HESI PN Exit Fall

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Sample questions from HESI PN Exit Fall

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

1. 1.At change of shift on a medical unit, the PN receives report on four clients. Which client should the PN report to the RN first?

   • A.A client with diabetes whose premeal glucose is 168 mg/dL
   • B.A client 1 day after surgery requesting assistance to the bathroom
   • C.A client with chronic back pain reporting 7/10 pain after walking
   • D.A client with heart failure who has new confusion and an SpO2 of 88% on room air

   Rationale: New confusion with oxygen saturation of 88% may indicate acute hypoxemia and requires prompt RN assessment. Pain, a moderately elevated glucose, and a request for toileting need care but are less urgent than impaired oxygenation. Report the change promptly and follow the facility's emergency response procedures if the client deteriorates.

2. 2.In a long-term care facility, an RN asks the PN to assign a stable resident's routine morning bath to an unlicensed assistive personnel (UAP). Which task is appropriate for the PN to assign?

   • A.Help the resident with a familiar bath and report any observed changes
   • B.Evaluate whether a pain medication was effective
   • C.Assess the resident's skin for a new pressure injury
   • D.Teach the resident how to manage a new ostomy

   Rationale: A UAP may provide routine, predictable personal care to a stable resident and report observations. Skin assessment, initial teaching, and evaluation require nursing judgment and are not appropriate UAP assignments. The PN should follow facility policy and remain responsible for communicating reported changes to the RN.

3. 3.During a home health visit, a 76-year-old client with heart failure reports increased fatigue and ankle swelling. Which findings should the PN report promptly to the RN? Select all that apply.

   • A.Weight increased 2.3 kg (5 lb) in 3 days
   • B.New shortness of breath while sitting still
   • C.Bilateral ankle edema is unchanged from the prior visit
   • D.Client says, "I skipped my diuretic yesterday because I was going out"
   • E.SpO2 is 90% on room air, down from 96% at the prior visit

   Rationale: A rapid weight gain, new dyspnea at rest, and a fall in oxygen saturation suggest worsening fluid overload and need prompt RN follow-up. Skipping the diuretic is important medication information to report so the RN can address adherence and assess risk. Unchanged edema alone is not a new deterioration, although it should still be documented and monitored.

4. 4.A provider prescribes a medication dose that is substantially higher than the dose listed in the facility drug reference for a 9-year-old. What should the PN do before administering it?

   • A.Give half the prescribed dose and document the change
   • B.Hold the medication and clarify the prescription with the RN or provider
   • C.Ask another PN to verify the dose and then administer it
   • D.Give the dose because the provider prescribed it

   Answer and rationale are in the full material.

5. 5.In a rehabilitation unit, a client with a new below-knee amputation says, "I do not understand how to care for this incision." Which action is appropriate for the PN?

   • A.Independently teach a new incision-care procedure
   • B.Determine which home-care services the client will need
   • C.Reinforce the RN's incision-care instructions and report remaining questions
   • D.Create the client's discharge teaching plan

   Answer and rationale are in the full material.