HESI Exit Exam Over 700 Questions, Answers
Rationale New 2019/2020 latest 100%
1. Following discharge teaching, a male client with duodenal ulcer
tells the nurse the he will drink plenty of dairy products, such as
milk, to help coat and protect his ulcer. What is the best follow-up
action by the nurse?
a- Remind the client that it is also important to switch to decaffeinated
coffee and tea.
b- Suggest that the client also plan to eat frequent small meals to
reduce discomfort
c- Review with the client the need to avoid foods that are rich in
milk and cream.
d- Reinforce this teaching by asking the client to list a dairy food that he
might select.
Rationale: Diets rich in milk and cream stimulate gastric acid secretion
and should be avoided.
2. A male client with hypertension, who received new
antihypertensive prescriptions at his last visit returns to the clinic
two weeks later to evaluate his blood pressure (BP). His BP is
158/106 and he admits that he has not been taking the prescribed
medication because the drugs make him “feel bad”. In explaining
the need for hypertension control, the nurse should stress that an
elevated BP places the client at risk for which pathophysiological
condition?
a- Blindness secondary to cataracts
b- Acute kidney injury due to glomerular damage
c- Stroke secondary to hemorrhage
d- Heart block due to myocardial damage
Rationale: Stroke related to cerebral hemorrhage is major risk for
uncontrolled hypertension.
3. The nurse observes an unlicensed assistive personnel (UAP)
positioning a newly admitted client who has a seizure disorder.
The client is supine and the UAP is placing soft pillows along the
side rails. What action should the nurse implement?
a- Ensure that the UAP has placed the pillows effectively to protect the
client.
b- Instruct the UAP to obtain soft blankets to secure to the side rails
instead of pillows.
a- Assume responsibility for placing the pillows while the UAP
completes another task.
b- Ask the UAP to use some of the pillows to prop the client in a side
lying position.
Rationale: The nurse should instruct the UAP to pad the side rails with
soft blankest because the use of pillows could result in suffocation and
would need to be removed at the onset of the seizure. The nurse can
delegate paddling the side rails to the UAP
4. An adolescent with major depressive disorder has been taking
duloxetine (Cymbalta) for the past 12 days. Which assessment
finding requires immediate follow-up?
a- Describes life without purpose
b- Complains of nausea and loss of appetite
c- States is often fatigued and drowsy
d- Exhibits an increase in sweating.
Rationale: Cymbalta is a selective serotonin and norepinephrine
reuptake inhibitor that is known to increase the risk of suicidal
thinking in adolescents and young adults with major depressive
disorder. B, C and D are side effects
5. A 60-year-old female client with a positive family history of
ovarian cancer has developed an abdominal mass and is being
evaluated for possible ovarian cancer. Her Papanicolau (Pap)
smear results are negative. What information should the nurse
include in the client’s teaching plan?
a- Further evaluation involving surgery may be needed
b- A pelvic exam is also needed before cancer is ruled out
c- Pap smear evaluation should be continued every six month
d- One additional negative pap smear in six months is needed.
Rationale: An abdominal mass in a client with a family history for
ovarian cancer should be evaluated carefully
6. A client who recently underwear a tracheostomy is being
prepared for discharge to home. Which instructions is most
important for the nurse to include in the discharge plan?
a- Explain how to use communication tools.
b- Teach tracheal suctioning techniques
c- Encourage self-care and independence.
d- Demonstrate how to clean tracheostomy site.
Rationale: Suctioning helps to clear secretions and maintain an open
airway, which is critical.
7. In assessing an adult client with a partial rebreather mask, the
nurse notes that the oxygen reservoir bag does not deflate
completely during inspiration and the client’s respiratory rate is
14 breaths / minute. What action should the nurse implement?
a- Encourage the client to take deep breaths
b- Remove the mask to deflate the bag
c- Increase the liter flow of oxygen
d- Document the assessment data
Rational: reservoir bag should not deflate completely during inspiration
and the client’s respiratory rate is within normal limits.
8. During a home visit, the nurse observed an elderly client with
diabetes slip and fall. What action should the nurse take first?
a- Give the client 4 ounces of orange juice
b- Call 911 to summon emergency assistance
c- Check the client for lacerations or fractures
d- Asses clients blood sugar level
Rationale: After the client falls, the nurse should immediately assess for
the possibility of injuries and provide first aid as needed
9. At 0600 while admitting a woman for a schedule repeat cesarean
section (C-Section), the client tells the nurse that she drank a cup
a coffee at 0400 because she wanted to avoid getting a headache.
Which action should the nurse take first?
a- Ensure preoperative lab results are available
b- Start prescribed IV with lactated Ringer’s
c- Inform the anesthesia care provider
d- Contact the client’s obstetrician.
Rationale: Surgical preoperative instruction includes NPO after midnight
the day of surgery to decrease the risk of aspiration should vomiting
occur during anesthesia. While it is possible the C-section will be done
on schedule or rescheduled for later in the day, the anesthesia provider
should be notified first. 10. After placing a stethoscope as seen in the picture, the nurse
auscultates S1 and S2 heart sounds. To determine if an S3 heart
sound is present, what action should the nurse take first?
a- Side the stethoscope across the sternum.
b- Move the stethoscope to the mitral site
c- Listen with the bell at the same location
d- Observe the cardiac telemetry monitor
Rationale: The nurse uses the bell of the stethoscope to hear low-pitched
sounds such as S3 and S4. The nurse listens at the same site using the
diaphragm the diaphragm and bell before moving systematically to the
next sites.
11. A 66-year-old woman is retiring and will no longer have a
health insurance through her place of employment. Which agency
should the client be referred to by the employee health nurse for
health insurance needs?
a- Woman, Infant, and Children program
b- Medicaid
c- Medicare
d- Consolidated Omnibus Budget Reconciliation Act provision.
Rationale: Title XVII of the social security Act of 1965 created
Medicare Program to provide medical insurance for person more than 65
years or older, disable or with permeant kidney failure, WIC provides
supplemental nutrition to meet the needs of pregnant of breastfeeding
woman, infants and children up to age of 6. Medicaid provides financial
assistance to pay for medical services for poor older adults, blind,
disable and families with dependent children. COBRA(D) health benefit
provisions is a limited insurance plan for those who has been laid off or
become unemployed. 12. A client who is taking an oral dose of a tetracycline complains
of gastrointestinal upset. What snack should the nurse instruct
the client to take with the tetracycline?
a- Fruit-flavored yogurt.
b- Cheese and crackers.
c- Cold cereal with skim milk.
d- Toasted wheat bread and jelly
Rationale: Dairy products decrease the effect of tetracycline, so the
nurse instructs the client to eat a snack such as toast, which contains no
dairy products and may decrease GI symptoms.
13. Following a lumbar puncture, a client voices several
complaints. What complaint indicated to the nurse that the client
is experiencing a complication?
a- “I am having pain in my lower back when I move my legs”
b- “My throat hurts when I swallow”
c- “I feel sick to my stomach and am going to throw up”
d- I have a headache that gets worse when I sit up”
Rationale: A post-lumbar puncture headache, ranging from mild to
severe, may occur as a result of leakage of cerebrospinal fluid at the
puncture site. This complication is usually managed by bedrest,
analgesic, and hydration.
14. An elderly client seems confused and reports the onset of
nausea, dysuria, and urgency with incontinence. Which action
should the nurse implement?
a- Auscultate for renal bruits
b- Obtain a clean catch mid-stream specimen
c- Use a dipstick to measure for urinary ketone
d- Begin to strain the client’s urine.
Rationale: This elderly is experiencing symptoms of urinary tract
infection. The nurse should obtain a clean catch mid-stream specimen to
determine the causative agent so an anti-infective agent can be
prescribed. 15. The nurse is assisting the mother of a child with
phenylketonuria (PKU) to select foods that are in keeping with
the child’s dietary restrictions. Which foods are contraindicated
for this child?
a- Wheat products
b- Foods sweetened with aspartame.
c- High fat foods
d- High calories foods. Rationale: Aspartame should not be consumed by a child with PKU
because ut is converted to phenylalanine in the body. Additionally,
milk and milk products are contraindicated for children with PKU.
16. Before preparing a client for the first surgical case of the day, a
part-time scrub nurse asks the circulating nurse if a 3-minute
surgical hand scrub is adequate preparation for this client. Which
response should the circulating nurse provide?
a- Ask a more experience nurse to perform that scrub since it is the first
time of the day
b- Validate the nurse is implementing the OR policy for surgical hand
scrub
c- Inform the nurse that hand scrubs should be 3 minutes between cases.
d- Direct the nurse to continue the surgical hand scrub for a 5-
minute duration. Rationale: The surgical hand scrub should last for 5 to 10 mints, so the
nurse should be directed to continue the vigorous scrub using a
reliable agent for the total duration of 5 mints. It is not necessary to
reassign staff (A). The length of the hand scrub and subsequent scrubs
during the day require the same process for the same amount of time,
(B and C)
17. Which breakfast selection indicates that the client understands
the nurse’s instructions about the dietary management of
osteoporosis?
a- Egg whites, toast and coffee.
b- Bran muffin, mixed fruits, and orange juice.
c- Granola and grapefruit juice
d- Bagel with jelly and skim milk.
Rationale: D includes dairy products which contain calcium and does
not include any foods that inhibit calcium absorption. The primary
dietary implication of osteoporosis is the need for increased calcium and
reduction in foods that decrease calcium absorption, such as caffeine and
excessive fiber. 18. The charge nurse of a critical care unit is informed at the
beginning of the shift that less than the optimal number of
registered nurses will be working that shift. In planning
assignments, which client should receive the most care hours by a
registered nurse (RN)?
a- A 34-year -old admitted today after an emergency appendendectomy
who has a peripheral intravenous catheter and a Foley catheter.
b- A 48-year-old marathon runner with a central venous catheter who is
experiencing nausea and vomiting due to electrolyte disturbance
following a race.
c- A 63-year-old chain smoker admitted with chronic bronchitis who is
receiving oxygen via nasal cannula and has a saline-locked peripheral
intravenous catheter.
d- An 82-year-old client with Alzheimer’s disease newly-fractures
femur who has a Foley catheter and soft wrist restrains applied
Rationale: (D) describe the client at the most risk for injury and
complications because of the factor listed. (A) has complete the recovery
period form anesthesia but requires critical care because of the invasive
lines and new abdominal incision. (B) is likely to be in excellent
physical condition and has one invasive line needed for rehydration. (C)
is essentially stable, despite having a chronic condition.
19. Z
a- Cleanse the foot with soap and water and apply an antibiotic
ointment
b- Provide teaching about the need for a tetanus booster within the next
72 hours.
c- have the mother check the child's temperature q4h for the next 24
hours
d- transfer the child to the emergency department to receive a gamma
globulin injection
Rationale: The nurse should cleanse the wound first and implement B
next.
20. The mother of an adolescent tells the clinic nurse, “My son has
athlete’s foot, I have been applying triple antibiotic ointment for
two days, but there has been no improvement.” What instruction
should the nurse provide?
a- Antibiotics take two weeks to become effective against infections such
as athlete’s foot.
b- Continue using the ointment for a full week, even after the symptoms
disappear.
c- Applying too much ointment can deter its effectiveness. Apply a thin
layer to prevent maceration.
d- Stop using the ointment and encourage complete drying of the feet
and wearing clean socks.
Rationale: Athlete’s foot (tinea pedi) is a fungal infection that afflicts
the feet and causes scaliness and cracking of the skin between the toes
and on the soles of the feet. The feet should be ventilated, dried well
after bathing, and clean socks should be placed on the feet after
bathing. Antifungal ointments may be prescribed, but antibiotic
ointments are not useful.
21. A 26-year-old female client is admitted to the hospital for
treatment of a simple goiter, and levothyroxine sodium
(Synthroid) is prescribed. Which symptoms indicate to the nurse
that the prescribed dosage is too high for this client? The client
experiences
a- Palpitations and shortness of breath
b- Bradycardia and constipation
c- Lethargy and lack of appetite
d- Muscle cramping and dry, flushed skin
Rationale: An overdose of thyroid preparation generally manifests
symptoms of an agitated state such as tremors, palpitations, shortness of
breath, tachycardia, increased appetite, agitation, sweating and diarrhea.
22. A client with a history of heart failure presents to the clinic
with a nausea, vomiting, yellow vision and palpitations. Which
finding is most important for the nurse to assess to the client?
a- Determine the client’s level of orientation and cognition
b- Assess distal pulses and signs of peripheral edema
c- Obtain a list of medications taken for cardiac history.
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