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INSTANT PDF DOWNLOAD. HESI PN Exit V4 Exam study guide featuring NCLEX Next Generation (NGN) case-based scenarios and exam-style practice questions with answers. Covers clinical judgment, prioritization, delegation, patient safety, pharmacology, medical-surgical nursing, maternal-newborn, pediatrics, mental health, leadership, nursing fundamentals, and evidence-based nursing concepts for comprehensive HESI PN Exit and NCLEX-PN exam preparation. HESI PN Exit, HESI V4, NCLEX NGN, NCLEX-PN, Practice Questions, Nursing Review, Study Guide, Exam Prep HESI PN Exit, HESI V4, PN Exit Exam, NCLEX-PN, NGN NCLEX, Case Scenarios, Clinical Judgment, Nursing Exam, Practice Questions, Pharmacology, Med Surg, Maternal Nursing, Pediatrics, Mental Health, Leadership, HESI Review, Study Guide, Test Bank, Exam Prep, HESI PDF
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❖ multiple-choice questions (MCQs)** with four options (A–D), answers, and detailed rationales aligned with HESI PN Exit Exam 2025 standards. ❖ Some questions are flagged as NCLEX-style (NGN), and relevant case studies/vitals are integrated where applicable.
The practical nurse (PN) is caring for a client with obstructive sleep apnea (OSA). The PN should recognize the client is at increased risk for which complication?
A. Urinary tract infection B. Peptic ulcer disease C. Peripheral vascular disease D. Chronic kidney disease
Answer: B. Peptic ulcer disease
Rationale: Clients with obstructive sleep apnea experience hypoxia and increased sympathetic nervous system activity, which can increase gastric acid secretion and predispose them to peptic ulcer disease. Chronic intermittent hypoxia also promotes stress ulcers. While OSA can contribute to cardiovascular problems, peptic ulcers are a noted complication due to physiological stress and medication used for treatment.
During a mass casualty response to a natural flooding disaster, which information should the practical nurse include in health education for evacuees?
A. Use bottled water or boiled water for drinking and oral rehydration solutions B. Use only bottled water for washing hands C. All fruits and vegetables must be cooked before eating D. Use only alcohol-based sanitizers for cleaning food items
Answer: A. Use bottled water or boiled water for drinking and oral rehydration solutions
Rationale: After flooding, waterborne diseases are common; drinking boiled or bottled water and using oral rehydration solutions prevent dehydration and infection. Hand hygiene with soap and clean water or alcohol-based sanitizers is recommended (not just bottled water). Fruits and vegetables can be washed (not necessarily cooked) with clean water.
In administering nystatin oral suspension for an infant with oral candidiasis (thrush), which approach should the practical nurse use?
A. Administer suspension with a bottle nipple B. Use a gloved finger to apply the suspension over infected areas C. Mix medication with feeding formula D. Wipe the infant’s mouth with a cotton swab before administration
Answer: B. Use a gloved finger to apply the suspension over infected areas
Rationale: Nystatin should be applied directly to the affected mucosa for effectiveness. Using a gloved finger allows thorough coating of all infected surfaces. Mixing with formula (C) dilutes medication and reduces efficacy. Bottle nipple administration (A) risks uneven distribution, while wiping (D) is insufficient treatment.
Prior to administering pain medication to an older adult postoperative client, what important information should the practical nurse obtain?
D. Substitute with a macrolide antibiotic
Answer: A. Administer the medication and monitor for rash and hives
Rationale: Cephalexin is a cephalosporin with possible cross-reactivity (~10%) with penicillin allergies. Monitoring for allergic reactions is essential, but withholding medication may delay treatment. The PN must be alert for signs of hypersensitivity and intervene if needed.
During a focused gastrointestinal assessment, a male client reports his last bowel movement was three days ago. What is the practical nurse’s first action?
A. Administer a prescribed laxative immediately B. Document the information and continue assessment C. Determine the client’s usual bowel movement patterns D. Initiate bowel training program
Answer: C. Determine the client’s usual bowel movement patterns
Rationale: Understanding the client’s baseline bowel habits guides interpretation of current constipation. Some clients have less frequent normal bowel movements. Immediate intervention without assessment could be inappropriate.
The practical nurse is teaching an older client recovering from a stroke how to use a cane. Which instruction is correct regarding cane placement?
A. Place the cane on the ineffective (weaker) side B. Place the cane on the stronger side C. Use the cane only for balance, not support D. Place the cane two steps behind the foot
Answer: A. Place the cane on the ineffective (weaker) side
Rationale:
A client is receiving intravenous (IV) fluids via gravity infusion. Which part of the IV delivery system should the practical nurse monitor to ensure the client receives the correct fluid volume?
A. IV insertion site for signs of infiltration B. Hourly intake and output records C. The drip chamber to count drops per minute D. IV tubing for kinks or clots
Answer: C. The drip chamber to count drops per minute
Rationale: For gravity infusions, the drip chamber controls fluid flow rate; monitoring drops per minute ensures correct volume delivery. Inspection of insertion site (A) is important for safety but unrelated to volume accuracy. Intake/output (B) is indirect. Tubing condition (D) is important but secondary to flow rate control.
Scenario) The practical nurse (PN) is caring for a client with influenza who requires droplet precautions. Which action should the PN take after entering the client’s room to provide care?
A. Wear a particulate respirator mask B. Place the client in a negative pressure room C. Close the door to the client’s room D. Change gloves after every procedure
Answer: C. Close the door to the client’s room
Rationale: Influenza spreads via droplets that can travel short distances when the client coughs or sneezes. Closing the door limits the spread of these droplets to others in the vicinity. Wearing a respirator (A) is not required for droplet precautions (it is needed for airborne precautions). Negative pressure rooms (B) are used for airborne infections like tuberculosis. Changing gloves is important, but door management is key for droplet containment immediately after room entry.
(NGN Style) The PN working in a skilled nursing unit delegates a 2-hour turning schedule for bedridden clients to a UAP to minimize lower back injury. Which strategies should the PN implement when moving clients in bed?
A. Move the client alone without assistance B. Keep the base of support narrow to increase speed C. Encourage the client to help and maintain a broad base of support D. Use a twisting motion to reposition the client swiftly
Answer: C. Encourage the client to help and maintain a broad base of support
Rationale: Encouraging client participation decreases strain on the nurse or UAP. Maintaining a broad base of support increases stability and helps prevent injury during repositioning. Twisting motions and narrow stances increase injury risk, and moving a client alone without help is unsafe.
Style) Before giving pain medication, which assessments should the PN perform?
A. Document pain score, assess medication effectiveness, and note the last dose time B. Administer medication immediately and check vitals after C. Only give medication if vital signs are abnormal D. Rely on client’s verbal request without further assessment
Answer: A. Document pain score, assess medication effectiveness, and note the last dose time
Rationale: Effective pain management starts with assessing pain intensity (pain score), prior medication effectiveness, and timing of the last dose to avoid overdose. Administering medication without assessment risks under- or overmedicating. Client’s report is important but should be corroborated with clinical data.
The PN accompanies a healthcare provider when a client is diagnosed with stage 5 metastatic cancer. The client’s wife immediately says, “You must have made a mistake; we want a second opinion.” Which stage of the grieving process should the PN consider when responding?
A. Acceptance B. Denial C. Bargaining D. Depression
Answer: B. Denial
Rationale: Denial is a common initial response to bad news, where clients or families refuse to accept the reality of a diagnosis. Understanding this allows the PN to communicate with empathy and provide appropriate support. Acceptance occurs later, bargaining involves attempts to negotiate, and depression involves profound sadness.
During a focused assessment of a male client with schizophrenia admitted to an acute care facility, which behavior should the PN document as a symptom of schizophrenia?
A. The client expresses excessive happiness B. The client reports voices telling him to hurt himself C. The client denies all symptoms D. The client appears confused about time
Answer: B. The client reports voices telling him to hurt himself
Rationale: Auditory hallucinations (hearing voices) commanding self-harm reflect a classic positive symptom of schizophrenia. Excessive happiness is not a core symptom, denial is common but insufficient for diagnosis, and confusion may occur but is nonspecific.
(EMR) Use (NGN Style) Based on the computer documentation in the EMR, the PN should implement which action?
C. Lower the suction pressure to match the 15 cm level D. Notify the healthcare provider about possible tube dislodgment
Answer: B. Add sterile water to the suction chamber to 20 cm level
Rationale: The suction chamber requires sterile water at the prescribed 20 cm depth to generate effective suction. A fluid level below prescribed pressure indicates insufficient suction pressure. Clamping the tube can cause complications. Lowering suction without provider orders or unnecessary notification is premature.
The mother of an 8-year-old boy reports that he fell from a tree and hurt his arm and shoulder. Which finding should alert the PN to possible child abuse?
A. Bruising over the left arm B. The story given by the mother differs from what the child reports C. Delay in seeking medical treatment D. Child’s cooperation during assessment
Answer: B. The story given by the mother differs from what the child reports
Rationale: Discrepancies between caregiver and child reports of injury raise suspicion for potential abuse. Bruising and delay can occur in accidental injuries; cooperation does not rule out abuse. Early recognition is imperative for child safety.
A 15-year-old male client with mild intellectual disability is admitted to the adolescent psychiatric unit because he repeatedly refuses to complete personal hygiene tasks. The health care provider prescribes that the client brush his teeth 3 times daily. In the psychiatric team conference, a behavior modification program is recommended to engage the client’s participation.
Which reinforcement is the best for the practical nurse (PN) to provide?
A. Praise the client verbally after every hygiene task B. Offer candy for each successful hygiene task, such as brushing teeth C. Use time-out penalties for missed hygiene activities
