PN HESI EXIT EXAM V1 2026 – COMPLETE
PRACTICE TEST BANK | 200 REAL EXAM
QUESTIONS WITH VERIFIED ANSWERS &
DETAILED RATIONALES | ELSEVIER HESI PN
EXIT REVIEW GUIDE FOR NCLEX-PN
SUCCESS
PN HESI EXIT EXAM V1 2026 – COMPLETE PRACTICE TEST BANK
Document Overview:
• This comprehensive 200-question practice test bank is designed to prepare PN
candidates for the HESI EXIT exam with verified answers and detailed EXPERT
RATIONALE covering all major nursing domains including fundamentals,
pharmacology, medical-surgical nursing, maternal/newborn, pediatrics, and mental
health nursing.
• Study this material by reviewing each question carefully, attempting to answer
before checking the correct response, and using the detailed EXPERT RATIONALE
to reinforce understanding of key nursing concepts and clinical decision-making
skills essential for NCLEX-PN success.
QUESTION 1
A client with hypertension is prescribed lisinopril, an ACE inhibitor. Which side
effect should the nurse inform the client about that is commonly associated
with this medication?
A) Hyperkalemia and increased potassium levels
B) Persistent dry cough and throat irritation
C) Increased blood glucose levels
D) Rapid weight gain and fluid retention
E) Severe hyperventilation and respiratory alkalosis
✓ CORRECT ANSWER: B) Persistent dry cough and throat irritation
,EXPERT RATIONALE: ACE inhibitors like lisinopril block the breakdown of
bradykinin, a substance that causes a persistent dry cough in 10-20% of patients.
This is a very common side effect that clients should be warned about. While
hyperkalemia can occur, it is less common than cough. The other options are not
typical side effects of ACE inhibitors.
QUESTION 2
A nurse is assessing a client admitted with acute myocardial infarction. Which
clinical finding indicates cardiogenic shock?
A) Blood pressure 180/90 mmHg and heart rate 60 bpm
B) Systolic BP less than 90 mmHg, increased heart rate, and cool extremities
C) Respiratory rate of 12 breaths/min and warm skin
D) Normal urine output of 100 mL per hour
E) Decreased anxiety and alert mental status
✓ CORRECT ANSWER: B) Systolic BP less than 90 mmHg, increased heart rate,
and cool extremities
EXPERT RATIONALE: Cardiogenic shock is characterized by inadequate tissue
perfusion due to cardiac failure. Classic signs include hypotension (SBP <90 mmHg),
compensatory tachycardia, decreased peripheral perfusion (cool, clammy skin), and
oliguria. The other options represent normal or opposite findings that would not
indicate shock.
QUESTION 3
A client receiving chemotherapy develops severe nausea and vomiting. The
nurse is administering ondansetron. What is the primary mechanism of
action for this antiemetic?
A) Blocks dopamine receptors in the chemoreceptor trigger zone
,B) Blocks serotonin (5-HT3) receptors in the chemoreceptor trigger zone and GI
tract
C) Increases gastric motility and accelerates stomach emptying
D) Depresses the cerebral cortex and reduces nausea perception
E) Increases histamine release to counteract nausea signals
✓ CORRECT ANSWER: B) Blocks serotonin (5-HT3) receptors in the
chemoreceptor trigger zone and GI tract
EXPERT RATIONALE: Ondansetron is a 5-HT3 receptor antagonist that blocks
serotonin receptors in the chemoreceptor trigger zone and on vagal afferents in the
GI tract. This mechanism is highly effective for chemotherapy-induced nausea and
vomiting. The other options describe mechanisms of different antiemetic classes.
QUESTION 4
A postpartum client is experiencing heavy vaginal bleeding on day 3 after
delivery. The nurse suspects uterine atony. Which nursing intervention is
most appropriate as a first-line response?
A) Administer intravenous fluid bolus and prepare for blood transfusion
B) Perform fundal massage and assess for bladder distension
C) Notify the provider immediately for emergency hysterectomy
D) Position client in Trendelenburg and restrict all oral intake
E) Apply ice to the lower abdomen and encourage ambulation
✓ CORRECT ANSWER: B) Perform fundal massage and assess for bladder
distension
EXPERT RATIONALE: Uterine atony is managed first with fundal massage to
stimulate uterine contractions. A distended bladder can contribute to atony, so
assessment and catheterization if needed is important. These are first-line
interventions before more aggressive measures. The other options are either
premature or inappropriate for initial management of postpartum hemorrhage.
, QUESTION 5
A 2-year-old child is admitted with croup. Which clinical presentation is most
characteristic of this condition?
A) Barky, seal-like cough with stridor and respiratory distress
B) Severe sore throat with white exudate and difficulty swallowing
C) Inspiratory wheeze with fever and productive cough
D) Drooling, tripod positioning, and severe dyspnea
E) Intermittent cough with clear nasal discharge and low-grade fever
✓ CORRECT ANSWER: A) Barky, seal-like cough with stridor and respiratory
distress
EXPERT RATIONALE: Croup (laryngotracheobronchitis) presents with the
characteristic barky, seal-like cough, often with inspiratory stridor, hoarseness, and
respiratory distress. It commonly affects children ages 6 months to 3 years. Option
B describes pharyngitis, D describes epiglottitis, and E describes a viral URI.
QUESTION 6
A client diagnosed with bipolar disorder, manic phase, is prescribed lithium.
Which statement by the client indicates understanding of safe lithium use?
A) "I will decrease my salt intake to help the lithium work better"
B) "I need to maintain consistent salt and fluid intake daily"
C) "I should stop taking lithium if I develop diarrhea"
D) "I can increase my fluid intake only during hot weather"
E) "I will skip doses if I feel my mood is stable"
✓ CORRECT ANSWER: B) I need to maintain consistent salt and fluid intake
daily
PRACTICE TEST BANK | 200 REAL EXAM
QUESTIONS WITH VERIFIED ANSWERS &
DETAILED RATIONALES | ELSEVIER HESI PN
EXIT REVIEW GUIDE FOR NCLEX-PN
SUCCESS
PN HESI EXIT EXAM V1 2026 – COMPLETE PRACTICE TEST BANK
Document Overview:
• This comprehensive 200-question practice test bank is designed to prepare PN
candidates for the HESI EXIT exam with verified answers and detailed EXPERT
RATIONALE covering all major nursing domains including fundamentals,
pharmacology, medical-surgical nursing, maternal/newborn, pediatrics, and mental
health nursing.
• Study this material by reviewing each question carefully, attempting to answer
before checking the correct response, and using the detailed EXPERT RATIONALE
to reinforce understanding of key nursing concepts and clinical decision-making
skills essential for NCLEX-PN success.
QUESTION 1
A client with hypertension is prescribed lisinopril, an ACE inhibitor. Which side
effect should the nurse inform the client about that is commonly associated
with this medication?
A) Hyperkalemia and increased potassium levels
B) Persistent dry cough and throat irritation
C) Increased blood glucose levels
D) Rapid weight gain and fluid retention
E) Severe hyperventilation and respiratory alkalosis
✓ CORRECT ANSWER: B) Persistent dry cough and throat irritation
,EXPERT RATIONALE: ACE inhibitors like lisinopril block the breakdown of
bradykinin, a substance that causes a persistent dry cough in 10-20% of patients.
This is a very common side effect that clients should be warned about. While
hyperkalemia can occur, it is less common than cough. The other options are not
typical side effects of ACE inhibitors.
QUESTION 2
A nurse is assessing a client admitted with acute myocardial infarction. Which
clinical finding indicates cardiogenic shock?
A) Blood pressure 180/90 mmHg and heart rate 60 bpm
B) Systolic BP less than 90 mmHg, increased heart rate, and cool extremities
C) Respiratory rate of 12 breaths/min and warm skin
D) Normal urine output of 100 mL per hour
E) Decreased anxiety and alert mental status
✓ CORRECT ANSWER: B) Systolic BP less than 90 mmHg, increased heart rate,
and cool extremities
EXPERT RATIONALE: Cardiogenic shock is characterized by inadequate tissue
perfusion due to cardiac failure. Classic signs include hypotension (SBP <90 mmHg),
compensatory tachycardia, decreased peripheral perfusion (cool, clammy skin), and
oliguria. The other options represent normal or opposite findings that would not
indicate shock.
QUESTION 3
A client receiving chemotherapy develops severe nausea and vomiting. The
nurse is administering ondansetron. What is the primary mechanism of
action for this antiemetic?
A) Blocks dopamine receptors in the chemoreceptor trigger zone
,B) Blocks serotonin (5-HT3) receptors in the chemoreceptor trigger zone and GI
tract
C) Increases gastric motility and accelerates stomach emptying
D) Depresses the cerebral cortex and reduces nausea perception
E) Increases histamine release to counteract nausea signals
✓ CORRECT ANSWER: B) Blocks serotonin (5-HT3) receptors in the
chemoreceptor trigger zone and GI tract
EXPERT RATIONALE: Ondansetron is a 5-HT3 receptor antagonist that blocks
serotonin receptors in the chemoreceptor trigger zone and on vagal afferents in the
GI tract. This mechanism is highly effective for chemotherapy-induced nausea and
vomiting. The other options describe mechanisms of different antiemetic classes.
QUESTION 4
A postpartum client is experiencing heavy vaginal bleeding on day 3 after
delivery. The nurse suspects uterine atony. Which nursing intervention is
most appropriate as a first-line response?
A) Administer intravenous fluid bolus and prepare for blood transfusion
B) Perform fundal massage and assess for bladder distension
C) Notify the provider immediately for emergency hysterectomy
D) Position client in Trendelenburg and restrict all oral intake
E) Apply ice to the lower abdomen and encourage ambulation
✓ CORRECT ANSWER: B) Perform fundal massage and assess for bladder
distension
EXPERT RATIONALE: Uterine atony is managed first with fundal massage to
stimulate uterine contractions. A distended bladder can contribute to atony, so
assessment and catheterization if needed is important. These are first-line
interventions before more aggressive measures. The other options are either
premature or inappropriate for initial management of postpartum hemorrhage.
, QUESTION 5
A 2-year-old child is admitted with croup. Which clinical presentation is most
characteristic of this condition?
A) Barky, seal-like cough with stridor and respiratory distress
B) Severe sore throat with white exudate and difficulty swallowing
C) Inspiratory wheeze with fever and productive cough
D) Drooling, tripod positioning, and severe dyspnea
E) Intermittent cough with clear nasal discharge and low-grade fever
✓ CORRECT ANSWER: A) Barky, seal-like cough with stridor and respiratory
distress
EXPERT RATIONALE: Croup (laryngotracheobronchitis) presents with the
characteristic barky, seal-like cough, often with inspiratory stridor, hoarseness, and
respiratory distress. It commonly affects children ages 6 months to 3 years. Option
B describes pharyngitis, D describes epiglottitis, and E describes a viral URI.
QUESTION 6
A client diagnosed with bipolar disorder, manic phase, is prescribed lithium.
Which statement by the client indicates understanding of safe lithium use?
A) "I will decrease my salt intake to help the lithium work better"
B) "I need to maintain consistent salt and fluid intake daily"
C) "I should stop taking lithium if I develop diarrhea"
D) "I can increase my fluid intake only during hot weather"
E) "I will skip doses if I feel my mood is stable"
✓ CORRECT ANSWER: B) I need to maintain consistent salt and fluid intake
daily
