Elsevier Health Sciences
882–752 NP ISEH
+ +
ELSEVIER
HESI Exit Examination · Practical Nursing
A D V A N C I N G H E A LT H C A R E T H R O U G H K N O W L E D G E
EST. 1880
HESI PN EXIT 257–288
P O ST PA RT U M · N E U R O LO G I C A L · O RT H O P E D I C · P H A R M A CO LO G Y · D E L E G AT I O N · E M E R G E N C Y
RESPONSE
INSTITUTION Elsevier Health Sciences / HESI Testing COURSE CODE PN-HESI-257-288-2026
PROGRAM Practical Nursing (PN) · NCLEX-PN ACADEMIC YEAR
Preparation
EXAM TITLE HESI PN Exit Exam — Questions 257–288 TOTAL QUESTIONS 32 Questions
COURSE TITLE Practical Nursing Exit Readiness · Clinical FORMAT Multiple Choice / Select All That Apply —
Judgment & Safe Practice Select the Single Best Answer Unless
Otherwise Noted
EXAMINATION INSTRUCTIONS
▸ Questions span postpartum, neurological, orthopedic, pharmacology, delegation, and emergency response content areas.
▸ Select the single best answer for each question unless "Select all that apply" is explicitly stated.
▸ Clinical judgment questions require prioritization using nursing process frameworks.
▸ Correct answers and detailed rationales appear below each question for comprehensive NCLEX-PN exam preparation.
POSTPARTUM · NEUROLOGICAL · ORTHOPEDIC · PHARMACOLOGY · Questions 1
DELEGATION · EMERGENCY RESPONSE – 32
1. The PN determines that a client who is one day postpartum has a moderate amount of lochia rubra and the uterus is
firm, dextroverted, and three fingerbreadths above the umbilicus. Which should be the PN's initial action?
A. Massage the uterine fundus vigorously
B. Assess the bladder for distension
C. Administer prescribed oxytocin
D. Notify the healthcare provider immediately
CORRECT ANSWER B. Assess the bladder for distension
RATIONALE A dextroverted (displaced to the right) uterus elevated above the umbilicus strongly indicates bladder distension
pushing the uterus upward and to the side. A full bladder prevents effective uterine contraction and increases
postpartum hemorrhage risk. The first action is to assess for bladder distension and assist the client to void, then
reassess fundal position.
, 2. The PN notes that a UAP is ambulating a male client who had a stroke and has right-sided weakness. The UAP is
walking on the client's left side. Which action should the PN take?
A. Praise the UAP for proper ambulation technique
B. Instruct the UAP to walk on the client's affected side
C. Document that the UAP needs additional training
D. Report the UAP to the nurse manager
CORRECT ANSWER B. Instruct the UAP to walk on the client's affected side
RATIONALE When ambulating a client with unilateral weakness, the caregiver should stand on the affected (weaker) side to
provide support and prevent falls. The client has right-sided weakness, so the UAP should walk on the client's
right side. The PN should immediately correct this safety issue with direct instruction before documenting or
escalating.
3. The PN administers an injection using a syringe with a retractable needle. After the needle is removed from the client's
skin, the needle does not retract, and the PN gets stuck in the finger with the used needle. What action should the PN
take first?
A. Complete an incident report
B. Cleanse the finger with soap and water
C. Notify the employee health department
D. Obtain baseline lab work from the client
CORRECT ANSWER B. Cleanse the finger with soap and water
RATIONALE The first action after a needlestick injury is immediate wound care—cleanse the site thoroughly with soap and
water to reduce the risk of bloodborne pathogen transmission. Incident reporting, employee health notification,
and baseline lab work are all necessary subsequent steps, but wound cleansing takes priority to minimize
exposure. The site should be allowed to bleed freely before cleaning.
4. For the past six hours, a postoperative client has refused pain medication. When an opioid analgesic is finally
administered, the client has difficulty obtaining a satisfactory level of comfort. Which action is best for the PN to use in
assisting this client?
A. Administer a second dose of the opioid immediately
B. Guide the client through slow, rhythmic breathing
C. Tell the client the medication will take effect soon
D. Call the healthcare provider for a different analgesic
CORRECT ANSWER B. Guide the client through slow, rhythmic breathing
RATIONALE When pain medication has been delayed and the client is struggling to achieve comfort, non-pharmacologic
interventions should be implemented alongside the medication. Slow, rhythmic breathing reduces muscle
tension, decreases anxiety, and enhances relaxation—complementing the analgesic effect. A second dose cannot
be given without a specific order and risks oversedation. Reassurance alone is insufficient. Calling the provider is
premature.
882–752 NP ISEH
+ +
ELSEVIER
HESI Exit Examination · Practical Nursing
A D V A N C I N G H E A LT H C A R E T H R O U G H K N O W L E D G E
EST. 1880
HESI PN EXIT 257–288
P O ST PA RT U M · N E U R O LO G I C A L · O RT H O P E D I C · P H A R M A CO LO G Y · D E L E G AT I O N · E M E R G E N C Y
RESPONSE
INSTITUTION Elsevier Health Sciences / HESI Testing COURSE CODE PN-HESI-257-288-2026
PROGRAM Practical Nursing (PN) · NCLEX-PN ACADEMIC YEAR
Preparation
EXAM TITLE HESI PN Exit Exam — Questions 257–288 TOTAL QUESTIONS 32 Questions
COURSE TITLE Practical Nursing Exit Readiness · Clinical FORMAT Multiple Choice / Select All That Apply —
Judgment & Safe Practice Select the Single Best Answer Unless
Otherwise Noted
EXAMINATION INSTRUCTIONS
▸ Questions span postpartum, neurological, orthopedic, pharmacology, delegation, and emergency response content areas.
▸ Select the single best answer for each question unless "Select all that apply" is explicitly stated.
▸ Clinical judgment questions require prioritization using nursing process frameworks.
▸ Correct answers and detailed rationales appear below each question for comprehensive NCLEX-PN exam preparation.
POSTPARTUM · NEUROLOGICAL · ORTHOPEDIC · PHARMACOLOGY · Questions 1
DELEGATION · EMERGENCY RESPONSE – 32
1. The PN determines that a client who is one day postpartum has a moderate amount of lochia rubra and the uterus is
firm, dextroverted, and three fingerbreadths above the umbilicus. Which should be the PN's initial action?
A. Massage the uterine fundus vigorously
B. Assess the bladder for distension
C. Administer prescribed oxytocin
D. Notify the healthcare provider immediately
CORRECT ANSWER B. Assess the bladder for distension
RATIONALE A dextroverted (displaced to the right) uterus elevated above the umbilicus strongly indicates bladder distension
pushing the uterus upward and to the side. A full bladder prevents effective uterine contraction and increases
postpartum hemorrhage risk. The first action is to assess for bladder distension and assist the client to void, then
reassess fundal position.
, 2. The PN notes that a UAP is ambulating a male client who had a stroke and has right-sided weakness. The UAP is
walking on the client's left side. Which action should the PN take?
A. Praise the UAP for proper ambulation technique
B. Instruct the UAP to walk on the client's affected side
C. Document that the UAP needs additional training
D. Report the UAP to the nurse manager
CORRECT ANSWER B. Instruct the UAP to walk on the client's affected side
RATIONALE When ambulating a client with unilateral weakness, the caregiver should stand on the affected (weaker) side to
provide support and prevent falls. The client has right-sided weakness, so the UAP should walk on the client's
right side. The PN should immediately correct this safety issue with direct instruction before documenting or
escalating.
3. The PN administers an injection using a syringe with a retractable needle. After the needle is removed from the client's
skin, the needle does not retract, and the PN gets stuck in the finger with the used needle. What action should the PN
take first?
A. Complete an incident report
B. Cleanse the finger with soap and water
C. Notify the employee health department
D. Obtain baseline lab work from the client
CORRECT ANSWER B. Cleanse the finger with soap and water
RATIONALE The first action after a needlestick injury is immediate wound care—cleanse the site thoroughly with soap and
water to reduce the risk of bloodborne pathogen transmission. Incident reporting, employee health notification,
and baseline lab work are all necessary subsequent steps, but wound cleansing takes priority to minimize
exposure. The site should be allowed to bleed freely before cleaning.
4. For the past six hours, a postoperative client has refused pain medication. When an opioid analgesic is finally
administered, the client has difficulty obtaining a satisfactory level of comfort. Which action is best for the PN to use in
assisting this client?
A. Administer a second dose of the opioid immediately
B. Guide the client through slow, rhythmic breathing
C. Tell the client the medication will take effect soon
D. Call the healthcare provider for a different analgesic
CORRECT ANSWER B. Guide the client through slow, rhythmic breathing
RATIONALE When pain medication has been delayed and the client is struggling to achieve comfort, non-pharmacologic
interventions should be implemented alongside the medication. Slow, rhythmic breathing reduces muscle
tension, decreases anxiety, and enhances relaxation—complementing the analgesic effect. A second dose cannot
be given without a specific order and risks oversedation. Reassurance alone is insufficient. Calling the provider is
premature.
