PN HESI Exit Exam Questions
and Answers – V3 Complete
(2026 Latest Update)
Exam Design: Completely Correct Answered Exam –
Correct Exam Format
Instructions: Read each question carefully and select the
best answer. Bolded text indicates the question, correct
answer, and rationale.
1) The LPN/LVN receives the client's next scheduled
bag of TPN labeled with the additive NPH insulin.
Which action should the nurse implement?
A. Hang the solution at the current rate.
B. Refrigerate the solution until needed.
C. Prepare the solution with new tubing.
D. Return the solution to the pharmacy.
Correct Answer: D. Return the solution to the
pharmacy.
Rationale: NPH insulin should never be added to TPN
solutions. Insulin is compatible with TPN only in regular
(short-acting) form. The nurse must return the solution to the
pharmacy because it is improperly prepared and unsafe to
administer.
2) A male client has just undergone a laryngectomy
and has a cuffed tracheostomy tube in place. When
initiating bolus tube feedings postoperatively, when
should the nurse inflate the cuff?
A. Immediately after feeding
B. Just prior to tube feeding
C. Continuous inflation is required
D. Inflation is not required
Correct Answer: B. Just prior to tube feeding
Rationale: The cuff should be inflated just before tube
feedings to prevent aspiration of formula into the trachea.
After the feeding is complete, the cuff may be deflated (if
1
,ordered) to allow the client to speak or breathe more
naturally, depending on the clinical situation.
3) A client on telemetry has a pattern of uncontrolled
atrial fibrillation with a rapid ventricular response.
Based on this finding, the nurse anticipates assisting
the physician with which treatment?
A. Administer lidocaine, 75 mg intravenous push.
B. Perform synchronized cardioversion.
C. Defibrillate the client as soon as possible.
D. Administer atropine, 0.4 mg intravenous push.
Correct Answer: B. Perform synchronized
cardioversion.
Rationale: Uncontrolled atrial fibrillation with a rapid
ventricular response is treated with synchronized
cardioversion to convert the rhythm and restore
hemodynamic stability. Defibrillation is used for ventricular
fibrillation or pulseless ventricular tachycardia, not atrial
fibrillation.
4) A 63-year-old client with type 2 diabetes mellitus is
admitted for treatment of an ulcer on the heel of the
left foot that has not healed with wound care. The
nurse observes that the entire left foot is darker in
color than the right foot. Which additional symptom
should the nurse expect to find?
A. Pedal pulses will be weak or absent in the left foot.
B. The client will state that the left foot is usually warm.
C. Flexion and extension of the left foot will be limited.
D. Capillary refill of the client's left toes will be brisk.
Correct Answer: A. Pedal pulses will be weak or
absent in the left foot.
Rationale: Darkened skin, non-healing ulcers, and cool
extremities are signs of peripheral arterial disease (PAD). In
PAD, pedal pulses are weak or absent due to reduced arterial
blood flow. Warmth, brisk capillary refill, and limited flexion
are not typical findings.
2
,5) A client with cirrhosis develops increasing pedal
edema and ascites. Which dietary modification is most
important for the nurse to teach this client?
A. Avoid high-carbohydrate foods.
B. Decrease intake of fat-soluble vitamins.
C. Decrease caloric intake.
D. Restrict salt and fluid intake.
Correct Answer: D. Restrict salt and fluid intake.
Rationale: Ascites and pedal edema in cirrhosis are caused
by portal hypertension and sodium/fluid retention.
Restricting salt and fluid intake is the most important dietary
modification to reduce fluid accumulation.
6) During report, the nurse learns that a client with
tumor lysis syndrome is receiving an IV infusion
containing insulin. Which assessment should the
nurse complete first?
A. Review the client's history for diabetes mellitus.
B. Observe the extremity distal to the IV site.
C. Monitor the client's serum potassium and blood
glucose levels.
D. Evaluate the client's oxygen saturation and breath
sounds.
Correct Answer: C. Monitor the client's serum
potassium and blood glucose levels.
Rationale: Insulin is given in tumor lysis syndrome to shift
potassium intracellularly and treat hyperkalemia. The nurse
must monitor serum potassium and blood glucose closely
because insulin can cause hypoglycemia and hypokalemia.
7) A resident in a long-term care facility is diagnosed
with hepatitis B. Which intervention should the nurse
implement with the staff caring for this client?
A. Determine if all employees have had the hepatitis B
vaccine series.
B. Explain that this type of hepatitis can be transmitted when
feeding the client.
C. Assure the employees that they cannot contract hepatitis
B when providing direct care.
3
, D. Tell the employees that wearing gloves and a gown are
required when providing care.
Correct Answer: A. Determine if all employees have
had the hepatitis B vaccine series.
Rationale: Hepatitis B is transmitted through blood and
body fluids. All healthcare workers should be vaccinated
against hepatitis B. The nurse should verify vaccination
status of staff. Standard precautions (gloves as needed) are
required, but gowns are not always necessary.
8) The LPN/LVN notes that the client's drainage has
decreased from 50 to 5 mL/hr 12 hours after chest
tube insertion for hemothorax. What is the best initial
action for the nurse to take?
A. Document this expected decrease in drainage.
B. Clamp the chest tube while assessing for air leaks.
C. Milk the tube to remove any excessive blood clot buildup.
D. Assess for kinks or dependent loops in the tubing.
Correct Answer: D. Assess for kinks or dependent
loops in the tubing.
Rationale: A sudden decrease in chest tube drainage may
indicate obstruction, kinks, or dependent loops in the tubing.
The nurse's first action is to assess the tubing for patency.
Clamping or milking the tube is not the initial action.
9) The nurse notes that a client who is scheduled for
surgery the next morning has an elevated blood urea
nitrogen (BUN) level. Which condition is most likely to
have contributed to this finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C. Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture
Correct Answer: B. Anorexia and vomiting for the past
2 days
Rationale: BUN rises with dehydration, decreased renal
perfusion, or increased protein catabolism. Anorexia and
vomiting cause dehydration and elevated BUN. The other
conditions are less likely to cause an acute elevation.
4
and Answers – V3 Complete
(2026 Latest Update)
Exam Design: Completely Correct Answered Exam –
Correct Exam Format
Instructions: Read each question carefully and select the
best answer. Bolded text indicates the question, correct
answer, and rationale.
1) The LPN/LVN receives the client's next scheduled
bag of TPN labeled with the additive NPH insulin.
Which action should the nurse implement?
A. Hang the solution at the current rate.
B. Refrigerate the solution until needed.
C. Prepare the solution with new tubing.
D. Return the solution to the pharmacy.
Correct Answer: D. Return the solution to the
pharmacy.
Rationale: NPH insulin should never be added to TPN
solutions. Insulin is compatible with TPN only in regular
(short-acting) form. The nurse must return the solution to the
pharmacy because it is improperly prepared and unsafe to
administer.
2) A male client has just undergone a laryngectomy
and has a cuffed tracheostomy tube in place. When
initiating bolus tube feedings postoperatively, when
should the nurse inflate the cuff?
A. Immediately after feeding
B. Just prior to tube feeding
C. Continuous inflation is required
D. Inflation is not required
Correct Answer: B. Just prior to tube feeding
Rationale: The cuff should be inflated just before tube
feedings to prevent aspiration of formula into the trachea.
After the feeding is complete, the cuff may be deflated (if
1
,ordered) to allow the client to speak or breathe more
naturally, depending on the clinical situation.
3) A client on telemetry has a pattern of uncontrolled
atrial fibrillation with a rapid ventricular response.
Based on this finding, the nurse anticipates assisting
the physician with which treatment?
A. Administer lidocaine, 75 mg intravenous push.
B. Perform synchronized cardioversion.
C. Defibrillate the client as soon as possible.
D. Administer atropine, 0.4 mg intravenous push.
Correct Answer: B. Perform synchronized
cardioversion.
Rationale: Uncontrolled atrial fibrillation with a rapid
ventricular response is treated with synchronized
cardioversion to convert the rhythm and restore
hemodynamic stability. Defibrillation is used for ventricular
fibrillation or pulseless ventricular tachycardia, not atrial
fibrillation.
4) A 63-year-old client with type 2 diabetes mellitus is
admitted for treatment of an ulcer on the heel of the
left foot that has not healed with wound care. The
nurse observes that the entire left foot is darker in
color than the right foot. Which additional symptom
should the nurse expect to find?
A. Pedal pulses will be weak or absent in the left foot.
B. The client will state that the left foot is usually warm.
C. Flexion and extension of the left foot will be limited.
D. Capillary refill of the client's left toes will be brisk.
Correct Answer: A. Pedal pulses will be weak or
absent in the left foot.
Rationale: Darkened skin, non-healing ulcers, and cool
extremities are signs of peripheral arterial disease (PAD). In
PAD, pedal pulses are weak or absent due to reduced arterial
blood flow. Warmth, brisk capillary refill, and limited flexion
are not typical findings.
2
,5) A client with cirrhosis develops increasing pedal
edema and ascites. Which dietary modification is most
important for the nurse to teach this client?
A. Avoid high-carbohydrate foods.
B. Decrease intake of fat-soluble vitamins.
C. Decrease caloric intake.
D. Restrict salt and fluid intake.
Correct Answer: D. Restrict salt and fluid intake.
Rationale: Ascites and pedal edema in cirrhosis are caused
by portal hypertension and sodium/fluid retention.
Restricting salt and fluid intake is the most important dietary
modification to reduce fluid accumulation.
6) During report, the nurse learns that a client with
tumor lysis syndrome is receiving an IV infusion
containing insulin. Which assessment should the
nurse complete first?
A. Review the client's history for diabetes mellitus.
B. Observe the extremity distal to the IV site.
C. Monitor the client's serum potassium and blood
glucose levels.
D. Evaluate the client's oxygen saturation and breath
sounds.
Correct Answer: C. Monitor the client's serum
potassium and blood glucose levels.
Rationale: Insulin is given in tumor lysis syndrome to shift
potassium intracellularly and treat hyperkalemia. The nurse
must monitor serum potassium and blood glucose closely
because insulin can cause hypoglycemia and hypokalemia.
7) A resident in a long-term care facility is diagnosed
with hepatitis B. Which intervention should the nurse
implement with the staff caring for this client?
A. Determine if all employees have had the hepatitis B
vaccine series.
B. Explain that this type of hepatitis can be transmitted when
feeding the client.
C. Assure the employees that they cannot contract hepatitis
B when providing direct care.
3
, D. Tell the employees that wearing gloves and a gown are
required when providing care.
Correct Answer: A. Determine if all employees have
had the hepatitis B vaccine series.
Rationale: Hepatitis B is transmitted through blood and
body fluids. All healthcare workers should be vaccinated
against hepatitis B. The nurse should verify vaccination
status of staff. Standard precautions (gloves as needed) are
required, but gowns are not always necessary.
8) The LPN/LVN notes that the client's drainage has
decreased from 50 to 5 mL/hr 12 hours after chest
tube insertion for hemothorax. What is the best initial
action for the nurse to take?
A. Document this expected decrease in drainage.
B. Clamp the chest tube while assessing for air leaks.
C. Milk the tube to remove any excessive blood clot buildup.
D. Assess for kinks or dependent loops in the tubing.
Correct Answer: D. Assess for kinks or dependent
loops in the tubing.
Rationale: A sudden decrease in chest tube drainage may
indicate obstruction, kinks, or dependent loops in the tubing.
The nurse's first action is to assess the tubing for patency.
Clamping or milking the tube is not the initial action.
9) The nurse notes that a client who is scheduled for
surgery the next morning has an elevated blood urea
nitrogen (BUN) level. Which condition is most likely to
have contributed to this finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C. Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture
Correct Answer: B. Anorexia and vomiting for the past
2 days
Rationale: BUN rises with dehydration, decreased renal
perfusion, or increased protein catabolism. Anorexia and
vomiting cause dehydration and elevated BUN. The other
conditions are less likely to cause an acute elevation.
4
