ACTUAL EXAM| ELSEVIER HESI PN
EXIT EXAM V1 WITH COMPLETE 150
REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST
RECENT!!)
PN HESI EXIT EXAM V1 - PRACTICE TEST
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1. A practical nurse (PN) is reinforcing teaching to a client with type 1 diabetes mellitus abo
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ut preventing hypoglycemia during exercise. Which statement by the client indicates a nee
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d for further teaching?
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A. "I should check my blood glucose level before exercising."
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B. "I should eat a snack if my blood glucose is below 100 mg/dL."
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C. "I should inject my insulin into my thigh before I go for a run."
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D. "I should wear a medical identification bracelet."
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Correct Answer: C jh jh
Rationale: Insulin absorption is increased with exercise, especially when injected into an extremity
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that will be used during the activity (like the thigh for running). This can lead to hypoglycemia. The
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client should inject insulin into the abdomen for more consistent absorption. Options A, B, and D
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are correct actions for preventing hypoglycemia during exercise.
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2. A client with heart failure is prescribed furosemide (Lasix). Which assessment finding is
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most important for the PN to report to the registered nurse (RN) immediately?
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A. Weight loss of 1 kg in 24 hours.
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B. Serum potassium level of 3.0 mEq/L.
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C. Blood pressure of 110/70 mmHg.
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D. Urine output of 120 mL in 4 hours.
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Correct Answer: B jh jh
Rationale: Furosemide is a loop diuretic that can cause significant potassium loss (hypokalemia).
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A serum potassium level of 3.0 mEq/L is critically low and can lead to life-
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threatening cardiac dysrhythmias. This finding requires immediate reporting. Option A indicates e
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,ffective diuresis. Option C is a normal blood pressure. Option D represents a low urine output (less
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than 30 mL/hr), which is concerning, but hypokalemia is the more immediate and life-
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threatening lab value. jh jh
3. A client is being treated for major depressive disorder and is taking phenelzine (Nardil).
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The PN reinforces dietary teaching. Which food choice by the client indicates a correct und
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erstanding of the instructions? jh jh jh
A. A slice of pepperoni pizza.
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B. A grilled chicken salad with ranch dressing.
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C. A glass of red wine.
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D. A bag of cheddar cheese-flavored chips.
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Correct Answer: D jh jh
Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). Clients must avoid foods high in
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tyramine, which can cause a hypertensive crisis. Tyramine-
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rich foods include aged cheeses, cured meats (pepperoni), fermented foods, and alcoholic bevera
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ges (especially red wine). Cheddar cheese-
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flavored chips are a safe choice as they do not contain real aged cheese. A grilled chicken salad is
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a better choice than the others, but ranch dressing is generally safe. The chips are the most clearly
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correct choice. jh
4. A PN is preparing to administer a 0900 dose of enoxaparin (Lovenox) subcutaneously. W
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hich action should the PN take?
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A. Expel the air bubble from the prefilled syringe before injection.
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B. Massage the injection site vigorously after administration.
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C. Administer the injection in the client's abdomen, at least 2 inches away from the umbilicus.
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D. Rub the site with an alcohol swab after the injection to clean the area.
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Correct Answer: C jh jh
Rationale: Enoxaparin is administered subcutaneously in the abdomen, at least 2 inches away fro
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m the umbilicus. The air bubble in the prefilled syringe is designed to prevent medication from lea
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king from the injection site and should not be expelled. The site should be pinched, and the medic
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ation is injected, but it should not be massaged, as this can cause bruising or hematoma. The site i
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s gently patted or left alone after injection.
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5. A client with a nasogastric (NG) tube connected to low continuous suction is complainin
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g of nausea and abdominal distention. What is the PN's priority action?
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A. Irrigate the NG tube with 30 mL of sterile water.
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B. Check the patency and placement of the NG tube.
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,C. Reposition the client onto their right side.
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D. Administer the prescribed antiemetic medication.
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Correct Answer: B jh jh
Rationale: Nausea and distention in a client with an NG tube indicate a potential blockage or malf
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unction of the tube. The nurse's priority is to assess the patency and placement of the NG tube to
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ensure it is functioning correctly. Irrigating the tube may be necessary, but only after assessing pat
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ency and with a provider's order. Repositioning may help, but assessment comes first. Administeri
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ng an antiemetic does not address the underlying cause of the distention.
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6. A client is admitted with a deep vein thrombosis (DVT) in the left calf. Which finding req
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uires the PN's immediate action? jh jh jh jh
A. The client reports a dull ache in the left calf.
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B. The left calf is warm and edematous compared to the right.
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C. The client suddenly develops shortness of breath and chest pain.
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D. The client's left foot is pale and cool to the touch.
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Correct Answer: C jh jh
Rationale: Sudden shortness of breath and chest pain in a client with a DVT are classic signs of a p
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ulmonary embolism (PE), a life- jh jh jh jh
threatening complication. This requires immediate emergency intervention. Options A and B are e
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xpected findings of a DVT. Option D (pale, cool foot) could indicate arterial insufficiency, which is a
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concern but is not as immediately life-threatening as a PE.
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7. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/mi
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n via nasal cannula. The PN notes the client is lethargic and has a respiratory rate of 8 breat
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hs per minute. Which action should the PN take first?
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A. Increase the oxygen flow rate to 4 L/min.
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B. Notify the RN immediately.
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C. Place the client in a high Fowler's position.
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D. Check the client's oxygen saturation level.
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Correct Answer: B jh jh
Rationale: The client is exhibiting signs of oxygen- jh jh jh jh jh jh jh
induced hypoventilation due to a loss of hypoxic drive. With a respiratory rate of 8 and lethargy, th
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e client is at risk for respiratory failure. The PN should not increase the oxygen; instead, they shoul
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d immediately notify the RN or rapid response team. The priority is to get help and prepare for pot
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ential interventions (like BiPAP or intubation). Checking oxygen saturation can be done rapidly, bu
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t the immediate action is to report the significant change in clinical status.
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, 8. The PN is reinforcing discharge teaching to a client prescribed warfarin (Coumadin). Whi
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ch statement by the client indicates an understanding of the medication?
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A. "I will take a multivitamin with extra vitamin K every day."
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B. "I will use a soft-bristled toothbrush and an electric razor."
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C. "I will avoid foods like spinach and kale completely."
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D. "I will take ibuprofen for my headaches instead of acetaminophen."
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Correct Answer: B jh jh
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. Clients should use a sof
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t-
bristled toothbrush and an electric razor to prevent bleeding from the gums or skin cuts. Vitamin
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K is the antidote to warfarin and should be kept consistent in the diet, not eliminated or suppleme
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nted excessively. The client does not need to avoid green leafy vegetables completely but should
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maintain a consistent intake. Ibuprofen (an NSAID) increases the risk of bleeding and should be av
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oided; acetaminophen is preferred for pain.jh jh jh jh jh
9. A PN is caring for a client who is 6 hours post-
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total hip arthroplasty. Which position is most appropriate for the PN to maintain the client'
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s operative leg in?
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A. Adducted and internally rotated.
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B. Abducted and externally rotated.
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C. Adducted and externally rotated.
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D. Abducted and internally rotated.
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Correct Answer: B jh jh
Rationale: Following a total hip arthroplasty, especially via a posterior approach, the affected leg
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must be positioned to prevent dislocation. The leg should be maintained in abduction (away fro
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m the midline) and external rotation. A pillow or abduction wedge is often placed between the le
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gs. Adduction and internal rotation are the positions that put the new hip at greatest risk for disloc
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ation and must be avoided. jh jh jh jh
10. A client is admitted with a diagnosis of acute pancreatitis. Which finding is the priority f
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or the PN to report to the RN?
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A. Serum amylase of 200 U/L.
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B. Serum glucose of 150 mg/dL.
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C. Blood pressure of 90/60 mmHg.
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D. Pain rated as an 8 on a 0-10 scale.
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Correct Answer: C jh jh
Rationale: Acute pancreatitis can cause a massive shift of fluid into the abdominal cavity ("third sp
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