HESI Exit PN Spring 2026

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Sample questions from HESI Exit PN Spring 2026

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.Refer to the client's chart. Which change should the PN report to the RN immediately?

   • A.Heart rate decreased to 100 beats/min
   • B.Temperature decreased to 38.1 C
   • C.Urine output decreased to 15 mL during the past hour
   • D.Oxygen saturation increased to 95%

   Rationale: Urine output of 15 mL/hr with a falling blood pressure suggests worsening organ perfusion despite improvement in other measurements. The decreases in temperature and heart rate suggest partial improvement rather than the most urgent deterioration. Oxygen saturation improved after oxygen administration. In suspected sepsis, report evidence of impaired perfusion promptly.

2. 2.During a home visit, a client with heart failure reports gaining 3 lb in 24 hours and needing an extra pillow to sleep. Which action should the PN take?

   • A.Suggest increasing fluid intake to improve renal circulation
   • B.Reinforce that gradual weight gain is expected with aging
   • C.Advise taking twice the prescribed diuretic dose
   • D.Report the findings to the RN or provider today

   Rationale: Rapid weight gain and increasing orthopnea suggest fluid retention and require timely reporting. These findings are not expected aging changes, and extra fluid can worsen congestion. Independently doubling a diuretic is outside the PN's authority and may cause electrolyte or volume disturbances. Daily weights help detect heart failure exacerbations early.

3. 3.While assisting a client with COPD to dress, the PN notices increasing breathlessness. The client remains alert and has an SpO2 of 91%, within the prescribed target of 88%-92%. Which action is most appropriate?

   • A.Increase oxygen until the saturation reaches 100%
   • B.Pause the activity and coach pursed-lip breathing
   • C.Have the client lie flat until breathing slows
   • D.Encourage rapid, shallow breaths to complete dressing

   Rationale: Rest and pursed-lip breathing reduce air trapping and the work of breathing. The oxygen saturation is within the prescribed target, so increasing oxygen to achieve 100% is not indicated. Lying flat can worsen ventilation, and rapid shallow breathing promotes ineffective breathing patterns. Pace activities and use controlled exhalation for exertional dyspnea.

4. 4.At breakfast, a client admitted after a stroke coughs after drinking water and develops a wet-sounding voice. What should the PN do first?

   • A.Stop oral intake and notify the RN
   • B.Ask the client to tilt the head backward when swallowing
   • C.Offer the remaining liquids through a straw
   • D.Substitute a soft diet and continue feeding

   Answer and rationale are in the full material.

5. 5.Refer to the client's chart. Which findings require prompt reporting to the RN during treatment? Select all that apply.

   • A.New muscle weakness
   • B.Potassium of 3.1 mEq/L
   • C.New premature ventricular contractions
   • D.Glucose decreased to 280 mg/dL
   • E.Urine output of 50 mL/hr

   Answer and rationale are in the full material.