HESI PN EXIT V2 EXAM
Practical Nursing Comprehensive Exit Examination
Elsevier Assessment Technologies Institute
Next Generation NCLEX-Aligned | NCSBN CJMM
150 QUESTIONS
NCLEX-PN Preparation | Verified Answers
100% Correct | Graded A+
2026/2027 Academic Year
HESI/NCLEX-PN–Aligned Format
, HESI PN Exit V2 — Comprehensive Practical Nursing Examination 2026/2027
Section 1: Fundamental Nursing Skills & Concepts (Questions 1-15)
1. The PN is preparing to administer medications to a patient. Which action is the most
critical step in verifying the correct patient prior to medication administration?
A. Check the room number on the door
B. Ask the patient to state their full name and date of birth
C. Verify the patient's identity using the medical record number only
D. Ask the family member to confirm the patient's identity
Rationale: Using two patient identifiers, such as the patient's full name and date of birth, is the gold
standard for safe medication administration per Joint Commission National Patient Safety Goals.
Room numbers and medical record numbers alone are not sufficient identifiers because patients can
be moved and record numbers can be transposed. Family members should not be used as the primary
source of identification. The nurse should always compare identifiers against the medication
administration record (MAR) to ensure accuracy.
2. Which interventions should the PN implement for a patient identified as at high risk
for falls? (Select All That Apply) (Select All That Apply)
A. Place a call light within the patient's reach
B. Keep the bed in the lowest position with brakes locked
C. Apply soft wrist restraints for safety during the night shift
D. Place a fall risk alert sign on the door
E. Encourage the patient to ambulate independently to promote mobility
Rationale: Fall prevention interventions include keeping the call light within reach, maintaining the bed
at the lowest position with brakes locked, and placing a fall risk sign on the door to alert staff. Restraints
should never be applied solely for fall prevention; they require a specific physician order, clinical
justification, and must meet regulatory requirements. Patients at high risk for falls should not be
encouraged to ambulate independently; they should receive supervised or assisted ambulation.
Additional interventions include non-skid footwear, adequate lighting, and a clear pathway to the
bathroom.
3. The PN is caring for a patient with Clostridioides difficile infection. Which type of
precautions is most appropriate for this patient?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
Page
, HESI PN Exit V2 — Comprehensive Practical Nursing Examination 2026/2027
D. Airborne precautions
Rationale: C. difficile is transmitted primarily through the fecal-oral route via contact with spores on
surfaces or equipment. Contact precautions require the use of gloves and gowns during patient care and
dedicated equipment. Hand hygiene with soap and water is essential because alcohol-based hand rubs
do not effectively kill C. difficile spores. Standard precautions are used for all patients but are not
sufficient for C. difficile. Droplet and airborne precautions are used for different transmission routes
such as respiratory infections or tuberculosis.
4. The PN is performing a sterile dressing change. Which action breaks sterile technique?
A. Holding sterile objects above waist level
B. Opening the sterile package by peeling back the edges without touching the inner surface
C. Reaching across the sterile field to obtain supplies
D. Pouring sterile solution into a sterile basin from a height of 6 inches
Rationale: Reaching across a sterile field contaminates it because the nurse's nonsterile clothing or
arms may come into contact with the field. Sterile objects should be held above waist level to prevent
contamination from below, and sterile packages should be opened without touching the inner surface.
Pouring sterile solution from a height of 6 inches or less minimizes splashing and contamination. If an
item is needed on the sterile field, the nurse should walk around the field or have another nurse hand the
item from the opposite side.
5. The PN is performing a complete set of vital signs on a newly admitted patient.
Place the following assessments in the correct sequence. (Place in Correct Order)
A. Measure blood pressure
B. Count respiratory rate
C. Obtain oxygen saturation via pulse oximetry
D. Measure oral temperature
E. Assess radial pulse rate and rhythm
Rationale: The correct sequence begins with temperature measurement, as it is the least anxiety-
provoking and provides baseline data. The radial pulse is assessed next, followed by blood pressure,
which should be measured before respiratory rate because the act of taking blood pressure can alter the
patient's breathing pattern.
Respiratory rate is counted after blood pressure measurement, ideally while the patient is unaware,
because conscious awareness can alter the rate. Oxygen saturation via pulse oximetry is typically
obtained last in this sequence. This order minimizes patient anxiety and yields the most accurate results.
Page
, HESI PN Exit V2 — Comprehensive Practical Nursing Examination 2026/2027
6. A patient reports a pain level of 7 on a scale of 0 to 10. The PN notes the patient is
grimacing and guarding the right lower quadrant. Which documentation using the PQRST
method is most appropriate?
A. Pain 7/10, located in RLQ, sharp in quality, started 2 hours ago after eating,
worsened with movement, radiates to back
B. Pain 7/10, patient appears comfortable, started yesterday, improves with rest
C. Pain 3/10, located in RUQ, dull ache, started this morning, no aggravating factors
D. Pain 7/10, located diffusely, cramping quality, started 1 week ago, unprovoked
Rationale: The PQRST method provides a structured approach to pain assessment:
Provocation/Palliation (what provokes or relieves the pain), Quality (sharp, dull, burning),
Region/Radiation (location and radiation), Severity (0-10 scale), and Timing (onset and duration).
Option A comprehensively documents all PQRST components and aligns with the patient's observed
behaviors (grimacing, guarding). Accurate pain documentation is critical for evaluating treatment
effectiveness and communicating findings to the healthcare team. The nurse should also document
nonverbal cues, especially for patients who may underreport or overreport pain.
7. The PN is calling the physician to report a change in a patient's condition. Using the
SBAR format, which statement represents the 'A' component?
A. 'The patient's blood pressure has dropped from 130/80 to 90/60 mmHg in the last hour.'
B. 'I think the patient may be experiencing internal bleeding and needs an urgent
assessment.'
C. 'I am calling about Mrs. Jones in Room 312, who is 2 days postoperative from an abdominal
hysterectomy.'
D. 'What orders would you like me to implement at this time?'
Rationale: In the SBAR communication framework, 'A' stands for Assessment, which is the nurse's
professional judgment about the situation. The assessment component communicates what the nurse
believes is happening based on clinical findings. The situation is the identification of the patient and the
reason for the call. The background provides relevant clinical context. The recommendation is the
nurse's suggestion for action. Using SBAR improves communication clarity, reduces errors, and
ensures that critical information is conveyed efficiently between healthcare team members.
8. The PN is assisting a patient from the bed to a wheelchair using a mechanical lift. Which
action is most important to ensure patient safety?
A. Lower the bed to the lowest position before transferring
Page
Practical Nursing Comprehensive Exit Examination
Elsevier Assessment Technologies Institute
Next Generation NCLEX-Aligned | NCSBN CJMM
150 QUESTIONS
NCLEX-PN Preparation | Verified Answers
100% Correct | Graded A+
2026/2027 Academic Year
HESI/NCLEX-PN–Aligned Format
, HESI PN Exit V2 — Comprehensive Practical Nursing Examination 2026/2027
Section 1: Fundamental Nursing Skills & Concepts (Questions 1-15)
1. The PN is preparing to administer medications to a patient. Which action is the most
critical step in verifying the correct patient prior to medication administration?
A. Check the room number on the door
B. Ask the patient to state their full name and date of birth
C. Verify the patient's identity using the medical record number only
D. Ask the family member to confirm the patient's identity
Rationale: Using two patient identifiers, such as the patient's full name and date of birth, is the gold
standard for safe medication administration per Joint Commission National Patient Safety Goals.
Room numbers and medical record numbers alone are not sufficient identifiers because patients can
be moved and record numbers can be transposed. Family members should not be used as the primary
source of identification. The nurse should always compare identifiers against the medication
administration record (MAR) to ensure accuracy.
2. Which interventions should the PN implement for a patient identified as at high risk
for falls? (Select All That Apply) (Select All That Apply)
A. Place a call light within the patient's reach
B. Keep the bed in the lowest position with brakes locked
C. Apply soft wrist restraints for safety during the night shift
D. Place a fall risk alert sign on the door
E. Encourage the patient to ambulate independently to promote mobility
Rationale: Fall prevention interventions include keeping the call light within reach, maintaining the bed
at the lowest position with brakes locked, and placing a fall risk sign on the door to alert staff. Restraints
should never be applied solely for fall prevention; they require a specific physician order, clinical
justification, and must meet regulatory requirements. Patients at high risk for falls should not be
encouraged to ambulate independently; they should receive supervised or assisted ambulation.
Additional interventions include non-skid footwear, adequate lighting, and a clear pathway to the
bathroom.
3. The PN is caring for a patient with Clostridioides difficile infection. Which type of
precautions is most appropriate for this patient?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
Page
, HESI PN Exit V2 — Comprehensive Practical Nursing Examination 2026/2027
D. Airborne precautions
Rationale: C. difficile is transmitted primarily through the fecal-oral route via contact with spores on
surfaces or equipment. Contact precautions require the use of gloves and gowns during patient care and
dedicated equipment. Hand hygiene with soap and water is essential because alcohol-based hand rubs
do not effectively kill C. difficile spores. Standard precautions are used for all patients but are not
sufficient for C. difficile. Droplet and airborne precautions are used for different transmission routes
such as respiratory infections or tuberculosis.
4. The PN is performing a sterile dressing change. Which action breaks sterile technique?
A. Holding sterile objects above waist level
B. Opening the sterile package by peeling back the edges without touching the inner surface
C. Reaching across the sterile field to obtain supplies
D. Pouring sterile solution into a sterile basin from a height of 6 inches
Rationale: Reaching across a sterile field contaminates it because the nurse's nonsterile clothing or
arms may come into contact with the field. Sterile objects should be held above waist level to prevent
contamination from below, and sterile packages should be opened without touching the inner surface.
Pouring sterile solution from a height of 6 inches or less minimizes splashing and contamination. If an
item is needed on the sterile field, the nurse should walk around the field or have another nurse hand the
item from the opposite side.
5. The PN is performing a complete set of vital signs on a newly admitted patient.
Place the following assessments in the correct sequence. (Place in Correct Order)
A. Measure blood pressure
B. Count respiratory rate
C. Obtain oxygen saturation via pulse oximetry
D. Measure oral temperature
E. Assess radial pulse rate and rhythm
Rationale: The correct sequence begins with temperature measurement, as it is the least anxiety-
provoking and provides baseline data. The radial pulse is assessed next, followed by blood pressure,
which should be measured before respiratory rate because the act of taking blood pressure can alter the
patient's breathing pattern.
Respiratory rate is counted after blood pressure measurement, ideally while the patient is unaware,
because conscious awareness can alter the rate. Oxygen saturation via pulse oximetry is typically
obtained last in this sequence. This order minimizes patient anxiety and yields the most accurate results.
Page
, HESI PN Exit V2 — Comprehensive Practical Nursing Examination 2026/2027
6. A patient reports a pain level of 7 on a scale of 0 to 10. The PN notes the patient is
grimacing and guarding the right lower quadrant. Which documentation using the PQRST
method is most appropriate?
A. Pain 7/10, located in RLQ, sharp in quality, started 2 hours ago after eating,
worsened with movement, radiates to back
B. Pain 7/10, patient appears comfortable, started yesterday, improves with rest
C. Pain 3/10, located in RUQ, dull ache, started this morning, no aggravating factors
D. Pain 7/10, located diffusely, cramping quality, started 1 week ago, unprovoked
Rationale: The PQRST method provides a structured approach to pain assessment:
Provocation/Palliation (what provokes or relieves the pain), Quality (sharp, dull, burning),
Region/Radiation (location and radiation), Severity (0-10 scale), and Timing (onset and duration).
Option A comprehensively documents all PQRST components and aligns with the patient's observed
behaviors (grimacing, guarding). Accurate pain documentation is critical for evaluating treatment
effectiveness and communicating findings to the healthcare team. The nurse should also document
nonverbal cues, especially for patients who may underreport or overreport pain.
7. The PN is calling the physician to report a change in a patient's condition. Using the
SBAR format, which statement represents the 'A' component?
A. 'The patient's blood pressure has dropped from 130/80 to 90/60 mmHg in the last hour.'
B. 'I think the patient may be experiencing internal bleeding and needs an urgent
assessment.'
C. 'I am calling about Mrs. Jones in Room 312, who is 2 days postoperative from an abdominal
hysterectomy.'
D. 'What orders would you like me to implement at this time?'
Rationale: In the SBAR communication framework, 'A' stands for Assessment, which is the nurse's
professional judgment about the situation. The assessment component communicates what the nurse
believes is happening based on clinical findings. The situation is the identification of the patient and the
reason for the call. The background provides relevant clinical context. The recommendation is the
nurse's suggestion for action. Using SBAR improves communication clarity, reduces errors, and
ensures that critical information is conveyed efficiently between healthcare team members.
8. The PN is assisting a patient from the bed to a wheelchair using a mechanical lift. Which
action is most important to ensure patient safety?
A. Lower the bed to the lowest position before transferring
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