# HESI PN Exit Exam 2021/2022 LATEST UPDATED
VERSION 2023 – 70 Practice Questions with
Rationales
---
**01.** A licensed practical nurse (LPN) is reinforcing teaching with a client who has a new prescription
for furosemide. Which instruction should the LPN include?
A) “Take this medication at bedtime to prevent nocturia.”
B) “Increase your intake of potassium‑rich foods like bananas and oranges.”
C) “Avoid drinking fluids while taking this medication.”
D) “Stop taking this medication if you feel dizzy.”
🔍 RATIONALE💡-- Furosemide is a loop diuretic that causes potassium loss (hypokalemia). Clients
should be encouraged to eat potassium‑rich foods. The medication is best taken in the morning to avoid
nocturia. Dizziness may indicate hypotension, but the medication should not be stopped without
provider notification.
ANSWER💫✔️-- B) “Increase your intake of potassium‑rich foods like bananas and oranges.”
---
**02.** A nurse is caring for a client who is 2 hours post‑operative following a thyroidectomy. Which
finding requires immediate notification of the provider?
A) Hoarse voice
B) Serosanguineous drainage on the dressing
C) Tingling around the mouth
D) Pain rated 4 on a 0‑10 scale
,🔍 RATIONALE💡-- Tingling around the mouth indicates hypocalcemia due to accidental parathyroid
injury, which can lead to laryngeal spasm and respiratory arrest. Hoarse voice is expected from
intubation. Drainage and mild pain are expected post‑operatively.
ANSWER💫✔️-- C) Tingling around the mouth
---
**03.** A nurse is reinforcing teaching with a client who has a new prescription for warfarin. Which
statement by the client indicates a need for further teaching?
A) “I will use an electric razor to shave.”
B) “I will eat the same amount of leafy green vegetables each week.”
C) “I can take ibuprofen for my headaches.”
D) “I will have my INR checked regularly.”
🔍 RATIONALE💡-- Ibuprofen (an NSAID) increases bleeding risk when taken with warfarin.
Acetaminophen is safer. The other statements are correct: electric razor prevents cuts, consistent
vitamin K intake is important, and INR monitoring is essential.
ANSWER💫✔️-- C) “I can take ibuprofen for my headaches.”
---
**04.** A nurse is caring for a client with a potassium level of 6.0 mEq/L. Which ECG change should the
nurse expect?
A) Flattened T waves
B) Prominent U waves
C) Peaked T waves
D) Prolonged QT interval
,🔍 RATIONALE💡-- Hyperkalemia causes peaked (tented) T waves, widened QRS, and eventually a sine
wave pattern. Flattened T waves and U waves are seen in hypokalemia.
ANSWER💫✔️-- C) Peaked T waves
---
**05.** A nurse is reinforcing teaching with a client who has a new colostomy about stoma care. Which
statement indicates correct understanding?
A) “I will change the pouch every day to prevent infection.”
B) “My stoma should look dark purple and dry.”
C) “I will cut the skin barrier opening 1‑2 mm larger than my stoma.”
D) “I can use hydrogen peroxide to clean the stoma.”
🔍 RATIONALE💡-- The skin barrier opening should be cut 1‑2 mm larger than the stoma to prevent skin
irritation. A healthy stoma is pink/red and moist; hydrogen peroxide is too harsh. Pouches can stay on
for 3‑7 days.
ANSWER💫✔️-- C) “I will cut the skin barrier opening 1‑2 mm larger than my stoma.”
---
**06.** A nurse is caring for a client with a chest tube connected to a water‑seal drainage system. The
nurse notes continuous bubbling in the water seal chamber. Which action should the nurse take first?
A) Clamp the chest tube near the insertion site
B) Increase the suction pressure
C) Check the system for an air leak
D) Document the finding as normal
🔍 RATIONALE💡-- Continuous bubbling indicates an air leak. The nurse should check all connections for
loose fittings. Clamping can cause tension pneumothorax.
, ANSWER💫✔️-- C) Check the system for an air leak
---
**07.** A nurse is assessing a client with a traumatic brain injury. Which finding suggests increased
intracranial pressure (ICP)?
A) Glasgow Coma Scale score of 15
B) Pupils equal and reactive to light
C) Widening pulse pressure with bradycardia
D) Tachycardia and hypotension
🔍 RATIONALE💡-- Widening pulse pressure (increasing systolic with stable diastolic) and bradycardia
are components of Cushing’s triad, a late sign of increased ICP.
ANSWER💫✔️-- C) Widening pulse pressure with bradycardia
---
**08.** A nurse is preparing to administer digoxin to a client with heart failure. The client’s apical pulse
is 52 bpm and they report nausea. What should the nurse do first?
A) Administer the digoxin as ordered
B) Check the digoxin level
C) Hold the dose and notify the provider
D) Administer atropine to increase heart rate
🔍 RATIONALE💡-- Bradycardia (<60 bpm) and nausea are signs of digoxin toxicity. The nurse should hold
the dose and notify the provider. The digoxin level can be checked after notifying.
ANSWER💫✔️-- C) Hold the dose and notify the provider
VERSION 2023 – 70 Practice Questions with
Rationales
---
**01.** A licensed practical nurse (LPN) is reinforcing teaching with a client who has a new prescription
for furosemide. Which instruction should the LPN include?
A) “Take this medication at bedtime to prevent nocturia.”
B) “Increase your intake of potassium‑rich foods like bananas and oranges.”
C) “Avoid drinking fluids while taking this medication.”
D) “Stop taking this medication if you feel dizzy.”
🔍 RATIONALE💡-- Furosemide is a loop diuretic that causes potassium loss (hypokalemia). Clients
should be encouraged to eat potassium‑rich foods. The medication is best taken in the morning to avoid
nocturia. Dizziness may indicate hypotension, but the medication should not be stopped without
provider notification.
ANSWER💫✔️-- B) “Increase your intake of potassium‑rich foods like bananas and oranges.”
---
**02.** A nurse is caring for a client who is 2 hours post‑operative following a thyroidectomy. Which
finding requires immediate notification of the provider?
A) Hoarse voice
B) Serosanguineous drainage on the dressing
C) Tingling around the mouth
D) Pain rated 4 on a 0‑10 scale
,🔍 RATIONALE💡-- Tingling around the mouth indicates hypocalcemia due to accidental parathyroid
injury, which can lead to laryngeal spasm and respiratory arrest. Hoarse voice is expected from
intubation. Drainage and mild pain are expected post‑operatively.
ANSWER💫✔️-- C) Tingling around the mouth
---
**03.** A nurse is reinforcing teaching with a client who has a new prescription for warfarin. Which
statement by the client indicates a need for further teaching?
A) “I will use an electric razor to shave.”
B) “I will eat the same amount of leafy green vegetables each week.”
C) “I can take ibuprofen for my headaches.”
D) “I will have my INR checked regularly.”
🔍 RATIONALE💡-- Ibuprofen (an NSAID) increases bleeding risk when taken with warfarin.
Acetaminophen is safer. The other statements are correct: electric razor prevents cuts, consistent
vitamin K intake is important, and INR monitoring is essential.
ANSWER💫✔️-- C) “I can take ibuprofen for my headaches.”
---
**04.** A nurse is caring for a client with a potassium level of 6.0 mEq/L. Which ECG change should the
nurse expect?
A) Flattened T waves
B) Prominent U waves
C) Peaked T waves
D) Prolonged QT interval
,🔍 RATIONALE💡-- Hyperkalemia causes peaked (tented) T waves, widened QRS, and eventually a sine
wave pattern. Flattened T waves and U waves are seen in hypokalemia.
ANSWER💫✔️-- C) Peaked T waves
---
**05.** A nurse is reinforcing teaching with a client who has a new colostomy about stoma care. Which
statement indicates correct understanding?
A) “I will change the pouch every day to prevent infection.”
B) “My stoma should look dark purple and dry.”
C) “I will cut the skin barrier opening 1‑2 mm larger than my stoma.”
D) “I can use hydrogen peroxide to clean the stoma.”
🔍 RATIONALE💡-- The skin barrier opening should be cut 1‑2 mm larger than the stoma to prevent skin
irritation. A healthy stoma is pink/red and moist; hydrogen peroxide is too harsh. Pouches can stay on
for 3‑7 days.
ANSWER💫✔️-- C) “I will cut the skin barrier opening 1‑2 mm larger than my stoma.”
---
**06.** A nurse is caring for a client with a chest tube connected to a water‑seal drainage system. The
nurse notes continuous bubbling in the water seal chamber. Which action should the nurse take first?
A) Clamp the chest tube near the insertion site
B) Increase the suction pressure
C) Check the system for an air leak
D) Document the finding as normal
🔍 RATIONALE💡-- Continuous bubbling indicates an air leak. The nurse should check all connections for
loose fittings. Clamping can cause tension pneumothorax.
, ANSWER💫✔️-- C) Check the system for an air leak
---
**07.** A nurse is assessing a client with a traumatic brain injury. Which finding suggests increased
intracranial pressure (ICP)?
A) Glasgow Coma Scale score of 15
B) Pupils equal and reactive to light
C) Widening pulse pressure with bradycardia
D) Tachycardia and hypotension
🔍 RATIONALE💡-- Widening pulse pressure (increasing systolic with stable diastolic) and bradycardia
are components of Cushing’s triad, a late sign of increased ICP.
ANSWER💫✔️-- C) Widening pulse pressure with bradycardia
---
**08.** A nurse is preparing to administer digoxin to a client with heart failure. The client’s apical pulse
is 52 bpm and they report nausea. What should the nurse do first?
A) Administer the digoxin as ordered
B) Check the digoxin level
C) Hold the dose and notify the provider
D) Administer atropine to increase heart rate
🔍 RATIONALE💡-- Bradycardia (<60 bpm) and nausea are signs of digoxin toxicity. The nurse should hold
the dose and notify the provider. The digoxin level can be checked after notifying.
ANSWER💫✔️-- C) Hold the dose and notify the provider
