PN HESI EXIT EXAM TESTBANK / LATEST COMPLETE VERSION /
ACTUAL AUTHENTIC EXAM QUESTIONS AND ANSWERS PLUS
RATIONALES (A+ GUIDE SOLUTION) 2025/2026
Question 1
An elderly client who is 12 hours postoperative for a hernia repair suddenly becomes agitated,
staggers into the corridor, and demands to be set free. After assisting the client back to bed and
administering pain medication, which intervention is best for the practical nurse (PN) to implement?
A) Notify the healthcare provider and request a prescription for restraints.
B) Raise the side rails and notify the family to come sit with the client.
C) Administer a prescribed narcotic antagonist to reverse the effects of any analgesic accumulation.
D) Instruct a UAP to keep the upper side rails up and check on the client every 15 minutes.
Correct Answer: C) Administer prescribed narcotic antagonist to reverse the effects of any
analgesic accumulation.
Rationale: Sudden agitation and confusion in an elderly postoperative patient who has
received narcotics can be a sign of analgesic accumulation or overdose. The most direct and
immediate intervention to reverse these life-threatening effects is the administration of a
narcotic antagonist like naloxone, which will reverse respiratory depression and altered
mental status caused by the opioid.
Question 2
A male client in a community support program tells the practical nurse (PN) that his drugs of choice
are cocaine and heroin, which he sometimes injects. This client is at the greatest risk for which
health condition?
A) Hepatitis
B) Glaucoma
C) Diabetes
D) Hypotension
Correct Answer: A) Hepatitis
Rationale: Injecting drugs, especially with shared needles, is a primary risk factor for the
transmission of blood-borne pathogens. Hepatitis B and Hepatitis C are viral infections that
attack the liver and are commonly spread through contaminated needles and drug
paraphernalia.
Question 3
The practical nurse (PN) is charting vital signs on a hand-written flow sheet and realizes an error has
been made. What should the PN do to rectify this error?
A) Draw one line through the incorrect entry, write "error" above it, and insert the correct information
with their initials.
B) Use white-out to completely cover the error and write the correct information over it.
C) Obliterate the entry with a black marker and insert the correct information in the next available
, space.
D) Notify the charge nurse and ask them to correct the entry in the medical record.
Correct Answer: A) Draw one line through the incorrect entry, write "error" above it, and insert
the correct information with their initials.
Rationale: This is the legally and professionally accepted method for correcting an error in a
written medical record. It ensures that the original entry is still legible, and the correction is
transparent, dated, timed, and initialed by the person who made it. Obliterating the entry can
be seen as an attempt to hide information.
Question 4
The charge nurse brings a #18 French catheter with a 30 mL balloon to the practical nurse (PN) who
is preparing to insert a catheter in a 50 kg female client for routine post-operative monitoring. Which
action should the PN take first?
A) Ask the client if she has previously been catheterized with this size.
B) Obtain a 30 mL syringe and a vial of sterile water.
C) Consult with the charge nurse about the appropriateness of the catheter size.
D) Position the client and observe the urinary meatus to assess size.
Correct Answer: C) Consult with the charge nurse about the appropriateness of the catheter
size.
Rationale: A #18 French catheter with a 30 mL balloon is a very large size, typically used for
specific urological situations like post-prostatectomy to provide hemostasis. For a routine
catheterization in a 50 kg female, a smaller catheter (e.g., #14 or #16 French) with a 5 or 10 mL
balloon is standard. The PN should use their clinical judgment to question the
appropriateness of the supplied equipment before proceeding.
Question 5
The practical nurse (PN) is caring for a client newly diagnosed with diabetes mellitus (DM). Which
finding is an early sign of hypoglycemia?
A) Bradycardia
B) Tremors
C) Polyuria
D) Fruity breath odor
Correct Answer: B) Tremors
Rationale: Hypoglycemia (low blood sugar) triggers a sympathetic nervous system response.
Early signs and symptoms include tremors, shakiness, diaphoresis (sweating), anxiety, and
palpitations. Polyuria and fruity breath are signs of hyperglycemia and ketoacidosis.
Question 6
While caring for a client with Guillain-Barré syndrome, which finding is most critical for the practical
nurse (PN) to report immediately to the charge nurse?
ACTUAL AUTHENTIC EXAM QUESTIONS AND ANSWERS PLUS
RATIONALES (A+ GUIDE SOLUTION) 2025/2026
Question 1
An elderly client who is 12 hours postoperative for a hernia repair suddenly becomes agitated,
staggers into the corridor, and demands to be set free. After assisting the client back to bed and
administering pain medication, which intervention is best for the practical nurse (PN) to implement?
A) Notify the healthcare provider and request a prescription for restraints.
B) Raise the side rails and notify the family to come sit with the client.
C) Administer a prescribed narcotic antagonist to reverse the effects of any analgesic accumulation.
D) Instruct a UAP to keep the upper side rails up and check on the client every 15 minutes.
Correct Answer: C) Administer prescribed narcotic antagonist to reverse the effects of any
analgesic accumulation.
Rationale: Sudden agitation and confusion in an elderly postoperative patient who has
received narcotics can be a sign of analgesic accumulation or overdose. The most direct and
immediate intervention to reverse these life-threatening effects is the administration of a
narcotic antagonist like naloxone, which will reverse respiratory depression and altered
mental status caused by the opioid.
Question 2
A male client in a community support program tells the practical nurse (PN) that his drugs of choice
are cocaine and heroin, which he sometimes injects. This client is at the greatest risk for which
health condition?
A) Hepatitis
B) Glaucoma
C) Diabetes
D) Hypotension
Correct Answer: A) Hepatitis
Rationale: Injecting drugs, especially with shared needles, is a primary risk factor for the
transmission of blood-borne pathogens. Hepatitis B and Hepatitis C are viral infections that
attack the liver and are commonly spread through contaminated needles and drug
paraphernalia.
Question 3
The practical nurse (PN) is charting vital signs on a hand-written flow sheet and realizes an error has
been made. What should the PN do to rectify this error?
A) Draw one line through the incorrect entry, write "error" above it, and insert the correct information
with their initials.
B) Use white-out to completely cover the error and write the correct information over it.
C) Obliterate the entry with a black marker and insert the correct information in the next available
, space.
D) Notify the charge nurse and ask them to correct the entry in the medical record.
Correct Answer: A) Draw one line through the incorrect entry, write "error" above it, and insert
the correct information with their initials.
Rationale: This is the legally and professionally accepted method for correcting an error in a
written medical record. It ensures that the original entry is still legible, and the correction is
transparent, dated, timed, and initialed by the person who made it. Obliterating the entry can
be seen as an attempt to hide information.
Question 4
The charge nurse brings a #18 French catheter with a 30 mL balloon to the practical nurse (PN) who
is preparing to insert a catheter in a 50 kg female client for routine post-operative monitoring. Which
action should the PN take first?
A) Ask the client if she has previously been catheterized with this size.
B) Obtain a 30 mL syringe and a vial of sterile water.
C) Consult with the charge nurse about the appropriateness of the catheter size.
D) Position the client and observe the urinary meatus to assess size.
Correct Answer: C) Consult with the charge nurse about the appropriateness of the catheter
size.
Rationale: A #18 French catheter with a 30 mL balloon is a very large size, typically used for
specific urological situations like post-prostatectomy to provide hemostasis. For a routine
catheterization in a 50 kg female, a smaller catheter (e.g., #14 or #16 French) with a 5 or 10 mL
balloon is standard. The PN should use their clinical judgment to question the
appropriateness of the supplied equipment before proceeding.
Question 5
The practical nurse (PN) is caring for a client newly diagnosed with diabetes mellitus (DM). Which
finding is an early sign of hypoglycemia?
A) Bradycardia
B) Tremors
C) Polyuria
D) Fruity breath odor
Correct Answer: B) Tremors
Rationale: Hypoglycemia (low blood sugar) triggers a sympathetic nervous system response.
Early signs and symptoms include tremors, shakiness, diaphoresis (sweating), anxiety, and
palpitations. Polyuria and fruity breath are signs of hyperglycemia and ketoacidosis.
Question 6
While caring for a client with Guillain-Barré syndrome, which finding is most critical for the practical
nurse (PN) to report immediately to the charge nurse?
