2022-2024 HESI PN Child Care Comprehensive Exit Exam With Answers (115 Solved Questions)

Name: 2022-2024 HESI PN Child Care Comprehensive Exit Exam With Answers (115 Solved Questions)
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ATI COMPREHENSIVE HESI PN EXIT EXAM | UPDATED
VERSION 2022/2023/2024 | REAL EXAMS
• The practical nurse (PN) is observing a client self-administering
a dose if subcutaneous insulin. What step of the injection
technique should the practical nurse (PN) reteach?
a. Injects air into the insulin vial to displace the dose
b. Selects the same site that was used for the previous injection
c. Inserts the needle at a 90-degree angle to the skin surface
d. Uses a circular motion when applying an alcohol pad to the site
Rationale: The PN should reteach the client to rotate the NOON site
to a site other than the same one used for the AM dose. Different
sites used throughout the day may provide a varying rate of
absorption related to activity. Intra-site rotation is recommended for
the dose used during one specific time of the day. The other choices
are acceptable techniques for subcutaneous injection of insulin.

• The practical nurse (PN) observes a newly hired unlicensed assistive
Personnel (UAP) who is counting a client’s radial pulse as
seen in the picture. Which action should the PN take?
a. Confirm accuracy of the pulse rate obtained by the UAP
b. Instruct the UAP to report any abnormal findings
c. Remind the UAP to check the clients pulse volume
d. Demonstrate the correct pulse site to the UAP (follow the
thumb for the radial pulse,follow the pinky for the brachial)
Rationale: When checking the radial pulse, the index and middle finger
should be aligned withthe thumb, for brachial pulse assessment should
be aligned with the pinky finger.
• The birth weight of an infant delivered by a woman with gestational
diabetes is 10.1 pounds (4,581 grams). The infant is jittery and
has a heel stick glucose level of 40 mg/dL(2.2 mmol/L or SI units)
30 minutes after birth. Based on this information, which
intervention should the practical nurse (PN) implement first?
a. Repeat the heel stick for glucose in one hour
b. Offer nipple feedings of 10% dextrose
c. Begin frequent feedings of breast milk or formula
d. Assess for signs of hypocalcemia

Rationale: Providing frequent feedings will reduce the infants blood
glucose; we wouldn’twant to obtain another heel stick as we want to
do less invasive as possible.
• A client consumes 8 ounces (oz) of broth, 4 oz of apple juice, 4 ounces
of
flavored gelatinand 1 banana. During the same shift, this client
receives 1 liter of IV fluid and voids 700 mL. How many mL total oral
and IV intake should the PN document on the client’s medical
record? (Enter numeric value only).
8 oz x 30 mL = 240 mL
4 oz x 30 mL = 120 mL
4 oz x 30 mL = 120 mL
1 L = 1000 mL
Total intake = 1480 mL
• The nurse is very busy and running late with administering
medications and asks thepractical nurse (PN) to administer a
medication already drawn up in an unlabeled syringe. How
should the PN respond?
a. “You should know that I cannot administer the medication in this
syringe”
b. “As long as the charge nurse checks the syringe, I can give the
medication”
c. “Teamwork is the best approach. I will be glad to help you get caught

up”
d. “I am not comfortable doing that. Is there something else I
can do to help you?”
Rationale: Explaining your comfortability is always okay because you
don’t want to jeopardize your license, so offering to help with the
nurse’s other workload is being. A team player.
• The practical nurse (PN) is assigning care for a group of clients on the
urology medicalunit. Which client should the PN assign to the
unlicensed assistive personnel (UAP)? (Select all that apply.)
a. Irrigate an indwelling urinary catheter for a client with bladder
suspension
b. Obtain a post-voided residual (PVR) volume
c. Empty beside drainage unit for a client with indwelling urinary
catheter
d. Teach the client with 昀氀uid restrictions how to measure urine output
e. Transport a urine culture sample to the laboratory
Rationale: The scope of practice of UAP includes personal care such as
bowel and bladder careincluding intake and output measurements.
Emptying urine from bedside drainage units and transporting
specimens are tasks that can be assigned to the UAP.
• Which intervention should the practical nurse (PN) reinforce for a client
with

pruritis?
a. Encourage a warm sleeping environment
b. Do not take any type of tub bath
c. Discourage use of skin lubricants
d. Keep fingernails trimmed short
Rationale: Keeping fingernails short with rough edges filed helps
minimize excoriation fromscratching the pruritic (itch) area.
• While administering prescription medications to an older resident
in an extended care facility, the practical nurse (PN) notices that
the client is
having difficulty hearing. What action is most important for the
PN to take?
a. Speak louder so the client can hear the conversation
b. Encourage the client to read the practical nurse’s lips
c. Provide written instructions about how to take medications
d. Determine if the client has had di昀케culty in the past
Rationale: In the older population, presbycusis is common and results
from degenerative changes in the ear with again and is often a gradual
progressive, bilateral inability to hear, especially high frequency
sounds. Most importantly, the PN should determine if the clients

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hearing problem is new or gradual, chronic condition.
• The healthcare provider prescribes cefazolin 500 mg IM every 6
hours. The available vialis labeled, “Cefazolin 1 gram,” and the
instructions for reconstitution state, “For IM use, add 2.5 mL sterile
water for injection to provide a total volume of 3.0 mL.” After
reconstitution, how many mL should be administered to the client?
(enter numeric valueonly. If rounding is required, round to the
nearest tenth.)
1.3 mL
Rationale: 1 g 1000 mg; 500 mg/ 1000 = 0.5; 0.5 x 2.5 mL =
1.25 rounded to nearesttenth = 1.3 mL
• In caring for a client with Buck’s traction, the practical nurse
(PN) observes that the prescribed amount weights are
hanging freely, and
the traction rope is on the pulley.Which action should
the PN implement first?
a. Adjust the traction rope so it is free from the pulley
b. Place the weights on blocks to increase their stability
c. Contact the orthopedic technician to adjust the traction
d. Document that the Buck’s traction is being maintained

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Rationale: Weights that hang freely with ropes in the pulleys indicate
the traction is correctlyapplied. The PN should document the Buck’s
traction is being maintained.
• When a small fire breaks out in the kitchen of a long-term
care facility, which task ismost important for the practical
nurse (PN) to perform instead of assigning to a unlicensed
assistive personnel?
a. Provide blankets to each of the residents for use during evacuation
b. Identify the method for transporting and evacuating each resident
c. Close the doors to all of the residents’ rooms
d. Offer comfort care and reassurance to each resident
• The practical nurse (PN) is caring for a client with coronary artery
disease who is admitted with intermittent chest pain. The
admission laboratory results indicate elevations in troponin I and
creatine phosphokinase myoglobulin isoenzyme (CK-MB) levels.
What should the PN consider the
most significant risk for this client on the secondday of admission?

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a. The lab results indicate myocardial damage, and the
client is at risk for cardiacdysrhythmias
b. The client is at risk for recurrent long-term angina
pain and subsequent myocardialinfarction
c. The client is at risk for pulmonary embolism,
and lifestyle modifications need to
beimplemented
d. The lab results indicate risk factors for transient ischemic
attack (TIA), and neuro-vitalsigns should be monitored
Rationale: Elevations in serum troponin 1 and CK-MB indicate
myocardial cell damage whichcause an instability of the myocardial
call membrane and can precipitate life-threatening cardiac
dysrhythmias that increase in the first 24-48 hours after a MI.
Although the clients underlying pathology places the client at risk for
other complications, the incidence of dysrhythmias in the immediate
post-MI period is greatest.
• `The practical nurse (PN) observes hematuria in the urinary
catheter drainage tubing of aclient who is receiving
intravenous heparin. Which action should the PN implement
first?
a. Obtain a urine specimen for urinalysis
b. Check the client’s gums for bleeding
c. Document the finding in the client’s medical record

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d. Irrigate the urinary catheter with sterile normal saline
• The practical nurse (PN) explains the 2-week dosage
prescription of prednisone to a client who has poison ivy
covering multiple skin surfaces.
What should the PN emphasizeabout the dosing schedule?
a. Take the prednisone with meals
b. Monitor oral temperature daily
c. Return for blood glucose monitoring in one week
d. Decrease dosage daily as prescribed
• A client is receiving an anticonvulsant, diazepam, intravenously
for status epilepticus.Which intervention is most important for the
practical nurse (PN) to implement?
a. Monitor the client’s respiratory rate and effort
b. Observe the clients’ eyes for deviation to the side
c. Record hourly blood pressures for the next 4 hours
d. Measure hourly urinary output for the next 8 hours
• The practical nurse (PN) administers filgrastim to a client with
neutropenia. The clientlater complains of bone pain. Which
action should the PN take?

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a. Reassure the client that neutropenia often causes bone pain
b. Plan to administer the next dose at an alternate injection site
c. Offer to administer a prescribed PRN analgesic to the client
d. Prepare a variance report about the onset of pain after injection
Rationale: Medullary bone pain is a side effect of filgrastim, and the PN
should offer toadminister an analgesic to provide pain relief.
• The practical nurse (PN) is caring for a client who has been taking
nonsteroidal anti- in昀氀ammatory drug ibuprofen for arthritic
pain. Which action will the PN include in thisclient plan of care?
a. Give the medication on an empty stomach
b. Observe for signs of gastrointestinal bleeding
c. Encourage the client to wear sunblock when outside
d. Monitor the blood pressure frequently
Rationale: A common side effect of NSAIDs is gastrointestinal (GI)
distress. The PN shouldobserve for any signs of GI bleeding, and these
should be reported immediately, and the client should quit taking the
medication.
• The practical nurse (PN) reviews instructions for use
of polyethylene glycol, a laxative,with a client
scheduled for a colonoscopy. Which instruction
should the PN include?

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a. Report the onset of watery diarrhea to the healthcare provider
b. Dilute the liquid medication with fruit juice to mask the 昀氀avor
c. Drink each glass of solution rapidly at regular specified time
intervals
d. Drink the solution with the evening meal before the scheduled exam
Rationale: to produce the best effect, the client should be instructed
to drink each glass (240ml) of polyethylene glycol solution rapidly and
at regular intervals
• The practical nurse (PN) notifies the healthcare provider about
client information usingSituation, Background, Assessment,
Recommendation (SBAR) technique. Which information should
the PN provide first?
a. A 26-year-old client
b. Intravenous 昀氀uids infusing at 75 mL/hr
c. Blood pressure is 80/48 mmHg
d. Cholecystectomy 24 hours ago
• In administering nystatin suspension to the gums of an infant
with candida infection,which approach should the practical
nurse (PN) use?
a. Irrigate the infected area medicated solution after applying sterile
gloves

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b. Draw up the medication in a needle-less syringe which the infant
can suck
c. Use a gloved finger to rub the suspension over the infected area
d. Measure the prescribed amount of solution into the infant’s bottle
• When obtaining a capillary blood sample for glucose
measurement, which interventionshould the practical nurse
(PN) implement?
a. Grasp the subcutaneous tissue and pull upward
b. Remove any nail polish from the fingernails
c. Determine which finger was used previously
d. Apply a tourniquet above the antecubital fossa
Rationale: Using another site than a previously accessed finger pad
reduces repeated traumato the tissue and capillary supply in the
distal finger where the blood sample is taken.
• The practical nurse (PN) is assisting a client to cough and deep
breathe following surgery.To facilitate effective coughing, the PN
should assist the client to assume which position?
a. Lying prone with the head turned to one side
b. Leaning forward over the bedside table
c. Left-lateral with pillow between 昀氀exed knees
d. Sitting on the side of bed with feet 昀氀at on the 昀氀oor

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Rationale: Sitting upright facilitates diaphragm excursion and enhances
thoracic andabdominal expansion.
• An older female adult who was admitted to a long-term care
facility yesterday is confused about what day of the week it is.
Her history does not indicate that she wasconfused prior to
admission. What action should the practical nurse (PN) take?
a. Remind the client what day of the week it is
b. Document the client’s loss of memory in the record
c. Notify the family of the changes in the client’s condition
d. Encourage the client to rest during the day
Rationale: Relocation often results in confusion among elderly
clients during times of adjustment to new surroundings. The PN
should remind the client which day of the week it iswhen she
forgets or becomes confused. The other actions are not indicated at
this time for relocation or stress.
• The practical nurse (PN) learns that a client who is receiving
chemotherapy has developed stomatitis. Which information
should the PN obtain from the client during afocused
assessment?
a. Frequency of bowel movements
b. Blood pressure while standing

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c. Ability to swallow
d. Urinary output
Rationale: Stomatitis or in昀氀ammation of the oral mucosa can
cause pain and result in di昀케culty in swallowing. The PN should
gather information related to the client’s ability toswallow.
• The practical nurse (PN) is assigned to care for a client who had
an endoscopic procedure in which the local anesthetic was
sprayed on the throat. Which priority actionshould the PN
include in the clients plan of care?
a. Instruct the client to speak
b. Inquire about a sore throat
c. Observe for belching
d. Assess the gag re昀氀ex
• A client receives ondansetron prior to a
chemotherapy treatment. How should thepractical
nurse evaluate the effectiveness of the
medication?
a. Determine if the client feels calm and relaxed before the treatment
b. Monitor the client for nausea and vomiting following the treatment
c. Observe the client for signs of pain or discomfort during the treatment
d. Assess for changes in vital signs during and after the treatment

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Rationale: Ondansetron is an antiemetic administered prior to
chemotherapy to prevent post-treatment nausea and vomiting. The
other actions do not evaluate the desired effect of ondansetron.
• When gathering data about a client with dark skin tones,
which site should the practicalnurse (PN) observe?
a. Finger and toenails
b. Sclera and mucous membranes
c. Forehead and face
d. Hands and feet
• An older client who had a colon resection 8 days ago is straining
at stool. The practical nurse (PN) observes sudden spillage of
serosanguinous drainage from the client's woundfollowed by
appearance of bowel on the skin. Which complication has
occurred?
a. Evisceration
b. Dehiscence
c. Hemorrhage
d. Infection
Rationale: Evisceration is the complete separation of a wound with

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2022-2024 HESI PN Child Care Comprehensive Exit Exam With Answers (115 Solved Questions)

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