S
HESI PN Exit Exam Questions and Answers
PROVEN SUCCESS BUNDLE: REAL EXAM
SAMPLES & ANSWER KEYS 2027 READINESS
KIT: VERIFIED TEST BANK FOR FINAL
EVALUATION
A nurse is performing a focused respiratory assessment on a client admitted with acute left-
sided heart failure. Upon auscultation of the bilateral lung bases, the nurse notes high-
pitched, popping, discontinuous sounds that occur primarily during inspiration and do not
clear with coughing. How should the nurse document this specific lung sound?
A) Rhonchi
B) Stridor
C) Fine crackles
D) Wheezes
• Correct Answer: C) Fine crackles
• Rationale: Fine crackles are descriptive of discontinuous, high-pitched, popping sounds
caused by the sudden opening of fluid-filled alveoli and small airways, which is typical in
pulmonary congestion and edema from left-sided heart failure. Rhonchi resemble
snoring and indicate fluid in larger airways; wheezes are continuous, musical, high-
pitched sounds caused by bronchoconstriction; and stridor is a harsh, high-pitched
sound indicating upper airway obstruction.
A client with chronic bronchitis is prescribed acetylcysteine via nebulization to thin thick
secretions. During the administration of the treatment, the nurse notes the sudden onset of
dyspnea, an increased work of breathing, and continuous high-pitched, musical whistling
sounds across all lung fields. Which complication has the client developed, and what is the
nurse's priority action?
A) Pulmonary edema; prepare for immediate airway suctioning.
B) Bronchospasm; discontinue the nebulizer and administer a rescue bronchodilator.
D
,S
C) Severe stridor; prepare the client for emergent endotracheal intubation.
D) Rhonchi accumulation; instruct the client to perform a deep-coughing exercise.
• Correct Answer: B) Bronchospasm; discontinue the nebulizer and administer a rescue
bronchodilator.
• Rationale: Acetylcysteine can trigger an adverse reaction of severe airway irritation and
acute bronchospasm, which presents as a continuous high-pitched wheeze and
dyspnea. The priority nursing action is to stop the nebulizer treatment immediately to
remove the offending agent and administer a fast-acting rescue bronchodilator (such as
albuterol) to open the airway.
Module 2: Advanced Maternal-Newborn Nursing
A laboring client requests an epidural block for pain management at dilation. Shortly after the
anesthesia provider initiates the epidural infusion, the nurse notes a sharp drop in the client's
blood pressure to . Which immediate maternal risk from epidural anesthesia does this
represent, and what is the underlying mechanism?
A) Severe urinary retention due to direct mechanical compression of the bladder.
B) Maternal hypotension caused by widespread sympathetic blockade and venous pooling.
C) A post-dural puncture headache resulting from rapid loss of cerebrospinal fluid.
D) Accelerated labor progression caused by rapid cervical dilation.
• Correct Answer: B) Maternal hypotension caused by widespread sympathetic blockade
and venous pooling.
• Rationale: Maternal hypotension is a frequent and serious side effect of epidural
anesthesia. The local anesthetic blocks the sympathetic nervous system pathways,
leading to widespread vasodilation and venous pooling of blood, which reduces venous
return and cardiac output. This requires proactive IV fluid boluses and careful position
adjustments.
A nurse is caring for a client in early labor who reports that her "water broke" at home. Which
action should the nurse take first?
A) Perform a sterile vaginal examination to check for maximum cervical dilation.
B) Ask what time the rupture occurred and note the color, amount, and odor of the fluid.
D
, S
C) Administer a prophylactic dose of vitamin K to prevent fetal hemorrhage.
D) Place the client in a high-Fowler's recumbent position to prepare for immediate birth.
• Correct Answer: B) Ask what time the rupture occurred and note the color, amount, and
odor of the fluid.
• Rationale: When a client reports spontaneous rupture of membranes, the nurse must
first assess the timing and characteristics of the fluid. Finding out the time helps
determine the risk for infection (which increases after 24 hours). Noting the color helps
detect meconium staining (which can cause fetal respiratory distress), while the odor
can help identify an underlying infection (amnionitis).
Module 3: Psychiatric-Mental Health Nursing Interventions
A client diagnosed with obsessive-compulsive disorder (OCD) is admitted to an inpatient
mental health unit. The nurse observes the client performing a repetitive, ritualistic hand-
washing sequence that has lasted for 20 minutes, causing significant skin redness. Which
intervention should the nurse implement?
A) Forcefully pull the client away from the sink to stop the behavior immediately.
B) Allow the client time to complete the ritual before gently redirecting them to other activities.
C) Remove all cleaning materials, soap, and water access from the unit to prevent the behavior.
D) Inform the client that their hand-washing behavior is irrational and unnecessary.
• Correct Answer: B) Allow the client time to complete the ritual before gently redirecting
them to other activities.
• Rationale: In the early stages of treatment for OCD, stopping a client's ritualistic
behavior can trigger extreme, unmanageable anxiety. The nurse should allow the client
to complete the ritual safely to preserve their coping mechanism, while gradually
working to reduce the time spent on rituals by replacing them with alternative anxiety-
reduction strategies over time.
A client diagnosed with schizophrenia is sitting alone in the dayroom, appearing unkempt and
withdrawn from social interactions. To establish a therapeutic relationship and encourage
engagement, which initial question should the nurse ask?
A) "Why have you stopped keeping up with your personal hygiene routines?"
B) "What activities did you enjoy in the past?"
D
HESI PN Exit Exam Questions and Answers
PROVEN SUCCESS BUNDLE: REAL EXAM
SAMPLES & ANSWER KEYS 2027 READINESS
KIT: VERIFIED TEST BANK FOR FINAL
EVALUATION
A nurse is performing a focused respiratory assessment on a client admitted with acute left-
sided heart failure. Upon auscultation of the bilateral lung bases, the nurse notes high-
pitched, popping, discontinuous sounds that occur primarily during inspiration and do not
clear with coughing. How should the nurse document this specific lung sound?
A) Rhonchi
B) Stridor
C) Fine crackles
D) Wheezes
• Correct Answer: C) Fine crackles
• Rationale: Fine crackles are descriptive of discontinuous, high-pitched, popping sounds
caused by the sudden opening of fluid-filled alveoli and small airways, which is typical in
pulmonary congestion and edema from left-sided heart failure. Rhonchi resemble
snoring and indicate fluid in larger airways; wheezes are continuous, musical, high-
pitched sounds caused by bronchoconstriction; and stridor is a harsh, high-pitched
sound indicating upper airway obstruction.
A client with chronic bronchitis is prescribed acetylcysteine via nebulization to thin thick
secretions. During the administration of the treatment, the nurse notes the sudden onset of
dyspnea, an increased work of breathing, and continuous high-pitched, musical whistling
sounds across all lung fields. Which complication has the client developed, and what is the
nurse's priority action?
A) Pulmonary edema; prepare for immediate airway suctioning.
B) Bronchospasm; discontinue the nebulizer and administer a rescue bronchodilator.
D
,S
C) Severe stridor; prepare the client for emergent endotracheal intubation.
D) Rhonchi accumulation; instruct the client to perform a deep-coughing exercise.
• Correct Answer: B) Bronchospasm; discontinue the nebulizer and administer a rescue
bronchodilator.
• Rationale: Acetylcysteine can trigger an adverse reaction of severe airway irritation and
acute bronchospasm, which presents as a continuous high-pitched wheeze and
dyspnea. The priority nursing action is to stop the nebulizer treatment immediately to
remove the offending agent and administer a fast-acting rescue bronchodilator (such as
albuterol) to open the airway.
Module 2: Advanced Maternal-Newborn Nursing
A laboring client requests an epidural block for pain management at dilation. Shortly after the
anesthesia provider initiates the epidural infusion, the nurse notes a sharp drop in the client's
blood pressure to . Which immediate maternal risk from epidural anesthesia does this
represent, and what is the underlying mechanism?
A) Severe urinary retention due to direct mechanical compression of the bladder.
B) Maternal hypotension caused by widespread sympathetic blockade and venous pooling.
C) A post-dural puncture headache resulting from rapid loss of cerebrospinal fluid.
D) Accelerated labor progression caused by rapid cervical dilation.
• Correct Answer: B) Maternal hypotension caused by widespread sympathetic blockade
and venous pooling.
• Rationale: Maternal hypotension is a frequent and serious side effect of epidural
anesthesia. The local anesthetic blocks the sympathetic nervous system pathways,
leading to widespread vasodilation and venous pooling of blood, which reduces venous
return and cardiac output. This requires proactive IV fluid boluses and careful position
adjustments.
A nurse is caring for a client in early labor who reports that her "water broke" at home. Which
action should the nurse take first?
A) Perform a sterile vaginal examination to check for maximum cervical dilation.
B) Ask what time the rupture occurred and note the color, amount, and odor of the fluid.
D
, S
C) Administer a prophylactic dose of vitamin K to prevent fetal hemorrhage.
D) Place the client in a high-Fowler's recumbent position to prepare for immediate birth.
• Correct Answer: B) Ask what time the rupture occurred and note the color, amount, and
odor of the fluid.
• Rationale: When a client reports spontaneous rupture of membranes, the nurse must
first assess the timing and characteristics of the fluid. Finding out the time helps
determine the risk for infection (which increases after 24 hours). Noting the color helps
detect meconium staining (which can cause fetal respiratory distress), while the odor
can help identify an underlying infection (amnionitis).
Module 3: Psychiatric-Mental Health Nursing Interventions
A client diagnosed with obsessive-compulsive disorder (OCD) is admitted to an inpatient
mental health unit. The nurse observes the client performing a repetitive, ritualistic hand-
washing sequence that has lasted for 20 minutes, causing significant skin redness. Which
intervention should the nurse implement?
A) Forcefully pull the client away from the sink to stop the behavior immediately.
B) Allow the client time to complete the ritual before gently redirecting them to other activities.
C) Remove all cleaning materials, soap, and water access from the unit to prevent the behavior.
D) Inform the client that their hand-washing behavior is irrational and unnecessary.
• Correct Answer: B) Allow the client time to complete the ritual before gently redirecting
them to other activities.
• Rationale: In the early stages of treatment for OCD, stopping a client's ritualistic
behavior can trigger extreme, unmanageable anxiety. The nurse should allow the client
to complete the ritual safely to preserve their coping mechanism, while gradually
working to reduce the time spent on rituals by replacing them with alternative anxiety-
reduction strategies over time.
A client diagnosed with schizophrenia is sitting alone in the dayroom, appearing unkempt and
withdrawn from social interactions. To establish a therapeutic relationship and encourage
engagement, which initial question should the nurse ask?
A) "Why have you stopped keeping up with your personal hygiene routines?"
B) "What activities did you enjoy in the past?"
D
