HESI PN EXIT EXAM V5 | Advanced/Hard/Mixed Difficulty
| Comprehensive Practical Nursing Review | 100% Pass
Guaranteed | Graded A+
1. The practical nurse is caring for a client with heart failure who is receiving digoxin and
furosemide. Which assessment finding requires immediate intervention?
A. Serum potassium level of 3.2 mEq/L
B. Apical pulse of 68 beats per minute
C. Urinary output of 40 mL per hour
D. Serum digoxin level of 1.2 ng/mL
☑ Correct Answer: A
☑ Explanation: Hypokalemia (serum potassium < 3.5 mEq/L) increases the risk of digoxin
toxicity. Furosemide is a loop diuretic that can cause potassium wasting. A serum potassium of
3.2 mEq/L requires immediate intervention. An apical pulse of 68 is within normal limits (60-
100). Urinary output of 40 mL/hr is adequate (>30 mL/hr). A digoxin level of 1.2 ng/mL is within
the therapeutic range (0.8-2.0 ng/mL).
,2. A client with type 1 diabetes mellitus is exhibiting confusion, diaphoresis, and tachycardia.
Which action should the practical nurse take first?
A. Administer 50% dextrose intravenously
B. Check the client's blood glucose level
C. Give the client a glass of orange juice
D. Notify the healthcare provider immediately
☑ Correct Answer: B
☑ Explanation: The client is exhibiting signs of hypoglycemia. The first action is to check
the blood glucose level to confirm the diagnosis before initiating treatment. While orange juice
or IV dextrose may be appropriate depending on the client's condition, assessment must
precede intervention. Notifying the healthcare provider is not the priority action.
3. The practical nurse is preparing to administer a medication via the intramuscular route.
Which needle length and gauge is most appropriate for a deltoid injection in an average-sized
adult?
A. 5/8 inch, 25 gauge
B. 1 inch, 23 gauge
,C. 1 1/2 inch, 21 gauge
D. 2 inch, 18 gauge
☑ Correct Answer: B
☑ Explanation: For an intramuscular injection in the deltoid muscle of an average-sized
adult, a 1-inch, 23-gauge needle is appropriate. A 5/8-inch needle is typically used for
subcutaneous injections. A 1 1/2-inch needle is more appropriate for the ventrogluteal or vastus
lateralis sites. An 18-gauge needle is too large and would cause unnecessary tissue trauma.
4. A postpartum client who is Rh-negative gives birth to an Rh-positive infant. The practical
nurse should anticipate administering which medication?
A. Rh immunoglobulin (RhoGAM)
B. Hepatitis B vaccine
C. Vitamin K (phytonadione)
D. Erythromycin ophthalmic ointment
☑ Correct Answer: A
☑ Explanation: Rh-negative mothers who deliver Rh-positive infants should receive Rh
, immunoglobulin (RhoGAM) within 72 hours of delivery to prevent maternal sensitization and
hemolytic disease of the newborn in subsequent pregnancies. Hepatitis B vaccine and vitamin K
are administered to the newborn, not the mother. Erythromycin ophthalmic ointment is given to
the newborn for ophthalmia neonatorum prophylaxis.
5. The practical nurse is caring for a client with pneumonia who has a prescription for oxygen
at 2 L/min via nasal cannula. Which finding indicates that oxygen therapy is effective?
A. Respiratory rate decreases from 28 to 18 breaths per minute
B. Pulse oximetry reading increases from 88% to 92%
C. Client reports decreased chest pain
D. Crackles are auscultated in the lung bases
☑ Correct Answer: B
☑ Explanation: The primary goal of oxygen therapy is to improve oxygenation. An increase
in pulse oximetry from 88% to 92% indicates that oxygen therapy is effective. While a decreased
respiratory rate may indicate improvement, it is not the primary indicator of oxygenation
effectiveness. Decreased chest pain is a subjective finding and crackles indicate fluid in the
lungs.
| Comprehensive Practical Nursing Review | 100% Pass
Guaranteed | Graded A+
1. The practical nurse is caring for a client with heart failure who is receiving digoxin and
furosemide. Which assessment finding requires immediate intervention?
A. Serum potassium level of 3.2 mEq/L
B. Apical pulse of 68 beats per minute
C. Urinary output of 40 mL per hour
D. Serum digoxin level of 1.2 ng/mL
☑ Correct Answer: A
☑ Explanation: Hypokalemia (serum potassium < 3.5 mEq/L) increases the risk of digoxin
toxicity. Furosemide is a loop diuretic that can cause potassium wasting. A serum potassium of
3.2 mEq/L requires immediate intervention. An apical pulse of 68 is within normal limits (60-
100). Urinary output of 40 mL/hr is adequate (>30 mL/hr). A digoxin level of 1.2 ng/mL is within
the therapeutic range (0.8-2.0 ng/mL).
,2. A client with type 1 diabetes mellitus is exhibiting confusion, diaphoresis, and tachycardia.
Which action should the practical nurse take first?
A. Administer 50% dextrose intravenously
B. Check the client's blood glucose level
C. Give the client a glass of orange juice
D. Notify the healthcare provider immediately
☑ Correct Answer: B
☑ Explanation: The client is exhibiting signs of hypoglycemia. The first action is to check
the blood glucose level to confirm the diagnosis before initiating treatment. While orange juice
or IV dextrose may be appropriate depending on the client's condition, assessment must
precede intervention. Notifying the healthcare provider is not the priority action.
3. The practical nurse is preparing to administer a medication via the intramuscular route.
Which needle length and gauge is most appropriate for a deltoid injection in an average-sized
adult?
A. 5/8 inch, 25 gauge
B. 1 inch, 23 gauge
,C. 1 1/2 inch, 21 gauge
D. 2 inch, 18 gauge
☑ Correct Answer: B
☑ Explanation: For an intramuscular injection in the deltoid muscle of an average-sized
adult, a 1-inch, 23-gauge needle is appropriate. A 5/8-inch needle is typically used for
subcutaneous injections. A 1 1/2-inch needle is more appropriate for the ventrogluteal or vastus
lateralis sites. An 18-gauge needle is too large and would cause unnecessary tissue trauma.
4. A postpartum client who is Rh-negative gives birth to an Rh-positive infant. The practical
nurse should anticipate administering which medication?
A. Rh immunoglobulin (RhoGAM)
B. Hepatitis B vaccine
C. Vitamin K (phytonadione)
D. Erythromycin ophthalmic ointment
☑ Correct Answer: A
☑ Explanation: Rh-negative mothers who deliver Rh-positive infants should receive Rh
, immunoglobulin (RhoGAM) within 72 hours of delivery to prevent maternal sensitization and
hemolytic disease of the newborn in subsequent pregnancies. Hepatitis B vaccine and vitamin K
are administered to the newborn, not the mother. Erythromycin ophthalmic ointment is given to
the newborn for ophthalmia neonatorum prophylaxis.
5. The practical nurse is caring for a client with pneumonia who has a prescription for oxygen
at 2 L/min via nasal cannula. Which finding indicates that oxygen therapy is effective?
A. Respiratory rate decreases from 28 to 18 breaths per minute
B. Pulse oximetry reading increases from 88% to 92%
C. Client reports decreased chest pain
D. Crackles are auscultated in the lung bases
☑ Correct Answer: B
☑ Explanation: The primary goal of oxygen therapy is to improve oxygenation. An increase
in pulse oximetry from 88% to 92% indicates that oxygen therapy is effective. While a decreased
respiratory rate may indicate improvement, it is not the primary indicator of oxygenation
effectiveness. Decreased chest pain is a subjective finding and crackles indicate fluid in the
lungs.
