HESI PN Comprehensive Exam 1
2026:Full Practice Questions with
Detailed Rationales
1. A client with deep partial-thickness and full-thickness burns of the
face and chest is receiving wound care using the open method.
The plan of care includes the Nsg Dx, "Risk for infection R/T
impaired tissue integrity." Based on the expected outcome,
"Client remains free of infections," which nursing interventions
should the PN implement?
A. Wear gown, cap, mask, and gloves during direct client care.
B. Restrict visitors in order to prevent wound contamination.
C. Use sterile water for debridement in the hydrotherapy tank.
D. Apply sterile dressings after debridement of burn wounds. -
answer-A. Wear gown, cap, mask, and gloves during direct
client care.
2. No dressing is used for burn wound care using the open method.
The burn area is exposed and an aseptic environment is needed to
prevent contamination and infection. Protective isolation
precautions should be implemented during direct client care and
wound care, which should include wearing gown, cap, mask, and
gloves.
,3. What action should the PN implement to facilitate speech for a
client who has a fenestrated tracheostomy tube?
A. Show the client how to use a tracheostomy plug.
B. Determine the client's ability to swallow.
C. Remove the inner cannula.
D. Give oxygen at 6 L/minute via tracheostomy collar. - answer-
B. Determine the client's ability to swallow.
4. A fenestrated tracheostomy has an opening or hole on the
posterior aspect of the outer cannula that allows airflow over the
vocal cords and speech in a client who is spontaneously breathing.
It does not have a cuff, so the client's risk for aspiration should be
determined.
5. A male client scheduled for a total laryngectomy and radical neck
dissection for cancer of the larynx asks the PN if he will ever be
able to speak. Which response is bets for the PN to provide?
A. Breathing occurs through a permanent neck opening which
prevents normal speech.
B. Permanent removal of the voice box requires rehabilitation
for esophageal speech.
C. Due to removal of the vocal cords, communication requires
the use of sign language.
, D. Once the breathing hole in the neck heals, the ability to
speak requires a device. - answer-B. Permanent removal of
the voice box requires rehabilitation for esophageal speech.
6. A total laryngectomy includes removal of the larynx and pre-
epiglottis region resulting in a permanent tracheostomy and loss
of normal speech abilities. Rehab is required to learn to speak
using a prosthesis, esophageal speech, or an electrolarynx.
7. A client is wearing a continuous 24-hour Holter monitor for
elevation of heart rhythm disturbances. What info should the PN
reinforce with this client?
A. Remove the electrodes to shower or bathe
B. Keep a diary of activities as long as the monitor is worn.
C. Exercise as much as possible while the monitor is in place.
D. Call the assigned number if an episode of irregular
heartbeats occurs. - answer-B. Keep a diary of activities as
long as the monitor is worn.
8. Nursing care for a client with a Holter monitor includes
preparation of the skin, placement of the electrodes and leads,
and activities of daily living, so the client should be informed of
the importance of keeping an accurate record of activities and
symptoms
, 9. The PN is caring for a client who is receiving a therapeutic dose of
warfarin (Coumadin). The client asks the PN to explain the effect
of eating green leafy vegetables. What info should the PN
provide?
A. The high content of vitamin K in green leafy vegetables
decreases Coumadin's action.
B. Green vegetables are high in fiber and cellulose that
decrease the absorption of Coumadin.
C. These foods have a natural anticoagulant effect that
potentiates the effect of Coumadin.
D. Dietary intake of green leafy vegetables alters the bowel
bacteria's production of vitamin K. - answer-A. The high
content of vitamin K in green leafy vegetables decreases
Coumadin's action.
10. Coumadin works as an anticoagulant by blocking hepatic
utilization of vitamin K in the production of prothrombin, which is
a component of the blood clotting cascade. Green leafy
vegetables are high in vitamin K, which counteracts the
anticoagulant effect of Coumadin.
11. The PN is reviewing the effects of NSAIDs (nonsteroidal anti-
inflammatory drugs) with a client who has acute gastritis. What
info is correct about the action of NSAIDs?
2026:Full Practice Questions with
Detailed Rationales
1. A client with deep partial-thickness and full-thickness burns of the
face and chest is receiving wound care using the open method.
The plan of care includes the Nsg Dx, "Risk for infection R/T
impaired tissue integrity." Based on the expected outcome,
"Client remains free of infections," which nursing interventions
should the PN implement?
A. Wear gown, cap, mask, and gloves during direct client care.
B. Restrict visitors in order to prevent wound contamination.
C. Use sterile water for debridement in the hydrotherapy tank.
D. Apply sterile dressings after debridement of burn wounds. -
answer-A. Wear gown, cap, mask, and gloves during direct
client care.
2. No dressing is used for burn wound care using the open method.
The burn area is exposed and an aseptic environment is needed to
prevent contamination and infection. Protective isolation
precautions should be implemented during direct client care and
wound care, which should include wearing gown, cap, mask, and
gloves.
,3. What action should the PN implement to facilitate speech for a
client who has a fenestrated tracheostomy tube?
A. Show the client how to use a tracheostomy plug.
B. Determine the client's ability to swallow.
C. Remove the inner cannula.
D. Give oxygen at 6 L/minute via tracheostomy collar. - answer-
B. Determine the client's ability to swallow.
4. A fenestrated tracheostomy has an opening or hole on the
posterior aspect of the outer cannula that allows airflow over the
vocal cords and speech in a client who is spontaneously breathing.
It does not have a cuff, so the client's risk for aspiration should be
determined.
5. A male client scheduled for a total laryngectomy and radical neck
dissection for cancer of the larynx asks the PN if he will ever be
able to speak. Which response is bets for the PN to provide?
A. Breathing occurs through a permanent neck opening which
prevents normal speech.
B. Permanent removal of the voice box requires rehabilitation
for esophageal speech.
C. Due to removal of the vocal cords, communication requires
the use of sign language.
, D. Once the breathing hole in the neck heals, the ability to
speak requires a device. - answer-B. Permanent removal of
the voice box requires rehabilitation for esophageal speech.
6. A total laryngectomy includes removal of the larynx and pre-
epiglottis region resulting in a permanent tracheostomy and loss
of normal speech abilities. Rehab is required to learn to speak
using a prosthesis, esophageal speech, or an electrolarynx.
7. A client is wearing a continuous 24-hour Holter monitor for
elevation of heart rhythm disturbances. What info should the PN
reinforce with this client?
A. Remove the electrodes to shower or bathe
B. Keep a diary of activities as long as the monitor is worn.
C. Exercise as much as possible while the monitor is in place.
D. Call the assigned number if an episode of irregular
heartbeats occurs. - answer-B. Keep a diary of activities as
long as the monitor is worn.
8. Nursing care for a client with a Holter monitor includes
preparation of the skin, placement of the electrodes and leads,
and activities of daily living, so the client should be informed of
the importance of keeping an accurate record of activities and
symptoms
, 9. The PN is caring for a client who is receiving a therapeutic dose of
warfarin (Coumadin). The client asks the PN to explain the effect
of eating green leafy vegetables. What info should the PN
provide?
A. The high content of vitamin K in green leafy vegetables
decreases Coumadin's action.
B. Green vegetables are high in fiber and cellulose that
decrease the absorption of Coumadin.
C. These foods have a natural anticoagulant effect that
potentiates the effect of Coumadin.
D. Dietary intake of green leafy vegetables alters the bowel
bacteria's production of vitamin K. - answer-A. The high
content of vitamin K in green leafy vegetables decreases
Coumadin's action.
10. Coumadin works as an anticoagulant by blocking hepatic
utilization of vitamin K in the production of prothrombin, which is
a component of the blood clotting cascade. Green leafy
vegetables are high in vitamin K, which counteracts the
anticoagulant effect of Coumadin.
11. The PN is reviewing the effects of NSAIDs (nonsteroidal anti-
inflammatory drugs) with a client who has acute gastritis. What
info is correct about the action of NSAIDs?
