---
**Latest 2025/2026 HESI PN Exit Exam Version 3: 100 Practice
Questions with Verified Rationales – Your Ultimate
Preparation for First‑Time Success**
---
1. A client with a new diagnosis of type 2 diabetes asks the nurse, “Why do I have to check my blood
sugar if I don’t take insulin?” Which response is most accurate?
A) “Oral diabetes medications can still cause low blood sugar, so monitoring is important.”
B) “You don’t really need to check if you are not taking insulin.”
C) “Blood sugar checks are only necessary for people on insulin therapy.”
D) “You should check only when you feel dizzy or sweaty.”
🔍 RATIONALE 💡-- Even clients on oral agents (e.g., sulfonylureas) or non‑insulin injectables (GLP‑1
agonists) can experience hypoglycemia. Monitoring guides treatment and helps prevent complications.
ANSWER💫✔️-- A) “Oral diabetes medications can still cause low blood sugar, so monitoring is
important.”
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2. A nurse is caring for a client with a history of alcoholism who is now disoriented, tremulous, and has a
fever of 101.2°F (38.4°C). Which medication does the nurse anticipate administering?
A) Naltrexone (ReVia)
B) Lorazepam (Ativan)
C) Disulfiram (Antabuse)
D) Acamprosate (Campral)
,🔍 RATIONALE 💡-- Fever, tremor, and disorientation suggest alcohol withdrawal delirium (delirium
tremens). Benzodiazepines (lorazepam, diazepam) are first‑line to prevent seizures and autonomic
instability.
ANSWER💫✔️-- B) Lorazepam (Ativan)
---
3. A client receiving total parenteral nutrition (TPN) via a central line develops a fever and chills. What is
the nurse’s priority action?
A) Slow the TPN infusion rate.
B) Change the TPN tubing and filter.
C) Stop the TPN infusion immediately and notify the provider.
D) Obtain a blood glucose level.
🔍 RATIONALE 💡-- Fever and chills in a client with a central line and TPN suggest catheter‑related
bloodstream infection (CRBSI). The TPN should be stopped (it is a perfect bacterial growth medium), and
blood cultures obtained from the line and peripherally.
ANSWER💫✔️-- C) Stop the TPN infusion immediately and notify the provider.
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4. A client with a history of deep vein thrombosis (DVT) is prescribed warfarin (Coumadin). Which
laboratory value indicates a therapeutic effect?
A) aPTT 60 seconds (control 30)
B) INR 2.5
C) Platelet count 150,000/mm³
D) PT 12 seconds
,🔍 RATIONALE 💡-- Warfarin is monitored using INR. The therapeutic INR for most DVT/PE indications is
2.0–3.0. aPTT is for heparin.
ANSWER💫✔️-- B) INR 2.5
---
5. A nurse is teaching a client with asthma how to use a peak flow meter. Which statement indicates
correct understanding?
A) “I will use the peak flow meter only when I feel short of breath.”
B) “I will stand up and take a deep breath, then blow out as hard and fast as I can.”
C) “I will perform three attempts and record the highest number.”
D) “I will perform three attempts and record the average of the three.”
🔍 RATIONALE 💡-- Proper peak flow technique: standing, deep breath, seal lips around mouthpiece,
blow out as hard and fast as possible. Perform three attempts and record the highest value, not the
average.
ANSWER💫✔️-- C) “I will perform three attempts and record the highest number.”
---
6. A client with heart failure has an order for furosemide (Lasix) 40 mg IV push. The nurse should
administer the medication over at least how many minutes?
A) 30 seconds
B) 1–2 minutes
C) 5–10 minutes
D) 15–20 minutes
🔍 RATIONALE 💡-- IV furosemide should be administered slowly (usually over 1–2 minutes) to prevent
ototoxicity (tinnitus, hearing loss). Rapid administration increases risk.
, ANSWER💫✔️-- B) 1–2 minutes
---
7. A client with a traumatic brain injury has a Glasgow Coma Scale (GCS) score of 13. Which finding is
consistent with this score?
A) The client is comatose and unresponsive.
B) The client opens eyes to pain, makes incomprehensible sounds, and decorticate posturing.
C) The client opens eyes spontaneously, is confused but converses, and localizes pain.
D) The client is intubated and sedated.
🔍 RATIONALE 💡-- GCS 13 indicates mild traumatic brain injury. A score of 13 means: Eye opening 4
(spontaneous), Verbal 4 (confused conversation), Motor 5 (localizes pain) = total 13.
ANSWER💫✔️-- C) The client opens eyes spontaneously, is confused but converses, and localizes pain.
---
8. A nurse is caring for a client receiving a continuous enteral feeding via nasogastric tube. The nurse
aspirates 250 mL of gastric residual. What should the nurse do?
A) Discard the residual and continue the feeding at the same rate.
B) Return the residual and continue the feeding; recheck in 4 hours.
C) Hold the feeding and notify the healthcare provider.
D) Return the residual and increase the feeding rate to compensate.
🔍 RATIONALE 💡-- Large residual (>200–250 mL per facility policy) often warrants holding the feeding
and reassessing (e.g., checking bowel sounds, abdominal distension). The nurse should notify the
provider if the problem persists.
**Latest 2025/2026 HESI PN Exit Exam Version 3: 100 Practice
Questions with Verified Rationales – Your Ultimate
Preparation for First‑Time Success**
---
1. A client with a new diagnosis of type 2 diabetes asks the nurse, “Why do I have to check my blood
sugar if I don’t take insulin?” Which response is most accurate?
A) “Oral diabetes medications can still cause low blood sugar, so monitoring is important.”
B) “You don’t really need to check if you are not taking insulin.”
C) “Blood sugar checks are only necessary for people on insulin therapy.”
D) “You should check only when you feel dizzy or sweaty.”
🔍 RATIONALE 💡-- Even clients on oral agents (e.g., sulfonylureas) or non‑insulin injectables (GLP‑1
agonists) can experience hypoglycemia. Monitoring guides treatment and helps prevent complications.
ANSWER💫✔️-- A) “Oral diabetes medications can still cause low blood sugar, so monitoring is
important.”
---
2. A nurse is caring for a client with a history of alcoholism who is now disoriented, tremulous, and has a
fever of 101.2°F (38.4°C). Which medication does the nurse anticipate administering?
A) Naltrexone (ReVia)
B) Lorazepam (Ativan)
C) Disulfiram (Antabuse)
D) Acamprosate (Campral)
,🔍 RATIONALE 💡-- Fever, tremor, and disorientation suggest alcohol withdrawal delirium (delirium
tremens). Benzodiazepines (lorazepam, diazepam) are first‑line to prevent seizures and autonomic
instability.
ANSWER💫✔️-- B) Lorazepam (Ativan)
---
3. A client receiving total parenteral nutrition (TPN) via a central line develops a fever and chills. What is
the nurse’s priority action?
A) Slow the TPN infusion rate.
B) Change the TPN tubing and filter.
C) Stop the TPN infusion immediately and notify the provider.
D) Obtain a blood glucose level.
🔍 RATIONALE 💡-- Fever and chills in a client with a central line and TPN suggest catheter‑related
bloodstream infection (CRBSI). The TPN should be stopped (it is a perfect bacterial growth medium), and
blood cultures obtained from the line and peripherally.
ANSWER💫✔️-- C) Stop the TPN infusion immediately and notify the provider.
---
4. A client with a history of deep vein thrombosis (DVT) is prescribed warfarin (Coumadin). Which
laboratory value indicates a therapeutic effect?
A) aPTT 60 seconds (control 30)
B) INR 2.5
C) Platelet count 150,000/mm³
D) PT 12 seconds
,🔍 RATIONALE 💡-- Warfarin is monitored using INR. The therapeutic INR for most DVT/PE indications is
2.0–3.0. aPTT is for heparin.
ANSWER💫✔️-- B) INR 2.5
---
5. A nurse is teaching a client with asthma how to use a peak flow meter. Which statement indicates
correct understanding?
A) “I will use the peak flow meter only when I feel short of breath.”
B) “I will stand up and take a deep breath, then blow out as hard and fast as I can.”
C) “I will perform three attempts and record the highest number.”
D) “I will perform three attempts and record the average of the three.”
🔍 RATIONALE 💡-- Proper peak flow technique: standing, deep breath, seal lips around mouthpiece,
blow out as hard and fast as possible. Perform three attempts and record the highest value, not the
average.
ANSWER💫✔️-- C) “I will perform three attempts and record the highest number.”
---
6. A client with heart failure has an order for furosemide (Lasix) 40 mg IV push. The nurse should
administer the medication over at least how many minutes?
A) 30 seconds
B) 1–2 minutes
C) 5–10 minutes
D) 15–20 minutes
🔍 RATIONALE 💡-- IV furosemide should be administered slowly (usually over 1–2 minutes) to prevent
ototoxicity (tinnitus, hearing loss). Rapid administration increases risk.
, ANSWER💫✔️-- B) 1–2 minutes
---
7. A client with a traumatic brain injury has a Glasgow Coma Scale (GCS) score of 13. Which finding is
consistent with this score?
A) The client is comatose and unresponsive.
B) The client opens eyes to pain, makes incomprehensible sounds, and decorticate posturing.
C) The client opens eyes spontaneously, is confused but converses, and localizes pain.
D) The client is intubated and sedated.
🔍 RATIONALE 💡-- GCS 13 indicates mild traumatic brain injury. A score of 13 means: Eye opening 4
(spontaneous), Verbal 4 (confused conversation), Motor 5 (localizes pain) = total 13.
ANSWER💫✔️-- C) The client opens eyes spontaneously, is confused but converses, and localizes pain.
---
8. A nurse is caring for a client receiving a continuous enteral feeding via nasogastric tube. The nurse
aspirates 250 mL of gastric residual. What should the nurse do?
A) Discard the residual and continue the feeding at the same rate.
B) Return the residual and continue the feeding; recheck in 4 hours.
C) Hold the feeding and notify the healthcare provider.
D) Return the residual and increase the feeding rate to compensate.
🔍 RATIONALE 💡-- Large residual (>200–250 mL per facility policy) often warrants holding the feeding
and reassessing (e.g., checking bowel sounds, abdominal distension). The nurse should notify the
provider if the problem persists.
