HESI PN EXIT 2026 ACTUAL EXAM REVIEW 150 QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES COVERING THE MOST TESTED
QUESTIONS GUARANTEE A+ GRADE
1. A male client admitted the morning of his scheduled surgery tells the PN that he drank water last
night. What intervention should the PN implement first?
A) Cancel the surgery
B) Notify the surgeon
C) ☑ Determine the amount of water and exact time it was taken
D) Document and continue care
Rationale: Determining amount and timing is required before deciding if surgery must be delayed.
2. A client receives ondansetron prior to chemotherapy. How should the PN evaluate the effectiveness
of this medication?
A) Monitor bowel sounds
B) Assess appetite
C) ☑ Monitor for nausea or vomiting after treatment
D) Check liver enzymes
Rationale: Ondansetron is an antiemetic; absence of nausea/vomiting indicates effectiveness.
3. A client with OCD repeatedly wipes the same table. Which intervention should the PN implement?
A) Stop the behavior immediately
B) Redirect forcefully
C) ☑ Allow time for the behavior, then guide to other activities
D) Ignore the behavior
Rationale: Permitting ritual behavior reduces anxiety and prevents escalation.
4. An older adult client is confused and incontinent. Which factor increases the risk for impaired skin
integrity?
A) Decreased appetite
B) Immobility
C) ☑ Frequent urinary incontinence
D) Advanced age
Rationale: Moisture from incontinence increases skin breakdown risk.
,5. A client with cirrhosis has peripheral edema. What action should the PN take?
A) Elevate legs
B) Restrict fluids
C) ☑ Protect the client’s feet from injury
D) Apply heat
Rationale: Edematous tissue is fragile and prone to injury and infection.
6. A client is admitted after a lobectomy with two chest tubes. Bubbling is noted in the water-seal
chamber. What action should the PN take?
A) Clamp the tubing
B) Increase suction
C) ☑ Maintain system integrity to promote lung re-expansion
D) Disconnect suction
Rationale: Bubbling can be expected; maintaining system function is priority.
7. Where is the correct location for assessing an apical heart rate in an adult male?
A) Right sternal border
B) Second intercostal space
C) ☑ Just below the left nipple (5th ICS, MCL)
D) Epigastric area
Rationale: This is the standard PMI location.
8. At the end of the shift, cloudy urine is noted in a catheter. What action should the PN take next?
A) Remove catheter
B) Increase fluids
C) ☑ Review the most recent white blood cell count
D) Change tubing
Rationale: Cloudy urine may indicate infection; labs support assessment.
9. A client with a new below-knee cast is being discharged. Which instruction is most important?
A) Elevate leg at night
B) Apply lotion under cast
,C) ☑ Never scratch under the cast
D) Remove cast if itching occurs
Rationale: Scratching can cause skin injury and infection.
10. Thirty minutes after IV morphine, a client reports continued pain. What should the PN do first?
A) Give another dose
B) Notify provider
C) ☑ Implement complementary pain-relief methods
D) Withhold medication
Rationale: Non-pharmacologic methods enhance pain control.
11. A client with schizophrenia is withdrawn and minimally responsive. What is the priority
intervention?
A) Encourage group activity
B) Explore feelings
C) ☑ Measure vital signs
D) Provide snacks
Rationale: Physical causes must be ruled out before psychiatric assumptions.
12. A client falls while ambulating. What should the PN do first?
A) Complete incident report
B) Help client up
C) ☑ Stay with the client and call for assistance
D) Notify family
Rationale: Client safety and assessment are the immediate priorities.
13. While assisting a female client to collect a urine specimen, what should the PN instruct next after
cleansing?
A) Collect immediately
B) Stop voiding
C) ☑ Begin voiding, then collect midstream urine
D) Hold urine
Rationale: Midstream urine reduces contamination.
, 14. A child in 90-90 traction has weights touching the bed. What should the PN do?
A) Ignore
B) Increase weights
C) ☑ Correct the traction setup
D) Notify parents
Rationale: Weights must hang freely for traction effectiveness.
15. A client with hyperthyroidism increased calorie and protein intake. What should the PN do?
A) Stop changes
B) Modify diet
C) ☑ Encourage continuation
D) Refer to dietitian only
Rationale: Increased metabolism requires increased intake.
16. A preschool child plays “doctor” with dolls after surgery. This behavior indicates:
A) Anxiety
B) Regression
C) ☑ Normal coping
D) Fear
Rationale: Play is a healthy coping mechanism in children.
17. A client with glomerulonephritis is discharged. What should the PN include in teaching about
intake/output?
A) Why fluids are restricted
B) ☑ Which foods count as fluids
C) How to urinate
D) When to drink fluids
Rationale: Accurate fluid measurement is essential for management.
18. A mother brings children to clinic. Which finding suggests abuse?
A) Sibling fighting
B) Bruises on legs
C) ☑ Circular burns on trunk and legs
D) Crying child
CORRECT ANSWERS WITH RATIONALES COVERING THE MOST TESTED
QUESTIONS GUARANTEE A+ GRADE
1. A male client admitted the morning of his scheduled surgery tells the PN that he drank water last
night. What intervention should the PN implement first?
A) Cancel the surgery
B) Notify the surgeon
C) ☑ Determine the amount of water and exact time it was taken
D) Document and continue care
Rationale: Determining amount and timing is required before deciding if surgery must be delayed.
2. A client receives ondansetron prior to chemotherapy. How should the PN evaluate the effectiveness
of this medication?
A) Monitor bowel sounds
B) Assess appetite
C) ☑ Monitor for nausea or vomiting after treatment
D) Check liver enzymes
Rationale: Ondansetron is an antiemetic; absence of nausea/vomiting indicates effectiveness.
3. A client with OCD repeatedly wipes the same table. Which intervention should the PN implement?
A) Stop the behavior immediately
B) Redirect forcefully
C) ☑ Allow time for the behavior, then guide to other activities
D) Ignore the behavior
Rationale: Permitting ritual behavior reduces anxiety and prevents escalation.
4. An older adult client is confused and incontinent. Which factor increases the risk for impaired skin
integrity?
A) Decreased appetite
B) Immobility
C) ☑ Frequent urinary incontinence
D) Advanced age
Rationale: Moisture from incontinence increases skin breakdown risk.
,5. A client with cirrhosis has peripheral edema. What action should the PN take?
A) Elevate legs
B) Restrict fluids
C) ☑ Protect the client’s feet from injury
D) Apply heat
Rationale: Edematous tissue is fragile and prone to injury and infection.
6. A client is admitted after a lobectomy with two chest tubes. Bubbling is noted in the water-seal
chamber. What action should the PN take?
A) Clamp the tubing
B) Increase suction
C) ☑ Maintain system integrity to promote lung re-expansion
D) Disconnect suction
Rationale: Bubbling can be expected; maintaining system function is priority.
7. Where is the correct location for assessing an apical heart rate in an adult male?
A) Right sternal border
B) Second intercostal space
C) ☑ Just below the left nipple (5th ICS, MCL)
D) Epigastric area
Rationale: This is the standard PMI location.
8. At the end of the shift, cloudy urine is noted in a catheter. What action should the PN take next?
A) Remove catheter
B) Increase fluids
C) ☑ Review the most recent white blood cell count
D) Change tubing
Rationale: Cloudy urine may indicate infection; labs support assessment.
9. A client with a new below-knee cast is being discharged. Which instruction is most important?
A) Elevate leg at night
B) Apply lotion under cast
,C) ☑ Never scratch under the cast
D) Remove cast if itching occurs
Rationale: Scratching can cause skin injury and infection.
10. Thirty minutes after IV morphine, a client reports continued pain. What should the PN do first?
A) Give another dose
B) Notify provider
C) ☑ Implement complementary pain-relief methods
D) Withhold medication
Rationale: Non-pharmacologic methods enhance pain control.
11. A client with schizophrenia is withdrawn and minimally responsive. What is the priority
intervention?
A) Encourage group activity
B) Explore feelings
C) ☑ Measure vital signs
D) Provide snacks
Rationale: Physical causes must be ruled out before psychiatric assumptions.
12. A client falls while ambulating. What should the PN do first?
A) Complete incident report
B) Help client up
C) ☑ Stay with the client and call for assistance
D) Notify family
Rationale: Client safety and assessment are the immediate priorities.
13. While assisting a female client to collect a urine specimen, what should the PN instruct next after
cleansing?
A) Collect immediately
B) Stop voiding
C) ☑ Begin voiding, then collect midstream urine
D) Hold urine
Rationale: Midstream urine reduces contamination.
, 14. A child in 90-90 traction has weights touching the bed. What should the PN do?
A) Ignore
B) Increase weights
C) ☑ Correct the traction setup
D) Notify parents
Rationale: Weights must hang freely for traction effectiveness.
15. A client with hyperthyroidism increased calorie and protein intake. What should the PN do?
A) Stop changes
B) Modify diet
C) ☑ Encourage continuation
D) Refer to dietitian only
Rationale: Increased metabolism requires increased intake.
16. A preschool child plays “doctor” with dolls after surgery. This behavior indicates:
A) Anxiety
B) Regression
C) ☑ Normal coping
D) Fear
Rationale: Play is a healthy coping mechanism in children.
17. A client with glomerulonephritis is discharged. What should the PN include in teaching about
intake/output?
A) Why fluids are restricted
B) ☑ Which foods count as fluids
C) How to urinate
D) When to drink fluids
Rationale: Accurate fluid measurement is essential for management.
18. A mother brings children to clinic. Which finding suggests abuse?
A) Sibling fighting
B) Bruises on legs
C) ☑ Circular burns on trunk and legs
D) Crying child
