Med-Surg Hesi PN Exam 2025/2026 Questions With
Complete Solutions
A 70-year-old client status post hip replacement is transferred to
a rehabilitation facility. Which scale should the practical nurse
(PN) identify as the best tool to predict the client's risk for
developing skin breakdown?
a. Braden Scale
b. Morse Scale
c. Aldrete Scale
d. Wong-Baker Face Scale Correct Answer a. Braden Scale
The Braden Scale is made up of six subscales: sensory
perception, moisture, activity, mobility, nutrition, and friction
and shear. A hospitalized adult with a score 16 or below or an
older adult with a score of 18 or below is at an increased risk for
skin breakdown.
A client comes to the clinic and reports the presence of a painful
lesion in the genital area; they described it as a blister 2 days
earlier that is now crusty. Which intervention should the
practical nurse (PN) implement first?
a. Ask the client if they have had unprotected sex.
b. Prepare the client for a culture and sensitivity test of the
lesion.
c. Inform the client this occurrence will have to be reported to
the public health department.
d. Prepare to administer penicillin intramuscularly into the
dorsogluteal area. Correct Answer a. Ask the client if they
have had unprotected sex.
Rationale:
,These are typical signs and symptoms of herpes simplex virus 2
(HSV2), a sexually transmitted disease (STD), so the PN should
ask the client if they had unprotected sex and if the client has
exposed others to the disease.
A client demonstrated pupillary constriction when a pen light
was shined in their eyes. Which nursing action should the
practical nurse perform?
a. Report the finding to the health care provider.
b. Record the finding on the assessment notes.
c. Assess blood pressure to rule out hypertension.
d. Record that the client has poor vision. Correct Answer b.
Record the finding on the assessment notes.
Pupillary constriction to light is a normal finding and should be
documented in the assessment notes.
A client diagnosed with a brain tumor is receiving radiation
beam treatments to the right frontal area. The practical nurse
(PN) should observe this client for which problem during the
early post-therapy days?
a. Hemiplegia
b. Headache
c. Hearing loss
d. Dysphagia Correct Answer b. Headache
Rationale:
Radiotherapy is a local treatment, and most side effects are site-
specific, such as inflammation of surrounding brain tissue,
swelling, headache, and fatigue.
,A client diagnosed with a fracture of the left radius has a plaster
cast applied. The nurse has reinforced instructions for drying the
cast over the next 24 hours. Which statement by the client
indicates the teaching was effective?
a. "I will wrap the cast in plastic wrap for 24 hours."
b. "I will support the cast on a firm surface during the night."
c. "I will not cover it; instead I'll keep the cast surfaces exposed
to circulating air."
d. "I can use a blow dryer on medium setting until the plaster
cast feels dry to the touch." Correct Answer c. "I will not
cover it; instead I'll keep the cast surfaces exposed to circulating
air."
Rationale:
The nurse should instruct the client to keep the cast exposed to
circulating air and avoid covering it with material that might
keep it moist.
A client diagnosed with a skull hematoma and fractured left (L)
clavicle following a six foot fall from a ladder is admitted to the
unit. Which sign should the practical nurse (PN) report
immediately?
a. Spontaneously opens eyes.
b. Obeys commands in movement and grip.
c. Answers questions, but is confused.
d. Has abnormal flexion or extension of (L) arm. Correct
Answer c. Answers questions, but is confused.
Rationale:
Confusion following a head injury is usually the first sign of
increased intracranial pressure.
, A client diagnosed with bacterial meningitis is admitted to the
unit and is prescribed neuro checks every 2 hours. Which
manifestation would the practical nurse monitor for that would
provide the first indication of altered neurological function?
a. Change in level of consciousness
b. Increasing muscular weakness
c. Changes in pupil size bilaterally
d. Progressive nuchal rigidity Correct Answer a. Change in
level of consciousness
A decrease or change in the level of consciousness is usually the
first indication of neurological deterioration.
A client diagnosed with chronic obstructive pulmonary disease
complains to the practical nurse of extreme fatigue after
coughing. Which self-care measures can help minimize the
client's dyspnea? (Select all that apply.)
a. Assume a sitting position with shoulders relaxed and knees
flexed.
b. Support forearms with a pillow and place both feet flat on the
floor.
c. Slightly drop the head, bend forward, and slowly exhale with
pursed lips.
d. Resume sitting up straight, using diaphragmatic breathing to
inhale slowly and deeply.
e. Repeat inhaling deeply and slowly with pursed lips while
bending forward only once.
f. Repeat exhaling and wait for the cough reflex to facilitate
movement of the secretions.
Complete Solutions
A 70-year-old client status post hip replacement is transferred to
a rehabilitation facility. Which scale should the practical nurse
(PN) identify as the best tool to predict the client's risk for
developing skin breakdown?
a. Braden Scale
b. Morse Scale
c. Aldrete Scale
d. Wong-Baker Face Scale Correct Answer a. Braden Scale
The Braden Scale is made up of six subscales: sensory
perception, moisture, activity, mobility, nutrition, and friction
and shear. A hospitalized adult with a score 16 or below or an
older adult with a score of 18 or below is at an increased risk for
skin breakdown.
A client comes to the clinic and reports the presence of a painful
lesion in the genital area; they described it as a blister 2 days
earlier that is now crusty. Which intervention should the
practical nurse (PN) implement first?
a. Ask the client if they have had unprotected sex.
b. Prepare the client for a culture and sensitivity test of the
lesion.
c. Inform the client this occurrence will have to be reported to
the public health department.
d. Prepare to administer penicillin intramuscularly into the
dorsogluteal area. Correct Answer a. Ask the client if they
have had unprotected sex.
Rationale:
,These are typical signs and symptoms of herpes simplex virus 2
(HSV2), a sexually transmitted disease (STD), so the PN should
ask the client if they had unprotected sex and if the client has
exposed others to the disease.
A client demonstrated pupillary constriction when a pen light
was shined in their eyes. Which nursing action should the
practical nurse perform?
a. Report the finding to the health care provider.
b. Record the finding on the assessment notes.
c. Assess blood pressure to rule out hypertension.
d. Record that the client has poor vision. Correct Answer b.
Record the finding on the assessment notes.
Pupillary constriction to light is a normal finding and should be
documented in the assessment notes.
A client diagnosed with a brain tumor is receiving radiation
beam treatments to the right frontal area. The practical nurse
(PN) should observe this client for which problem during the
early post-therapy days?
a. Hemiplegia
b. Headache
c. Hearing loss
d. Dysphagia Correct Answer b. Headache
Rationale:
Radiotherapy is a local treatment, and most side effects are site-
specific, such as inflammation of surrounding brain tissue,
swelling, headache, and fatigue.
,A client diagnosed with a fracture of the left radius has a plaster
cast applied. The nurse has reinforced instructions for drying the
cast over the next 24 hours. Which statement by the client
indicates the teaching was effective?
a. "I will wrap the cast in plastic wrap for 24 hours."
b. "I will support the cast on a firm surface during the night."
c. "I will not cover it; instead I'll keep the cast surfaces exposed
to circulating air."
d. "I can use a blow dryer on medium setting until the plaster
cast feels dry to the touch." Correct Answer c. "I will not
cover it; instead I'll keep the cast surfaces exposed to circulating
air."
Rationale:
The nurse should instruct the client to keep the cast exposed to
circulating air and avoid covering it with material that might
keep it moist.
A client diagnosed with a skull hematoma and fractured left (L)
clavicle following a six foot fall from a ladder is admitted to the
unit. Which sign should the practical nurse (PN) report
immediately?
a. Spontaneously opens eyes.
b. Obeys commands in movement and grip.
c. Answers questions, but is confused.
d. Has abnormal flexion or extension of (L) arm. Correct
Answer c. Answers questions, but is confused.
Rationale:
Confusion following a head injury is usually the first sign of
increased intracranial pressure.
, A client diagnosed with bacterial meningitis is admitted to the
unit and is prescribed neuro checks every 2 hours. Which
manifestation would the practical nurse monitor for that would
provide the first indication of altered neurological function?
a. Change in level of consciousness
b. Increasing muscular weakness
c. Changes in pupil size bilaterally
d. Progressive nuchal rigidity Correct Answer a. Change in
level of consciousness
A decrease or change in the level of consciousness is usually the
first indication of neurological deterioration.
A client diagnosed with chronic obstructive pulmonary disease
complains to the practical nurse of extreme fatigue after
coughing. Which self-care measures can help minimize the
client's dyspnea? (Select all that apply.)
a. Assume a sitting position with shoulders relaxed and knees
flexed.
b. Support forearms with a pillow and place both feet flat on the
floor.
c. Slightly drop the head, bend forward, and slowly exhale with
pursed lips.
d. Resume sitting up straight, using diaphragmatic breathing to
inhale slowly and deeply.
e. Repeat inhaling deeply and slowly with pursed lips while
bending forward only once.
f. Repeat exhaling and wait for the cough reflex to facilitate
movement of the secretions.
