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HESI Exit Exam Practice
Questions
HESI Exit Exam Review
This document summarizes information related to a HESI exit exam, containing 799 questions. The content is presented in a question-and- answer format, covering various nursing topics.
Patient Education and Care
A male client with a duodenal ulcer states he will drink plenty of dairy products. The nurse should review the need to avoid foods rich in milk and cream.
When an unlicensed assistive personnel (UAP) is positioning a client with a seizure disorder, the nurse should use pillows to prop the client in a side- lying position.
A hypertensive male client returns to the clinic two weeks after receiving new antihypertensive prescriptions. The nurse should be aware that stroke secondary to hemorrhage is a potential complication.
An adolescent taking duloxetine (Cymbalta) for major depressive disorder for 12 days requires immediate follow-up if they describe life without purpose.
A 60-year-old female with a family history of ovarian cancer and an abdominal mass may need further evaluation involving surgery.
When assessing an adult client with a partial rebreather mask where the oxygen reservoir bag does not deflate completely during inspiration and the respiratory rate is 14 breaths/minute, the nurse should document the assessment data.
During shift report, if the central electrocardiogram (EKG) monitoring system alarms, the nurse should investigate respiratory apnea of 30 seconds first.
If an elderly client with diabetes slips and falls during a home visit, the nurse should check the client for lacerations or fractures.
A woman scheduled for a repeat cesarean section (C-section) admits to drinking coffee at 0400. The nurse should inform the anesthesia care provider.
After placing a stethoscope to auscultate S1 and S2 heart sounds, the nurse should listen with the bell at the same location.
A 66-year-old woman retiring and losing health insurance should be referred to Medicare.
A client taking an oral tetracycline complains of gastrointestinal upset. Toasted wheat bread and jelly is an appropriate food choice.
Following a lumbar puncture, a client complaining of a headache that gets worse when sitting up indicates a complication.
An elderly client with confusion, nausea, dysuria, urgency, and incontinence requires the nurse to obtain a clean-catch mid-stream urine specimen.
The mother of a child with phenylketonuria (PKU) should avoid foods sweetened with aspartame.
Before the first surgical case of the day, a part-time scrub nurse asking if a 3-minute surgical hand scrub is adequate should be directed to continue the surgical hand scrub for a 5-minute duration.
Nursing Prioritization and Assessment
In a critical care unit with less than the optimal number of registered nurses, an 82-year-old client with Alzheimer's disease, a newly fractured femur, a Foley catheter, and soft wrist restraints requires the most care hours by a registered nurse (RN).
A mother brings her 6-year-old child who stepped on a rusty nail to the pediatrician's office. The nurse should cleanse the foot with soap and water and apply an antibiotic ointment.
The mother of an adolescent with athlete's foot who has been applying triple antibiotic ointment for two days without improvement should be advised to use an antifungal ointment and encourage complete drying of the feet and wearing clean socks.
A 26-year-old female client admitted for a simple goiter and prescribed levothyroxine sodium (Synthroid) should be monitored for palpitations and shortness of breath.
A client with a history of heart failure presenting with nausea, vomiting, yellow vision, and palpitations requires the nurse to obtain a list of medications taken for cardiac history.
When auscultating a client's heart sounds, the nurse should identify a murmur.
A client receiving hydromorphone (Dilaudid) every six hours for four days requires the nurse to auscultate the client's bowel sounds.
Acute Respiratory Distress Syndrome (ARDS)
When caring for a client who has acute respiratory distress syndrome (ARDS), the nurse elevates the head of the bed 30 degrees to reduce abdominal pressure on the diaphragm.
Gallbladder Palpation
When assessing a mildly obese 35-year-old female client, the nurse is unable to locate the gallbladder when palpating below the liver margin at the lateral border of the rectus abdominal muscle. The gallbladder is normal.
Postpartum Anxiety
A woman with an anxiety disorder calls her obstetrician's office and reports increased anxiety since the normal vaginal delivery of her son three weeks ago. The nurse should inform her that some antianxiety medications are safe to take while breastfeeding.
Diabetes, Abdominal Cramping, and Vomiting
An older male client with a history of type 1 diabetes has not felt well the past few days and arrives at the clinic with abdominal cramping and vomiting. The nurse should first start an intravenous (IV) infusion of normal saline.
Antihypertensive Medications and Syncope
A client who received multiple antihypertensive medications experiences syncope due to a drop in blood pressure to 70/40. The effect of multiple medications has caused the blood pressure to drop too low.
Risk for Delirium
An adult client who cannot sleep due to constant pain is at the greatest risk for developing delirium.
Chronic Obstructive Pulmonary Disease (COPD)
For a client with Chronic Obstructive Pulmonary Disease (COPD), the nurse should include reducing risk factors for infection in a long-term plan of care.
Hypothyroidism Screening
The text does not specify the best location for beginning a screening program for hypothyroidism.
Prednisone Use
A female client has been taking a high dose of prednisone, a corticosteroid, for several months. Measuring vital signs is the most important nursing intervention to implement.
Numbness, Tingling, and Serum Calcium
A male client reports the onset of numbness and tingling in his fingers and around his mouth. The nurse should review the serum calcium lab before contacting the health care provider.
Log-Rolling Technique
The best explanation for the nurse to provide a client who asks the purpose of using the log-rolling technique for turning is that turning instead of pulling reduces the likelihood of skin damage.
Chemotherapy and Neutropenia
A client receiving chemotherapy has severe neutropenia. Baked apples topped with dried raisins is an appropriate food choice.
Scoliosis Screening
When conducting a screening for scoliosis, the school nurse should first inspect for symmetrical shoulder height.
HESI Exit Exam Questions
Vital Signs and UAP Reports
An unlicensed assistive personnel (UAP) reports a client has a weak pulse with a rate of 44 beats/minute.
Loss of Consciousness and Blood Glucose
A female client experiences a sudden loss of consciousness and is taken to the ED. Initial assessment reveals a critically low blood glucose level.
Dietary Recommendations
Following a sudden loss of consciousness and critically low blood glucose, a low-carbohydrate and high-protein diet is encouraged.
Medical Alert Bracelet
Suggest wearing a medical alert bracelet at all times.
Critical Lab Value
Glucose is a critical lab value.
Azithromycin Education
Azithromycin is prescribed for an adolescent female with lower lobe pneumonia and recurrent chlamydia. It is most important for the nurse to advise the client to use two forms of contraception while taking this drug.
Rapid Speech and Flight of Ideas
A client in the emergency center demonstrates rapid speech, flight of ideas, and reports sleeping only three hours during the past 48 hours. Divalproex is indicated.
Bipolar Disorder and Lithium Levels
A male client admitted for bipolar disorder has slurred speech and an unsteady gait. The most important assessment finding to report is a serum lithium level of 1.6 mEq/L or mmol/l (SI).
Chest Pain Assessment
A client admitted to the cardiac observation unit complaining of chest pain should have the following intervention: Administer prescribed morphine sulfate IV and provide oxygen at 2 L/min per nasal cannula.
Community Teaching Program
When developing a teaching program for the community, literacy level is a key factor to consider.
Warfarin (Coumadin) Discharge Instructions
A client being discharged with a prescription for warfarin (Coumadin) should be instructed to eat approximately the same amount of leafy green vegetables daily so the amount of vitamin K consumed is consistent.
MRSA Precautions
A client who had a small bowel resection acquired methicillin resistant staphylococcus aureus (MRSA) while hospitalized. Maintain contact transmission precaution.
Morphine Sulfate Overdose
A postoperative female client has a prescription for morphine sulfate 10 mg IV q3 hours for pain. If the client is overdosing, administer Naloxone IV.
Osteoporosis and Fall Prevention
The most important intervention for the nurse to include in the plan of care for an older woman with osteoporosis is to place the client on fall precautions.
Labor Monitoring
Continue to monitor the progress of labor.
Intestinal Obstruction and Nasogastric Tube
A client with intestinal obstruction has a nasogastric tube to low intermittent suction and is receiving an IV of lactated ringer's at 100 ml/H. The most important finding to report is a serum potassium level of 3.1 mEq/ L or mmol/L (SI).
Leukocyte Function
Eosinophils are involved with allergic responses and the destruction of parasitic worms.
Cephradine Administration
The healthcare provider prescribes the antibiotic cephradine 500mg PO every 6 hours for a client with a postoperative wound infection. Administer with cinnamon applesauce.
Neuropathic Pain
Several months after a foot injury, an adult woman is diagnosed with neuropathic pain.
Leg Fracture Complication
One day following an open reduction and internal fixation of a compound fracture of the leg, a male client complains of 'a tingly sensation' in his left foot.
Multiple Sclerosis and Uhthoff's Sign
A client with multiple sclerosis (MS) has decreased motor function after taking a hot bath (Uhthoff's sign). Temporary vasodilation is the pathophysiological mechanism that supports this response.
Radial Artery Catheter Complication
While assessing a radial artery catheter, the client complains of numbness and pain distal to the insertion site.
Postural Drainage for COPD
When performing postural drainage on a client with COPD, the nurse should explain that the client may be placed in five positions.
Bell's Palsy vs. Stroke
A client presents with right-sided facial asymmetry. Inability to close the affected eye, raise the brow, or smile suggests Bell's palsy rather than a stroke.
Colostomy Irrigation
A client is taught how to perform colostomy irrigation. Keeping the irrigating container less than 18 inches above the stoma indicates understanding of the teaching.
Dronedarone Precautions
The nurse should teach the client to avoid grapefruits and its juice while taking dronedarone.
Head Injury Assessment
A client with a head injury following an automobile collision is admitted to the hospital. Confusion and papilledema are key findings.
Central Venous Catheter
A client is receiving continuous IV fluids through a single lumen central venous catheter (CVC). Gently flush the catheter lumen with sterile saline solution.
Elevated Fasting Blood Sugar
An older woman's fasting blood sugar (FBS) is determined to be 140 mg/dl during an annual physical examination. A repeated fasting blood sugar (FBS) is 132 mg/dl.
New Mother's Uncertainty
A new mother expresses uncertainty about transitioning into parenthood. Determine if she can ask for support from family, friend, or the baby's father.
Dehydration and IV Infusion
A client admitted with severe dehydration is complaining of pain. A 24 gauge IV with normal saline is infusing at a rate of 150 ml/hour.
Change in Sensorium
An elderly female is admitted because of a change in her level of sensorium.
Unna Boot Application
An Unna boot is applied to a client with a venous stasis ulcer. Monitor the ongoing wound healing.
Preoperative Anxiety
At the end of a preoperative teaching session on pain management techniques, a client starts to cry and states, 'I just know I can't handle all the pain.' This indicates anxiety.
Umbilical Cord Prolapse
The nurse notes a visible prolapse of the umbilical cord after a client experiences spontaneous rupture of the membranes during labor. Elevate the presenting part off the cord.
Post-Hip Replacement Complications
A client who had a right hip replacement 3 days ago is pale, has diminished breath sounds over the left lower lung fields, a temperature of 100.2 F, and an oxygen saturation rate of 90%. Reassess readiness for SNF transfer.
Health History with Older Client
An older male comes to the clinic with a family member. When the nurse attempts to take the client's health history, he does not respond to questions in a clear manner. Assess the surroundings for noise and distractions.
Acute Renal Failure
The nurse caring for a client with acute renal fluid (ARF) has noted that the client has voided 800 ml of urine in 4 hours.
Tetanus in a Child
Which intervention should the nurse include in the plan of care for a child with tetanus? Minimize the number of stimuli in the room.
