HESI PN Exit Examination
MAXE • TIXE NP
✦ HESI ✦
PN Elsevier · Health Education Systems, Inc.
E V O LV E · A S S E S S · A C H I E V E
ELSEVIER
HESI PN EXIT EXAM LATEST 2024-2025/PN HESI EXIT
COMPLETE EXAM REAL EXAM QUESTIONS AND
CORRECT ANSWERS|AGRADE
CO M P R E H E N S I V E P N E X I T E X A M · M E D I C A L-S U R G I C A L · M AT E R N I TY · P E D I AT R I C · P SYC H I AT R I C ·
F U N D A M E N TA LS
INSTITUTION Elsevier · HESI (Health Education Systems, EXAM TYPE PN Exit Examination (Practical Nurse)
Inc.)
ACADEMIC YEAR TOTAL QUESTIONS 50 Questions (Part 1 of 3)
SUBJECT AREAS Med-Surg · Maternity · Peds · Psych · FORMAT Multiple Choice & SATA — Select the
Fundamentals · Pharmacology Single Best Answer
EXIT EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless SATA (Select All That Apply) is specified.
▸ Content covers all PN core areas: medical-surgical, maternity, pediatric, psychiatric/mental health, fundamentals, and
pharmacology.
▸ Each question includes the correct answer with a detailed clinical rationale.
SECTION I — COMPREHENSIVE PN EXIT EXAM Questions 1 – 50
1. A nurse is reviewing the laboratory results of a client who has rheumatoid arthritis. Which of the following findings
should the nurse report to the provider?
A. WBC count 8,000/mm³
B. Platelets 150,000/mm³
C. Aspartate aminotransferase 10 units/L
D. Erythrocyte sedimentation rate 75 mm/hr
CORRECT ANSWER D — Erythrocyte sedimentation rate 75 mm/hr
RATIONALE An ESR of 75 mm/hr is significantly elevated (normal: <20–30 mm/hr depending on age and gender). ESR is a
marker of inflammation and is typically elevated in active rheumatoid arthritis — this value indicates active
disease that should be reported. WBC 8,000 (A) is within normal range (4,500–11,000). Platelets 150,000 (B) is
at the lower limit of normal (150,000–450,000) but not critically abnormal. AST 10 (C) is within normal range
(5–40 units/L). An elevated ESR in RA indicates active inflammation and potential joint damage progression.
, 2. A nurse is caring for a client who has generalized petechiae and ecchymoses. The nurse should expect a
prescription for which of the following laboratory tests?
A. Platelet count
B. Potassium level
C. Creatinine clearance
D. Prealbumin
CORRECT ANSWER A — Platelet count
RATIONALE Generalized petechiae and ecchymoses indicate a potential bleeding disorder, most commonly
thrombocytopenia (low platelet count). Platelets are essential for primary hemostasis. Thrombocytopenia
can result from decreased production (bone marrow disorders), increased destruction (ITP, DIC), or
sequestration (splenomegaly). Potassium (B) assesses electrolyte balance. Creatinine clearance (C) assesses
kidney function. Prealbumin (D) assesses nutritional status. The priority lab for bleeding manifestations is the
platelet count, along with PT/PTT and possibly a bleeding time.
3. A nurse is caring for a client following application of a cast. Which of the following actions should the nurse take
first?
A. Place an ice pack over the cast
B. Palpate the pulse distal to the cast
C. Teach the client to keep the cast clean and dry
D. Position the casted extremity on a pillow
CORRECT ANSWER B — Palpate the pulse distal to the cast
RATIONALE The priority following cast application is neurovascular assessment — checking for the "5 Ps": Pain, Pallor,
Pulselessness, Paresthesia, and Paralysis. Palpating the distal pulse assesses circulation and is the highest
priority because compromised circulation can lead to compartment syndrome, tissue ischemia, and
permanent damage. Ice (A), positioning (D), and teaching (C) are all appropriate interventions but are
secondary to assessing circulatory status. The nursing process requires assessment before intervention.
4. A nurse is caring for a client who has vision loss. Which of the following actions should the nurse take? (SATA)
A. Keep objects in the client's room in the same place.
B. Ensure there is high-wattage lighting in the client's room.
C. Approach the client from the side.
D. Allow extra time for the client to perform tasks.
E. Touch the client gently to announce presence.
CORRECT ANSWER A, B, D — Keep objects in the same place; ensure high-wattage lighting; allow extra time
RATIONALE For clients with vision loss: (A) maintaining a consistent environment prevents falls and promotes
independence. (B) High-wattage lighting maximizes residual vision. (D) Extra time allows the client to process
information and navigate safely. INCORRECT: (C) Approach from the FRONT, not the side, to avoid startling. (E)
Announce presence verbally before touching — do NOT touch first, as unexpected touch can be frightening for
a visually impaired person.
MAXE • TIXE NP
✦ HESI ✦
PN Elsevier · Health Education Systems, Inc.
E V O LV E · A S S E S S · A C H I E V E
ELSEVIER
HESI PN EXIT EXAM LATEST 2024-2025/PN HESI EXIT
COMPLETE EXAM REAL EXAM QUESTIONS AND
CORRECT ANSWERS|AGRADE
CO M P R E H E N S I V E P N E X I T E X A M · M E D I C A L-S U R G I C A L · M AT E R N I TY · P E D I AT R I C · P SYC H I AT R I C ·
F U N D A M E N TA LS
INSTITUTION Elsevier · HESI (Health Education Systems, EXAM TYPE PN Exit Examination (Practical Nurse)
Inc.)
ACADEMIC YEAR TOTAL QUESTIONS 50 Questions (Part 1 of 3)
SUBJECT AREAS Med-Surg · Maternity · Peds · Psych · FORMAT Multiple Choice & SATA — Select the
Fundamentals · Pharmacology Single Best Answer
EXIT EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless SATA (Select All That Apply) is specified.
▸ Content covers all PN core areas: medical-surgical, maternity, pediatric, psychiatric/mental health, fundamentals, and
pharmacology.
▸ Each question includes the correct answer with a detailed clinical rationale.
SECTION I — COMPREHENSIVE PN EXIT EXAM Questions 1 – 50
1. A nurse is reviewing the laboratory results of a client who has rheumatoid arthritis. Which of the following findings
should the nurse report to the provider?
A. WBC count 8,000/mm³
B. Platelets 150,000/mm³
C. Aspartate aminotransferase 10 units/L
D. Erythrocyte sedimentation rate 75 mm/hr
CORRECT ANSWER D — Erythrocyte sedimentation rate 75 mm/hr
RATIONALE An ESR of 75 mm/hr is significantly elevated (normal: <20–30 mm/hr depending on age and gender). ESR is a
marker of inflammation and is typically elevated in active rheumatoid arthritis — this value indicates active
disease that should be reported. WBC 8,000 (A) is within normal range (4,500–11,000). Platelets 150,000 (B) is
at the lower limit of normal (150,000–450,000) but not critically abnormal. AST 10 (C) is within normal range
(5–40 units/L). An elevated ESR in RA indicates active inflammation and potential joint damage progression.
, 2. A nurse is caring for a client who has generalized petechiae and ecchymoses. The nurse should expect a
prescription for which of the following laboratory tests?
A. Platelet count
B. Potassium level
C. Creatinine clearance
D. Prealbumin
CORRECT ANSWER A — Platelet count
RATIONALE Generalized petechiae and ecchymoses indicate a potential bleeding disorder, most commonly
thrombocytopenia (low platelet count). Platelets are essential for primary hemostasis. Thrombocytopenia
can result from decreased production (bone marrow disorders), increased destruction (ITP, DIC), or
sequestration (splenomegaly). Potassium (B) assesses electrolyte balance. Creatinine clearance (C) assesses
kidney function. Prealbumin (D) assesses nutritional status. The priority lab for bleeding manifestations is the
platelet count, along with PT/PTT and possibly a bleeding time.
3. A nurse is caring for a client following application of a cast. Which of the following actions should the nurse take
first?
A. Place an ice pack over the cast
B. Palpate the pulse distal to the cast
C. Teach the client to keep the cast clean and dry
D. Position the casted extremity on a pillow
CORRECT ANSWER B — Palpate the pulse distal to the cast
RATIONALE The priority following cast application is neurovascular assessment — checking for the "5 Ps": Pain, Pallor,
Pulselessness, Paresthesia, and Paralysis. Palpating the distal pulse assesses circulation and is the highest
priority because compromised circulation can lead to compartment syndrome, tissue ischemia, and
permanent damage. Ice (A), positioning (D), and teaching (C) are all appropriate interventions but are
secondary to assessing circulatory status. The nursing process requires assessment before intervention.
4. A nurse is caring for a client who has vision loss. Which of the following actions should the nurse take? (SATA)
A. Keep objects in the client's room in the same place.
B. Ensure there is high-wattage lighting in the client's room.
C. Approach the client from the side.
D. Allow extra time for the client to perform tasks.
E. Touch the client gently to announce presence.
CORRECT ANSWER A, B, D — Keep objects in the same place; ensure high-wattage lighting; allow extra time
RATIONALE For clients with vision loss: (A) maintaining a consistent environment prevents falls and promotes
independence. (B) High-wattage lighting maximizes residual vision. (D) Extra time allows the client to process
information and navigate safely. INCORRECT: (C) Approach from the FRONT, not the side, to avoid startling. (E)
Announce presence verbally before touching — do NOT touch first, as unexpected touch can be frightening for
a visually impaired person.
