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HESI PN EXIT EXAM ACTUAL 2026 | Version 1 Through V7
Complete Question Bank | Verified Revised Full Exam | All
7 Versions | Pass Guaranteed - A+ Graded
VERSION 1: Safe & Effective Care Environment - Management
of Care (Q1-15) & Safety/Infection Control (Q16-25)
Management of Care (Q1-15)
Q1. A client with terminal cancer expresses a desire to refuse further chemotherapy.
The practical nurse should first: A. Contact the client's family to convince them to
change the client's mind B. Notify the physician immediately and request a
psychiatric consult C. Ensure the client understands the consequences and document
the informed refusal D. Explain that refusing treatment violates the healthcare facility
policy
A. Contact the client's family to convince them to change the client's mind B. Notify
the physician immediately and request a psychiatric consult C. Ensure the client
understands the consequences and document the informed refusal [CORRECT] D.
Explain that refusing treatment violates the healthcare facility policy
Rationale: Clients have the legal right to refuse treatment; the PN's role is to ensure
informed refusal through education and documentation, not to coerce or override
autonomy. Contacting family to change the client's mind (A) violates autonomy, and
psychiatric consults (B) are only needed if decisional capacity is questionable.
Correct Answer: C
Q2. Which task is appropriate for the practical nurse to delegate to an unlicensed
assistive personnel (UAP)? A. Assessing a postoperative client's incision for signs of
infection B. Measuring and recording the intake and output of a stable client C.
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Administering an oral antibiotic to a client with pneumonia D. Teaching a newly
diagnosed diabetic client about foot care
A. Assessing a postoperative client's incision for signs of infection B. Measuring and
recording the intake and output of a stable client [CORRECT] C. Administering an
oral antibiotic to a client with pneumonia D. Teaching a newly diagnosed diabetic
client about foot care
Rationale: Measuring intake and output is a standard, non-invasive task within the
UAP scope. Assessment (A), medication administration (C), and client education (D)
require nursing judgment and licensure, making them inappropriate for delegation
to UAP.
Correct Answer: B
Q3. A client is admitted with a living will stating "no heroic measures." The client
codes. The practical nurse should: A. Begin CPR immediately and contact the
physician for clarification B. Honor the living will and do not initiate resuscitation C.
Wait for the family to arrive before making any decisions D. Initiate CPR only if the
family agrees with the living will
A. Begin CPR immediately and contact the physician for clarification B. Honor the
living will and do not initiate resuscitation [CORRECT] C. Wait for the family to arrive
before making any decisions D. Initiate CPR only if the family agrees with the living
will
Rationale: A valid living will is a legal advance directive that must be honored;
initiating CPR (A) would violate the client's documented wishes. Family wishes (C, D)
do not override a legally executed advance directive.
Correct Answer: B
Q4. The practical nurse is caring for a client who has designated a healthcare proxy.
The proxy requests discontinuation of the client's feeding tube, but the client
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previously told the nurse they wanted "everything done." The practical nurse should:
A. Follow the proxy's decision as the legal representative B. Honor the client's most
recent verbal statement to the nurse C. Convene an ethics committee meeting
immediately D. Continue the feeding tube and notify the physician of the conflict
A. Follow the proxy's decision as the legal representative B. Honor the client's most
recent verbal statement to the nurse C. Convene an ethics committee meeting
immediately D. Continue the feeding tube and notify the physician of the conflict
[CORRECT]
Rationale: When there is a conflict between a healthcare proxy's decision and the
client's previously expressed wishes, the nurse must notify the physician to resolve
the discrepancy while continuing current life-sustaining treatment. The proxy's
authority is based on the client's prior wishes, not independent decision-making.
Correct Answer: D
Q5. A practical nurse observes a colleague documenting vital signs that were not
actually obtained. The nurse's first action should be: A. Report the incident to the
state board of nursing immediately B. Confront the colleague privately and demand
they correct the documentation C. Report the observation to the nurse manager
according to facility policy D. Ignore the incident because it is the colleague's
responsibility
A. Report the incident to the state board of nursing immediately B. Confront the
colleague privately and demand they correct the documentation C. Report the
observation to the nurse manager according to facility policy [CORRECT] D. Ignore
the incident because it is the colleague's responsibility
Rationale: Falsifying documentation is a serious breach of professional conduct; the
nurse must follow the chain of command and facility policy by reporting to the nurse
manager first. Immediate reporting to the state board (A) bypasses internal
resolution, and ignoring (D) constitutes professional negligence.
Correct Answer: C
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Q6. A practical nurse is asked to obtain informed consent for a surgical procedure
from a client who received sedation 30 minutes ago. The nurse should: A. Proceed
with obtaining consent since the physician requested it B. Delay consent until the
client is no longer under the influence of sedation C. Ask the family to sign the
consent form instead D. Have the client sign a waiver stating they understand while
sedated
A. Proceed with obtaining consent since the physician requested it B. Delay consent
until the client is no longer under the influence of sedation [CORRECT] C. Ask the
family to sign the consent form instead D. Have the client sign a waiver stating they
understand while sedated
Rationale: Informed consent requires the client to be fully alert and competent;
sedation impairs judgment and legally invalidates consent. Family cannot sign unless
the client lacks decisional capacity and has designated a proxy or guardian.
Correct Answer: B
Q7. Which action by the practical nurse demonstrates appropriate delegation to a
UAP? A. Asking the UAP to evaluate the effectiveness of a client's pain medication B.
Instructing the UAP to report any changes in a client's respiratory rate immediately C.
Requesting the UAP to insert a straight catheter for urine specimen collection D.
Directing the UAP to ambulate a stable client who has a gait belt applied
A. Asking the UAP to evaluate the effectiveness of a client's pain medication B.
Instructing the UAP to report any changes in a client's respiratory rate immediately C.
Requesting the UAP to insert a straight catheter for urine specimen collection D.
Directing the UAP to ambulate a stable client who has a gait belt applied [CORRECT]
Rationale: Ambulating a stable client with a gait belt is within UAP scope. Evaluation
of medication effectiveness (A) requires nursing judgment, reporting respiratory
changes (B) requires assessment skills, and catheter insertion (C) is an invasive
procedure requiring licensure.
Correct Answer: D
HESI PN EXIT EXAM ACTUAL 2026 | Version 1 Through V7
Complete Question Bank | Verified Revised Full Exam | All
7 Versions | Pass Guaranteed - A+ Graded
VERSION 1: Safe & Effective Care Environment - Management
of Care (Q1-15) & Safety/Infection Control (Q16-25)
Management of Care (Q1-15)
Q1. A client with terminal cancer expresses a desire to refuse further chemotherapy.
The practical nurse should first: A. Contact the client's family to convince them to
change the client's mind B. Notify the physician immediately and request a
psychiatric consult C. Ensure the client understands the consequences and document
the informed refusal D. Explain that refusing treatment violates the healthcare facility
policy
A. Contact the client's family to convince them to change the client's mind B. Notify
the physician immediately and request a psychiatric consult C. Ensure the client
understands the consequences and document the informed refusal [CORRECT] D.
Explain that refusing treatment violates the healthcare facility policy
Rationale: Clients have the legal right to refuse treatment; the PN's role is to ensure
informed refusal through education and documentation, not to coerce or override
autonomy. Contacting family to change the client's mind (A) violates autonomy, and
psychiatric consults (B) are only needed if decisional capacity is questionable.
Correct Answer: C
Q2. Which task is appropriate for the practical nurse to delegate to an unlicensed
assistive personnel (UAP)? A. Assessing a postoperative client's incision for signs of
infection B. Measuring and recording the intake and output of a stable client C.
,2
Administering an oral antibiotic to a client with pneumonia D. Teaching a newly
diagnosed diabetic client about foot care
A. Assessing a postoperative client's incision for signs of infection B. Measuring and
recording the intake and output of a stable client [CORRECT] C. Administering an
oral antibiotic to a client with pneumonia D. Teaching a newly diagnosed diabetic
client about foot care
Rationale: Measuring intake and output is a standard, non-invasive task within the
UAP scope. Assessment (A), medication administration (C), and client education (D)
require nursing judgment and licensure, making them inappropriate for delegation
to UAP.
Correct Answer: B
Q3. A client is admitted with a living will stating "no heroic measures." The client
codes. The practical nurse should: A. Begin CPR immediately and contact the
physician for clarification B. Honor the living will and do not initiate resuscitation C.
Wait for the family to arrive before making any decisions D. Initiate CPR only if the
family agrees with the living will
A. Begin CPR immediately and contact the physician for clarification B. Honor the
living will and do not initiate resuscitation [CORRECT] C. Wait for the family to arrive
before making any decisions D. Initiate CPR only if the family agrees with the living
will
Rationale: A valid living will is a legal advance directive that must be honored;
initiating CPR (A) would violate the client's documented wishes. Family wishes (C, D)
do not override a legally executed advance directive.
Correct Answer: B
Q4. The practical nurse is caring for a client who has designated a healthcare proxy.
The proxy requests discontinuation of the client's feeding tube, but the client
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previously told the nurse they wanted "everything done." The practical nurse should:
A. Follow the proxy's decision as the legal representative B. Honor the client's most
recent verbal statement to the nurse C. Convene an ethics committee meeting
immediately D. Continue the feeding tube and notify the physician of the conflict
A. Follow the proxy's decision as the legal representative B. Honor the client's most
recent verbal statement to the nurse C. Convene an ethics committee meeting
immediately D. Continue the feeding tube and notify the physician of the conflict
[CORRECT]
Rationale: When there is a conflict between a healthcare proxy's decision and the
client's previously expressed wishes, the nurse must notify the physician to resolve
the discrepancy while continuing current life-sustaining treatment. The proxy's
authority is based on the client's prior wishes, not independent decision-making.
Correct Answer: D
Q5. A practical nurse observes a colleague documenting vital signs that were not
actually obtained. The nurse's first action should be: A. Report the incident to the
state board of nursing immediately B. Confront the colleague privately and demand
they correct the documentation C. Report the observation to the nurse manager
according to facility policy D. Ignore the incident because it is the colleague's
responsibility
A. Report the incident to the state board of nursing immediately B. Confront the
colleague privately and demand they correct the documentation C. Report the
observation to the nurse manager according to facility policy [CORRECT] D. Ignore
the incident because it is the colleague's responsibility
Rationale: Falsifying documentation is a serious breach of professional conduct; the
nurse must follow the chain of command and facility policy by reporting to the nurse
manager first. Immediate reporting to the state board (A) bypasses internal
resolution, and ignoring (D) constitutes professional negligence.
Correct Answer: C
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Q6. A practical nurse is asked to obtain informed consent for a surgical procedure
from a client who received sedation 30 minutes ago. The nurse should: A. Proceed
with obtaining consent since the physician requested it B. Delay consent until the
client is no longer under the influence of sedation C. Ask the family to sign the
consent form instead D. Have the client sign a waiver stating they understand while
sedated
A. Proceed with obtaining consent since the physician requested it B. Delay consent
until the client is no longer under the influence of sedation [CORRECT] C. Ask the
family to sign the consent form instead D. Have the client sign a waiver stating they
understand while sedated
Rationale: Informed consent requires the client to be fully alert and competent;
sedation impairs judgment and legally invalidates consent. Family cannot sign unless
the client lacks decisional capacity and has designated a proxy or guardian.
Correct Answer: B
Q7. Which action by the practical nurse demonstrates appropriate delegation to a
UAP? A. Asking the UAP to evaluate the effectiveness of a client's pain medication B.
Instructing the UAP to report any changes in a client's respiratory rate immediately C.
Requesting the UAP to insert a straight catheter for urine specimen collection D.
Directing the UAP to ambulate a stable client who has a gait belt applied
A. Asking the UAP to evaluate the effectiveness of a client's pain medication B.
Instructing the UAP to report any changes in a client's respiratory rate immediately C.
Requesting the UAP to insert a straight catheter for urine specimen collection D.
Directing the UAP to ambulate a stable client who has a gait belt applied [CORRECT]
Rationale: Ambulating a stable client with a gait belt is within UAP scope. Evaluation
of medication effectiveness (A) requires nursing judgment, reporting respiratory
changes (B) requires assessment skills, and catheter insertion (C) is an invasive
procedure requiring licensure.
Correct Answer: D
