Elsevier Health Sciences
ISEH TIXE NP
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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
PN Exit HESI Comprehensive Examination
P R A C T I C A L N U R S I N G · M E D I C A L-S U R G I C A L · M AT E R N A L- N E W B O R N · P E D I AT R I C · M E N TA L H E A LT H ·
P H A R M A CO LO G Y
INSTITUTION Elsevier Health Sciences / HESI Testing COURSE CODE PN-EXIT-HESI-2026
PROGRAM Practical Nursing (PN) · NCLEX-PN ACADEMIC YEAR
Preparation
EXAM TITLE PN Exit HESI — Comprehensive Practice TOTAL QUESTIONS 75 Questions
Examination
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 all PN content areas: medical-surgical, pharmacology, maternal-newborn, pediatric, mental health, and professional
practice.
▸ Select the single best answer for each question unless "Select all that apply" is explicitly stated.
▸ Clinical judgment questions require prioritization using ABC (Airway-Breathing-Circulation), Maslow's hierarchy, and nursing process
frameworks.
▸ Correct answers and detailed rationales appear below each question for comprehensive NCLEX-PN exam preparation.
▸ All content reflects current HESI Exit Exam and NCLEX-PN test plan standards.
MEDICAL-SURGICAL · PHARMACOLOGY · MATERNAL-NEWBORN · PEDIATRIC · Questions
MENTAL HEALTH · PROFESSIONAL PRACTICE 1 – 75
1. Which client information is most important for the PN to consider when providing instructions to the unlicensed
assistive personnel about providing morning care to a postoperative client?
A. The client is oriented to person only
B. Urinary output of 50 mL/hour
C. The client had surgery 24 hours ago
D. The client requests a shower rather than bed bath
CORRECT ANSWER B. Urinary output of 50 mL/hour
RATIONALE Urinary output of 50 mL/hour (within the expected minimum of 30 mL/hr) indicates adequate renal perfusion—a
critical postoperative assessment. The UAP should be instructed to report any decrease. While orientation status
and surgery timing matter, hemodynamic stability (organ perfusion evidenced by urine output) takes priority in
postoperative delegation instructions to UAPs.
, 2. The PN is caring for a client with coronary artery disease admitted with intermittent chest pain. Admission labs indicate
elevations in troponin I and CK-MB. What should the PN consider the most significant risk for this client on the second
day of admission?
A. Development of pneumonia due to immobility
B. The lab results indicate myocardial damage, and the client is at risk for cardiac dysrhythmias
C. Deep vein thrombosis from prolonged bed rest
D. Urinary retention from medication side effects
CORRECT ANSWER B. The lab results indicate myocardial damage, and the client is at risk for cardiac dysrhythmias
RATIONALE Elevated troponin I and CK-MB are cardiac biomarkers confirming myocardial necrosis. Days 1–3 post-MI carry the
highest risk for lethal dysrhythmias (ventricular tachycardia/fibrillation) due to electrical instability of the injured
myocardium. While pneumonia, DVT, and urinary retention are potential complications, cardiac dysrhythmia is
the most life-threatening and requires vigilant monitoring.
3. An older adult female is admitted with syncope and lab findings indicate hemoglobin of 8.0 g/dL. She has a recent
history of headaches and frequent falls. Admission prescription includes continuation of all home medications. Which
medication should the PN withhold until consulting with the charge nurse?
A. Calcium carbonate
B. Aspirin
C. Levothyroxine
D. Metformin
CORRECT ANSWER B. Aspirin
RATIONALE Aspirin is an antiplatelet agent that can cause or worsen gastrointestinal bleeding, contributing to anemia (Hgb
8.0 g/dL). With syncope, headaches, and falls potentially related to anemia, continuing aspirin may exacerbate
occult bleeding. Calcium carbonate, levothyroxine, and metformin do not directly worsen anemia or bleeding risk.
The PN should withhold aspirin and consult the charge nurse before administration.
4. Prior to administering pain medication to an adult postoperative client, what information should the PN obtain?
(Select all that apply.)
A. Time of last administration of pain medication
B. Client's pain rating on a scale of 1 to 10
C. Effectiveness of last pain medication administered
D. The client's insurance coverage for the medication
CORRECT ANSWER A, B, and C — Time of last administration; Client's pain rating on a scale of 1 to 10; Effectiveness of last pain
medication administered
RATIONALE Before administering pain medication, the PN must know when the last dose was given (to prevent overdose),
current pain intensity (to evaluate need), and prior medication effectiveness (to guide treatment). Insurance
coverage is not a clinical consideration for safe administration. These assessments align with the "right
assessment" and "right evaluation" components of medication administration.
ISEH TIXE NP
+
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
PN Exit HESI Comprehensive Examination
P R A C T I C A L N U R S I N G · M E D I C A L-S U R G I C A L · M AT E R N A L- N E W B O R N · P E D I AT R I C · M E N TA L H E A LT H ·
P H A R M A CO LO G Y
INSTITUTION Elsevier Health Sciences / HESI Testing COURSE CODE PN-EXIT-HESI-2026
PROGRAM Practical Nursing (PN) · NCLEX-PN ACADEMIC YEAR
Preparation
EXAM TITLE PN Exit HESI — Comprehensive Practice TOTAL QUESTIONS 75 Questions
Examination
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 all PN content areas: medical-surgical, pharmacology, maternal-newborn, pediatric, mental health, and professional
practice.
▸ Select the single best answer for each question unless "Select all that apply" is explicitly stated.
▸ Clinical judgment questions require prioritization using ABC (Airway-Breathing-Circulation), Maslow's hierarchy, and nursing process
frameworks.
▸ Correct answers and detailed rationales appear below each question for comprehensive NCLEX-PN exam preparation.
▸ All content reflects current HESI Exit Exam and NCLEX-PN test plan standards.
MEDICAL-SURGICAL · PHARMACOLOGY · MATERNAL-NEWBORN · PEDIATRIC · Questions
MENTAL HEALTH · PROFESSIONAL PRACTICE 1 – 75
1. Which client information is most important for the PN to consider when providing instructions to the unlicensed
assistive personnel about providing morning care to a postoperative client?
A. The client is oriented to person only
B. Urinary output of 50 mL/hour
C. The client had surgery 24 hours ago
D. The client requests a shower rather than bed bath
CORRECT ANSWER B. Urinary output of 50 mL/hour
RATIONALE Urinary output of 50 mL/hour (within the expected minimum of 30 mL/hr) indicates adequate renal perfusion—a
critical postoperative assessment. The UAP should be instructed to report any decrease. While orientation status
and surgery timing matter, hemodynamic stability (organ perfusion evidenced by urine output) takes priority in
postoperative delegation instructions to UAPs.
, 2. The PN is caring for a client with coronary artery disease admitted with intermittent chest pain. Admission labs indicate
elevations in troponin I and CK-MB. What should the PN consider the most significant risk for this client on the second
day of admission?
A. Development of pneumonia due to immobility
B. The lab results indicate myocardial damage, and the client is at risk for cardiac dysrhythmias
C. Deep vein thrombosis from prolonged bed rest
D. Urinary retention from medication side effects
CORRECT ANSWER B. The lab results indicate myocardial damage, and the client is at risk for cardiac dysrhythmias
RATIONALE Elevated troponin I and CK-MB are cardiac biomarkers confirming myocardial necrosis. Days 1–3 post-MI carry the
highest risk for lethal dysrhythmias (ventricular tachycardia/fibrillation) due to electrical instability of the injured
myocardium. While pneumonia, DVT, and urinary retention are potential complications, cardiac dysrhythmia is
the most life-threatening and requires vigilant monitoring.
3. An older adult female is admitted with syncope and lab findings indicate hemoglobin of 8.0 g/dL. She has a recent
history of headaches and frequent falls. Admission prescription includes continuation of all home medications. Which
medication should the PN withhold until consulting with the charge nurse?
A. Calcium carbonate
B. Aspirin
C. Levothyroxine
D. Metformin
CORRECT ANSWER B. Aspirin
RATIONALE Aspirin is an antiplatelet agent that can cause or worsen gastrointestinal bleeding, contributing to anemia (Hgb
8.0 g/dL). With syncope, headaches, and falls potentially related to anemia, continuing aspirin may exacerbate
occult bleeding. Calcium carbonate, levothyroxine, and metformin do not directly worsen anemia or bleeding risk.
The PN should withhold aspirin and consult the charge nurse before administration.
4. Prior to administering pain medication to an adult postoperative client, what information should the PN obtain?
(Select all that apply.)
A. Time of last administration of pain medication
B. Client's pain rating on a scale of 1 to 10
C. Effectiveness of last pain medication administered
D. The client's insurance coverage for the medication
CORRECT ANSWER A, B, and C — Time of last administration; Client's pain rating on a scale of 1 to 10; Effectiveness of last pain
medication administered
RATIONALE Before administering pain medication, the PN must know when the last dose was given (to prevent overdose),
current pain intensity (to evaluate need), and prior medication effectiveness (to guide treatment). Insurance
coverage is not a clinical consideration for safe administration. These assessments align with the "right
assessment" and "right evaluation" components of medication administration.
