HESI PN EXIT EXAM V3 LATEST VERSION 2025 ALL 110
QUESTIONS AND VERIFIED ANSWERS PLUS RATIONALES/PN
HESI EXIT EXAM V3
Question 1
A Licensed Practical Nurse (LPN) is caring for a client with a new prescription
for digoxin. Which of the following findings would require the LPN to hold the
medication and notify the Registered Nurse (RN) or provider?
A) Apical pulse 72/min
B) Blood pressure 120/80 mmHg
C) Serum potassium 3.0 mEq/L
D) Respiratory rate 18/min
E) Temperature 98.6°F (37°C)
Correct Answer: C) Serum potassium 3.0 mEq/L
Rationale: Hypokalemia (low potassium) can potentiate digoxin
toxicity, even with therapeutic digoxin levels. An apical pulse below
60/min would also warrant holding the medication, but a low
potassium level is a critical predisposing factor to toxicity.
Question 2
An LPN is providing discharge teaching to a client diagnosed with newly
prescribed warfarin. Which of the following instructions should the LPN
include?
A) "Increase your intake of leafy green vegetables to prevent constipation."
B) "Take aspirin daily to prevent blood clots."
C) "Report any unusual bruising or bleeding to your provider."
D) "You can stop taking the medication once your symptoms improve."
E) "Avoid all physical activity to prevent injury."
Correct Answer: C) "Report any unusual bruising or bleeding to your
provider."
Rationale: Warfarin is an anticoagulant (blood thinner) that
increases the risk of bleeding. Clients should be instructed to report
any signs of excessive bleeding (e.g., unusual bruising, nosebleeds,
blood in urine/stool) immediately.
Question 3
A client with type 2 diabetes mellitus is prescribed metformin. The LPN
should recognize that this medication works by:
A) Stimulating the pancreas to produce more insulin.
B) Increasing glucose absorption from the gastrointestinal tract.
C) Decreasing hepatic glucose production and increasing insulin
sensitivity.
D) Replacing insulin that the body cannot produce.
,E) Causing the kidneys to excrete more glucose.
Correct Answer: C) Decreasing hepatic glucose production and
increasing insulin sensitivity.
Rationale: Metformin (a biguanide) primarily reduces glucose
production by the liver and improves insulin sensitivity in peripheral
tissues, leading to better glucose uptake by cells.
Question 4
An LPN is assisting with the care of a client who is NPO and receiving total
parenteral nutrition (TPN). Which of the following actions should the LPN
perform?
A) Administer the TPN via a peripheral IV line.
B) Monitor the client's blood glucose levels regularly.
C) Discontinue the TPN immediately if the client develops a fever.
D) Flush the TPN line with saline every 4 hours.
E) Encourage the client to chew ice chips to relieve thirst.
Correct Answer: B) Monitor the client's blood glucose levels
regularly.
Rationale: TPN solutions are high in glucose, so clients receiving
TPN are at risk for hyperglycemia. Regular blood glucose monitoring
is essential. TPN is typically administered via a central line, and
abrupt discontinuation should be avoided.
Question 5
An LPN is caring for a client with a nasogastric (NG) tube connected to low
intermittent suction. The LPN notes gastric distention and no drainage in the
suction canister. What is the first action the LPN should take?
A) Increase the suction setting.
B) Irrigate the NG tube with normal saline.
C) Reposition the NG tube.
D) Clamp the NG tube.
E) Administer an antiemetic.
Correct Answer: C) Reposition the NG tube.
Rationale: If an NG tube is not draining, the most common cause is
displacement or the tip resting against the gastric wall.
Repositioning the client or gently repositioning the tube itself (if
allowed by facility policy and without resistance) is the first action.
If this fails, irrigation might be considered.
Question 6
A client reports dull, aching pain in their lower back after lifting a heavy
, object. The LPN should initially recommend which of the following
interventions?
A) Apply heat to the affected area.
B) Perform vigorous stretching exercises.
C) Maintain bed rest for several days.
D) Apply ice to the affected area.
E) Take a strong opioid pain reliever.
Correct Answer: D) Apply ice to the affected area.
Rationale: For acute musculoskeletal injuries (like a muscle strain
from lifting), RICE (Rest, Ice, Compression, Elevation) is the initial
treatment. Ice helps reduce inflammation and pain in the acute
phase. Heat is generally for chronic pain or muscle relaxation after
the acute phase.
Question 7
An LPN is preparing to administer an intramuscular (IM) injection to an adult
client. Which of the following sites is appropriate for administering more than
2 mL of medication?
A) Deltoid
B) Vastus lateralis
C) Dorsogluteal
D) Rectus femoris
E) Ventrogluteal
Correct Answer: E) Ventrogluteal
Rationale: The ventrogluteal site is the preferred and safest site for
IM injections in adults, especially for volumes greater than 2 mL,
due to its large muscle mass, distance from major nerves and blood
vessels, and reduced risk of fat injection. The dorsogluteal is
generally avoided due to sciatic nerve risk.
Question 8
A client with heart failure is prescribed furosemide. The LPN should monitor
for which of the following adverse effects?
A) Hyperkalemia
B) Bradycardia
C) Hypokalemia
D) Hypertension
E) Constipation
Correct Answer: C) Hypokalemia
Rationale: Furosemide is a loop diuretic, which works by increasing
the excretion of sodium, chloride, and potassium. Therefore,
QUESTIONS AND VERIFIED ANSWERS PLUS RATIONALES/PN
HESI EXIT EXAM V3
Question 1
A Licensed Practical Nurse (LPN) is caring for a client with a new prescription
for digoxin. Which of the following findings would require the LPN to hold the
medication and notify the Registered Nurse (RN) or provider?
A) Apical pulse 72/min
B) Blood pressure 120/80 mmHg
C) Serum potassium 3.0 mEq/L
D) Respiratory rate 18/min
E) Temperature 98.6°F (37°C)
Correct Answer: C) Serum potassium 3.0 mEq/L
Rationale: Hypokalemia (low potassium) can potentiate digoxin
toxicity, even with therapeutic digoxin levels. An apical pulse below
60/min would also warrant holding the medication, but a low
potassium level is a critical predisposing factor to toxicity.
Question 2
An LPN is providing discharge teaching to a client diagnosed with newly
prescribed warfarin. Which of the following instructions should the LPN
include?
A) "Increase your intake of leafy green vegetables to prevent constipation."
B) "Take aspirin daily to prevent blood clots."
C) "Report any unusual bruising or bleeding to your provider."
D) "You can stop taking the medication once your symptoms improve."
E) "Avoid all physical activity to prevent injury."
Correct Answer: C) "Report any unusual bruising or bleeding to your
provider."
Rationale: Warfarin is an anticoagulant (blood thinner) that
increases the risk of bleeding. Clients should be instructed to report
any signs of excessive bleeding (e.g., unusual bruising, nosebleeds,
blood in urine/stool) immediately.
Question 3
A client with type 2 diabetes mellitus is prescribed metformin. The LPN
should recognize that this medication works by:
A) Stimulating the pancreas to produce more insulin.
B) Increasing glucose absorption from the gastrointestinal tract.
C) Decreasing hepatic glucose production and increasing insulin
sensitivity.
D) Replacing insulin that the body cannot produce.
,E) Causing the kidneys to excrete more glucose.
Correct Answer: C) Decreasing hepatic glucose production and
increasing insulin sensitivity.
Rationale: Metformin (a biguanide) primarily reduces glucose
production by the liver and improves insulin sensitivity in peripheral
tissues, leading to better glucose uptake by cells.
Question 4
An LPN is assisting with the care of a client who is NPO and receiving total
parenteral nutrition (TPN). Which of the following actions should the LPN
perform?
A) Administer the TPN via a peripheral IV line.
B) Monitor the client's blood glucose levels regularly.
C) Discontinue the TPN immediately if the client develops a fever.
D) Flush the TPN line with saline every 4 hours.
E) Encourage the client to chew ice chips to relieve thirst.
Correct Answer: B) Monitor the client's blood glucose levels
regularly.
Rationale: TPN solutions are high in glucose, so clients receiving
TPN are at risk for hyperglycemia. Regular blood glucose monitoring
is essential. TPN is typically administered via a central line, and
abrupt discontinuation should be avoided.
Question 5
An LPN is caring for a client with a nasogastric (NG) tube connected to low
intermittent suction. The LPN notes gastric distention and no drainage in the
suction canister. What is the first action the LPN should take?
A) Increase the suction setting.
B) Irrigate the NG tube with normal saline.
C) Reposition the NG tube.
D) Clamp the NG tube.
E) Administer an antiemetic.
Correct Answer: C) Reposition the NG tube.
Rationale: If an NG tube is not draining, the most common cause is
displacement or the tip resting against the gastric wall.
Repositioning the client or gently repositioning the tube itself (if
allowed by facility policy and without resistance) is the first action.
If this fails, irrigation might be considered.
Question 6
A client reports dull, aching pain in their lower back after lifting a heavy
, object. The LPN should initially recommend which of the following
interventions?
A) Apply heat to the affected area.
B) Perform vigorous stretching exercises.
C) Maintain bed rest for several days.
D) Apply ice to the affected area.
E) Take a strong opioid pain reliever.
Correct Answer: D) Apply ice to the affected area.
Rationale: For acute musculoskeletal injuries (like a muscle strain
from lifting), RICE (Rest, Ice, Compression, Elevation) is the initial
treatment. Ice helps reduce inflammation and pain in the acute
phase. Heat is generally for chronic pain or muscle relaxation after
the acute phase.
Question 7
An LPN is preparing to administer an intramuscular (IM) injection to an adult
client. Which of the following sites is appropriate for administering more than
2 mL of medication?
A) Deltoid
B) Vastus lateralis
C) Dorsogluteal
D) Rectus femoris
E) Ventrogluteal
Correct Answer: E) Ventrogluteal
Rationale: The ventrogluteal site is the preferred and safest site for
IM injections in adults, especially for volumes greater than 2 mL,
due to its large muscle mass, distance from major nerves and blood
vessels, and reduced risk of fat injection. The dorsogluteal is
generally avoided due to sciatic nerve risk.
Question 8
A client with heart failure is prescribed furosemide. The LPN should monitor
for which of the following adverse effects?
A) Hyperkalemia
B) Bradycardia
C) Hypokalemia
D) Hypertension
E) Constipation
Correct Answer: C) Hypokalemia
Rationale: Furosemide is a loop diuretic, which works by increasing
the excretion of sodium, chloride, and potassium. Therefore,
