HESI PN Exit V2 Exam ACTUAL
EXAM 2026/2027 | NCLEX-PN
Preparation | 160 Questions | Verified
Q&A | Pass Guaranteed - A+ Graded
Client Needs: Safe and Effective Care Environment – Management of Care (18 Questions)
Q1: An LPN is assigned to care for four patients on a medical-surgical unit. Which task should the LPN
perform FIRST?
A. Administer morning insulin to a patient with type 1 diabetes mellitus
B. Reapply a dry sterile dressing for a patient with a stage 2 pressure injury
C. Check the blood pressure of a postoperative patient who reports feeling "lightheaded" [CORRECT]
D. Document intake and output for a patient on fluid restriction
Correct Answer: C
Rationale: The patient reporting lightheadedness may have hypotension or hemorrhage, representing a
potential safety risk and change in condition that requires immediate assessment. The LPN scope
includes collecting data on vital signs and reporting changes to the RN . Insulin administration (A) is
time-sensitive but not the priority over a symptomatic patient. Dressing change (B) and I&O
documentation (D) are routine tasks that can be delayed safely. This follows the clinical judgment model
of recognizing cues and prioritizing risk .
Q2: The charge nurse delegates the following tasks to an LPN and an unlicensed assistive personnel
(UAP). Which task is MOST APPROPRIATE for the LPN to delegate to the UAP?
A. Obtaining a blood glucose reading for a patient with type 2 diabetes
B. Assisting a patient with a new colostomy to empty the ostomy bag
C. Performing a sterile dressing change for a patient with a surgical wound
D. Reinforcing teaching about a low-sodium diet to a patient with heart failure
Correct Answer: A
,Rationale: Obtaining a blood glucose reading is a routine, stable task within UAP scope when the
patient's condition is predictable . The UAP can perform this under LPN supervision. Assisting with
ostomy care (B) requires assessment of stoma appearance and teaching, which is LPN scope. Sterile
dressing changes (C) require sterile technique and wound assessment, which is beyond UAP scope.
Reinforcing teaching (D) is an LPN function per the 2026 NCLEX-PN test plan activity statements .
Q3: An LPN receives a telephone order from a provider for a new medication. Which action
demonstrates the LPN's understanding of safe medication practices?
A. Immediately administer the medication to ensure timely therapy
B. Write the order, read it back to the provider, and document the read-back [CORRECT]
C. Ask the UAP to transcribe the order while the LPN prepares the medication
D. Wait for the RN to return from break to accept the verbal order
Correct Answer: B
Rationale: The LPN can accept telephone orders in many states, but must follow the "read-back"
protocol to prevent transcription errors, a critical safety measure . The LPN should not administer (A)
without verifying the order. Delegating transcription to UAP (C) is unsafe as UAPs cannot interpret
medical orders. Waiting for the RN (D) may delay necessary treatment when the LPN is capable of
accepting the order per facility protocol.
Q4: [SATA] An LPN is caring for a patient who was admitted for dehydration and has a new order for
intravenous fluids. Which actions are within the LPN's scope of practice? (Select all that apply.)
A. Initiating the IV catheter insertion after completing IV certification [CORRECT]
B. Monitoring the IV site for signs of infiltration or phlebitis [CORRECT]
C. Administering IV push medications through the established line
D. Adjusting the flow rate based on the patient's urine output
E. Documenting the patient's response to the IV therapy [CORRECT]
F. Mixing IV solutions with additives per the provider's order
Correct Answers: A, B, E
Rationale: LPNs with additional IV certification may initiate IV therapy in many states under RN or
physician direction . Monitoring the IV site (B) and documenting responses (E) are within standard LPN
scope per the 2026 test plan . IV push medications (C) and mixing IV solutions (F) are prohibited in most
states for LPNs . Adjusting flow rates (D) based on assessment data requires RN-level clinical judgment
and is outside LPN scope .
,Q5: [Ordered Response] Place the following nursing actions in the correct priority order when the LPN
discovers a patient has fallen in the bathroom.
Check the patient for injuries and level of consciousness
Call for assistance from other staff members
Document the incident and assessment findings
Notify the RN and provider of the incident
Correct Sequence: 2, 1, 4, 3 [CORRECT SEQUENCE]
Rationale: First, call for assistance (2) to ensure help is available for safe patient handling and potential
emergency response. Second, assess the patient (1) for injuries and consciousness level—the LPN scope
includes data collection and recognizing changes in condition . Third, notify the RN and provider (4) as
this is a change in condition requiring further evaluation and possible orders. Finally, document (3) after
immediate safety needs are addressed. Documentation should never delay assessment or notification of
significant changes.
Q6: An LPN is assigned to a team of patients on a busy medical-surgical unit. Which patient should the
LPN assess FIRST?
A. A patient scheduled for discharge in 2 hours who needs final teaching
B. A patient with a blood pressure of 148/92 mmHg who is asymptomatic
C. A patient with a new onset of confusion and a heart rate of 110 bpm [CORRECT]
D. A patient requesting a PRN pain medication for a headache rated 3/10
Correct Answer: C
Rationale: New onset confusion with tachycardia represents an acute change in condition that could
indicate infection, hypoxia, or cardiac compromise—requiring immediate assessment and RN
notification . This follows the clinical judgment priority framework of addressing life-threatening or
potentially deteriorating conditions first . Discharge teaching (A) is important but not urgent.
Asymptomatic hypertension (B) and mild pain (D) are stable conditions that can wait.
Q7: An LPN overhears two UAPs discussing a patient's HIV status in the cafeteria. Which action should
the LPN take FIRST?
A. Report the UAPs to the state board of nursing immediately
B. Confront the UAPs privately and remind them of HIPAA regulations [CORRECT]
C. Document the incident in the patient's medical record
, D. Ignore the conversation since the LPN was not involved in the disclosure
Correct Answer: B
Rationale: The LPN has an ethical obligation to address breaches of confidentiality immediately and
directly . HIPAA violations require immediate intervention to stop the breach; confronting the UAPs
privately maintains professionalism while correcting the behavior. Reporting to the board (A) is
premature without first addressing the issue at the facility level. Documentation (C) should occur after
addressing the immediate breach. Ignoring (D) violates the LPN's ethical responsibility to safeguard
patient information .
Q8: [Exhibit] The LPN reviews the following medication administration record (MAR) for a patient with
heart failure:
Table
Time Medication Dose Route Status
0800 Furosemide 40 mg PO Given
0800 Potassium chloride 20 mEq PO Held
1200 Digoxin 0.25 mgPO Scheduled
The patient's morning laboratory results show: Potassium 3.2 mEq/L (Normal: 3.5-5.0). Which action
should the LPN take?
A. Administer the scheduled digoxin at 1200 as ordered
B. Administer the held potassium chloride and notify the RN [CORRECT]
C. Hold the digoxin and potassium until the RN reviews the labs
D. Administer all medications as scheduled since the provider ordered them
Correct Answer: B
Rationale: The LPN recognizes that hypokalemia (3.2 mEq/L) increases the risk of digoxin toxicity and
cardiac dysrhythmias. The held potassium chloride should be administered to correct the potassium
level before digoxin administration . The LPN must notify the RN of the lab value and the plan, as the RN
must evaluate whether to administer digoxin. Administering digoxin (A) with hypokalemia is unsafe.
Holding all meds (C) without addressing the potassium deficit delays necessary treatment. Administering
all meds (D) ignores critical lab values that affect medication safety.
Q9: An LPN is caring for a patient who requires restraints due to pulling at tubes. Which action
demonstrates the LPN's understanding of restraint regulations?
A. Apply the restraints tightly to prevent the patient from escaping
EXAM 2026/2027 | NCLEX-PN
Preparation | 160 Questions | Verified
Q&A | Pass Guaranteed - A+ Graded
Client Needs: Safe and Effective Care Environment – Management of Care (18 Questions)
Q1: An LPN is assigned to care for four patients on a medical-surgical unit. Which task should the LPN
perform FIRST?
A. Administer morning insulin to a patient with type 1 diabetes mellitus
B. Reapply a dry sterile dressing for a patient with a stage 2 pressure injury
C. Check the blood pressure of a postoperative patient who reports feeling "lightheaded" [CORRECT]
D. Document intake and output for a patient on fluid restriction
Correct Answer: C
Rationale: The patient reporting lightheadedness may have hypotension or hemorrhage, representing a
potential safety risk and change in condition that requires immediate assessment. The LPN scope
includes collecting data on vital signs and reporting changes to the RN . Insulin administration (A) is
time-sensitive but not the priority over a symptomatic patient. Dressing change (B) and I&O
documentation (D) are routine tasks that can be delayed safely. This follows the clinical judgment model
of recognizing cues and prioritizing risk .
Q2: The charge nurse delegates the following tasks to an LPN and an unlicensed assistive personnel
(UAP). Which task is MOST APPROPRIATE for the LPN to delegate to the UAP?
A. Obtaining a blood glucose reading for a patient with type 2 diabetes
B. Assisting a patient with a new colostomy to empty the ostomy bag
C. Performing a sterile dressing change for a patient with a surgical wound
D. Reinforcing teaching about a low-sodium diet to a patient with heart failure
Correct Answer: A
,Rationale: Obtaining a blood glucose reading is a routine, stable task within UAP scope when the
patient's condition is predictable . The UAP can perform this under LPN supervision. Assisting with
ostomy care (B) requires assessment of stoma appearance and teaching, which is LPN scope. Sterile
dressing changes (C) require sterile technique and wound assessment, which is beyond UAP scope.
Reinforcing teaching (D) is an LPN function per the 2026 NCLEX-PN test plan activity statements .
Q3: An LPN receives a telephone order from a provider for a new medication. Which action
demonstrates the LPN's understanding of safe medication practices?
A. Immediately administer the medication to ensure timely therapy
B. Write the order, read it back to the provider, and document the read-back [CORRECT]
C. Ask the UAP to transcribe the order while the LPN prepares the medication
D. Wait for the RN to return from break to accept the verbal order
Correct Answer: B
Rationale: The LPN can accept telephone orders in many states, but must follow the "read-back"
protocol to prevent transcription errors, a critical safety measure . The LPN should not administer (A)
without verifying the order. Delegating transcription to UAP (C) is unsafe as UAPs cannot interpret
medical orders. Waiting for the RN (D) may delay necessary treatment when the LPN is capable of
accepting the order per facility protocol.
Q4: [SATA] An LPN is caring for a patient who was admitted for dehydration and has a new order for
intravenous fluids. Which actions are within the LPN's scope of practice? (Select all that apply.)
A. Initiating the IV catheter insertion after completing IV certification [CORRECT]
B. Monitoring the IV site for signs of infiltration or phlebitis [CORRECT]
C. Administering IV push medications through the established line
D. Adjusting the flow rate based on the patient's urine output
E. Documenting the patient's response to the IV therapy [CORRECT]
F. Mixing IV solutions with additives per the provider's order
Correct Answers: A, B, E
Rationale: LPNs with additional IV certification may initiate IV therapy in many states under RN or
physician direction . Monitoring the IV site (B) and documenting responses (E) are within standard LPN
scope per the 2026 test plan . IV push medications (C) and mixing IV solutions (F) are prohibited in most
states for LPNs . Adjusting flow rates (D) based on assessment data requires RN-level clinical judgment
and is outside LPN scope .
,Q5: [Ordered Response] Place the following nursing actions in the correct priority order when the LPN
discovers a patient has fallen in the bathroom.
Check the patient for injuries and level of consciousness
Call for assistance from other staff members
Document the incident and assessment findings
Notify the RN and provider of the incident
Correct Sequence: 2, 1, 4, 3 [CORRECT SEQUENCE]
Rationale: First, call for assistance (2) to ensure help is available for safe patient handling and potential
emergency response. Second, assess the patient (1) for injuries and consciousness level—the LPN scope
includes data collection and recognizing changes in condition . Third, notify the RN and provider (4) as
this is a change in condition requiring further evaluation and possible orders. Finally, document (3) after
immediate safety needs are addressed. Documentation should never delay assessment or notification of
significant changes.
Q6: An LPN is assigned to a team of patients on a busy medical-surgical unit. Which patient should the
LPN assess FIRST?
A. A patient scheduled for discharge in 2 hours who needs final teaching
B. A patient with a blood pressure of 148/92 mmHg who is asymptomatic
C. A patient with a new onset of confusion and a heart rate of 110 bpm [CORRECT]
D. A patient requesting a PRN pain medication for a headache rated 3/10
Correct Answer: C
Rationale: New onset confusion with tachycardia represents an acute change in condition that could
indicate infection, hypoxia, or cardiac compromise—requiring immediate assessment and RN
notification . This follows the clinical judgment priority framework of addressing life-threatening or
potentially deteriorating conditions first . Discharge teaching (A) is important but not urgent.
Asymptomatic hypertension (B) and mild pain (D) are stable conditions that can wait.
Q7: An LPN overhears two UAPs discussing a patient's HIV status in the cafeteria. Which action should
the LPN take FIRST?
A. Report the UAPs to the state board of nursing immediately
B. Confront the UAPs privately and remind them of HIPAA regulations [CORRECT]
C. Document the incident in the patient's medical record
, D. Ignore the conversation since the LPN was not involved in the disclosure
Correct Answer: B
Rationale: The LPN has an ethical obligation to address breaches of confidentiality immediately and
directly . HIPAA violations require immediate intervention to stop the breach; confronting the UAPs
privately maintains professionalism while correcting the behavior. Reporting to the board (A) is
premature without first addressing the issue at the facility level. Documentation (C) should occur after
addressing the immediate breach. Ignoring (D) violates the LPN's ethical responsibility to safeguard
patient information .
Q8: [Exhibit] The LPN reviews the following medication administration record (MAR) for a patient with
heart failure:
Table
Time Medication Dose Route Status
0800 Furosemide 40 mg PO Given
0800 Potassium chloride 20 mEq PO Held
1200 Digoxin 0.25 mgPO Scheduled
The patient's morning laboratory results show: Potassium 3.2 mEq/L (Normal: 3.5-5.0). Which action
should the LPN take?
A. Administer the scheduled digoxin at 1200 as ordered
B. Administer the held potassium chloride and notify the RN [CORRECT]
C. Hold the digoxin and potassium until the RN reviews the labs
D. Administer all medications as scheduled since the provider ordered them
Correct Answer: B
Rationale: The LPN recognizes that hypokalemia (3.2 mEq/L) increases the risk of digoxin toxicity and
cardiac dysrhythmias. The held potassium chloride should be administered to correct the potassium
level before digoxin administration . The LPN must notify the RN of the lab value and the plan, as the RN
must evaluate whether to administer digoxin. Administering digoxin (A) with hypokalemia is unsafe.
Holding all meds (C) without addressing the potassium deficit delays necessary treatment. Administering
all meds (D) ignores critical lab values that affect medication safety.
Q9: An LPN is caring for a patient who requires restraints due to pulling at tubes. Which action
demonstrates the LPN's understanding of restraint regulations?
A. Apply the restraints tightly to prevent the patient from escaping
