HESI PN Exit Exam Version 3 – Practical Nursing
Comprehensive Exit Assessment Updated and Latest
Questions and Correct Answers with Rationale
1. A client with congestive heart failure is being discharged with a prescription for furosemide. Which
instruction should the practical nurse include in the teaching plan?
A. Increase the intake of potassium-rich foods like bananas.
B. Take the medication immediately before going to sleep.
C. Limit physical activity to prevent excessive sweating.
D. Restrict all fluid intake to less than 500 mL per day.
Ans: A
Rationale: Furosemide is a loop diuretic that causes the loss of potassium through urine. The practical
nurse must instruct the client to consume potassium-rich foods to prevent hypokalemia. Symptoms of
low potassium include muscle weakness and cardiac arrhythmias. Taking the medication in the morning
prevents nocturia and sleep disruption. Clients should be taught to weigh themselves daily and report
significant gains to the healthcare provider.
2. A client is 12 hours post-operative following a total hip arthroplasty. Which nursing intervention is a
priority to prevent dislocation?
A. Place an abduction pillow between the client’s legs.
B. Maintain the client in a high-Fowler’s position.
C. Keep the affected leg in an adducted position.
D. Encourage the client to cross their legs while sitting.
Ans: A
,Rationale: Using an abduction pillow helps maintain the hip in a neutral position to prevent the
prosthesis from dislodging. The practical nurse should ensure the client avoids flexing the hip more than
90 degrees. Adduction and internal rotation are contraindicated as they increase the risk of dislocation.
The nurse should also monitor for signs of neurovascular compromise in the affected extremity.
Education on avoiding low chairs is essential for long-term recovery success.
3. The practical nurse is monitoring a client receiving a blood transfusion. Which sign most likely indicates a
hemolytic reaction?
A. Itching and hives on the chest and arms.
B. A sudden onset of lower back pain and fever.
C. An isolated increase in blood pressure.
D. Dry cough and mild shortness of breath.
Ans: B
Rationale: Low back pain and fever are hallmark signs of an acute hemolytic transfusion reaction caused
by blood incompatibility. This occurs when the recipient’s antibodies destroy the donor’s red blood cells.
The practical nurse must stop the infusion immediately and notify the registered nurse or provider.
Normal saline should be infused through a new tubing set to maintain IV access. Monitoring vital signs
and collecting a urine sample to check for hemoglobinuria are standard follow-up steps.
4. Which assessment finding should the practical nurse report immediately for a child with an arm cast?
A. The skin at the edge of the cast is pink.
B. The child reports itching under the cast.
C. The fingers are pale and cool to the touch.
D. The cast feels heavy and warm to the child.
, Ans: C
Rationale: Pale and cool fingers are early indicators of compartment syndrome or impaired peripheral
circulation. This is a medical emergency that requires immediate intervention to prevent permanent
tissue damage. The practical nurse should check for capillary refill and the presence of a distal pulse.
Intense pain that is unrelieved by medication is another critical warning sign. Frequent neurovascular
assessments are the standard of care for any client with a restrictive cast.
5. A client with Type 1 diabetes mellitus is found unconscious and clammy. What is the priority action for
the practical nurse?
A. Administer 15 grams of oral carbohydrates.
B. Check the client’s blood glucose level immediately.
C. Wait for the client to wake up to assess orientation.
D. Administer glucagon subcutaneously as ordered.
Ans: D
Rationale: If a diabetic client is unconscious and showing signs of hypoglycemia, glucagon must be
administered because the client cannot safely swallow. This medication works by stimulating the liver to
release glucose into the bloodstream. The practical nurse should also call for emergency assistance while
preparing the medication. Once the client regains consciousness and can swallow, oral carbohydrates
should be provided. Preventing prolonged hypoglycemia is vital to avoid neurological damage or death.
6. Which food choice should the practical nurse recommend for a client with iron-deficiency anemia?
A. Spinach and lean beef.
B. Whole milk and white bread.
C. Apples and white rice.
Comprehensive Exit Assessment Updated and Latest
Questions and Correct Answers with Rationale
1. A client with congestive heart failure is being discharged with a prescription for furosemide. Which
instruction should the practical nurse include in the teaching plan?
A. Increase the intake of potassium-rich foods like bananas.
B. Take the medication immediately before going to sleep.
C. Limit physical activity to prevent excessive sweating.
D. Restrict all fluid intake to less than 500 mL per day.
Ans: A
Rationale: Furosemide is a loop diuretic that causes the loss of potassium through urine. The practical
nurse must instruct the client to consume potassium-rich foods to prevent hypokalemia. Symptoms of
low potassium include muscle weakness and cardiac arrhythmias. Taking the medication in the morning
prevents nocturia and sleep disruption. Clients should be taught to weigh themselves daily and report
significant gains to the healthcare provider.
2. A client is 12 hours post-operative following a total hip arthroplasty. Which nursing intervention is a
priority to prevent dislocation?
A. Place an abduction pillow between the client’s legs.
B. Maintain the client in a high-Fowler’s position.
C. Keep the affected leg in an adducted position.
D. Encourage the client to cross their legs while sitting.
Ans: A
,Rationale: Using an abduction pillow helps maintain the hip in a neutral position to prevent the
prosthesis from dislodging. The practical nurse should ensure the client avoids flexing the hip more than
90 degrees. Adduction and internal rotation are contraindicated as they increase the risk of dislocation.
The nurse should also monitor for signs of neurovascular compromise in the affected extremity.
Education on avoiding low chairs is essential for long-term recovery success.
3. The practical nurse is monitoring a client receiving a blood transfusion. Which sign most likely indicates a
hemolytic reaction?
A. Itching and hives on the chest and arms.
B. A sudden onset of lower back pain and fever.
C. An isolated increase in blood pressure.
D. Dry cough and mild shortness of breath.
Ans: B
Rationale: Low back pain and fever are hallmark signs of an acute hemolytic transfusion reaction caused
by blood incompatibility. This occurs when the recipient’s antibodies destroy the donor’s red blood cells.
The practical nurse must stop the infusion immediately and notify the registered nurse or provider.
Normal saline should be infused through a new tubing set to maintain IV access. Monitoring vital signs
and collecting a urine sample to check for hemoglobinuria are standard follow-up steps.
4. Which assessment finding should the practical nurse report immediately for a child with an arm cast?
A. The skin at the edge of the cast is pink.
B. The child reports itching under the cast.
C. The fingers are pale and cool to the touch.
D. The cast feels heavy and warm to the child.
, Ans: C
Rationale: Pale and cool fingers are early indicators of compartment syndrome or impaired peripheral
circulation. This is a medical emergency that requires immediate intervention to prevent permanent
tissue damage. The practical nurse should check for capillary refill and the presence of a distal pulse.
Intense pain that is unrelieved by medication is another critical warning sign. Frequent neurovascular
assessments are the standard of care for any client with a restrictive cast.
5. A client with Type 1 diabetes mellitus is found unconscious and clammy. What is the priority action for
the practical nurse?
A. Administer 15 grams of oral carbohydrates.
B. Check the client’s blood glucose level immediately.
C. Wait for the client to wake up to assess orientation.
D. Administer glucagon subcutaneously as ordered.
Ans: D
Rationale: If a diabetic client is unconscious and showing signs of hypoglycemia, glucagon must be
administered because the client cannot safely swallow. This medication works by stimulating the liver to
release glucose into the bloodstream. The practical nurse should also call for emergency assistance while
preparing the medication. Once the client regains consciousness and can swallow, oral carbohydrates
should be provided. Preventing prolonged hypoglycemia is vital to avoid neurological damage or death.
6. Which food choice should the practical nurse recommend for a client with iron-deficiency anemia?
A. Spinach and lean beef.
B. Whole milk and white bread.
C. Apples and white rice.
