HESI PN EXIT EXAM
HESI PN Exit Exam
2026/2027 Edition
Official Practice Exam - 110 Questions & Answers (Verified)
Safe Care Environment | Health Promotion | Psychosocial Integrity | Physiological Integrity
Questions Minutes Passing Score Format
110 120 80% Multiple Choice
TABLE OF CONTENTS
Section 1: Safe and Effective Care Environment Q1-Q20
Section 2: Health Promotion and Maintenance Q21-Q38
Section 3: Psychosocial Integrity Q39-Q56
Section 4: Basic Care and Comfort Q57-Q74
Section
EXAM 5: Pharmacological & Parenteral Therapies
INSTRUCTIONS Q75-Q92
Section 6: Reduction of Risk & Physiological Adaptation Q93-Q110
1. This exam consists of 110 multiple-choice questions across 6 sections. You have 120 minutes to complete all
questions.
2. Each question has four answer choices (A, B, C, D). Select the single best answer for each question.
3. A passing score of 80% (88 out of 110 questions correct) is required to pass this exam.
4. Read each question carefully. Every question begins with a realistic clinical scenario relevant to practical nursing.
5. After completing the exam, review the answer key and detailed rationales provided at the end of this document.
6. The correct answer for each question is printed in green immediately below the question, followed by a detailed
rationale.
7. This practice exam is designed to mirror the content, format, and difficulty of the actual HESI PN Exit Exam.
8. Do not use any reference materials during the exam. Time yourself to simulate actual testing conditions.
HESI PN Exit Exam - 2026/2027 | Passing Score: 80% | Page 1
,Section 1: Safe and Effective Care Environment 20 Questions
Q1 Question 1 of 110
A 72-year-old client is admitted to a medical-surgical unit with a diagnosis of pneumonia. The nurse
notices that the bedside rails are down and the client is confused and attempting to climb out of
bed. The priority nursing action is to
A. raise the side rails and ensure the bed is in the lowest position with the call light within
reach
B. restrain the client with wrist restraints to prevent a fall and notify the provider
C. administer a sedative medication to calm the client and reduce the risk of injury
D. assign a family member to sit with the client at the bedside around the clock
Correct Answer: A
Rationale:
Raising the side rails and lowering the bed are the least restrictive interventions to prevent falls in a confused
client. Restraints require a provider order and are a last resort. Sedatives increase confusion and fall risk. Family
presence is helpful but cannot be mandated and does not replace nursing interventions.
Q2 Question 2 of 110
A practical nurse is delegating the task of ambulating a postoperative client to a nursing assistant.
The client had a total knee replacement two days ago and requires the use of a walker. Which
information must the PN communicate to the nursing assistant during delegation?
A. The client's complete medical history and surgical procedure details for reference
B. Specific instructions about how far the client may ambulate and the need for supervision
with the walker
C. Permission to administer pain medication before ambulation if the client requests it
D. Authorization to discontinue the ambulation if the client appears fatigued without further reporting
Correct Answer: B
Rationale:
When delegating, the PN must provide specific, clear instructions about the task parameters including the
distance, assistive device requirements, and supervision level. Complete medical history is unnecessary for the
task, medication administration is outside the nursing assistant scope, and discontinuation criteria must include
reporting back to the nurse.
,Section 1: Safe and Effective Care Environment Continued
Q3 Question 3 of 110
A client with a do-not-resuscitate (DNR) order is admitted to the unit. During the shift, the client's
condition deteriorates significantly. A family member at the bedside demands that the nurse call a
code and begin resuscitation. The nurse should
A. immediately begin resuscitation because the family member's request overrides the DNR order
B. call the provider to obtain a new order that clarifies whether resuscitation should be initiated
C. acknowledge the family member's distress and explain that the DNR order reflects the
client's own wishes and must be followed
D. defer the decision to the next of kin who is not currently present at the bedside
Correct Answer: C
Rationale:
A DNR order represents the client's autonomous decision and must be honored by the healthcare team. The
nurse should acknowledge the family's emotional distress while upholding the client's expressed wishes.
Beginning resuscitation would violate the client's rights. The provider does not need to rewrite the order, and
deferring to an absent family member delays appropriate action.
Q4 Question 4 of 110
A nurse discovers that a medication error has occurred: a client received 10 mg of metoprolol
instead of the prescribed 25 mg. The client is stable with no adverse effects. The nurse should first
A. document the error in the client's medical record and monitor for delayed adverse effects
B. inform the client about the medication error and ask whether any symptoms have developed
C. contact the pharmacy to determine whether the lower dose could have therapeutic benefits
D. assess the client's current status, notify the provider, and complete an incident report per
facility policy
Correct Answer: D
Rationale:
The priority after a medication error is assessing the client, notifying the provider, and completing an incident
report. Documentation must be factual and timely. Informing the client is appropriate but not the first action.
Contacting the pharmacy does not address the immediate clinical and administrative responsibilities.
HESI PN Exit Exam - 2026/2027 | Passing Score: 80% | Page 3
, Section 1: Safe and Effective Care Environment Continued
Q5 Question 5 of 110
A client on isolation precautions for Clostridium difficile infection needs to be transported to the
radiology department. The nurse should
A. ensure the client performs hand hygiene, wears a clean gown, and that transport staff follow
contact precautions
B. cancel the radiology appointment because clients on isolation cannot leave the room under any
circumstances
C. send the client to radiology without special precautions as long as the client wears a surgical mask
D. request that radiology staff come to the client's room to perform portable imaging to avoid transport
Correct Answer: A
Rationale:
Clients on contact isolation for C. difficile may be transported when necessary, but precautions must be
maintained during transport. Hand hygiene, a clean gown, and communication with transport and radiology staff
about precautions are required. Isolation does not prohibit all transport, surgical masks do not address contact
transmission, and portable imaging is not always available or appropriate.
Q6 Question 6 of 110
A newly licensed practical nurse is preparing to administer a blood transfusion for the first time. The
charge nurse should verify that the LPN understands that the initial vital sign baseline must be
taken
A. 15 minutes after the transfusion has been running to allow the client to adjust to the blood product
B. immediately before starting the transfusion after the client identification verification is
complete
C. at the time the blood product arrives from the blood bank and before it enters the client's room
D. 30 minutes before the transfusion is scheduled to begin to establish a resting baseline
Correct Answer: B
Rationale:
Vital signs must be taken immediately before starting the transfusion, after the two-nurse identification
verification of the client and blood product. This establishes the most accurate baseline for comparison during
monitoring. Taking vital signs at other times does not provide the immediate pre-transfusion status needed to
detect early reactions.
HESI PN Exit Exam - 2026/2027 | Passing Score: 80% | Page 4
HESI PN Exit Exam
2026/2027 Edition
Official Practice Exam - 110 Questions & Answers (Verified)
Safe Care Environment | Health Promotion | Psychosocial Integrity | Physiological Integrity
Questions Minutes Passing Score Format
110 120 80% Multiple Choice
TABLE OF CONTENTS
Section 1: Safe and Effective Care Environment Q1-Q20
Section 2: Health Promotion and Maintenance Q21-Q38
Section 3: Psychosocial Integrity Q39-Q56
Section 4: Basic Care and Comfort Q57-Q74
Section
EXAM 5: Pharmacological & Parenteral Therapies
INSTRUCTIONS Q75-Q92
Section 6: Reduction of Risk & Physiological Adaptation Q93-Q110
1. This exam consists of 110 multiple-choice questions across 6 sections. You have 120 minutes to complete all
questions.
2. Each question has four answer choices (A, B, C, D). Select the single best answer for each question.
3. A passing score of 80% (88 out of 110 questions correct) is required to pass this exam.
4. Read each question carefully. Every question begins with a realistic clinical scenario relevant to practical nursing.
5. After completing the exam, review the answer key and detailed rationales provided at the end of this document.
6. The correct answer for each question is printed in green immediately below the question, followed by a detailed
rationale.
7. This practice exam is designed to mirror the content, format, and difficulty of the actual HESI PN Exit Exam.
8. Do not use any reference materials during the exam. Time yourself to simulate actual testing conditions.
HESI PN Exit Exam - 2026/2027 | Passing Score: 80% | Page 1
,Section 1: Safe and Effective Care Environment 20 Questions
Q1 Question 1 of 110
A 72-year-old client is admitted to a medical-surgical unit with a diagnosis of pneumonia. The nurse
notices that the bedside rails are down and the client is confused and attempting to climb out of
bed. The priority nursing action is to
A. raise the side rails and ensure the bed is in the lowest position with the call light within
reach
B. restrain the client with wrist restraints to prevent a fall and notify the provider
C. administer a sedative medication to calm the client and reduce the risk of injury
D. assign a family member to sit with the client at the bedside around the clock
Correct Answer: A
Rationale:
Raising the side rails and lowering the bed are the least restrictive interventions to prevent falls in a confused
client. Restraints require a provider order and are a last resort. Sedatives increase confusion and fall risk. Family
presence is helpful but cannot be mandated and does not replace nursing interventions.
Q2 Question 2 of 110
A practical nurse is delegating the task of ambulating a postoperative client to a nursing assistant.
The client had a total knee replacement two days ago and requires the use of a walker. Which
information must the PN communicate to the nursing assistant during delegation?
A. The client's complete medical history and surgical procedure details for reference
B. Specific instructions about how far the client may ambulate and the need for supervision
with the walker
C. Permission to administer pain medication before ambulation if the client requests it
D. Authorization to discontinue the ambulation if the client appears fatigued without further reporting
Correct Answer: B
Rationale:
When delegating, the PN must provide specific, clear instructions about the task parameters including the
distance, assistive device requirements, and supervision level. Complete medical history is unnecessary for the
task, medication administration is outside the nursing assistant scope, and discontinuation criteria must include
reporting back to the nurse.
,Section 1: Safe and Effective Care Environment Continued
Q3 Question 3 of 110
A client with a do-not-resuscitate (DNR) order is admitted to the unit. During the shift, the client's
condition deteriorates significantly. A family member at the bedside demands that the nurse call a
code and begin resuscitation. The nurse should
A. immediately begin resuscitation because the family member's request overrides the DNR order
B. call the provider to obtain a new order that clarifies whether resuscitation should be initiated
C. acknowledge the family member's distress and explain that the DNR order reflects the
client's own wishes and must be followed
D. defer the decision to the next of kin who is not currently present at the bedside
Correct Answer: C
Rationale:
A DNR order represents the client's autonomous decision and must be honored by the healthcare team. The
nurse should acknowledge the family's emotional distress while upholding the client's expressed wishes.
Beginning resuscitation would violate the client's rights. The provider does not need to rewrite the order, and
deferring to an absent family member delays appropriate action.
Q4 Question 4 of 110
A nurse discovers that a medication error has occurred: a client received 10 mg of metoprolol
instead of the prescribed 25 mg. The client is stable with no adverse effects. The nurse should first
A. document the error in the client's medical record and monitor for delayed adverse effects
B. inform the client about the medication error and ask whether any symptoms have developed
C. contact the pharmacy to determine whether the lower dose could have therapeutic benefits
D. assess the client's current status, notify the provider, and complete an incident report per
facility policy
Correct Answer: D
Rationale:
The priority after a medication error is assessing the client, notifying the provider, and completing an incident
report. Documentation must be factual and timely. Informing the client is appropriate but not the first action.
Contacting the pharmacy does not address the immediate clinical and administrative responsibilities.
HESI PN Exit Exam - 2026/2027 | Passing Score: 80% | Page 3
, Section 1: Safe and Effective Care Environment Continued
Q5 Question 5 of 110
A client on isolation precautions for Clostridium difficile infection needs to be transported to the
radiology department. The nurse should
A. ensure the client performs hand hygiene, wears a clean gown, and that transport staff follow
contact precautions
B. cancel the radiology appointment because clients on isolation cannot leave the room under any
circumstances
C. send the client to radiology without special precautions as long as the client wears a surgical mask
D. request that radiology staff come to the client's room to perform portable imaging to avoid transport
Correct Answer: A
Rationale:
Clients on contact isolation for C. difficile may be transported when necessary, but precautions must be
maintained during transport. Hand hygiene, a clean gown, and communication with transport and radiology staff
about precautions are required. Isolation does not prohibit all transport, surgical masks do not address contact
transmission, and portable imaging is not always available or appropriate.
Q6 Question 6 of 110
A newly licensed practical nurse is preparing to administer a blood transfusion for the first time. The
charge nurse should verify that the LPN understands that the initial vital sign baseline must be
taken
A. 15 minutes after the transfusion has been running to allow the client to adjust to the blood product
B. immediately before starting the transfusion after the client identification verification is
complete
C. at the time the blood product arrives from the blood bank and before it enters the client's room
D. 30 minutes before the transfusion is scheduled to begin to establish a resting baseline
Correct Answer: B
Rationale:
Vital signs must be taken immediately before starting the transfusion, after the two-nurse identification
verification of the client and blood product. This establishes the most accurate baseline for comparison during
monitoring. Taking vital signs at other times does not provide the immediate pre-transfusion status needed to
detect early reactions.
HESI PN Exit Exam - 2026/2027 | Passing Score: 80% | Page 4
