PN HESI EXIT EXAM 2026 | HESI PN EXIT EXAM
WITH NGN | ACTUAL EXAM | Complete Exam
Questions & Correct Verified Answers | Latest 2025
/ 2026 Update | Already Graded A
1. Traditional Multiple-Choice
A client with COPD is receiving oxygen at 5 L/min via nasal cannula. Which
finding should the PN report immediately?
A. Oxygen saturation 98%
B. Respiratory rate 18/min
C. Client reports feeling "less short of breath"
D. Arterial blood gas shows PaCO₂ 65 mmHg
Correct Answer: D
Rationale: A PaCO₂ of 65 mmHg indicates hypoventilation and possible CO₂ narcosis
from excessive O₂ in a COPD client. High-flow O₂ can blunt the hypoxic respiratory drive.
SaO₂ 98% may be slightly high but not immediately dangerous; RR 18 is normal;
symptom relief is expected.
2. NGN Case Study (linked items 2-4)
Client: 67 kg, 28 yrs, 38 weeks pregnant, admitted in active labor. FHR baseline
150 bpm, variability moderate, accelerations present. Cervix 6 cm/90%/0 station.
Contractions q3 min, 60 sec duration.
2.1 Matrix (Select one per row)
Which assessment requires immediate intervention?
,TableCopy
Finding Immediate Action Needed
FHR 150 with moderate variability No
Late decelerations noted last 3 contractions Yes
Maternal temp 37.1 °C No
Cervical change 1 cm/hr No
Correct Row: Late decelerations – Yes
Rationale: Late decels indicate uteroplacental insufficiency and require prompt
RN/physician notification and intrauterine resuscitation.
2.2 Multi-response
Select all interventions the PN should prepare for late decelerations (select 3).
A. Administer O₂ 8–10 L/min by tight face mask
B. Increase Pitocin to shorten labor
C. Turn client to left lateral position
D. Perform amnioinfusion
E. Document and continue routine care
Correct: A, C, D
,Scoring logic: 1 point each (max 3). B is unsafe; E ignores problem.
2.3 Bow-tie
Complete the pathway for uteroplacental insufficiency using the options below (place
one letter per box; some options will not be used).
Options: A. Supine hypotension B. Placental abruption C. Maternal dehydration D.
Umbilical cord compression E. Maternal fever F. Tocolysis G. Left-lateral positioning H.
Amnioinfusion I. Increase IV fluids
Central problem: Late decelerations
Contributing factors: B, C
Immediate nursing actions: G, I
Potential medical therapy: F
Rationale: Abruption and dehydration reduce perfusion; left turn and fluids improve
perfusion; tocolysis decreases uterine tone and improves blood flow.
3. Traditional
When teaching a client with heart failure about daily weights, which statement
indicates understanding?
A. "I will weigh weekly after breakfast."
B. "A 3-pound gain in 2 days is expected."
C. "I will call the clinic for a 2-pound overnight gain."
D. "Weight is not important if my ankles are not swollen."
Correct Answer: C
, Rationale: Heart failure guidelines recommend calling for ≥2 lb (0.9 kg) overnight or ≥5
lb (2.3 kg) in a week. Daily weights are taken at the same time, same clothes, before
eating. Ankles may swell later.
4. NGN Trend
A client receiving heparin infusion: 0800 aPTT 42 sec, 1000 aPTT 48 sec, 1200
aPTT 54 sec (control 30 sec). Protocol target 60–80 sec. Which action is
correct?
A. Stop infusion – aPTT trending to supratherapeutic
B. Increase rate by 2 units/kg/hr – still below target
C. Continue current rate – within acceptable range
D. Obtain anti-Xa level – aPTT unreliable
Correct Answer: B
Rationale: aPTT is still subtherapeutic (goal ~2–2.5 × control = 60–75 sec). A small
upward titration per protocol is indicated. Anti-Xa is not needed unless discrepant.
5. Traditional
The PN is delegating tasks on a medical floor. Which activity is appropriate for
assistive personnel (AP)?
A. Insert a nasogastric tube
B. Perform sterile wound irrigation
C. Obtain vital signs on stable post-op client
D. Evaluate gait-training progress
Correct Answer: C
Rationale: Stable vital signs are within AP scope. NG insertion, sterile procedures, and
evaluation require licensed nurse or therapist.
WITH NGN | ACTUAL EXAM | Complete Exam
Questions & Correct Verified Answers | Latest 2025
/ 2026 Update | Already Graded A
1. Traditional Multiple-Choice
A client with COPD is receiving oxygen at 5 L/min via nasal cannula. Which
finding should the PN report immediately?
A. Oxygen saturation 98%
B. Respiratory rate 18/min
C. Client reports feeling "less short of breath"
D. Arterial blood gas shows PaCO₂ 65 mmHg
Correct Answer: D
Rationale: A PaCO₂ of 65 mmHg indicates hypoventilation and possible CO₂ narcosis
from excessive O₂ in a COPD client. High-flow O₂ can blunt the hypoxic respiratory drive.
SaO₂ 98% may be slightly high but not immediately dangerous; RR 18 is normal;
symptom relief is expected.
2. NGN Case Study (linked items 2-4)
Client: 67 kg, 28 yrs, 38 weeks pregnant, admitted in active labor. FHR baseline
150 bpm, variability moderate, accelerations present. Cervix 6 cm/90%/0 station.
Contractions q3 min, 60 sec duration.
2.1 Matrix (Select one per row)
Which assessment requires immediate intervention?
,TableCopy
Finding Immediate Action Needed
FHR 150 with moderate variability No
Late decelerations noted last 3 contractions Yes
Maternal temp 37.1 °C No
Cervical change 1 cm/hr No
Correct Row: Late decelerations – Yes
Rationale: Late decels indicate uteroplacental insufficiency and require prompt
RN/physician notification and intrauterine resuscitation.
2.2 Multi-response
Select all interventions the PN should prepare for late decelerations (select 3).
A. Administer O₂ 8–10 L/min by tight face mask
B. Increase Pitocin to shorten labor
C. Turn client to left lateral position
D. Perform amnioinfusion
E. Document and continue routine care
Correct: A, C, D
,Scoring logic: 1 point each (max 3). B is unsafe; E ignores problem.
2.3 Bow-tie
Complete the pathway for uteroplacental insufficiency using the options below (place
one letter per box; some options will not be used).
Options: A. Supine hypotension B. Placental abruption C. Maternal dehydration D.
Umbilical cord compression E. Maternal fever F. Tocolysis G. Left-lateral positioning H.
Amnioinfusion I. Increase IV fluids
Central problem: Late decelerations
Contributing factors: B, C
Immediate nursing actions: G, I
Potential medical therapy: F
Rationale: Abruption and dehydration reduce perfusion; left turn and fluids improve
perfusion; tocolysis decreases uterine tone and improves blood flow.
3. Traditional
When teaching a client with heart failure about daily weights, which statement
indicates understanding?
A. "I will weigh weekly after breakfast."
B. "A 3-pound gain in 2 days is expected."
C. "I will call the clinic for a 2-pound overnight gain."
D. "Weight is not important if my ankles are not swollen."
Correct Answer: C
, Rationale: Heart failure guidelines recommend calling for ≥2 lb (0.9 kg) overnight or ≥5
lb (2.3 kg) in a week. Daily weights are taken at the same time, same clothes, before
eating. Ankles may swell later.
4. NGN Trend
A client receiving heparin infusion: 0800 aPTT 42 sec, 1000 aPTT 48 sec, 1200
aPTT 54 sec (control 30 sec). Protocol target 60–80 sec. Which action is
correct?
A. Stop infusion – aPTT trending to supratherapeutic
B. Increase rate by 2 units/kg/hr – still below target
C. Continue current rate – within acceptable range
D. Obtain anti-Xa level – aPTT unreliable
Correct Answer: B
Rationale: aPTT is still subtherapeutic (goal ~2–2.5 × control = 60–75 sec). A small
upward titration per protocol is indicated. Anti-Xa is not needed unless discrepant.
5. Traditional
The PN is delegating tasks on a medical floor. Which activity is appropriate for
assistive personnel (AP)?
A. Insert a nasogastric tube
B. Perform sterile wound irrigation
C. Obtain vital signs on stable post-op client
D. Evaluate gait-training progress
Correct Answer: C
Rationale: Stable vital signs are within AP scope. NG insertion, sterile procedures, and
evaluation require licensed nurse or therapist.
