HESI PN Exit 2023

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Sample questions from HESI PN Exit 2023

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

1. 1.At change of shift on a medical-surgical unit, a 76-year-old client with pneumonia has T 38.1 C, HR 92/min, RR 20/min, BP 128/74 mm Hg, and SpO2 94% on 2 L/min oxygen. Which task is appropriate for the PN to delegate to unlicensed assistive personnel (UAP)?

   • A.Evaluate whether the oxygen flow rate is effective.
   • B.Obtain and record the client's oral temperature in 1 hour.
   • C.Teach the client how to use an incentive spirometer.
   • D.Assess the client's response to the first antibiotic dose.

   Rationale: Obtaining a routine temperature is a predictable task that can be assigned to UAP, with results reported to the PN. Assessing a medication response, teaching, and evaluating oxygen effectiveness require nursing judgment. The PN remains responsible for following up on abnormal findings.

2. 2.In a long-term care facility, an 82-year-old resident with heart failure has new dyspnea while dressing; RR is 28/min and SpO2 is 89% on room air. Which action should the PN take first?

   • A.Offer a large glass of water and reassess in 30 minutes.
   • B.Document the finding at the end of the shift.
   • C.Help the resident sit upright and promptly notify the RN.
   • D.Finish assisting with dressing before reporting the change.

   Rationale: The new dyspnea and low oxygen saturation require immediate attention; upright positioning supports breathing while the PN promptly reports the change. Delaying to finish dressing or waiting 30 minutes risks deterioration. Documentation does not replace timely intervention and communication.

3. 3.During a home visit, a 68-year-old client with diabetes has a healing foot ulcer, temperature 37.2 C, and capillary glucose 196 mg/dL. Which findings should the PN report to the RN? Select all that apply.

   • A.The ulcer has new purulent drainage.
   • B.Redness has spread 2 cm beyond the wound edge since yesterday.
   • C.The client says the prescribed dressing is changed as directed.
   • D.The client reports a new fever and chills overnight.
   • E.The client has a glucose reading of 196 mg/dL after lunch.
   • F.The client reports new numbness extending up the foot.

   Rationale: Purulent drainage, fever with chills, spreading redness, and new ascending numbness suggest infection or worsening tissue and nerve involvement and should be reported. Correct dressing use is reassuring, not an urgent change. A single postmeal glucose of 196 mg/dL should be documented and interpreted according to the client's prescribed parameters, but it is not as concerning as the other findings.

4. 4.A provider prescribes an oral antibiotic for a 54-year-old clinic client. Before administration, the client says, "I had trouble breathing after penicillin." What should the PN do?

   • A.Give the dose with food and observe for a rash.
   • B.Document the statement and administer the medication as prescribed.
   • C.Ask the client to take half the dose first.
   • D.Withhold the dose and promptly report the allergy history to the RN or provider.

   Answer and rationale are in the full material.

5. 5.On a rehabilitation unit, a 70-year-old client with a new leg cast reports increasing pain despite prescribed oral analgesia; toes are cool and capillary refill is 4 seconds. What should the PN do?

   • A.Promptly report the findings to the RN and keep the limb supported at heart level.
   • B.Wait until the next scheduled neurovascular check.
   • C.Apply a heating pad over the cast.
   • D.Encourage walking to improve circulation.

   Answer and rationale are in the full material.