2026 HESI PN
Fundamentals
3 FULL SET EXAMS
(NGN-STYLE QUESTIONS & CASE “SCENARIOS”)
Pass The Exam Score With Confidence
This Document contains:
➢ Achieve a 900+ or Higher Exam Score
➢ Passing Score Guarantee
➢ multiple-choice format with correct answers
➢ Some questions feature “case scenarios”
,Table of Contents
HESI PN Fundamentals Exam 1 .................................... 2
HESI PN Fundamentals Exam 2 .................................. 38
HESI PN Fundamentals Exam 3 .................................. 63
HESI PN Fundamentals Exam 1
1. Post-op wound-healing scenario (converted into 3 NGN-style questions)
The client is awake and alert, denies pain. The client is still unable to tolerate
solid foods but is drinking full liquids with no issues. No signs of hypovolemia.
The surgical wound is slow- healing and red around the edges. Serosanguinous
drainage noted coming from the wound.
Vital signs:
BP 122/78 mm Hg, HR 86/min, RR 18/min, Temp 37.0°C (98.6°F), SpO₂ 98% on
room air.
1a. Actions to take
Which action by the practical nurse (PN) best promotes this client’s wound healing
while respecting the current diet order?
A. Encourage the client to drink only clear fluids to reduce nausea
B. Hold all oral intake until the wound is fully healed
C. Include protein supplement shakes in the client's diet
D. Advance diet to regular as tolerated, despite current intolerance
Correct Answer: C. Include protein supplement shakes in the client's diet
,Expert rationale:
The wound is slow-healing and the client can tolerate full liquids. Protein is
essential for collagen synthesis and tissue repair. Adding high-protein liquid
supplements provides needed nutrients without violating the full-liquid
restriction. Advancing to solids is premature (option D), and restricting intake (A or
B) would further impair nutritional status and slow healing.
1b. Potential condition
Based on the client’s slow-healing wound and current nutritional intake, which
potential condition is the PN most concerned about?
A. Protein deficiency
B. Hypovolemia
C. Acute blood loss anemia
D. Hyperglycemia
Correct Answer: A. Protein deficiency
Expert rationale:
Slow wound healing in the context of limited intake and no signs of hypovolemia
suggests inadequate protein stores. Protein deficiency delays granulation tissue
formation and collagen deposition. There are no data indicating hypovolemia,
anemia, or hyperglycemia in the stem.
1c. Parameters to monitor
Which parameter is most important for the PN to monitor to detect complications
early?
A. Daily urine output
B. Signs of infection at the wound site
C. Bowel sounds in all four quadrants
D. Client’s sleep pattern
,Correct Answer: B. Signs of infection at the wound site
Expert rationale:
The wound is already red with serosanguinous drainage, which can progress to
infection. Monitoring for increased redness, warmth, purulent drainage, odor, or
fever allows early intervention. While wound healing overall is important,
infection is the priority complication to detect promptly.
2. Dyspneic client – morning care
In assisting a dyspneic client with morning care, which action by the practical
nurse (PN) is most important?
Vital signs:
BP 138/84 mm Hg, HR 104/min, RR 28/min, SpO₂ 90% on 2 L/min via nasal
cannula.
A. Encourage the client to complete all care as quickly as possible
B. Schedule frequent rest periods during care
C. Provide all care with the client in the supine position
D. Withhold all morning care until the client’s respiratory rate is normal
Correct Answer: B. Schedule frequent rest periods during care.
Expert rationale:
Dyspneic clients fatigue easily and have increased oxygen demand. Planning care
with frequent rest periods reduces work of breathing and prevents
decompensation. Supine positioning worsens ventilation (C), rushing care (A)
increases oxygen demand, and completely withholding basic care (D) is
unnecessary and can negatively affect comfort and hygiene.
,3. Stroke with aphasia – nonverbal signs
The practical nurse (PN) is providing care for a client with a history of a stroke
and who has aphasia. The client is exhibiting restlessness, shallow respirations
and is clenching teeth. Which problem should the PN assess further?
Vital signs:
BP 150/90 mm Hg, HR 110/min, RR 30/min, SpO₂ 93% on room air.
A. Impaired physical mobility
B. Altered level of consciousness
C. Alteration in comfort
D. Ineffective airway clearance
Correct Answer: C. Alteration in comfort.
Expert rationale:
In a client with aphasia who cannot verbalize needs, nonverbal cues (restlessness,
teeth-clenching, shallow respirations) commonly indicate pain or discomfort. The
PN should further assess pain/comfort. There is no evidence of decreased LOC (B),
secretion retention (D), or new mobility change (A) in the stem.
4. Turning client with right-sided paralysis
The practical nurse (PN) turns a client with right sided paralysis from a supine to
a left lateral position. Which bony prominence is most likely to manifest signs of
erythema when first turned?
A. Sacrum
B. Right greater trochanter
C. Iliac crest
D. Occiput
Correct Answer: C. Iliac crest
,Expert rationale:
When placed in the left lateral position, pressure is greatest over left-sided bony
prominences such as the iliac crest, greater trochanter, and lateral malleolus.
Among the listed options, the iliac crest is the most likely area to show early
erythema from pressure in this position. The sacrum and occiput are more
affected in supine, and the right trochanter would be off-loaded in left lateral.
5. Potassium chloride – paresthesias
One week after beginning a new prescription for potassium chloride, a client
tells the practical nurse (PN) that there is tingling and numbness in the feet and
hands. Which action should the PN take?
Vital signs:
BP 128/80 mm Hg, HR 96/min, RR 18/min, SpO₂ 98% on room air.
A. Reassure the client that this is a normal side effect of the medication
B. Instruct the client to increase fluid intake and continue the medication
C. Notify the unit charge nurse of the client's reported symptoms immediately
D. Tell the client to stop taking the medication without notifying the healthcare
provider
Correct Answer: C. Notify the unit charge nurse of the client's reported symptoms
immediately.
Expert rationale:
Tingling and numbness (paresthesias) can indicate potassium imbalance, which
may progress to life-threatening cardiac dysrhythmias. These symptoms require
prompt evaluation and possible lab testing or change in therapy. The PN should
promptly escalate to the charge nurse/HCP. Reassurance or advice to continue the
medication (A, B) is unsafe, and stopping prescribed KCl independently (D) is
outside PN scope.
6. Stage I sacral pressure injury – home care
,An older adult client with a stage one sacral pressure wound is discharged with
instructions for home care. Which information should the practical nurse
reinforce with the client?
Vital signs:
BP 130/76 mm Hg, HR 78/min, RR 16/min, Temp 36.8°C (98.2°F).
A. Sit upright in a chair all day to keep pressure off the sacrum
B. Change positions every 2 hours
C. Massage the reddened area to increase circulation
D. Apply ice packs to the area twice daily
Correct Answer: B. Change positions every 2 hours.
Expert rationale:
Frequent repositioning (at least every 2 hours) redistributes pressure and
promotes tissue perfusion, preventing progression of a stage I pressure injury.
Prolonged sitting (A) can still cause sacral pressure. Massaging a reddened area (C)
can further damage capillaries, and cold therapy (D) may impair local blood flow
and healing.
7. Full liquid diet – skin integrity risk
A client on a prescribed full liquid diet has a nursing problem of, "Risk for
impaired skin integrity related to reduced oral intake." Which snack would be
best to provide this client?
A. Clear lemon gelatin
B. Fruit-flavored popsicle
C. Clear broth
D. A liquid nutritional supplement that contains protein
Correct Answer: D. A liquid nutritional supplement that contains protein
Expert rationale:
Protein is crucial for maintaining skin integrity and supporting tissue repair. A
,liquid nutritional supplement with protein fits within a full-liquid diet and targets
the identified risk. Gelatin, popsicles, and broth (A–C) contribute mostly fluid and
carbohydrate, with minimal protein.
8. Cyanotic lips/mouth – oxygenation
The practical nurse (PN) observes a client's mouth and lips as seen in the
picture. Which follow-up action is most important for the PN to take?
Assume findings: bluish lips and oral mucosa.
Vital signs:
BP 142/88 mm Hg, HR 110/min, RR 28/min, SpO₂ 86% on room air.
A. Reassess the client’s mouth and lips in 30 minutes
B. Administer oxygen as prescribed
C. Encourage the client to drink a glass of water
D. Ask the client to rest and slow their breathing
Correct Answer: B. Administer oxygen
Expert rationale:
Cyanotic lips and oral mucosa with low oxygen saturation indicate hypoxemia. The
priority is to improve oxygenation by administering supplemental oxygen per
prescription and then reassessing. Delay (A), oral fluids (C), or simple coaching (D)
do not directly correct the underlying oxygen deficit.
9. New state of employment – licensure
After accepting employment in a state different from where a practical nurse
(PN) is currently employed, it is most important for the PN to review which
reference?
A. The hiring facility’s employee handbook
B. The job description for the PN position
,C. The national nurses’ association position statements
D. The licensing state's PN scope of practice
Correct Answer: D. The licensing state's PN scope of practice
Expert rationale:
Nursing scope of practice is defined by each state’s nurse practice act and
associated regulations. When moving to a new state, the PN must understand that
state’s scope to know what tasks and responsibilities are legally permitted. Facility
policies and job descriptions (A, B) cannot expand legal scope; national position
statements (C) are not law.
10. Infant vital signs – critical finding
The unlicensed assistive personnel (UAP) working in a small community hospital
obtains 0800 vital sign measurements of clients on the unit. In reviewing these
vital signs, which measurement warrants immediate intervention by the
practical nurse?
A. A one-month-old infant with a heart rate of 80 beats/minute
B. A 6-year-old child with a temperature of 37.8°C (100°F)
C. A 40-year-old adult with a blood pressure of 138/86 mm Hg
D. A 70-year-old client with a respiratory rate of 20 breaths/minute
Correct Answer: A. A one-month-old infant with a heart rate of 80 beats/minute.
Expert rationale:
Normal heart rate for a 1-month-old infant is higher (approximately 120–
160/min). A heart rate of 80/min represents bradycardia and may signal hypoxia,
increased intracranial pressure, or other serious problems, requiring immediate
assessment. The other values are within or near normal ranges for their age
groups.
11. Nutrition – fat calorie percentage (dropdown style NGN)
, The client is a 23-year-old male who is in the clinic for a well visit.
Vital signs:
BP 118/70 mm Hg, HR 72/min, RR 14/min, BMI 23 kg/m².
His 24-hour food recall indicates that approximately one-fourth of his total
calories are from fat.
Dropdown Group 1: The percentage of total calories from fat is:
1. 5 to 10%
2. 15 to 18%
3. 21 to 24%
4. 35 to 40%
Dropdown Group 2: This percentage:
A. is significantly below the recommended fat intake for calories
B. has an appropriate fat intake for calories
C. is significantly above the recommended fat intake for calories
D. requires immediate restriction of all dietary fat
Correct Answer:
• Dropdown Group 1: 3. 21 to 24%
• Dropdown Group 2: B. has an appropriate fat intake for calories
Expert rationale:
For healthy adults, recommended fat intake is roughly 20–35% of total calories. A
reported intake in the 21–24% range is within recommended limits and therefore
appropriate. It is neither significantly too low nor too high, so no drastic dietary
changes are indicated.
12. COPD client – ROM assessment
While performing a physical assessment on a client with chronic obstructive
pulmonary disease (COPD), the practical nurse (PN) determines that the client's
Fundamentals
3 FULL SET EXAMS
(NGN-STYLE QUESTIONS & CASE “SCENARIOS”)
Pass The Exam Score With Confidence
This Document contains:
➢ Achieve a 900+ or Higher Exam Score
➢ Passing Score Guarantee
➢ multiple-choice format with correct answers
➢ Some questions feature “case scenarios”
,Table of Contents
HESI PN Fundamentals Exam 1 .................................... 2
HESI PN Fundamentals Exam 2 .................................. 38
HESI PN Fundamentals Exam 3 .................................. 63
HESI PN Fundamentals Exam 1
1. Post-op wound-healing scenario (converted into 3 NGN-style questions)
The client is awake and alert, denies pain. The client is still unable to tolerate
solid foods but is drinking full liquids with no issues. No signs of hypovolemia.
The surgical wound is slow- healing and red around the edges. Serosanguinous
drainage noted coming from the wound.
Vital signs:
BP 122/78 mm Hg, HR 86/min, RR 18/min, Temp 37.0°C (98.6°F), SpO₂ 98% on
room air.
1a. Actions to take
Which action by the practical nurse (PN) best promotes this client’s wound healing
while respecting the current diet order?
A. Encourage the client to drink only clear fluids to reduce nausea
B. Hold all oral intake until the wound is fully healed
C. Include protein supplement shakes in the client's diet
D. Advance diet to regular as tolerated, despite current intolerance
Correct Answer: C. Include protein supplement shakes in the client's diet
,Expert rationale:
The wound is slow-healing and the client can tolerate full liquids. Protein is
essential for collagen synthesis and tissue repair. Adding high-protein liquid
supplements provides needed nutrients without violating the full-liquid
restriction. Advancing to solids is premature (option D), and restricting intake (A or
B) would further impair nutritional status and slow healing.
1b. Potential condition
Based on the client’s slow-healing wound and current nutritional intake, which
potential condition is the PN most concerned about?
A. Protein deficiency
B. Hypovolemia
C. Acute blood loss anemia
D. Hyperglycemia
Correct Answer: A. Protein deficiency
Expert rationale:
Slow wound healing in the context of limited intake and no signs of hypovolemia
suggests inadequate protein stores. Protein deficiency delays granulation tissue
formation and collagen deposition. There are no data indicating hypovolemia,
anemia, or hyperglycemia in the stem.
1c. Parameters to monitor
Which parameter is most important for the PN to monitor to detect complications
early?
A. Daily urine output
B. Signs of infection at the wound site
C. Bowel sounds in all four quadrants
D. Client’s sleep pattern
,Correct Answer: B. Signs of infection at the wound site
Expert rationale:
The wound is already red with serosanguinous drainage, which can progress to
infection. Monitoring for increased redness, warmth, purulent drainage, odor, or
fever allows early intervention. While wound healing overall is important,
infection is the priority complication to detect promptly.
2. Dyspneic client – morning care
In assisting a dyspneic client with morning care, which action by the practical
nurse (PN) is most important?
Vital signs:
BP 138/84 mm Hg, HR 104/min, RR 28/min, SpO₂ 90% on 2 L/min via nasal
cannula.
A. Encourage the client to complete all care as quickly as possible
B. Schedule frequent rest periods during care
C. Provide all care with the client in the supine position
D. Withhold all morning care until the client’s respiratory rate is normal
Correct Answer: B. Schedule frequent rest periods during care.
Expert rationale:
Dyspneic clients fatigue easily and have increased oxygen demand. Planning care
with frequent rest periods reduces work of breathing and prevents
decompensation. Supine positioning worsens ventilation (C), rushing care (A)
increases oxygen demand, and completely withholding basic care (D) is
unnecessary and can negatively affect comfort and hygiene.
,3. Stroke with aphasia – nonverbal signs
The practical nurse (PN) is providing care for a client with a history of a stroke
and who has aphasia. The client is exhibiting restlessness, shallow respirations
and is clenching teeth. Which problem should the PN assess further?
Vital signs:
BP 150/90 mm Hg, HR 110/min, RR 30/min, SpO₂ 93% on room air.
A. Impaired physical mobility
B. Altered level of consciousness
C. Alteration in comfort
D. Ineffective airway clearance
Correct Answer: C. Alteration in comfort.
Expert rationale:
In a client with aphasia who cannot verbalize needs, nonverbal cues (restlessness,
teeth-clenching, shallow respirations) commonly indicate pain or discomfort. The
PN should further assess pain/comfort. There is no evidence of decreased LOC (B),
secretion retention (D), or new mobility change (A) in the stem.
4. Turning client with right-sided paralysis
The practical nurse (PN) turns a client with right sided paralysis from a supine to
a left lateral position. Which bony prominence is most likely to manifest signs of
erythema when first turned?
A. Sacrum
B. Right greater trochanter
C. Iliac crest
D. Occiput
Correct Answer: C. Iliac crest
,Expert rationale:
When placed in the left lateral position, pressure is greatest over left-sided bony
prominences such as the iliac crest, greater trochanter, and lateral malleolus.
Among the listed options, the iliac crest is the most likely area to show early
erythema from pressure in this position. The sacrum and occiput are more
affected in supine, and the right trochanter would be off-loaded in left lateral.
5. Potassium chloride – paresthesias
One week after beginning a new prescription for potassium chloride, a client
tells the practical nurse (PN) that there is tingling and numbness in the feet and
hands. Which action should the PN take?
Vital signs:
BP 128/80 mm Hg, HR 96/min, RR 18/min, SpO₂ 98% on room air.
A. Reassure the client that this is a normal side effect of the medication
B. Instruct the client to increase fluid intake and continue the medication
C. Notify the unit charge nurse of the client's reported symptoms immediately
D. Tell the client to stop taking the medication without notifying the healthcare
provider
Correct Answer: C. Notify the unit charge nurse of the client's reported symptoms
immediately.
Expert rationale:
Tingling and numbness (paresthesias) can indicate potassium imbalance, which
may progress to life-threatening cardiac dysrhythmias. These symptoms require
prompt evaluation and possible lab testing or change in therapy. The PN should
promptly escalate to the charge nurse/HCP. Reassurance or advice to continue the
medication (A, B) is unsafe, and stopping prescribed KCl independently (D) is
outside PN scope.
6. Stage I sacral pressure injury – home care
,An older adult client with a stage one sacral pressure wound is discharged with
instructions for home care. Which information should the practical nurse
reinforce with the client?
Vital signs:
BP 130/76 mm Hg, HR 78/min, RR 16/min, Temp 36.8°C (98.2°F).
A. Sit upright in a chair all day to keep pressure off the sacrum
B. Change positions every 2 hours
C. Massage the reddened area to increase circulation
D. Apply ice packs to the area twice daily
Correct Answer: B. Change positions every 2 hours.
Expert rationale:
Frequent repositioning (at least every 2 hours) redistributes pressure and
promotes tissue perfusion, preventing progression of a stage I pressure injury.
Prolonged sitting (A) can still cause sacral pressure. Massaging a reddened area (C)
can further damage capillaries, and cold therapy (D) may impair local blood flow
and healing.
7. Full liquid diet – skin integrity risk
A client on a prescribed full liquid diet has a nursing problem of, "Risk for
impaired skin integrity related to reduced oral intake." Which snack would be
best to provide this client?
A. Clear lemon gelatin
B. Fruit-flavored popsicle
C. Clear broth
D. A liquid nutritional supplement that contains protein
Correct Answer: D. A liquid nutritional supplement that contains protein
Expert rationale:
Protein is crucial for maintaining skin integrity and supporting tissue repair. A
,liquid nutritional supplement with protein fits within a full-liquid diet and targets
the identified risk. Gelatin, popsicles, and broth (A–C) contribute mostly fluid and
carbohydrate, with minimal protein.
8. Cyanotic lips/mouth – oxygenation
The practical nurse (PN) observes a client's mouth and lips as seen in the
picture. Which follow-up action is most important for the PN to take?
Assume findings: bluish lips and oral mucosa.
Vital signs:
BP 142/88 mm Hg, HR 110/min, RR 28/min, SpO₂ 86% on room air.
A. Reassess the client’s mouth and lips in 30 minutes
B. Administer oxygen as prescribed
C. Encourage the client to drink a glass of water
D. Ask the client to rest and slow their breathing
Correct Answer: B. Administer oxygen
Expert rationale:
Cyanotic lips and oral mucosa with low oxygen saturation indicate hypoxemia. The
priority is to improve oxygenation by administering supplemental oxygen per
prescription and then reassessing. Delay (A), oral fluids (C), or simple coaching (D)
do not directly correct the underlying oxygen deficit.
9. New state of employment – licensure
After accepting employment in a state different from where a practical nurse
(PN) is currently employed, it is most important for the PN to review which
reference?
A. The hiring facility’s employee handbook
B. The job description for the PN position
,C. The national nurses’ association position statements
D. The licensing state's PN scope of practice
Correct Answer: D. The licensing state's PN scope of practice
Expert rationale:
Nursing scope of practice is defined by each state’s nurse practice act and
associated regulations. When moving to a new state, the PN must understand that
state’s scope to know what tasks and responsibilities are legally permitted. Facility
policies and job descriptions (A, B) cannot expand legal scope; national position
statements (C) are not law.
10. Infant vital signs – critical finding
The unlicensed assistive personnel (UAP) working in a small community hospital
obtains 0800 vital sign measurements of clients on the unit. In reviewing these
vital signs, which measurement warrants immediate intervention by the
practical nurse?
A. A one-month-old infant with a heart rate of 80 beats/minute
B. A 6-year-old child with a temperature of 37.8°C (100°F)
C. A 40-year-old adult with a blood pressure of 138/86 mm Hg
D. A 70-year-old client with a respiratory rate of 20 breaths/minute
Correct Answer: A. A one-month-old infant with a heart rate of 80 beats/minute.
Expert rationale:
Normal heart rate for a 1-month-old infant is higher (approximately 120–
160/min). A heart rate of 80/min represents bradycardia and may signal hypoxia,
increased intracranial pressure, or other serious problems, requiring immediate
assessment. The other values are within or near normal ranges for their age
groups.
11. Nutrition – fat calorie percentage (dropdown style NGN)
, The client is a 23-year-old male who is in the clinic for a well visit.
Vital signs:
BP 118/70 mm Hg, HR 72/min, RR 14/min, BMI 23 kg/m².
His 24-hour food recall indicates that approximately one-fourth of his total
calories are from fat.
Dropdown Group 1: The percentage of total calories from fat is:
1. 5 to 10%
2. 15 to 18%
3. 21 to 24%
4. 35 to 40%
Dropdown Group 2: This percentage:
A. is significantly below the recommended fat intake for calories
B. has an appropriate fat intake for calories
C. is significantly above the recommended fat intake for calories
D. requires immediate restriction of all dietary fat
Correct Answer:
• Dropdown Group 1: 3. 21 to 24%
• Dropdown Group 2: B. has an appropriate fat intake for calories
Expert rationale:
For healthy adults, recommended fat intake is roughly 20–35% of total calories. A
reported intake in the 21–24% range is within recommended limits and therefore
appropriate. It is neither significantly too low nor too high, so no drastic dietary
changes are indicated.
12. COPD client – ROM assessment
While performing a physical assessment on a client with chronic obstructive
pulmonary disease (COPD), the practical nurse (PN) determines that the client's
