Serum bicarbonate 22 mEq/L
C. Blood glucose 450 mg/dL with positive ketones
D. Serum potassium 3.0 mEq/L
☑ Correct Answer: C
☑ Explanation: DKA is characterized by hyperglycemia, metabolic acidosis (pH <7.35), low
bicarbonate, and positive ketones. Option C shows the classic findings. Option A shows normal pH, B
shows normal bicarbonate, and D shows hypokalemia, which may occur but is not the primary diagnostic
finding.
,4. A nurse is caring for a client who has a nasogastric (NG) tube set to low intermittent suction. Which
finding indicates the NG tube is functioning correctly?
A. The client reports abdominal cramping
B. The drainage is greenish-yellow in color
C. There is no drainage after 4 hours
D. The client's abdominal girth has increased
☑ Correct Answer: B
☑ Explanation: NG tube drainage is typically greenish-yellow (gastric contents) or tan. Abdominal
cramping (A) may indicate tube irritation or malfunction. No drainage (C) may indicate obstruction.
Increased abdominal girth (D) may indicate poor function or distension.
5. A client is 6 hours postoperative from a total knee replacement. Which finding is most important to
report to the healthcare provider?
A. Pain rated 5 on a 0-10 scale
B. Temperature of 99.2°F (37.3°C)
, C. The client's toes are pale and cold
D. The client is using the patient-controlled analgesia (PCA) pump
☑ Correct Answer: C
☑ Explanation: Pale, cold toes indicate decreased perfusion and possible vascular compromise,
which is an emergency after joint replacement. Pain (A) is expected. A temperature of 99.2°F (B) is
slightly elevated but not urgent. Using the PCA pump (D) is expected.
6. A client with a history of hypertension is prescribed lisinopril. Which adverse effect is most
important to monitor?
A. Hyperkalemia
B. Hypoglycemia
C. Tachycardia
D. Hyponatremia
☑ Correct Answer: A
☑ Explanation: Lisinopril is an ACE inhibitor that can cause hyperkalemia by reducing aldosterone
secretion. Hypoglycemia (B) is not typical. Tachycardia (C) is not common. Hyponatremia (D) is not the
primary concern.
Exit Exam | Advanced Practice Questions with Detailed
Rationales | Graded A+
1. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via nasal
cannula. Which assessment finding indicates the client is experiencing oxygen toxicity?
A. Productive cough with green sputum
B. Substernal chest pain and paresthesias
C. Decreased level of consciousness
D. Increased respiratory rate
☑ Correct Answer: B
☑ Explanation: Oxygen toxicity manifests as substernal chest pain, paresthesias, and dyspnea. A
productive cough (A) may indicate infection. Decreased LOC (C) and increased respiratory rate (D) are not
specific to oxygen toxicity.
2. A client is prescribed digoxin for heart failure. Which assessment finding indicates digoxin toxicity?
A. Heart rate of 72 beats/min
B. Blood pressure of 130/80 mmHg
,C. Nausea, vomiting, and visual disturbances
D. Respiratory rate of 18 breaths/min
☑ Correct Answer: C
☑ Explanation: Nausea, vomiting, anorexia, and visual disturbances (yellow-green halos, blurred
vision) are classic signs of digoxin toxicity. Options A, B, and D are within normal limits.
3. A client with diabetes mellitus type 1 is admitted with diabetic ketoacidosis (DKA). Which
laboratory finding is expected with this diagnosis?
A. Serum pH 7.45
B. Serum bicarbonate 22 mEq/L
C. Blood glucose 450 mg/dL with positive ketones
D. Serum potassium 3.0 mEq/L
☑ Correct Answer: C
☑ Explanation: DKA is characterized by hyperglycemia, metabolic acidosis (pH <7.35), low
bicarbonate, and positive ketones. Option C shows the classic findings. Option A shows normal pH, B
shows normal bicarbonate, and D shows hypokalemia, which may occur but is not the primary diagnostic
finding.
,4. A nurse is caring for a client who has a nasogastric (NG) tube set to low intermittent suction. Which
finding indicates the NG tube is functioning correctly?
A. The client reports abdominal cramping
B. The drainage is greenish-yellow in color
C. There is no drainage after 4 hours
D. The client's abdominal girth has increased
☑ Correct Answer: B
☑ Explanation: NG tube drainage is typically greenish-yellow (gastric contents) or tan. Abdominal
cramping (A) may indicate tube irritation or malfunction. No drainage (C) may indicate obstruction.
Increased abdominal girth (D) may indicate poor function or distension.
5. A client is 6 hours postoperative from a total knee replacement. Which finding is most important to
report to the healthcare provider?
A. Pain rated 5 on a 0-10 scale
B. Temperature of 99.2°F (37.3°C)
, C. The client's toes are pale and cold
D. The client is using the patient-controlled analgesia (PCA) pump
☑ Correct Answer: C
☑ Explanation: Pale, cold toes indicate decreased perfusion and possible vascular compromise,
which is an emergency after joint replacement. Pain (A) is expected. A temperature of 99.2°F (B) is
slightly elevated but not urgent. Using the PCA pump (D) is expected.
6. A client with a history of hypertension is prescribed lisinopril. Which adverse effect is most
important to monitor?
A. Hyperkalemia
B. Hypoglycemia
C. Tachycardia
D. Hyponatremia
☑ Correct Answer: A
☑ Explanation: Lisinopril is an ACE inhibitor that can cause hyperkalemia by reducing aldosterone
secretion. Hypoglycemia (B) is not typical. Tachycardia (C) is not common. Hyponatremia (D) is not the
primary concern.
