HESI PN exit version 1 2 $ 3 updated NCLEX PN EXIT
EXAM 2025/2026 WITH VERIFIED ANSWERS
(covering medical-surgical, fundamentals, pediatrics, maternity,
pharmacology, mental health, and safety)
1. A nurse prepares to administer digoxin to a client with heart failure.
Which finding requires the nurse to hold the medication?
A. Pulse 88 bpm
B. Pulse 72 bpm
C. Pulse 56 bpm
D. Pulse 94 bpm
Correct answer: C. A pulse below 60 bpm indicates risk for digoxin
toxicity, so the dose should be withheld.
2. A client with COPD is receiving oxygen at 4 L/min via nasal cannula.
Which action should the nurse take?
A. Maintain the oxygen as ordered
B. Decrease flow to 1–2 L/min
C. Switch to a face mask
D. Discontinue oxygen
Correct answer: B. High oxygen levels can suppress respiratory drive in
COPD; lower flow is safer.
,3. A postoperative client reports severe pain but is hesitant to take
opioids. What is the priority action?
A. Educate about addiction
B. Encourage non-pharmacologic interventions
C. Notify provider
D. Document refusal
Correct answer: A. Teaching reduces fear and promotes adequate pain
control.
4. Which finding indicates fluid overload?
A. Flat neck veins
B. Weight loss
C. Crackles in lungs
D. Decreased BP
Correct answer: C. Crackles indicate excess fluid in alveoli.
5. The nurse is preparing to insert a Foley catheter. What action
prevents infection?
A. Wearing clean gloves
B. Using sterile technique
C. Using lubricant
D. Positioning the client
Correct answer: B. Catheter insertion requires strict sterility to prevent
UTI.
,6. A diabetic client looks pale and diaphoretic. What should the nurse
do first?
A. Obtain a glucose level
B. Give insulin
C. Provide water
D. Call provider
Correct answer: A. Assess blood sugar to confirm hypoglycemia.
7. A client receiving furosemide reports muscle cramps. What
imbalance is suspected?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct answer: B. Loop diuretics commonly cause low potassium,
leading to cramps.
8. Which client should be seen first?
A. Fever 38.5°C
B. New onset confusion
C. BP 150/90
D. Chronic back pain
Correct answer: B. Confusion may indicate hypoxia or acute
neurological decline.
, 9. A child with asthma is wheezing. Which medication is priority?
A. Montelukast
B. Albuterol inhaler
C. Prednisone
D. Ipratropium
Correct answer: B. Albuterol provides rapid bronchodilation during an
acute attack.
10. A pregnant client reports bright red vaginal bleeding without pain.
Which condition is suspected?
A. Placental abruption
B. Placenta previa
C. Pre-eclampsia
D. Ectopic pregnancy
Correct answer: B. Painless bright red bleeding is a hallmark of
placenta previa.
11. A postoperative client with a PCA morphine pump is increasingly
drowsy with a RR of 8/min. What should the nurse do first?
A. Stop the PCA
B. Administer naloxone
C. Call the provider
D. Increase IV fluids
Correct answer: B. Naloxone immediately reverses opioid respiratory
depression.
EXAM 2025/2026 WITH VERIFIED ANSWERS
(covering medical-surgical, fundamentals, pediatrics, maternity,
pharmacology, mental health, and safety)
1. A nurse prepares to administer digoxin to a client with heart failure.
Which finding requires the nurse to hold the medication?
A. Pulse 88 bpm
B. Pulse 72 bpm
C. Pulse 56 bpm
D. Pulse 94 bpm
Correct answer: C. A pulse below 60 bpm indicates risk for digoxin
toxicity, so the dose should be withheld.
2. A client with COPD is receiving oxygen at 4 L/min via nasal cannula.
Which action should the nurse take?
A. Maintain the oxygen as ordered
B. Decrease flow to 1–2 L/min
C. Switch to a face mask
D. Discontinue oxygen
Correct answer: B. High oxygen levels can suppress respiratory drive in
COPD; lower flow is safer.
,3. A postoperative client reports severe pain but is hesitant to take
opioids. What is the priority action?
A. Educate about addiction
B. Encourage non-pharmacologic interventions
C. Notify provider
D. Document refusal
Correct answer: A. Teaching reduces fear and promotes adequate pain
control.
4. Which finding indicates fluid overload?
A. Flat neck veins
B. Weight loss
C. Crackles in lungs
D. Decreased BP
Correct answer: C. Crackles indicate excess fluid in alveoli.
5. The nurse is preparing to insert a Foley catheter. What action
prevents infection?
A. Wearing clean gloves
B. Using sterile technique
C. Using lubricant
D. Positioning the client
Correct answer: B. Catheter insertion requires strict sterility to prevent
UTI.
,6. A diabetic client looks pale and diaphoretic. What should the nurse
do first?
A. Obtain a glucose level
B. Give insulin
C. Provide water
D. Call provider
Correct answer: A. Assess blood sugar to confirm hypoglycemia.
7. A client receiving furosemide reports muscle cramps. What
imbalance is suspected?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct answer: B. Loop diuretics commonly cause low potassium,
leading to cramps.
8. Which client should be seen first?
A. Fever 38.5°C
B. New onset confusion
C. BP 150/90
D. Chronic back pain
Correct answer: B. Confusion may indicate hypoxia or acute
neurological decline.
, 9. A child with asthma is wheezing. Which medication is priority?
A. Montelukast
B. Albuterol inhaler
C. Prednisone
D. Ipratropium
Correct answer: B. Albuterol provides rapid bronchodilation during an
acute attack.
10. A pregnant client reports bright red vaginal bleeding without pain.
Which condition is suspected?
A. Placental abruption
B. Placenta previa
C. Pre-eclampsia
D. Ectopic pregnancy
Correct answer: B. Painless bright red bleeding is a hallmark of
placenta previa.
11. A postoperative client with a PCA morphine pump is increasingly
drowsy with a RR of 8/min. What should the nurse do first?
A. Stop the PCA
B. Administer naloxone
C. Call the provider
D. Increase IV fluids
Correct answer: B. Naloxone immediately reverses opioid respiratory
depression.
