1
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HESI PN EXIT EXAM – VERSION 3 (V3)
| 100 VERIFIED QUESTIONS WITH
CORRECT ANSWERS & RATIONALES |
UPDATED FOR 2025–2026
, 2
1. A nurse is caring for a client with COPD who is experiencing increased shortness of
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breath. What is the nurse’s priority action?
1. Increase oxygen to 6 L/min via nasal cannula
2. Place the client in supine position
✔ 3. Assist the client to sit in high-Fowler’s position
3. Administer a sedative to help the client relax
✔ Answer: 3
📘 Rationale: High-Fowler’s position promotes lung expansion and reduces the work of
breathing by maximizing diaphragmatic excursion. Increasing oxygen without an order may
cause CO₂ retention in COPD clients. Supine positioning restricts chest expansion, and
sedatives can depress respiratory drive. Prioritizing positioning is a safe and effective first
intervention.
2. A client is receiving digoxin for heart failure. Which finding requires immediate action?
1. Heart rate of 72 bpm
2. Serum potassium of 4.2 mEq/L
✔ 3. Client reports seeing yellow halos
3. Blood pressure of 122/78 mmHg
✔ Answer: 3
📘 Rationale: Visual disturbances like yellow or green halos are classic signs of digoxin
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toxicity. This is a medical emergency requiring immediate provider notification and serum
digoxin level evaluation. The heart rate and potassium level are within normal ranges, and BP
is stable.
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3. A nurse is reviewing lab results for a client on warfarin. The INR is 4.5. What is the
nurse’s best action?
✔ 1. Hold the next dose and notify the provider
2. Document the result as normal
3. Administer vitamin B12
4. Encourage more green leafy vegetables
✔ Answer: 1
📘 Rationale: A therapeutic INR for warfarin is typically 2.0–3.0. An INR of 4.5 places the
client at risk for bleeding. Holding the dose and notifying the provider is the correct response.
Administering vitamin K may be ordered, not B12. Encouraging more leafy vegetables could
worsen fluctuation in warfarin effectiveness.
4. A client post-op day 1 after abdominal surgery reports gas pains and abdominal distension.
What should the nurse do first?
1. Notify the provider
✔ 2. Assist the client to ambulate
2. Administer pain medication
3. Restrict oral fluids
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✔ Answer: 2
📘 Rationale: Early ambulation promotes peristalsis and relieves gas pains after abdominal
surgery. Walking helps stimulate bowel activity, relieving discomfort naturally. Pain meds
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might mask symptoms, and restricting fluids delays bowel recovery. No need to notify the
provider unless other complications arise.
5. A nurse prepares to administer an intramuscular injection to a 6-month-old infant. Which
site is most appropriate?
✔ 1. Vastus lateralis
2. Deltoid muscle
3. Dorsogluteal site
4. Ventrogluteal site
✔ Answer: 1
📘 Rationale: The vastus lateralis is the safest and most recommended site for IM injections
in infants under 12 months due to its well-developed muscle mass and low risk of nerve
injury. The deltoid and gluteal sites are avoided in this age group.
6. A client has been prescribed furosemide. Which assessment is most important before
administration?
✔ 1. Blood pressure and potassium level
2. Blood glucose and weight
Page | 1
HESI PN EXIT EXAM – VERSION 3 (V3)
| 100 VERIFIED QUESTIONS WITH
CORRECT ANSWERS & RATIONALES |
UPDATED FOR 2025–2026
, 2
1. A nurse is caring for a client with COPD who is experiencing increased shortness of
Page | 2
breath. What is the nurse’s priority action?
1. Increase oxygen to 6 L/min via nasal cannula
2. Place the client in supine position
✔ 3. Assist the client to sit in high-Fowler’s position
3. Administer a sedative to help the client relax
✔ Answer: 3
📘 Rationale: High-Fowler’s position promotes lung expansion and reduces the work of
breathing by maximizing diaphragmatic excursion. Increasing oxygen without an order may
cause CO₂ retention in COPD clients. Supine positioning restricts chest expansion, and
sedatives can depress respiratory drive. Prioritizing positioning is a safe and effective first
intervention.
2. A client is receiving digoxin for heart failure. Which finding requires immediate action?
1. Heart rate of 72 bpm
2. Serum potassium of 4.2 mEq/L
✔ 3. Client reports seeing yellow halos
3. Blood pressure of 122/78 mmHg
✔ Answer: 3
📘 Rationale: Visual disturbances like yellow or green halos are classic signs of digoxin
, 3
toxicity. This is a medical emergency requiring immediate provider notification and serum
digoxin level evaluation. The heart rate and potassium level are within normal ranges, and BP
is stable.
Page | 3
3. A nurse is reviewing lab results for a client on warfarin. The INR is 4.5. What is the
nurse’s best action?
✔ 1. Hold the next dose and notify the provider
2. Document the result as normal
3. Administer vitamin B12
4. Encourage more green leafy vegetables
✔ Answer: 1
📘 Rationale: A therapeutic INR for warfarin is typically 2.0–3.0. An INR of 4.5 places the
client at risk for bleeding. Holding the dose and notifying the provider is the correct response.
Administering vitamin K may be ordered, not B12. Encouraging more leafy vegetables could
worsen fluctuation in warfarin effectiveness.
4. A client post-op day 1 after abdominal surgery reports gas pains and abdominal distension.
What should the nurse do first?
1. Notify the provider
✔ 2. Assist the client to ambulate
2. Administer pain medication
3. Restrict oral fluids
, 4
✔ Answer: 2
📘 Rationale: Early ambulation promotes peristalsis and relieves gas pains after abdominal
surgery. Walking helps stimulate bowel activity, relieving discomfort naturally. Pain meds
Page | 4
might mask symptoms, and restricting fluids delays bowel recovery. No need to notify the
provider unless other complications arise.
5. A nurse prepares to administer an intramuscular injection to a 6-month-old infant. Which
site is most appropriate?
✔ 1. Vastus lateralis
2. Deltoid muscle
3. Dorsogluteal site
4. Ventrogluteal site
✔ Answer: 1
📘 Rationale: The vastus lateralis is the safest and most recommended site for IM injections
in infants under 12 months due to its well-developed muscle mass and low risk of nerve
injury. The deltoid and gluteal sites are avoided in this age group.
6. A client has been prescribed furosemide. Which assessment is most important before
administration?
✔ 1. Blood pressure and potassium level
2. Blood glucose and weight
