Elsevier HESI
TIXE • NP
E Health Education Systems, Inc.
EMPOWERING KNOWLEDGE
EST. 1880
Exit HESI PN — Complete Comprehensive Review
P R A C T I C A L N U R S E E X I T E X A M I N AT I O N — Q U E ST I O N S 1 – 7 7
INSTITUTION Elsevier / Health Education Systems, Inc. EXAM CODE HESI-PN-EXIT-2026
PROGRAM HESI PN Exit Examination ACADEMIC YEAR
EXAM TITLE Exit HESI PN — Complete Review (1–77) TOTAL QUESTIONS 77 Questions — All Topics
COURSE TITLE HESI PN Exit Examination Review FORMAT Multiple Choice / Select All That Apply
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless "Select All That Apply" is specified.
▸ Questions cover all PN exit exam domains: medical-surgical, maternal-newborn, pediatrics, mental health, pharmacology,
fundamentals, delegation, and professional practice.
▸ Distinguish carefully between PN scope of practice, RN responsibilities, and tasks appropriate for UAP delegation.
▸ Correct answers and detailed rationales appear below each question for comprehensive review.
▸ All content is derived from the HESI PN Exit Examination practice test bank — verified for accuracy.
SECTION I — COMPLETE PN EXIT EXAMINATION REVIEW Questions 1 – 77
1. What steps should you take for an older female client who was just admitted to a long-term facility and is
confused about the day of the week?
A. Document the confusion and notify the healthcare provider immediately
B. Remind the client what day of the week it is
C. Place a calendar in the client's room without additional explanation
D. Request a psychiatric consultation for cognitive impairment
CORRECT ANSWER B — Remind the client what day of the week it is
RATIONALE New admission to a long-term care facility is disorienting. Providing gentle reorientation by reminding the
client of the day is the appropriate first intervention. This is not necessarily pathological confusion —
relocation stress and environmental change commonly cause transient disorientation that responds to
simple reorientation.
,2. Which information about end-of-life care should a practical nurse (PN) ensure the client has?
A. The family makes all decisions about end-of-life care
B. Instructions for care should be included in the client's living will (advance directives)
C. Hospice care can only be provided in a hospital setting
D. Life-sustaining treatment must always be continued regardless of client wishes
CORRECT ANSWER B — Instructions for care should be included in the client's living will (advance directives)
RATIONALE A living will is part of advance directives that specify a client's wishes regarding end-of-life care. The PN must
ensure clients understand that their care preferences can and should be documented in advance directives,
which guide healthcare providers when the client cannot communicate their wishes.
3. After a routine vaginal delivery of a healthy newborn, a client is taken to the recovery room. You notice the client is
shaking and asks if she's cold. What's next?
A. Notify the healthcare provider immediately for possible hemorrhage
B. Apply light warm blanket and assure her that this is normal following delivery
C. Take the client's temperature and administer antipyretics
D. Place the client in Trendelenburg position
CORRECT ANSWER B — Apply light warm blanket and assure her that this is normal following delivery
RATIONALE Postpartum shaking chills are a common, benign phenomenon caused by hormonal shifts, vasomotor
changes, and the body's response to the exertion of labor. Providing warmth and reassurance is appropriate.
This is not typically indicative of hemorrhage or infection unless accompanied by other concerning signs.
4. The practical nurse (PN) is assessing an older client with left-sided heart failure. What intervention is most
important for the PN to implement?
A. Check peripheral pulses in all four extremities
B. Auscultate all the lung fields
C. Measure abdominal girth
D. Assess for pedal edema
CORRECT ANSWER B — Auscultate all the lung fields
RATIONALE Left-sided heart failure causes pulmonary congestion as blood backs up into the pulmonary circulation.
Auscultating lung fields for crackles, wheezes, or diminished breath sounds is the most important assessment
to detect pulmonary edema — a life-threatening complication of left-sided heart failure.
5. What is the most crucial step for the practical nurse to take while giving prescription medication to an elderly
resident of an extended care home who is having trouble hearing?
A. Administer the medication without verbal communication to save time
B. Determine if client has had difficulty hearing in the past
C. Shout the medication instructions loudly
D. Write the instructions down without speaking
CORRECT ANSWER B — Determine if client has had difficulty hearing in the past
RATIONALE Assessment is the first step of the nursing process. Determining whether the hearing difficulty is a new onset
(potentially indicating an acute problem requiring further evaluation) or a chronic condition helps the PN
determine the appropriate approach. If chronic, the PN can implement established communication
strategies.
, 6. A full-term 24-hour-old infant in the nursery regurgitates and suddenly turns cyanotic. Which immediate
intervention should the practical nurse (PN) take?
A. Begin chest compressions immediately
B. Turn the infant to the right side
C. Administer oxygen via face mask
D. Call a code blue
CORRECT ANSWER B — Turn the infant to the right side
RATIONALE Regurgitation with cyanosis suggests aspiration or airway obstruction. Positioning the infant on the right side
facilitates drainage of secretions and helps clear the airway while reducing risk of further aspiration. This is
the immediate first action before escalating interventions.
7. The practical nurse (PN) views the midline episiotomy of a client who reports pain in her stitches. What action
should the PN take first?
A. Administer prescribed pain medication immediately
B. Observe suture line for separation and hematoma formation
C. Apply an ice pack to the perineal area
D. Document the client's complaint in the chart
CORRECT ANSWER B — Observe suture line for separation and hematoma formation
RATIONALE Assessment must precede intervention. Before treating pain, the PN must inspect the episiotomy site for
complications such as wound dehiscence, hematoma, or signs of infection that could be causing the pain.
REEDA assessment (Redness, Edema, Ecchymosis, Discharge, Approximation) should be performed.
8. The practical nurse (PN) is obtaining fetal heart rates on a client in their third trimester of pregnancy. What fetal
heart rate should be reported to the registered nurse?
A. 120 beats per minute
B. 140 beats per minute
C. 160 beats per minute
D. 180 beats per minute
CORRECT ANSWER D — 180 beats per minute
RATIONALE Normal fetal heart rate ranges from 110–160 bpm. A rate of 180 bpm indicates fetal tachycardia, which can be
caused by maternal fever, infection, fetal hypoxia, or medications. This finding requires immediate reporting
to the RN for further assessment and intervention.
9. An older client who had a colon resection 8 days ago is straining at stool. The PN observes bowel appearing on the
skin. Which complication has occurred?
A. Dehiscence
B. Evisceration
C. Herniation
D. Fistula formation
CORRECT ANSWER B — Evisceration
RATIONALE Evisceration is the protrusion of abdominal contents (bowel) through a wound dehiscence. This is a surgical
emergency. The PN should cover the protruding bowel with sterile saline-soaked dressings, keep the client
NPO, position the client to reduce abdominal tension, and notify the surgeon immediately.
TIXE • NP
E Health Education Systems, Inc.
EMPOWERING KNOWLEDGE
EST. 1880
Exit HESI PN — Complete Comprehensive Review
P R A C T I C A L N U R S E E X I T E X A M I N AT I O N — Q U E ST I O N S 1 – 7 7
INSTITUTION Elsevier / Health Education Systems, Inc. EXAM CODE HESI-PN-EXIT-2026
PROGRAM HESI PN Exit Examination ACADEMIC YEAR
EXAM TITLE Exit HESI PN — Complete Review (1–77) TOTAL QUESTIONS 77 Questions — All Topics
COURSE TITLE HESI PN Exit Examination Review FORMAT Multiple Choice / Select All That Apply
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless "Select All That Apply" is specified.
▸ Questions cover all PN exit exam domains: medical-surgical, maternal-newborn, pediatrics, mental health, pharmacology,
fundamentals, delegation, and professional practice.
▸ Distinguish carefully between PN scope of practice, RN responsibilities, and tasks appropriate for UAP delegation.
▸ Correct answers and detailed rationales appear below each question for comprehensive review.
▸ All content is derived from the HESI PN Exit Examination practice test bank — verified for accuracy.
SECTION I — COMPLETE PN EXIT EXAMINATION REVIEW Questions 1 – 77
1. What steps should you take for an older female client who was just admitted to a long-term facility and is
confused about the day of the week?
A. Document the confusion and notify the healthcare provider immediately
B. Remind the client what day of the week it is
C. Place a calendar in the client's room without additional explanation
D. Request a psychiatric consultation for cognitive impairment
CORRECT ANSWER B — Remind the client what day of the week it is
RATIONALE New admission to a long-term care facility is disorienting. Providing gentle reorientation by reminding the
client of the day is the appropriate first intervention. This is not necessarily pathological confusion —
relocation stress and environmental change commonly cause transient disorientation that responds to
simple reorientation.
,2. Which information about end-of-life care should a practical nurse (PN) ensure the client has?
A. The family makes all decisions about end-of-life care
B. Instructions for care should be included in the client's living will (advance directives)
C. Hospice care can only be provided in a hospital setting
D. Life-sustaining treatment must always be continued regardless of client wishes
CORRECT ANSWER B — Instructions for care should be included in the client's living will (advance directives)
RATIONALE A living will is part of advance directives that specify a client's wishes regarding end-of-life care. The PN must
ensure clients understand that their care preferences can and should be documented in advance directives,
which guide healthcare providers when the client cannot communicate their wishes.
3. After a routine vaginal delivery of a healthy newborn, a client is taken to the recovery room. You notice the client is
shaking and asks if she's cold. What's next?
A. Notify the healthcare provider immediately for possible hemorrhage
B. Apply light warm blanket and assure her that this is normal following delivery
C. Take the client's temperature and administer antipyretics
D. Place the client in Trendelenburg position
CORRECT ANSWER B — Apply light warm blanket and assure her that this is normal following delivery
RATIONALE Postpartum shaking chills are a common, benign phenomenon caused by hormonal shifts, vasomotor
changes, and the body's response to the exertion of labor. Providing warmth and reassurance is appropriate.
This is not typically indicative of hemorrhage or infection unless accompanied by other concerning signs.
4. The practical nurse (PN) is assessing an older client with left-sided heart failure. What intervention is most
important for the PN to implement?
A. Check peripheral pulses in all four extremities
B. Auscultate all the lung fields
C. Measure abdominal girth
D. Assess for pedal edema
CORRECT ANSWER B — Auscultate all the lung fields
RATIONALE Left-sided heart failure causes pulmonary congestion as blood backs up into the pulmonary circulation.
Auscultating lung fields for crackles, wheezes, or diminished breath sounds is the most important assessment
to detect pulmonary edema — a life-threatening complication of left-sided heart failure.
5. What is the most crucial step for the practical nurse to take while giving prescription medication to an elderly
resident of an extended care home who is having trouble hearing?
A. Administer the medication without verbal communication to save time
B. Determine if client has had difficulty hearing in the past
C. Shout the medication instructions loudly
D. Write the instructions down without speaking
CORRECT ANSWER B — Determine if client has had difficulty hearing in the past
RATIONALE Assessment is the first step of the nursing process. Determining whether the hearing difficulty is a new onset
(potentially indicating an acute problem requiring further evaluation) or a chronic condition helps the PN
determine the appropriate approach. If chronic, the PN can implement established communication
strategies.
, 6. A full-term 24-hour-old infant in the nursery regurgitates and suddenly turns cyanotic. Which immediate
intervention should the practical nurse (PN) take?
A. Begin chest compressions immediately
B. Turn the infant to the right side
C. Administer oxygen via face mask
D. Call a code blue
CORRECT ANSWER B — Turn the infant to the right side
RATIONALE Regurgitation with cyanosis suggests aspiration or airway obstruction. Positioning the infant on the right side
facilitates drainage of secretions and helps clear the airway while reducing risk of further aspiration. This is
the immediate first action before escalating interventions.
7. The practical nurse (PN) views the midline episiotomy of a client who reports pain in her stitches. What action
should the PN take first?
A. Administer prescribed pain medication immediately
B. Observe suture line for separation and hematoma formation
C. Apply an ice pack to the perineal area
D. Document the client's complaint in the chart
CORRECT ANSWER B — Observe suture line for separation and hematoma formation
RATIONALE Assessment must precede intervention. Before treating pain, the PN must inspect the episiotomy site for
complications such as wound dehiscence, hematoma, or signs of infection that could be causing the pain.
REEDA assessment (Redness, Edema, Ecchymosis, Discharge, Approximation) should be performed.
8. The practical nurse (PN) is obtaining fetal heart rates on a client in their third trimester of pregnancy. What fetal
heart rate should be reported to the registered nurse?
A. 120 beats per minute
B. 140 beats per minute
C. 160 beats per minute
D. 180 beats per minute
CORRECT ANSWER D — 180 beats per minute
RATIONALE Normal fetal heart rate ranges from 110–160 bpm. A rate of 180 bpm indicates fetal tachycardia, which can be
caused by maternal fever, infection, fetal hypoxia, or medications. This finding requires immediate reporting
to the RN for further assessment and intervention.
9. An older client who had a colon resection 8 days ago is straining at stool. The PN observes bowel appearing on the
skin. Which complication has occurred?
A. Dehiscence
B. Evisceration
C. Herniation
D. Fistula formation
CORRECT ANSWER B — Evisceration
RATIONALE Evisceration is the protrusion of abdominal contents (bowel) through a wound dehiscence. This is a surgical
emergency. The PN should cover the protruding bowel with sterile saline-soaked dressings, keep the client
NPO, position the client to reduce abdominal tension, and notify the surgeon immediately.
