HESI Comprehensive Review for the
NCLEX-PN® Examination, 7th Edition
by HESI - 2025/2026 Ultimate Prep:
HESI PN Exit Version 2 Actual Exam
Questions & Verified Answers for First-
Time Success
1. Clinical Prioritization & Safety
Question 1
A nurse who has recently completed orientation is beginning work
in the labor and delivery unit for the first time. Which client should
the charge nurse assign to this new nurse?
A. A primigravida who is 8 cm dilated after 14 hours of labor
B. A client scheduled for a repeat cesarean birth at 38 weeks’
gestation
C. A client being induced for fetal demise at 20 weeks’ gestation
D. A multiparous client who is dilated 5 cm and 50% effaced
Answer: D
Rationale: The new nurse should be assigned the least
complicated client to gain experience and confidence while
protecting client safety. Client D is progressing well and is the
most stable of the options. Clients A, B, and C have actual or
,potential complications and should be assigned to a more
experienced nurse.
Question 2
A client with HIV infection has white lesions in the oral cavity that
resemble milk curds. Nystatin (Mycostatin) is prescribed as a swish
and swallow. Which information is most important for the nurse
to provide?
A. Oral hygiene should be performed before the medication.
B. Antifungal medications are available in many forms.
C. Candida albicans is the organism that causes the lesions.
D. Dairy and spicy foods should be limited.
Answer: A
Rationale: To ensure effective contact of the medication with the
oral lesions, the client should perform oral hygiene and drink
liquids before swishing the nystatin. Options B and C provide
additional information but do not directly enhance medication
effectiveness. Dairy restrictions are not indicated.
Question 3
A client with emphysema is having difficulty breathing. In which
position should the nurse place the client?
A. High-Fowler’s position without a pillow behind the head
B. Semi-Fowler’s position with a single pillow behind the head
C. Right side-lying position, head of bed elevated 45°
D. Sitting upright and leaning forward, arms supported on an
over-the-bed table
Answer: D
Rationale: Sitting upright and leaning forward with arms
supported allows the thoracic cage to expand in all four
,directions, reducing dyspnea and maximizing lung expansion.
High- or semi-Fowler’s positions and side-lying do not achieve
the same degree of thoracic expansion.
Question 4
A client with chronic renal insufficiency is taking
hydrochlorothiazide (HCTZ) 25 mg and furosemide (Lasix) 40 mg
daily. At a routine visit, the serum potassium is 4 mEq/L. What is
the most likely cause of this potassium level?
A. The client is noncompliant with medications.
B. The client recently consumed large quantities of pears or nuts.
C. The client’s renal function has affected the potassium level.
D. The client needs to be started on a potassium supplement.
Answer: C
Rationale: The normal potassium range is 3.5–5 mEq/L, so
4 mEq/L is normal. Chronic renal insufficiency can affect potassium
handling, but no action is needed based on this value.
Noncompliance, diet (pears/nuts do not alter potassium), and
unnecessary supplementation are not supported by this finding.
Question 5
A client is 12 hours postoperative for a hernia repair and suddenly
becomes agitated, staggers into the corridor, and demands to be
set free. After assisting the client back to bed and administering
pain medication, which intervention is best?
A. Notify the healthcare provider to request restraints.
B. Raise the side rail and notify the family to sit with the client to
reorient and cooperate.
C. Administer a prescribed narcotic antagonist.
, D. Instruct a UAP to keep the upper side rails up and check every
15 minutes.
Answer: B
Rationale: Ensuring safety while providing a calming presence
through family support is the best immediate intervention.
Restraints are a last resort. The agitation is likely related to
postoperative confusion or pain, not opioid accumulation, so a
narcotic antagonist is not indicated.
Question 6
The practical nurse (PN) hears adventitious breath sounds in an
older adult receiving IV D5W at 100 mL/hour. What should the PN
do next?
A. Document the findings and monitor the client.
B. Report the findings to the charge nurse.
C. Slow the infusion rate to 50 mL/hour.
D. Review the last intake and output balance.
Answer: B
Rationale: Adventitious breath sounds may indicate fluid
overload or evolving respiratory complications and warrant
immediate notification to the charge nurse for further assessment.
Slowing the infusion or merely documenting delays appropriate
intervention.
2. Infection Control / Medical-Surgical
NCLEX-PN® Examination, 7th Edition
by HESI - 2025/2026 Ultimate Prep:
HESI PN Exit Version 2 Actual Exam
Questions & Verified Answers for First-
Time Success
1. Clinical Prioritization & Safety
Question 1
A nurse who has recently completed orientation is beginning work
in the labor and delivery unit for the first time. Which client should
the charge nurse assign to this new nurse?
A. A primigravida who is 8 cm dilated after 14 hours of labor
B. A client scheduled for a repeat cesarean birth at 38 weeks’
gestation
C. A client being induced for fetal demise at 20 weeks’ gestation
D. A multiparous client who is dilated 5 cm and 50% effaced
Answer: D
Rationale: The new nurse should be assigned the least
complicated client to gain experience and confidence while
protecting client safety. Client D is progressing well and is the
most stable of the options. Clients A, B, and C have actual or
,potential complications and should be assigned to a more
experienced nurse.
Question 2
A client with HIV infection has white lesions in the oral cavity that
resemble milk curds. Nystatin (Mycostatin) is prescribed as a swish
and swallow. Which information is most important for the nurse
to provide?
A. Oral hygiene should be performed before the medication.
B. Antifungal medications are available in many forms.
C. Candida albicans is the organism that causes the lesions.
D. Dairy and spicy foods should be limited.
Answer: A
Rationale: To ensure effective contact of the medication with the
oral lesions, the client should perform oral hygiene and drink
liquids before swishing the nystatin. Options B and C provide
additional information but do not directly enhance medication
effectiveness. Dairy restrictions are not indicated.
Question 3
A client with emphysema is having difficulty breathing. In which
position should the nurse place the client?
A. High-Fowler’s position without a pillow behind the head
B. Semi-Fowler’s position with a single pillow behind the head
C. Right side-lying position, head of bed elevated 45°
D. Sitting upright and leaning forward, arms supported on an
over-the-bed table
Answer: D
Rationale: Sitting upright and leaning forward with arms
supported allows the thoracic cage to expand in all four
,directions, reducing dyspnea and maximizing lung expansion.
High- or semi-Fowler’s positions and side-lying do not achieve
the same degree of thoracic expansion.
Question 4
A client with chronic renal insufficiency is taking
hydrochlorothiazide (HCTZ) 25 mg and furosemide (Lasix) 40 mg
daily. At a routine visit, the serum potassium is 4 mEq/L. What is
the most likely cause of this potassium level?
A. The client is noncompliant with medications.
B. The client recently consumed large quantities of pears or nuts.
C. The client’s renal function has affected the potassium level.
D. The client needs to be started on a potassium supplement.
Answer: C
Rationale: The normal potassium range is 3.5–5 mEq/L, so
4 mEq/L is normal. Chronic renal insufficiency can affect potassium
handling, but no action is needed based on this value.
Noncompliance, diet (pears/nuts do not alter potassium), and
unnecessary supplementation are not supported by this finding.
Question 5
A client is 12 hours postoperative for a hernia repair and suddenly
becomes agitated, staggers into the corridor, and demands to be
set free. After assisting the client back to bed and administering
pain medication, which intervention is best?
A. Notify the healthcare provider to request restraints.
B. Raise the side rail and notify the family to sit with the client to
reorient and cooperate.
C. Administer a prescribed narcotic antagonist.
, D. Instruct a UAP to keep the upper side rails up and check every
15 minutes.
Answer: B
Rationale: Ensuring safety while providing a calming presence
through family support is the best immediate intervention.
Restraints are a last resort. The agitation is likely related to
postoperative confusion or pain, not opioid accumulation, so a
narcotic antagonist is not indicated.
Question 6
The practical nurse (PN) hears adventitious breath sounds in an
older adult receiving IV D5W at 100 mL/hour. What should the PN
do next?
A. Document the findings and monitor the client.
B. Report the findings to the charge nurse.
C. Slow the infusion rate to 50 mL/hour.
D. Review the last intake and output balance.
Answer: B
Rationale: Adventitious breath sounds may indicate fluid
overload or evolving respiratory complications and warrant
immediate notification to the charge nurse for further assessment.
Slowing the infusion or merely documenting delays appropriate
intervention.
2. Infection Control / Medical-Surgical
