HESI PN EXIT 2026 ACTUAL EXAM REVIEW 150 QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES COVERING THE MOST TESTED
QUESTIONS GUARANTEE A+ GRADE
1. What step should the practical nurse (PN) take for an older female client newly admitted to a long-
term care facility who is confused about the day of the week?
A) Reorient the client only if asked
B) Ignore confusion unless it worsens
C) Remind the client what day of the week it is ☑
D) Notify the provider immediately
Rationale: Frequent reorientation helps reduce confusion and supports cognitive function in older
adults.
2. Which information about end-of-life care should the PN ensure the client understands?
A) Funeral planning options
B) CPR procedures
C) Instructions for care included in the client’s living will ☑
D) Insurance coverage
Rationale: Advance directives such as living wills guide care decisions at the end of life.
3. After a routine vaginal delivery, a postpartum client is shaking and asks if she is cold. What is the
PN’s priority action?
A) Take the client’s temperature
B) Increase room temperature
C) Apply a light warm blanket and reassure the client ☑
D) Administer medication
Rationale: Postpartum shivering is common and benign; warmth and reassurance are appropriate.
4. A PN assesses an older client with left-sided heart failure. Which intervention is most important?
A) Monitor urine output
B) Check peripheral pulses
C) Auscultate all lung fields ☑
D) Assess bowel sounds
Rationale: Pulmonary congestion is common with left-sided heart failure and must be detected early.
,5. What is the most crucial step when administering prescription medications to an elderly client with
hearing difficulty?
A) Speak louder
B) Write instructions
C) Determine if the client has had hearing difficulty in the past ☑
D) Ask family to assist
Rationale: Identifying sensory deficits ensures safe communication and medication administration.
6. A full-term, 24-hour-old infant suddenly becomes cyanotic. What immediate action should the PN
take?
A) Start CPR
B) Administer oxygen
C) Turn the infant to the right side ☑
D) Notify the provider
Rationale: Positioning helps maintain airway patency in newborns.
7. A client reports pain at the site of a midline episiotomy. What should the PN do first?
A) Administer pain medication
B) Apply ice
C) Inspect the suture line for separation or hematoma ☑
D) Notify the provider
Rationale: Assessment always precedes intervention.
8. Which fetal heart rate obtained during the third trimester should be reported immediately to the
RN?
A) 110 bpm
B) 130 bpm
C) 150 bpm
D) 180 bpm ☑
Rationale: Normal fetal heart rate is 110–160 bpm; 180 indicates fetal distress.
9. An older client experiences protrusion of abdominal organs through a surgical incision. How should
this be documented?
,A) Dehiscence
B) Infection
C) Herniation
D) Evisceration ☑
Rationale: Evisceration involves organs protruding through an incision and is a surgical emergency.
10. Where should the PN palpate to assess submandibular lymph nodes?
A) Behind the ears
B) Base of the neck
C) Beneath the lower jaw ☑
D) Above the clavicle
Rationale: Submandibular nodes are located under the mandible.
11. What is the most significant side effect to monitor after an epidural during labor?
A) Headache
B) Nausea
C) Maternal hypotension ☑
D) Urinary retention
Rationale: Epidurals can cause vasodilation and hypotension affecting uteroplacental perfusion.
12. Which individual has the highest risk of developing laryngeal cancer?
A) Young female nonsmoker
B) Older female drinker
C) Older male who smokes and drinks heavily ☑
D) Teen who vapes
Rationale: Tobacco and alcohol use significantly increase laryngeal cancer risk.
13. A home health PN suspects elder abuse. What action should be taken?
A) Confront the family
B) Document only
C) Report suspected abuse to supervisor and protective services ☑
D) Ignore unless injury is visible
Rationale: Nurses are mandated reporters of suspected abuse.
, 14. Which intervention should the PN reinforce for a client with pruritus?
A) Hot showers
B) Scratching
C) Keep fingernails trimmed short ☑
D) Use alcohol-based lotions
Rationale: Short nails prevent skin injury and infection.
15. When assessing a client with dark skin tones, which area best reflects cyanosis?
A) Palms
B) Lips
C) Fingernails and toenails ☑
D) Forehead
Rationale: Nail beds best show oxygenation changes in dark-skinned clients.
16. What is the most important newborn assessment the PN must ensure is completed?
A) Length measurement
B) Weight
C) Head circumference ☑
D) Chest circumference
Rationale: Head circumference reflects brain growth and development.
17. A newborn of a diabetic mother is at risk for hypoglycemia. What should the PN encourage?
A) Water
B) Formula only
C) Breastfeeding or 10% dextrose ☑
D) Delayed feeding
Rationale: Early feeding prevents hypoglycemia.
18. A PN finds a client unresponsive. What instruction should be given to the UAP first?
A) Check pulse
B) Stay with client
C) Obtain emergency help ☑
D) Document findings
Rationale: Emergency assistance must be activated immediately.
CORRECT ANSWERS WITH RATIONALES COVERING THE MOST TESTED
QUESTIONS GUARANTEE A+ GRADE
1. What step should the practical nurse (PN) take for an older female client newly admitted to a long-
term care facility who is confused about the day of the week?
A) Reorient the client only if asked
B) Ignore confusion unless it worsens
C) Remind the client what day of the week it is ☑
D) Notify the provider immediately
Rationale: Frequent reorientation helps reduce confusion and supports cognitive function in older
adults.
2. Which information about end-of-life care should the PN ensure the client understands?
A) Funeral planning options
B) CPR procedures
C) Instructions for care included in the client’s living will ☑
D) Insurance coverage
Rationale: Advance directives such as living wills guide care decisions at the end of life.
3. After a routine vaginal delivery, a postpartum client is shaking and asks if she is cold. What is the
PN’s priority action?
A) Take the client’s temperature
B) Increase room temperature
C) Apply a light warm blanket and reassure the client ☑
D) Administer medication
Rationale: Postpartum shivering is common and benign; warmth and reassurance are appropriate.
4. A PN assesses an older client with left-sided heart failure. Which intervention is most important?
A) Monitor urine output
B) Check peripheral pulses
C) Auscultate all lung fields ☑
D) Assess bowel sounds
Rationale: Pulmonary congestion is common with left-sided heart failure and must be detected early.
,5. What is the most crucial step when administering prescription medications to an elderly client with
hearing difficulty?
A) Speak louder
B) Write instructions
C) Determine if the client has had hearing difficulty in the past ☑
D) Ask family to assist
Rationale: Identifying sensory deficits ensures safe communication and medication administration.
6. A full-term, 24-hour-old infant suddenly becomes cyanotic. What immediate action should the PN
take?
A) Start CPR
B) Administer oxygen
C) Turn the infant to the right side ☑
D) Notify the provider
Rationale: Positioning helps maintain airway patency in newborns.
7. A client reports pain at the site of a midline episiotomy. What should the PN do first?
A) Administer pain medication
B) Apply ice
C) Inspect the suture line for separation or hematoma ☑
D) Notify the provider
Rationale: Assessment always precedes intervention.
8. Which fetal heart rate obtained during the third trimester should be reported immediately to the
RN?
A) 110 bpm
B) 130 bpm
C) 150 bpm
D) 180 bpm ☑
Rationale: Normal fetal heart rate is 110–160 bpm; 180 indicates fetal distress.
9. An older client experiences protrusion of abdominal organs through a surgical incision. How should
this be documented?
,A) Dehiscence
B) Infection
C) Herniation
D) Evisceration ☑
Rationale: Evisceration involves organs protruding through an incision and is a surgical emergency.
10. Where should the PN palpate to assess submandibular lymph nodes?
A) Behind the ears
B) Base of the neck
C) Beneath the lower jaw ☑
D) Above the clavicle
Rationale: Submandibular nodes are located under the mandible.
11. What is the most significant side effect to monitor after an epidural during labor?
A) Headache
B) Nausea
C) Maternal hypotension ☑
D) Urinary retention
Rationale: Epidurals can cause vasodilation and hypotension affecting uteroplacental perfusion.
12. Which individual has the highest risk of developing laryngeal cancer?
A) Young female nonsmoker
B) Older female drinker
C) Older male who smokes and drinks heavily ☑
D) Teen who vapes
Rationale: Tobacco and alcohol use significantly increase laryngeal cancer risk.
13. A home health PN suspects elder abuse. What action should be taken?
A) Confront the family
B) Document only
C) Report suspected abuse to supervisor and protective services ☑
D) Ignore unless injury is visible
Rationale: Nurses are mandated reporters of suspected abuse.
, 14. Which intervention should the PN reinforce for a client with pruritus?
A) Hot showers
B) Scratching
C) Keep fingernails trimmed short ☑
D) Use alcohol-based lotions
Rationale: Short nails prevent skin injury and infection.
15. When assessing a client with dark skin tones, which area best reflects cyanosis?
A) Palms
B) Lips
C) Fingernails and toenails ☑
D) Forehead
Rationale: Nail beds best show oxygenation changes in dark-skinned clients.
16. What is the most important newborn assessment the PN must ensure is completed?
A) Length measurement
B) Weight
C) Head circumference ☑
D) Chest circumference
Rationale: Head circumference reflects brain growth and development.
17. A newborn of a diabetic mother is at risk for hypoglycemia. What should the PN encourage?
A) Water
B) Formula only
C) Breastfeeding or 10% dextrose ☑
D) Delayed feeding
Rationale: Early feeding prevents hypoglycemia.
18. A PN finds a client unresponsive. What instruction should be given to the UAP first?
A) Check pulse
B) Stay with client
C) Obtain emergency help ☑
D) Document findings
Rationale: Emergency assistance must be activated immediately.
