HESI LPN EXIT Exam 2025/2026 –
Verified Questions with Strong
Clinical Rationales
Question 1
A client with type 2 diabetes reports nausea and vomiting. Blood glucose is 350 mg/dL. What is
the LPN’s priority action?
A. Administer insulin as ordered.
B. Assess for signs of diabetic ketoacidosis (DKA).
C. Encourage oral fluids.
D. Provide an antiemetic.
Correct Answer: B
Rationale: Nausea, vomiting, and elevated blood glucose suggest possible DKA, a medical
emergency. The LPN’s priority is to assess for DKA symptoms (e.g., fruity breath, Kussmaul
respirations) and report findings, per 2025 ADA guidelines. Administering insulin (A) requires a
provider order and confirmation of DKA. Oral fluids (C) are unsafe during vomiting, and
antiemetics (D) address symptoms, not the underlying issue.
Question 2
A client is prescribed warfarin 5 mg daily. The INR is 3.8. What should the LPN do?
A. Administer the dose as ordered.
B. Withhold the dose and notify the provider.
C. Reduce the dose to 2.5 mg.
D. Administer vitamin K.
Correct Answer: B
Rationale: An INR of 3.8 exceeds the therapeutic range (2.0–3.0) for warfarin, increasing
bleeding risk. The LPN should withhold the dose and notify the provider for adjustment, per
2025 ACCP guidelines. Administering (A) or reducing the dose (C) without orders is unsafe.
Vitamin K (D) is provider-ordered for severe bleeding.
,Question 3
An LPN delegates a task to a certified nursing assistant (CNA). Which task is appropriate?
A. Administering oral medications.
B. Assisting with ambulation.
C. Assessing a wound.
D. Developing a care plan.
Correct Answer: B
Rationale: CNAs can assist with ambulation, an appropriate task within their scope, per 2025
NCSBN guidelines. Administering medications (A), assessing wounds (C), and developing care
plans (D) are LPN responsibilities and cannot be delegated to unlicensed personnel.
Question 4
A client with a stage II pressure ulcer has serous drainage. What is the most appropriate
dressing?
A. Dry gauze.
B. Hydrocolloid dressing.
C. Wet-to-dry dressing.
D. Transparent film.
Correct Answer: B
Rationale: Stage II pressure ulcers with serous drainage require a moist healing environment.
Hydrocolloid dressings maintain moisture and promote healing, per 2025 NPIAP guidelines. Dry
gauze (A) adheres to the wound, wet-to-dry (C) is for debridement, and transparent film (D) is
for minimal exudate.
Question 5
A postpartum client reports heavy vaginal bleeding 6 hours after delivery. What is the LPN’s
priority action?
A. Encourage breastfeeding.
B. Assess the fundus and notify the provider.
C. Administer oxytocin as ordered.
D. Apply a perineal ice pack.
,Correct Answer: B
Rationale: Heavy bleeding post-delivery suggests postpartum hemorrhage, often due to uterine
atony. The LPN should assess the fundus (firmness, height) and notify the provider, per 2025
ACOG guidelines. Breastfeeding (A) stimulates oxytocin but is not immediate. Oxytocin (C)
requires an order, and ice packs (D) address swelling, not bleeding.
Question 6
A 4-year-old child with asthma is prescribed albuterol via nebulizer. The child becomes agitated
during treatment. What should the LPN do?
A. Discontinue the treatment.
B. Reassure the child and continue the treatment.
C. Administer a sedative.
D. Switch to a metered-dose inhaler.
Correct Answer: B
Rationale: Agitation during albuterol nebulizer treatment is common due to the medication’s
stimulant effects or the child’s anxiety. The LPN should reassure the child and continue, per
2025 NHLBI guidelines. Discontinuing (A) risks undertreatment, sedatives (C) are inappropriate,
and switching (D) requires a provider order.
Question 7
A client with bipolar disorder reports insomnia and racing thoughts. The LPN observes
pressured speech. What is the priority intervention?
A. Encourage group therapy.
B. Notify the provider of possible mania.
C. Administer a PRN sedative.
D. Teach relaxation techniques.
Correct Answer: B
Rationale: Insomnia, racing thoughts, and pressured speech suggest mania in bipolar disorder,
requiring provider notification for medication adjustment (e.g., mood stabilizers), per 2025 APA
guidelines. Group therapy (A) and relaxation (D) are adjunctive, and sedatives (C) require
orders and may not address mania.
, Question 8
A client with heart failure is prescribed furosemide 40 mg IV. The LPN notes a potassium level
of 3.2 mEq/L. What should the LPN do?
A. Administer the dose as ordered.
B. Withhold the dose and notify the provider.
C. Administer half the dose.
D. Encourage potassium-rich foods.
Correct Answer: B
Rationale: Hypokalemia (3.2 mEq/L) increases the risk of furosemide-induced arrhythmias. The
LPN should withhold the dose and notify the provider, per 2025 ACC guidelines. Administering
(A or C) is unsafe, and dietary potassium (D) is insufficient for acute correction.
Question 9
An LPN is caring for a client with a colostomy. The client reports irritation around the stoma.
What is the best intervention?
A. Apply petroleum jelly to the stoma.
B. Assess the skin and ensure proper pouch fit.
C. Cleanse with alcohol-based solution.
D. Change the pouch weekly.
Correct Answer: B
Rationale: Stoma irritation is often due to poor pouch fit or leakage. Assessing the skin and
ensuring proper fit prevents further damage, per 2025 WOCN guidelines. Petroleum jelly (A) is
occlusive, alcohol (C) irritates, and weekly changes (D) may be too infrequent.
Question 10
A pregnant client at 32 weeks gestation reports decreased fetal movement. What is the LPN’s
priority action?
A. Encourage hydration.
B. Perform a non-stress test and notify the provider.
C. Reassure the client.
D. Schedule a follow-up visit.
Correct Answer: B
Verified Questions with Strong
Clinical Rationales
Question 1
A client with type 2 diabetes reports nausea and vomiting. Blood glucose is 350 mg/dL. What is
the LPN’s priority action?
A. Administer insulin as ordered.
B. Assess for signs of diabetic ketoacidosis (DKA).
C. Encourage oral fluids.
D. Provide an antiemetic.
Correct Answer: B
Rationale: Nausea, vomiting, and elevated blood glucose suggest possible DKA, a medical
emergency. The LPN’s priority is to assess for DKA symptoms (e.g., fruity breath, Kussmaul
respirations) and report findings, per 2025 ADA guidelines. Administering insulin (A) requires a
provider order and confirmation of DKA. Oral fluids (C) are unsafe during vomiting, and
antiemetics (D) address symptoms, not the underlying issue.
Question 2
A client is prescribed warfarin 5 mg daily. The INR is 3.8. What should the LPN do?
A. Administer the dose as ordered.
B. Withhold the dose and notify the provider.
C. Reduce the dose to 2.5 mg.
D. Administer vitamin K.
Correct Answer: B
Rationale: An INR of 3.8 exceeds the therapeutic range (2.0–3.0) for warfarin, increasing
bleeding risk. The LPN should withhold the dose and notify the provider for adjustment, per
2025 ACCP guidelines. Administering (A) or reducing the dose (C) without orders is unsafe.
Vitamin K (D) is provider-ordered for severe bleeding.
,Question 3
An LPN delegates a task to a certified nursing assistant (CNA). Which task is appropriate?
A. Administering oral medications.
B. Assisting with ambulation.
C. Assessing a wound.
D. Developing a care plan.
Correct Answer: B
Rationale: CNAs can assist with ambulation, an appropriate task within their scope, per 2025
NCSBN guidelines. Administering medications (A), assessing wounds (C), and developing care
plans (D) are LPN responsibilities and cannot be delegated to unlicensed personnel.
Question 4
A client with a stage II pressure ulcer has serous drainage. What is the most appropriate
dressing?
A. Dry gauze.
B. Hydrocolloid dressing.
C. Wet-to-dry dressing.
D. Transparent film.
Correct Answer: B
Rationale: Stage II pressure ulcers with serous drainage require a moist healing environment.
Hydrocolloid dressings maintain moisture and promote healing, per 2025 NPIAP guidelines. Dry
gauze (A) adheres to the wound, wet-to-dry (C) is for debridement, and transparent film (D) is
for minimal exudate.
Question 5
A postpartum client reports heavy vaginal bleeding 6 hours after delivery. What is the LPN’s
priority action?
A. Encourage breastfeeding.
B. Assess the fundus and notify the provider.
C. Administer oxytocin as ordered.
D. Apply a perineal ice pack.
,Correct Answer: B
Rationale: Heavy bleeding post-delivery suggests postpartum hemorrhage, often due to uterine
atony. The LPN should assess the fundus (firmness, height) and notify the provider, per 2025
ACOG guidelines. Breastfeeding (A) stimulates oxytocin but is not immediate. Oxytocin (C)
requires an order, and ice packs (D) address swelling, not bleeding.
Question 6
A 4-year-old child with asthma is prescribed albuterol via nebulizer. The child becomes agitated
during treatment. What should the LPN do?
A. Discontinue the treatment.
B. Reassure the child and continue the treatment.
C. Administer a sedative.
D. Switch to a metered-dose inhaler.
Correct Answer: B
Rationale: Agitation during albuterol nebulizer treatment is common due to the medication’s
stimulant effects or the child’s anxiety. The LPN should reassure the child and continue, per
2025 NHLBI guidelines. Discontinuing (A) risks undertreatment, sedatives (C) are inappropriate,
and switching (D) requires a provider order.
Question 7
A client with bipolar disorder reports insomnia and racing thoughts. The LPN observes
pressured speech. What is the priority intervention?
A. Encourage group therapy.
B. Notify the provider of possible mania.
C. Administer a PRN sedative.
D. Teach relaxation techniques.
Correct Answer: B
Rationale: Insomnia, racing thoughts, and pressured speech suggest mania in bipolar disorder,
requiring provider notification for medication adjustment (e.g., mood stabilizers), per 2025 APA
guidelines. Group therapy (A) and relaxation (D) are adjunctive, and sedatives (C) require
orders and may not address mania.
, Question 8
A client with heart failure is prescribed furosemide 40 mg IV. The LPN notes a potassium level
of 3.2 mEq/L. What should the LPN do?
A. Administer the dose as ordered.
B. Withhold the dose and notify the provider.
C. Administer half the dose.
D. Encourage potassium-rich foods.
Correct Answer: B
Rationale: Hypokalemia (3.2 mEq/L) increases the risk of furosemide-induced arrhythmias. The
LPN should withhold the dose and notify the provider, per 2025 ACC guidelines. Administering
(A or C) is unsafe, and dietary potassium (D) is insufficient for acute correction.
Question 9
An LPN is caring for a client with a colostomy. The client reports irritation around the stoma.
What is the best intervention?
A. Apply petroleum jelly to the stoma.
B. Assess the skin and ensure proper pouch fit.
C. Cleanse with alcohol-based solution.
D. Change the pouch weekly.
Correct Answer: B
Rationale: Stoma irritation is often due to poor pouch fit or leakage. Assessing the skin and
ensuring proper fit prevents further damage, per 2025 WOCN guidelines. Petroleum jelly (A) is
occlusive, alcohol (C) irritates, and weekly changes (D) may be too infrequent.
Question 10
A pregnant client at 32 weeks gestation reports decreased fetal movement. What is the LPN’s
priority action?
A. Encourage hydration.
B. Perform a non-stress test and notify the provider.
C. Reassure the client.
D. Schedule a follow-up visit.
Correct Answer: B
