HESI PN Comprehensive Nursing Exam | ACTUAL
EXAM | Complete Questions & Verified Answers |
Latest Update | Already Graded A
A PN is caring for a client with a new colostomy. Which observation indicates that the
client is beginning to accept the alteration in body image?
A. The client asks the PN to empty the pouch.
B. The client looks at the stoma and asks questions.
C. The client refuses to participate in pouch changes.
1. D. The client expresses anger toward the surgeon.
Correct Answer: B
Rationale: Looking at the stoma and asking questions shows initial acceptance and
willingness to learn, which are early signs of adapting to body image change. Option A
reflects dependence, not acceptance. Option C indicates denial or rejection. Option D
represents anger, a normal early stage of grief but not yet acceptance.
The PN receives report on four clients. Which client should the PN assess first?
A. Client with pneumonia reporting chills and fever
B. Client with chronic renal failure receiving a blood transfusion
C. Client 6 hours postoperative appendectomy with pain 4/10
2. D. Client with heart failure receiving IV furosemide
Correct Answer: B
Rationale: A blood transfusion carries the highest immediate risk for life-threatening
reactions; the PN must assess for hemolysis, allergic response, or fluid overload first.
,Option A is expected with pneumonia. Option C pain level is moderate and routine.
Option D diuretic therapy is standard and expected.
A client is prescribed metformin 500 mg PO twice daily. What is the most important
teaching point for the PN to reinforce?
A. Take the medication with meals to reduce GI upset.
B. Avoid alcohol to prevent lactic acidosis.
C. Monitor for hypoglycemia between meals.
3. D. Discontinue if urine ketones are present.
Correct Answer: B
Rationale: Metformin can precipitate rare but fatal lactic acidosis, especially with
alcohol use or renal insufficiency; alcohol avoidance is critical. Option A is helpful but
secondary. Option C is incorrect because metformin alone does not cause
hypoglycemia. Option D relates more to type 1 diabetes and insulin deficiency.
The PN is assisting with a sterile dressing change. Which action requires correction?
A. Opening sterile packages so the 1-inch border is considered unsterile
B. Placing sterile gloves on after setting up the sterile field
C. Holding forceps 6 inches above the field to maintain sterility
4. D. Using the dominant hand to reach across the sterile field
Correct Answer: D
Rationale: Reaching across the sterile field contaminates it; sterile items must be
handled from the sides. Option A is correct because the 1-inch edge is unsterile. Option
B sequence is acceptable. Option C height is appropriate to avoid contamination.
A 2-month-old infant is brought to the clinic for a check-up. Which finding should the PN
report immediately?
,A. Anterior fontanelle bulging while the infant is sitting quietly
B. Presence of Mongolian spots on the back
C. Weight gain of 1.5 lb since birth
5. D. Head circumference 2 cm larger than chest
Correct Answer: A
Rationale: A bulging anterior fontanelle at rest may indicate increased intracranial
pressure or infection and needs immediate provider evaluation. Option B is a benign
birthmark. Option C growth is within normal range. Option D is normal at this age.
A client with chronic obstructive pulmonary disease (COPD) asks why low-flow oxygen
is used. What explanation should the PN give?
A. “High oxygen levels can suppress your breathing drive.”
B. “Low flow prevents drying of your nasal passages.”
C. “It conserves hospital oxygen supplies.”
6. D. “It prevents oxygen toxicity in the lungs.”
Correct Answer: A
Rationale: COPD clients often depend on hypoxic drive; excessive oxygen can blunt
respiratory drive leading to hypoventilation and CO₂ narcosis. Option B is a minor
comfort issue. Option C is untrue and irrelevant. Option D is not the primary concern at
typical low-flow rates.
The PN is delegating tasks to an assistive personnel (AP). Which task is appropriate to
delegate?
A. Measuring intake and output for a stable client
B. Evaluating effectiveness of a cleansing enema
C. Reinforcing teaching about a low-sodium diet
, 7. D. Assessing skin integrity for a stage 3 pressure injury
Correct Answer: A
Rationale: Measuring I&O is a standard, unlicensed assistive task for stable clients.
Options B, C, and D require nursing judgment and assessment and cannot be delegated
to AP.
A client on lithium reports nausea, coarse hand tremors, and muscle weakness. Which
laboratory result should the PN review first?
A. Serum creatinine
B. Serum lithium level
C. Serum sodium
8. D. Serum potassium
Correct Answer: B
Rationale: Symptoms suggest lithium toxicity; the priority is to check the lithium level to
confirm. Option A assesses renal function but is not the immediate priority. Option C
hyponatremia can elevate lithium levels but is secondary to knowing the level. Option D
is unrelated.
A postpartum client asks the PN when breast-feeding jaundice usually peaks. What
response should the PN give?
A. Day 1–2
B. Day 3–5
C. Day 7–10
9. D. Day 14
Correct Answer: B
EXAM | Complete Questions & Verified Answers |
Latest Update | Already Graded A
A PN is caring for a client with a new colostomy. Which observation indicates that the
client is beginning to accept the alteration in body image?
A. The client asks the PN to empty the pouch.
B. The client looks at the stoma and asks questions.
C. The client refuses to participate in pouch changes.
1. D. The client expresses anger toward the surgeon.
Correct Answer: B
Rationale: Looking at the stoma and asking questions shows initial acceptance and
willingness to learn, which are early signs of adapting to body image change. Option A
reflects dependence, not acceptance. Option C indicates denial or rejection. Option D
represents anger, a normal early stage of grief but not yet acceptance.
The PN receives report on four clients. Which client should the PN assess first?
A. Client with pneumonia reporting chills and fever
B. Client with chronic renal failure receiving a blood transfusion
C. Client 6 hours postoperative appendectomy with pain 4/10
2. D. Client with heart failure receiving IV furosemide
Correct Answer: B
Rationale: A blood transfusion carries the highest immediate risk for life-threatening
reactions; the PN must assess for hemolysis, allergic response, or fluid overload first.
,Option A is expected with pneumonia. Option C pain level is moderate and routine.
Option D diuretic therapy is standard and expected.
A client is prescribed metformin 500 mg PO twice daily. What is the most important
teaching point for the PN to reinforce?
A. Take the medication with meals to reduce GI upset.
B. Avoid alcohol to prevent lactic acidosis.
C. Monitor for hypoglycemia between meals.
3. D. Discontinue if urine ketones are present.
Correct Answer: B
Rationale: Metformin can precipitate rare but fatal lactic acidosis, especially with
alcohol use or renal insufficiency; alcohol avoidance is critical. Option A is helpful but
secondary. Option C is incorrect because metformin alone does not cause
hypoglycemia. Option D relates more to type 1 diabetes and insulin deficiency.
The PN is assisting with a sterile dressing change. Which action requires correction?
A. Opening sterile packages so the 1-inch border is considered unsterile
B. Placing sterile gloves on after setting up the sterile field
C. Holding forceps 6 inches above the field to maintain sterility
4. D. Using the dominant hand to reach across the sterile field
Correct Answer: D
Rationale: Reaching across the sterile field contaminates it; sterile items must be
handled from the sides. Option A is correct because the 1-inch edge is unsterile. Option
B sequence is acceptable. Option C height is appropriate to avoid contamination.
A 2-month-old infant is brought to the clinic for a check-up. Which finding should the PN
report immediately?
,A. Anterior fontanelle bulging while the infant is sitting quietly
B. Presence of Mongolian spots on the back
C. Weight gain of 1.5 lb since birth
5. D. Head circumference 2 cm larger than chest
Correct Answer: A
Rationale: A bulging anterior fontanelle at rest may indicate increased intracranial
pressure or infection and needs immediate provider evaluation. Option B is a benign
birthmark. Option C growth is within normal range. Option D is normal at this age.
A client with chronic obstructive pulmonary disease (COPD) asks why low-flow oxygen
is used. What explanation should the PN give?
A. “High oxygen levels can suppress your breathing drive.”
B. “Low flow prevents drying of your nasal passages.”
C. “It conserves hospital oxygen supplies.”
6. D. “It prevents oxygen toxicity in the lungs.”
Correct Answer: A
Rationale: COPD clients often depend on hypoxic drive; excessive oxygen can blunt
respiratory drive leading to hypoventilation and CO₂ narcosis. Option B is a minor
comfort issue. Option C is untrue and irrelevant. Option D is not the primary concern at
typical low-flow rates.
The PN is delegating tasks to an assistive personnel (AP). Which task is appropriate to
delegate?
A. Measuring intake and output for a stable client
B. Evaluating effectiveness of a cleansing enema
C. Reinforcing teaching about a low-sodium diet
, 7. D. Assessing skin integrity for a stage 3 pressure injury
Correct Answer: A
Rationale: Measuring I&O is a standard, unlicensed assistive task for stable clients.
Options B, C, and D require nursing judgment and assessment and cannot be delegated
to AP.
A client on lithium reports nausea, coarse hand tremors, and muscle weakness. Which
laboratory result should the PN review first?
A. Serum creatinine
B. Serum lithium level
C. Serum sodium
8. D. Serum potassium
Correct Answer: B
Rationale: Symptoms suggest lithium toxicity; the priority is to check the lithium level to
confirm. Option A assesses renal function but is not the immediate priority. Option C
hyponatremia can elevate lithium levels but is secondary to knowing the level. Option D
is unrelated.
A postpartum client asks the PN when breast-feeding jaundice usually peaks. What
response should the PN give?
A. Day 1–2
B. Day 3–5
C. Day 7–10
9. D. Day 14
Correct Answer: B
