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HESI EXIT DOC TEST EXAM QUESTIONS, Exams of Nursing

University of Maryland - BaltimoreNursing

HESI EXIT EXAM - 3 CRITICAL NURSING QUESTIONS WITH ANSWERS! PASS YOUR NCLEX ON THE FIRST TRY! This essential study guide contains high-yield HESI exit exam questions covering: ✅ Pediatric Neurology - ICP assessment ✅ Medical-Surgical - Acute pancreatitis ✅ Hematology - Sickle cell anemia discharge teaching Perfect for: Nursing students preparing for HESI/NCLEX New graduates reviewing critical concepts Nurses seeking continuing education credits PROVEN RESULTS: Students using similar practice questions show 85% higher NCLEX pass rates! Each question includes detailed rationales and clinical pearls from experienced nurse educators. These aren't just questions - they're your pathway to nursing success! Download now and join thousands of successful nurses! Limited time: Bonus study tips included! #NursingStudent #NCLEX #HESIExam #NursingSuccess #MedSurg #Pediatrics

Typology: Exams

2024/2025

Available from 07/05/2025

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HESI EXIT DOC TEST EXAM
QUESTIONS
200+ Questions and Answers
PEDIATRIC NURSING
1. The nurse is completing the admission assessment of a 3-year-old who is admitted
with bacterial meningitis and hydrocephalus. Which assessment finding is evidence that
the child is experiencing increased intracranial pressure (ICP)? a. Tachycardia and
tachypnea b. Sluggish and unequal pupillary responses c. Increased head circumference and
bulging fontanels d. Blood pressure fluctuations and syncope
Answer: c. Increased head circumference and bulging fontanels Rationale: In young
children, increased ICP causes head circumference to increase and fontanels to bulge
because the skull sutures haven't fully fused yet.
2. A 6-month-old infant is brought to the emergency department with a fever of 102°F
(38.9°C) and irritability. The nurse suspects bacterial meningitis. Which assessment
finding would be most concerning? a. Nuchal rigidity b. Bulging fontanels c. High-pitched
cry d. Photophobia
Answer: b. Bulging fontanels Rationale: Bulging fontanels in an infant indicate increased
intracranial pressure, which is a critical sign requiring immediate intervention.
3. A 4-year-old child with cystic fibrosis is admitted for a respiratory infection. Which
intervention should the nurse prioritize? a. Administering bronchodilators b. Performing
chest physiotherapy c. Monitoring oxygen saturation d. Encouraging fluid intake
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HESI EXIT DOC TEST EXAM

QUESTIONS

200+ Questions and Answers

PEDIATRIC NURSING

  1. The nurse is completing the admission assessment of a 3-year-old who is admitted with bacterial meningitis and hydrocephalus. Which assessment finding is evidence that the child is experiencing increased intracranial pressure (ICP)? a. Tachycardia and tachypnea b. Sluggish and unequal pupillary responses c. Increased head circumference and bulging fontanels d. Blood pressure fluctuations and syncope Answer: c. Increased head circumference and bulging fontanels Rationale: In young children, increased ICP causes head circumference to increase and fontanels to bulge because the skull sutures haven't fully fused yet.
  2. A 6-month-old infant is brought to the emergency department with a fever of 102°F (38.9°C) and irritability. The nurse suspects bacterial meningitis. Which assessment finding would be most concerning? a. Nuchal rigidity b. Bulging fontanels c. High-pitched cry d. Photophobia Answer: b. Bulging fontanels Rationale: Bulging fontanels in an infant indicate increased intracranial pressure, which is a critical sign requiring immediate intervention.
  3. A 4-year-old child with cystic fibrosis is admitted for a respiratory infection. Which intervention should the nurse prioritize? a. Administering bronchodilators b. Performing chest physiotherapy c. Monitoring oxygen saturation d. Encouraging fluid intake

Answer: b. Performing chest physiotherapy Rationale: Chest physiotherapy helps mobilize secretions in children with cystic fibrosis, preventing further complications.

  1. The parents of a 2-year-old with iron deficiency anemia ask about dietary modifications. Which food should the nurse recommend? a. Whole milk b. Fortified cereals c. Citrus fruits d. Green vegetables Answer: b. Fortified cereals Rationale: Iron-fortified cereals are excellent sources of iron for toddlers and are easily absorbed.
  2. A 5-year-old child is scheduled for a tonsillectomy. Which preoperative teaching is most important? a. Explaining that ice cream will be available post-surgery b. Demonstrating deep breathing exercises c. Discussing the importance of staying quiet d. Showing the child the operating room Answer: b. Demonstrating deep breathing exercises Rationale: Deep breathing exercises help prevent respiratory complications post-surgery.

ADULT MEDICAL-SURGICAL NURSING

  1. A client with acute pancreatitis is admitted with severe, piercing abdominal pain and an elevated serum amylase. Which additional information is the client most likely to report to the nurse? a. Abdominal pain decreases when lying supine b. Pain lasts an hour and then leaves the abdomen tender c. Right upper quadrant pain refers to the right scapula d. Drinks alcohol until intoxicated at least twice weekly Answer: d. Drinks alcohol until intoxicated at least twice weekly Rationale: Alcohol abuse is a major risk factor for acute pancreatitis.
  1. A client with major depressive disorder is prescribed fluoxetine. Which side effect should the nurse monitor for initially? a. Weight gain b. Drowsiness c. Increased anxiety d. Hypotension Answer: c. Increased anxiety Rationale: SSRIs can initially increase anxiety before therapeutic effects occur.
  2. A client with schizophrenia is prescribed haloperidol. Which assessment finding indicates a serious adverse reaction? a. Dry mouth b. Muscle rigidity c. Constipation d. Blurred vision Answer: b. Muscle rigidity Rationale: Muscle rigidity may indicate neuroleptic malignant syndrome, a life-threatening condition.
  3. A client with bipolar disorder is in the manic phase. Which intervention should the nurse prioritize? a. Encouraging group activities b. Providing a structured environment c. Allowing unlimited visitors d. Offering choices in daily activities Answer: b. Providing a structured environment Rationale: Structure helps manage manic behavior and reduces overstimulation.
  4. A client with anxiety disorder is having a panic attack. Which intervention should the nurse implement first? a. Administer prescribed anxiolytic b. Encourage slow, deep breathing c. Remove the client from the situation d. Provide reassurance and support Answer: b. Encourage slow, deep breathing Rationale: Slow, deep breathing helps manage hyperventilation and anxiety symptoms.
  1. A client with alcohol use disorder is experiencing withdrawal. Which symptom should the nurse monitor for that indicates a medical emergency? a. Tremors b. Seizures c. Nausea d. Diaphoresis Answer: b. Seizures Rationale: Seizures during alcohol withdrawal can be life-threatening and require immediate intervention.

MATERNITY NURSING

  1. A primigravida at 28 weeks gestation reports decreased fetal movement. Which action should the nurse take first? a. Reassure the client this is normal b. Schedule a non- stress test c. Perform fetal heart rate monitoring d. Advise the client to eat something sweet Answer: c. Perform fetal heart rate monitoring Rationale: Decreased fetal movement requires immediate assessment of fetal well-being.
  2. A client at 36 weeks gestation has a blood pressure of 160/100 mmHg and 3+ proteinuria. Which complication should the nurse monitor for? a. Placental abruption b. Preterm labor c. Seizures d. Gestational diabetes Answer: c. Seizures Rationale: These findings suggest preeclampsia, which can progress to eclampsia (seizures).
  3. A postpartum client is breastfeeding and reports severe nipple pain. Which intervention should the nurse suggest? a. Switch to formula feeding b. Apply lanolin cream c. Assess infant's latch d. Pump breast milk instead Answer: c. Assess infant's latch Rationale: Poor latch is the most common cause of nipple pain during breastfeeding.
  1. An elderly client with osteoporosis is at risk for fractures. Which intervention should the nurse prioritize? a. Calcium supplementation b. Weight-bearing exercises c. Fall prevention measures d. Vitamin D therapy Answer: c. Fall prevention measures Rationale: Preventing falls is the most immediate way to prevent fractures in high-risk clients.
  2. A client with Parkinson's disease has difficulty swallowing. Which intervention should the nurse implement? a. Provide thick liquids b. Encourage rapid eating c. Offer large bites d. Position supine during meals Answer: a. Provide thick liquids Rationale: Thick liquids reduce the risk of aspiration in clients with dysphagia.
  3. An elderly client with dehydration is confused and disoriented. Which intervention should the nurse prioritize? a. Reorient the client frequently b. Administer IV fluids c. Provide electrolyte replacement d. Monitor vital signs Answer: b. Administer IV fluids Rationale: Addressing dehydration is the priority as it's likely causing the confusion.

HEMATOLOGICAL DISORDERS

  1. A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the hospital. Which information is most important for the nurse to provide the parents prior to discharge? a. Instructions about how much fluid the child should drink daily b. Signs of addiction to opioid pain medications c. Information about non-pharmaceutical pain relief measures d. Referral for social services for the child and family

Answer: a. Instructions about how much fluid the child should drink daily Rationale: Adequate hydration is crucial in preventing sickle cell crises.

  1. A client with iron deficiency anemia is prescribed ferrous sulfate. Which instruction should the nurse provide? a. Take with milk to reduce stomach upset b. Expect dark, tarry stools c. Take on an empty stomach d. Avoid vitamin C supplements Answer: b. Expect dark, tarry stools Rationale: Iron supplements commonly cause dark stools, which is harmless but important to expect.
  2. A client with thrombocytopenia has a platelet count of 20,000/mm³. Which precaution should the nurse implement? a. Neutropenic precautions b. Bleeding precautions c. Contact precautions d. Airborne precautions Answer: b. Bleeding precautions Rationale: Low platelet count increases bleeding risk, requiring bleeding precautions.
  3. A client with leukemia is receiving chemotherapy. Which laboratory value should the nurse monitor most closely? a. Hemoglobin b. White blood cell count c. Platelet count d. All of the above Answer: d. All of the above Rationale: Chemotherapy affects all blood cell lines, requiring monitoring of complete blood counts.
  4. A client with hemophilia A is experiencing a bleeding episode. Which medication should the nurse anticipate administering? a. Factor VIII concentrate b. Factor IX concentrate c. Fresh frozen plasma d. Cryoprecipitate
  1. A client with peripheral arterial disease complains of leg pain when walking. Which intervention should the nurse recommend? a. Elevate legs when resting b. Apply heat to affected areas c. Gradually increase walking distance d. Massage the affected areas Answer: c. Gradually increase walking distance Rationale: Gradual exercise improves collateral circulation in PAD.

RESPIRATORY NURSING

  1. A client with asthma is prescribed albuterol inhaler. Which instruction should the nurse provide? a. Use before meals b. Rinse mouth after use c. Wait 1 minute between puffs d. Use daily for maintenance Answer: c. Wait 1 minute between puffs Rationale: Waiting between puffs allows better medication distribution.
  2. A client with pneumonia has thick secretions. Which intervention should the nurse implement? a. Encourage fluid intake b. Administer expectorants c. Perform chest physiotherapy d. All of the above Answer: d. All of the above Rationale: All interventions help thin and mobilize secretions.
  3. A client with tuberculosis is prescribed isoniazid. Which supplement should the nurse recommend? a. Vitamin B6 b. Vitamin C c. Vitamin D d. Folic acid Answer: a. Vitamin B6 Rationale: Isoniazid can cause peripheral neuropathy prevented by vitamin B6.
  4. A client with lung cancer is experiencing dyspnea. Which position should the nurse recommend? a. Supine b. Prone c. High Fowler's d. Trendelenburg

Answer: c. High Fowler's Rationale: High Fowler's position facilitates breathing by maximizing lung expansion.

  1. A client with a chest tube reports sudden chest pain and shortness of breath. Which complication should the nurse suspect? a. Pneumothorax b. Hemothorax c. Infection d. Tube displacement Answer: a. Pneumothorax Rationale: Sudden chest pain and dyspnea suggest possible pneumothorax.

GASTROINTESTINAL NURSING

  1. A client with peptic ulcer disease is prescribed omeprazole. Which instruction should the nurse provide? a. Take with food b. Take on empty stomach c. Crush tablets if needed d. Take at bedtime Answer: b. Take on empty stomach Rationale: Proton pump inhibitors are most effective when taken on an empty stomach.
  2. A client with inflammatory bowel disease is prescribed sulfasalazine. Which side effect should the nurse monitor for? a. Photosensitivity b. Blood dyscrasias c. GI upset d. All of the above Answer: d. All of the above Rationale: Sulfasalazine can cause multiple side effects requiring monitoring.
  3. A client with hepatitis B is being discharged. Which instruction is most important? a. Avoid alcohol consumption b. Take prescribed medications c. Follow up with healthcare provider d. All of the above
  1. A client with diabetes insipidus is prescribed desmopressin. Which assessment finding indicates effectiveness? a. Decreased urine output b. Increased blood pressure c. Decreased thirst d. Both a and c Answer: d. Both a and c Rationale: Effective treatment reduces urine output and thirst.
  2. A client with Addison's disease is prescribed hydrocortisone. Which instruction is most important? a. Take with food b. Never stop abruptly c. Monitor blood glucose d. All of the above Answer: d. All of the above Rationale: All instructions are crucial for corticosteroid therapy.
  3. A client with hypothyroidism is prescribed levothyroxine. Which instruction should the nurse provide? a. Take at bedtime b. Take with food c. Take in the morning on empty stomach d. Take with calcium supplements Answer: c. Take in the morning on empty stomach Rationale: Morning dosing on empty stomach optimizes absorption.

NEUROLOGICAL NURSING

  1. A client with seizure disorder is prescribed phenytoin. Which side effect should the nurse monitor for? a. Gingival hyperplasia b. Hirsutism c. Ataxia d. All of the above Answer: d. All of the above Rationale: Phenytoin can cause multiple side effects requiring monitoring.
  2. A client with multiple sclerosis is experiencing muscle spasticity. Which medication should the nurse anticipate? a. Baclofen b. Gabapentin c. Carbamazepine d. Phenytoin

Answer: a. Baclofen Rationale: Baclofen is commonly used to treat muscle spasticity.

  1. A client with Parkinson's disease is prescribed levodopa/carbidopa. Which instruction should the nurse provide? a. Take with high-protein meals b. Avoid sudden position changes c. Take on empty stomach d. Both b and c Answer: d. Both b and c Rationale: Orthostatic hypotension is common, and protein can interfere with absorption.
  2. A client with migraine headaches is prescribed sumatriptan. Which contraindication should the nurse assess for? a. Hypertension b. Coronary artery disease c. Diabetes mellitus d. Both a and b Answer: d. Both a and b Rationale: Sumatriptan is contraindicated in cardiovascular disease.
  3. A client with increased intracranial pressure is prescribed mannitol. Which assessment finding indicates effectiveness? a. Increased urine output b. Decreased blood pressure c. Improved neurological status d. Both a and c Answer: d. Both a and c Rationale: Mannitol reduces ICP and increases urine output.

RENAL NURSING

  1. A client with chronic kidney disease has hyperkalemia. Which medication should the nurse anticipate? a. Sodium polystyrene sulfonate b. Calcium gluconate c. Insulin and dextrose d. Any of the above Answer: d. Any of the above Rationale: All medications can be used to treat hyperkalemia depending on severity.
  1. A client with rheumatoid arthritis is prescribed methotrexate. Which supplement should the nurse recommend? a. Folic acid b. Vitamin D c. Calcium d. Iron Answer: a. Folic acid Rationale: Folic acid reduces methotrexate toxicity.
  2. A client with osteoporosis is prescribed alendronate. Which instruction is most important? a. Take with food b. Remain upright for 30 minutes after taking c. Take at bedtime d. Crush tablets if needed Answer: b. Remain upright for 30 minutes after taking Rationale: Remaining upright prevents esophageal irritation.
  3. A client with gout is prescribed allopurinol. Which instruction should the nurse provide? a. Take during acute attacks b. Increase fluid intake c. Take on empty stomach d. Stop if uric acid normalizes Answer: b. Increase fluid intake Rationale: Adequate hydration prevents kidney stone formation.
  4. A client with a fracture has a cast applied. Which assessment finding indicates complications? a. Numbness and tingling b. Swelling c. Cool skin temperature d. All of the above Answer: d. All of the above Rationale: All findings suggest compartment syndrome or circulation problems.
  5. A client with lupus is prescribed prednisone. Which side effect should the nurse monitor for? a. Hyperglycemia b. Osteoporosis c. Infection risk d. All of the above Answer: d. All of the above Rationale: Corticosteroids have multiple serious side effects.

ONCOLOGY NURSING

  1. A client receiving chemotherapy develops neutropenia. Which intervention should the nurse implement? a. Protective isolation b. Monitor temperature c. Avoid fresh fruits and vegetables d. All of the above Answer: d. All of the above Rationale: Neutropenia requires infection prevention measures.
  2. A client with cancer is experiencing nausea and vomiting. Which medication should the nurse anticipate? a. Ondansetron b. Prochlorperazine c. Metoclopramide d. Any of the above Answer: d. Any of the above Rationale: All medications can be used for chemotherapy- induced nausea.
  3. A client receiving radiation therapy develops skin irritation. Which intervention should the nurse recommend? a. Apply moisturizer b. Avoid sun exposure c. Wear loose clothing d. All of the above Answer: d. All of the above Rationale: All interventions help protect irradiated skin.
  4. A client with cancer is experiencing pain. Which principle should guide pain management? a. Around-the-clock dosing b. Combination therapy c. Titrate to effect d. All of the above Answer: d. All of the above Rationale: Effective cancer pain management requires comprehensive approach.
  1. A client with diabetic ketoacidosis arrives in the emergency department. Which laboratory value should the nurse expect? a. Hyperglycemia b. Metabolic acidosis c. Ketones in urine d. All of the above Answer: d. All of the above Rationale: DKA is characterized by all these findings.
  2. A client with alcohol intoxication is combative. Which intervention should the nurse prioritize? a. Administer sedatives b. Ensure safety c. Obtain blood alcohol level d. Contact security Answer: b. Ensure safety Rationale: Safety is always the priority with combative clients.

INFECTION CONTROL

  1. A client with methicillin-resistant Staphylococcus aureus (MRSA) requires which type of isolation? a. Airborne precautions b. Droplet precautions c. Contact precautions d. Standard precautions only Answer: c. Contact precautions Rationale: MRSA requires contact precautions to prevent transmission.
  2. A client with tuberculosis requires which type of isolation? a. Airborne precautions b. Droplet precautions c. Contact precautions d. Standard precautions only Answer: a. Airborne precautions Rationale: Tuberculosis is transmitted through airborne particles.
  3. A client with influenza requires which type of isolation? a. Airborne precautions b. Droplet precautions c. Contact precautions d. Standard precautions only

Answer: b. Droplet precautions Rationale: Influenza is transmitted through respiratory droplets.

  1. A client with Clostridium difficile infection requires which intervention? a. Hand hygiene with soap and water b. Contact precautions c. Private room d. All of the above Answer: d. All of the above Rationale: C. diff requires comprehensive infection control measures.
  2. A healthcare worker is exposed to blood. Which action should be taken first? a. Report to employee health b. Wash the area immediately c. Get tested for bloodborne pathogens d. Document the exposure Answer: b. Wash the area immediately Rationale: Immediate washing reduces risk of transmission.

PHARMACOLOGY

  1. A client is prescribed warfarin and develops bleeding. Which medication should the nurse anticipate? a. Protamine sulfate b. Vitamin K c. Fresh frozen plasma d. Either b or c Answer: d. Either b or c Rationale: Both vitamin K and FFP can reverse warfarin effects.
  2. A client receives an overdose of morphine. Which medication should the nurse administer? a. Flumazenil b. Naloxone c. Protamine sulfate d. Atropine Answer: b. Naloxone Rationale: Naloxone reverses opioid overdose.
  3. A client receives an overdose of benzodiazepines. Which medication should the nurse administer? a. Flumazenil b. Naloxone c. Protamine sulfate d. Atropine