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HESI RN Exit Exam Questions with Verified Answers
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 pres- sure (ICP)?
A. Tachycardia and tachypnea
B. Sluggish and unequal pupillary responses
C. Increased head circumference and bulging fontanels
D. Blood pressure fluctuations and syncope: B. Sluggish and unequal pupillary responses
2. 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 leaves the abdomen tender
C. Right upper quadrant pain refers to right scapula
D. Drinks alcohol until intoxicated at least twice weekly.: A. Abdominal pain decreases when lying supine
3. 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: A. Instructions about how much fluid the child should drink
daily
4. To auscultate for a carotid bruit, the nurse places the stethoscope at what location. (Select the location on the
image with a red dot).: I placed the red dot on the base of the neck on the right side
5. After receiving report on an inpatient acute care unit, which client should the nurse assess first?
A. The client with an obstruction of the large intestine who is experiencing abdominal distention
B. The client who had surgery yesterday and is experiencing a paralytic ileus with absent bowel sounds
C. The client with a small bowel obstruction who has a nasogastric tube that is draining greenish fluid
D. The client with a bowel obstruction due to a volvulus who is experiencing abdominal rigidity: D. The client
with a bowel obstruction due to a volvulus who is experiencing abdominal rigidity
6. A teenager presents to the emergency department with palpitations after vaping at a party. The client is
anxious, fearful, and hyperventilating. The nurse anticipates the client developing which acid base imbalance?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory alkalosis: D. Respiratory alkalosis
7. A client with dyspnea is being admitted to the medical unit. To best prepare for the client's arrival, the nurse
should ensure that the client's bed is in which position?
A. Supine
B. supine; feet elevated higher than head
rescued the child from the swimming pool and initiated resuscitation. The nurse notices the older boy becomes withdrawn when asked about what happened. Which action should the nurse take?
A. Develop a water safety teaching plan for the family
B. Ask the older brother how he felt during the incident
C. Tell the older brother that he seems depressed
D. Commend the older brother for his heroic actions: B. Ask the older brother how he felt during the incident
11. A male client with cirrhosis has jaundice and pruritus. He tells the nurse that he has been soaking in hot
baths at night with no relief of his discomfort. Which action should the nurse take?
A. Encourage the client to use cooler water and apply calamine lotion after soaking
B. Obtain a PRN prescription for an analgesic that the client can use for symptom relief
C. Suggest that the client take brief showers and apply oil-based lotion after showering
D. Explain that the symptoms are caused by liver damage and cannot be relieved: A. Encourage the client to use
cooler water and apply calamine lotion after soaking
12. An older client with a long history of coronary artery disease (CAD), hy- pertension (HTN), and heart failure
(HF) arrives in the Emergency Department (ED) in respiratory distress. The healthcare provider prescribes furosemide IV. Which therapeutic response to furosemide should the nurse expected in the client with acute HF?
A. Increased cardiac contractility
B. Reduced preload
C. Relaxed vascular tone
D. Decreased afterload: B. Reduced preload
13. Which intervention should the nurse include in the plan of care for a child with tetanus?
A. Encourage coughing and deep breathing
B. Minimize the amount of stimuli in the room
C. Reposition from side to side every hour
D. Open window shades to provide natural light: B. Minimize the amount of stimuli in the room
14. An adolescent who was diagnosed with diabetes mellitus Type 1 at the age of 9, is admitted to the hospital in
diabetic ketoacidosis. Which occurrence is the most likely cause of the ketoacidosis?
A. Ate an extra peanut butter sandwich before gym class
B. incorrectly administered too much insulin
C. Had a cold and ear infection for the past two days
D. Skipped eating lunch: C. Had a cold and ear infection for the past two days
15. A client with a prescription for "do not resuscitate" (DNR) begins to mani- fest signs of impending death.
After notifying the family of the client's status, what priority action should the nurse implement?
A. The impending signs of death should be documented
B. The client's status should be conveyed to the chaplain
C. The client's need for pain medication should be determined
D. The nurse manager should be updated on the client's status: C. The client's need for pain medication should be
determined
16. Which self care measure is most important for the nurse to include in the plan of care of a client recently
19. A toddler presenting with a history of intermittent skin rashes, hives, abdominal pain, and vomiting that
occurs after ingesting of milk products arrives to the clinic accompanied by the parents. Which type of testing should the nurse provide education to the toddler's family about?
A. Serum immunoglobulin E (IgE)
B. Intradermal test
C. Atopy patch test
D. Placebo-controlled food challenge: A. Serum immunoglobulin E (IgE)
20. A client who is scheduled for a bronchoscopy in the morning is anxious and asking the nurse numerous
questions about the procedure. In preparing the client for the procedure, which intervention has the highest priority?
A. Allow client to gargle with warm salt water
B. Administer a sedative to alleviate anxiety
C. Instruct client to write down the questions
D. Deny client's request for a midnight snack: C. Instruct client to write down the questions
21. The nurse assesses a client one hour after starting a transfusion of packed red blood cells and determines that
there are no indications of a transfusion reaction. What instruction should the nurse provide the unlicensed assistive personnel (UAP) who is working with the nurse?
A. Notify the nurse when the transfusion has finished, so further client assess- ment can be done
B. Continue to measure the client's vital signs every thirty minutes until the transfusion is complete
C. Monitor the client carefully for the next three hours and report the onset of a reaction immediately
D. Since a reaction did not occur, the priority is to maintain client comfort during the transfusion: B. Continue to
measure the client's vital signs every thirty minutes until the transfusion is complete
22. The healthcare provider prescribes a sepsis protocol for a client with multi-organ failure caused by a
ruptured appendix. Which intervention is most important for the nurse to include in the plan of care?
A. Assess warmth of extremities
B. Keep head of bed raised 45 degrees
C. Monitor blood glucose level
D. Maintain strict intake and output: D. Maintain strict intake and output
23. A client presses the call bell and requests pain medication for a severe headache. To assess the quality of
the client's pain, which approach should the nurse use?
A. Ask the client to describe the pain
B. Observe body language and movement
C. Identify effective pain relief measures
D. Provide a numeric pain scale: A. Ask the client to describe the pain
24. A client presents to the labor and delivery unit with a report of leaking fluid that is greenish-brown vaginal
discharge. Which action should the nurse take first?
A. Start an intravenous infusion
B. Administer oxygen via facemask
C. Perform a vaginal exam
C. The unit was understaffed when the client fell
D. The client fell sustaining a fracture to the left hip: D. The client fell sustaining a fracture to the left hip
29. The nurse is reviewing the diagnostic tests prescribed for a client with a positive skin test. Which subjective
findings reported by the client supports the diagnosis of tuberculosis?
A. Barking cough and vomiting
B. Mucopurulent cough and night sweats
C. Dry cough and chest tightness
D. Chronic cough and fatty stools: B. Mucopurulent cough and night sweats
30. In assessing a client with type 1 diabetes mellitus, the nurse notes that the client's respirations have changed
from 16 breaths/min with a normal depth to 32 breaths/min and deep, and the client become lethargic. Which assessment data should the nurse obtain next?
A. Temperature
B. Breath sounds
C. Blood glucose
D. White blood cell count: C. Blood glucose
31. A nurse receives report on a client who is four hours post-total abdominal hysterectomy. The previous nurse
reports that it was necessary to change the client's perineal pad hourly and that it is again saturated. The previous nurse also reports that the client's urinary output has decreased. Which action should the nurse implement first?
A. Evaluate the skin turgor
B. Assess for weakness or dizziness
C. Change the perineal pad
D. Measure the urinary output: B. Assess for weakness or dizziness
32. The father of a 4-year-old has been battling metastatic lung cancer for the past 2 years. After discussing the
remaining options with his health- care provider, the client requests that all treatment stop and that no heroic measures be taken to save his life. When the client is transferred to the palliative care unit, which action is most important for the nurse working on the palliative care unit to take in facilitating continuity of care?
A. Reassure the client that his child will be allowed to visit
B. Provide the client written information about end-of-life care
C. Obtain a detailed report from the nurse transferring the client
D. Mark the chart with client's request for no heroic measures: C. Obtain a detailed report from the nurse
transferring the client
33. While assessing a client who is admitted with heart failure and pulmonary edema, the nurse identifies
dependent peripheral edema, an irregular heart rate, and a persistent cough that produces pink blood-tinged sputum. After initiating continuous telemetry and positioning the client, which intervention should the nurse implement?
A. Obtain sputum sample
B. Document degree of edema
C. Initiate hourly urine output measurement
D. Administer intravenous diuretics: A. Obtain sputum sample
37. The nurse identifies an electrolyte imbalance, a weight gain of 4.4lbs (2kg) in 24 hours and an elevated
central venous pressure for a client with full thickness burns. Which intervention should the nurse implement?
A. Auscultate for irregular heart rate
B. Review arterial blood gases results
C. Measure ankle circumference
D. Document abdominal girth: A. Auscultate for irregular heart rate
38. The nurse is caring for a group of clients with the help of a practical nurse (PN). Which nursing actions
should the nurse assign to the PN? (Select all that apply)
A. Administer a dose of insulin per sliding scale for a client with Type 2 DM
B. Start the second blood transfusion for a client 12 hours following a BKA
C. Initiate patient controlled analgesia (PCA) pumps for two clients immediate- ly postoperatively
D. Perform daily surgical dressing change for a client who had an abdominal hysterectomy
E. Obtain postoperative vital signs for a client one day following unilateral
knee arthroplasty: A. Administer a dose of insulin per sliding scale for a client with Type 2 DM D. Perform daily surgical dressing change for a client who had an abdominal hysterectomy E. Obtain postoperative vital signs for a client one day following unilateral knee arthroplasty
39. The nurse is teaching a group of women about osteoporosis and exercise. The nurse should emphasize the
need for which type of regular activity?
A. Core strengthening
B. Aerobic exercise
C. Weight-bearing exercise
D. Muscle stretching and toning: B. Aerobic exercise
40. A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary
embolism. Which information in the client's history requires follow-up by the nurse?
A. CT scan that was performed 6 months earlier
B. Metal hip prosthesis was placed 20 years ago
C. Report of client's sobriety for the last 5 years
D. Takes metformin for type 2 diabetes mellitus: D. Takes metformin for type 2 diabetes mellitus
41. A client with type 2 diabetes mellitus is admitted for frequent hyper- glycemic episodes and a glycosylated
hemoglobin (A1C) of 10%. Insulin glargine 10 units subcutaneously once a day at bedtime and a sliding scale of insulin aspart every 6h are prescribed. What actions should the nurse include in this client's plan of care? (Select all that apply)
A. Do not contaminate the insulin aspart so that it is available for IV use
B. Review with the client proper foot care and prevention of injury
C. Teach subcutaneous injection technique, site rotation, and insulin manage- ment
D. Coordinate carbohydrate controlled meals at consistent times and inter- vals.
E. Mix bedtime dose of insulin glargine with insulin aspart sliding scale dose
F. Fingerstick glucose assessments every 6h with meals: B. Review with client proper foot care and prevention of
injury C. Teach subcutaneous injection technique, site rotation, and insulin management D. Coordinate carbohydrate-controlled meals at consistent times and intervals
45. Prior to obtaining a trapeze bar for a client with limited mobility, which client assessment is most
important for the nurse to obtain?
A. Upper body muscle strength
B. Balance and posture
C. Risk for disuse syndrome
D. Pressure sore risk: A. Upper body muscle strength
46. A 3-year-old boy was successfully toilet trained prior to his admission to the hospital for injuries sustained
from a fall. His parents are very concerned that the child has regressed in his toileting behaviors. Which information should the nurse provide to the parents?
A. A retraining program will need to be initiated when the child returns home.
B. Diapering will be provided since hospitalization is stressful to preschool- ers
C. A potty chair should be brought from home so he can maintain his toileting skills
D. Children usually resume their toileting behaviors when they leave the
hospital: D. Children usually resume their toileting behaviors when they leave the hospital
47. The nurse is managing the care of a client with Cushing's syndrome. Which interventions should the nurse
delegate to the unlicensed assistive personnel (UAP)? (Select all that apply)
A. Report any client complaint of pain or discomfort
B. Evaluate the client for sleep disturbances
C. Assess the client for weakness and fatigue
D. Weigh the client and report any weight gain
E. Note and report the client's food and liquid intake during meals and snacks-
: A. Report any client complaint of pain or discomfort D. Weigh the client and report any weight gain E. Note and report the client's food and liquid intake during meals and snacks
48. A young adult visits the client reporting symptoms associated with gastri- tis. Which information in the
client's history is most important for the nurse to address in the teaching plan?
A. Consumes 10 or more drinks of alcohol every weekend
B. Snacks on foods with very high salt content on a daily basis
C. Exercises vigorously every evening right before going to bed
D. Recently became a vegetarian and eats a lot of high fiber foods: A. Con- sumes 10 or more drinks of alcohol
every weekend
49. After administering a proton pump inhibitor (PPI), which action should the nurse take to evaluate the
effectiveness of the medication?
emesis sample to the lab
2. Elevate the head of the bed
3. Complete focused assessment
4. Offer PRN pain medication
53. When taking a health history, which information collected by the nurse correlates most directly to a
diagnosis of chronic peripheral arterial insuffi- ciency?
A. History of intermittent claudication
B. A positive Brodie-Trendelenburg test
C. Ankle ulceration and edema
D. A serum cholesterol level of 250mg/dl (6.47mmol/L): A. History of intermittent claudication
54. The nurse is providing discharge teaching to the parents of a 13 month old child who underwent repair for
an atrial septal defect. The healthcare provider prescribes aspirin and an antibiotic for the first 6 months postoperatively to prevent infective endocarditis (IE). What information is most important for the nurse discuss with the parents about the child's recovery and prevention of IE?
A. Refer the mother to the healthcare provider to discuss infective endocardi- tis
B. Brush the child's teeth every day and ensure the child receives regular dental followup
C. Give the child acetaminophen for pain or fever and visit the surgeon for follow-up
D. Monitor the child for regular bowel movements and urine output that exceeds intake: B. Brush the child's teeth
every day and ensure the child receives regular dental followup
55. An unlicensed assistive personnel (UAP) is assigned to ambulate a client with influenza who has droplet
precautions implemented. The UAP requests a change in assignment, stating the reason of having not been fitted
yet for a N95 respirator mask. Which action should the nurse take?
A. send the UAP to be fitted for a particulate filter mask immediately so she can provide care to this client.
B. Instruct the UAP that a standard face mask is sufficient for the provision of care for the assigned client
C. Before changing assignments, determine which staff members have fitted particulate filter masks
D. Advise the UAP to wear a standard face mask to take vital signs, and then get fitted for a filter mask before
providing personal care: B. Instruct the UAP that a standard face mask is sufficient for the provision of care for the assigned client
56. The nurse implements a tertiary prevention program for type 2 diabetes in a rural health clinic. Which
outcome indicates that the program was effective?
A. Only 30% of clients did not attend self-management education sessions.
B. More than 50% of at-risk clients were diagnosed early in their disease process
C. Clients who developed disease complications promptly received rehabili- tation
D. Average client scores improved on specific risk factor knowledge tests: C. Clients who developed disease
complications promptly received rehabilitation
57. Then nurse identifies several nursing problems for client who is immobile and who has been experiencing
fecal incontinence and diarrhea for several days. The client's spouse is the primary caregiver. In planning care, which problem has the highest priority?
A. Impaired bed mobility
B. Caregiver role strain
C. Fluid volume deficit
D. Bowel incontinence: D. Bowel incontinence
