HESI EXIT EXAM 2019/RN HESI EXIT EXAM 160 QUESTIONS AND 100% CORRECT
ANSWERS
1. The nurse knows that which statement by the mother indicates that the mother understands safety
precautions with her four month-old infant and her 4 year-oldchild?
A) "I strap the infant car seat on the front seat to face backwards."
B) "I place my infant in the middle of the living room floor on a blanket to playwith my
4 year old while I make supper in the kitchen."
C) "My sleeping baby lies so cute in the crib with the little buttocks stuck up in theair
while the four year old naps on the sofa."
D) "I have the 4 year-old hold and help feed the four month-old a bottle in thekitchen
while I make supper."
The correct answer is D: "I have the four year-old hold and help feed the fourmonth-old
a bottle in the kitchen
2. Upon completing the admission documents, the nurse learns that the 87 year-oldclient
does not have an advance directive. What action should the nurse take?
,A) Record the information on the chart
B) Give information about advance directives
C) Assume that this client wishes a full code
D) Refer this issue to the unit secretary
The correct answer is B: Give information about advance directives
3. A nurse administers the influenza vaccine to a client in a clinic. Within 15minutes after
the immunization was given, the client complains of itchy and watery eyes,increased
anxiety, and difficulty breathing. The nurse expects that the first action in thesequence of
care for this client will be to
A) Maintain the airway
B) Administer epinephrine 1:1000 as ordered
C) Monitor for hypotension with shock
D) Administer diphenhydramine as ordered
The correct answer is B: Administer epinephrine 1:1000 as ordered .
4. Which of these children at the site of a disaster at a child day care center wouldthe
triage nurse put in the "treat last" category?
,A) An infant with intermittent bulging anterior fontanel between crying episodes
B) A toddler with severe deep abrasions over 98% of the body
C) A preschooler with 1 lower leg fracture and the other leg with an upper legfracture
D) A school-age child with singed eyebrows and hair on the arms
The correct answer is B: A toddler with severe deep abrasions over 98% of thebody .
5. When admitting a client to an acute care facility, an identification bracelet is sentup
with the admission form. In the event these do not match, the nurse’s best action isto
A) Change whichever item is incorrect to the correct information
B) Use the bracelet and admission form until a replacement is supplied
C) Notify the admissions office and wait to apply the bracelet
D) Make a corrected identification bracelet for the client
The correct answer is C: notify the admissions office and wait to apply the bracelet
6. The nurse is having difficulty reading the health care provider's written orderthat was
written right before the shift change. What action should be taken?
A) Leave the order for the oncoming staff to follow-up
, B) Contact the charge nurse for an interpretation
C) Ask the pharmacy for assistance in the interpretation
D) Call the provider for clarification
The correct answer is D: Call the provider for clarification
7. An adult client is found to be unresponsive on morning rounds. After checkingfor
responsiveness and calling for help, the next action that should be taken by thenurse is
to:
A) check the carotid pulse
B) deliver 5 abdominal thrusts
C) give 2 rescue breaths
D) open the client's airway
The correct answer is D: open the client''s airway
8. A client has an order for 1000 ml of D5W over an 8 hour period. The nursediscovers
that 800 ml has been infused after 4 hours. What is the priority nursing action?
A) Ask the client if there are any breathing problems
B) Have the client void as much as possible
C) Check the vital signs
ANSWERS
1. The nurse knows that which statement by the mother indicates that the mother understands safety
precautions with her four month-old infant and her 4 year-oldchild?
A) "I strap the infant car seat on the front seat to face backwards."
B) "I place my infant in the middle of the living room floor on a blanket to playwith my
4 year old while I make supper in the kitchen."
C) "My sleeping baby lies so cute in the crib with the little buttocks stuck up in theair
while the four year old naps on the sofa."
D) "I have the 4 year-old hold and help feed the four month-old a bottle in thekitchen
while I make supper."
The correct answer is D: "I have the four year-old hold and help feed the fourmonth-old
a bottle in the kitchen
2. Upon completing the admission documents, the nurse learns that the 87 year-oldclient
does not have an advance directive. What action should the nurse take?
,A) Record the information on the chart
B) Give information about advance directives
C) Assume that this client wishes a full code
D) Refer this issue to the unit secretary
The correct answer is B: Give information about advance directives
3. A nurse administers the influenza vaccine to a client in a clinic. Within 15minutes after
the immunization was given, the client complains of itchy and watery eyes,increased
anxiety, and difficulty breathing. The nurse expects that the first action in thesequence of
care for this client will be to
A) Maintain the airway
B) Administer epinephrine 1:1000 as ordered
C) Monitor for hypotension with shock
D) Administer diphenhydramine as ordered
The correct answer is B: Administer epinephrine 1:1000 as ordered .
4. Which of these children at the site of a disaster at a child day care center wouldthe
triage nurse put in the "treat last" category?
,A) An infant with intermittent bulging anterior fontanel between crying episodes
B) A toddler with severe deep abrasions over 98% of the body
C) A preschooler with 1 lower leg fracture and the other leg with an upper legfracture
D) A school-age child with singed eyebrows and hair on the arms
The correct answer is B: A toddler with severe deep abrasions over 98% of thebody .
5. When admitting a client to an acute care facility, an identification bracelet is sentup
with the admission form. In the event these do not match, the nurse’s best action isto
A) Change whichever item is incorrect to the correct information
B) Use the bracelet and admission form until a replacement is supplied
C) Notify the admissions office and wait to apply the bracelet
D) Make a corrected identification bracelet for the client
The correct answer is C: notify the admissions office and wait to apply the bracelet
6. The nurse is having difficulty reading the health care provider's written orderthat was
written right before the shift change. What action should be taken?
A) Leave the order for the oncoming staff to follow-up
, B) Contact the charge nurse for an interpretation
C) Ask the pharmacy for assistance in the interpretation
D) Call the provider for clarification
The correct answer is D: Call the provider for clarification
7. An adult client is found to be unresponsive on morning rounds. After checkingfor
responsiveness and calling for help, the next action that should be taken by thenurse is
to:
A) check the carotid pulse
B) deliver 5 abdominal thrusts
C) give 2 rescue breaths
D) open the client's airway
The correct answer is D: open the client''s airway
8. A client has an order for 1000 ml of D5W over an 8 hour period. The nursediscovers
that 800 ml has been infused after 4 hours. What is the priority nursing action?
A) Ask the client if there are any breathing problems
B) Have the client void as much as possible
C) Check the vital signs
