HESI PN EXIT EXAM COMPREHENSIVE
PRACTICE QUESTIONS AND ANSWERS
1. A nurse is caring for a client with a new prescription for lithium carbonate to treat bipolar
disorder. Which laboratory value is most important for the nurse to monitor to prevent
toxicity?
A. Blood glucose level
B. Serum calcium level
C. Serum sodium level
D. Hemoglobin A1C
Answer: C
Conceptual Explanation: Lithium is a salt, and its excretion is closely tied to sodium. Low
sodium levels lead to decreased lithium excretion, which can result in toxic levels of lithium
in the blood.
2. The nurse is prioritizing care for four assigned clients. Which client should the nurse assess
first?
A. A client with a history of asthma reporting a sore throat
B. A client with diabetes reporting a headache and hunger
,C. A client with chronic obstructive pulmonary disease (COPD) and an oxygen saturation of
90%
D. A client post-thyroidectomy with a high-pitched inspiratory sound
Answer: D
Conceptual Explanation: A high-pitched inspiratory sound (stridor) post-thyroidectomy
indicates possible airway obstruction due to edema or nerve damage, representing a life-
threatening emergency (Airway).
3. A client is diagnosed with right-sided heart failure. Which clinical manifestation should the
nurse expect to observe?
A. Crackles in the lungs
B. Peripheral edema
C. Dyspnea on exertion
D. Pink, frothy sputum
Answer: B
Conceptual Explanation: Right-sided heart failure results in systemic congestion, leading
to peripheral edema, jugular venous distention, and hepatomegaly. Left-sided failure
affects the lungs.
4. Which instruction should the nurse provide to a client taking alendronate for osteoporosis?
A. Take the medication with a full glass of water on an empty stomach.
, B. Lie down for 30 minutes after taking the pill.
C. Take the medication right before bedtime.
D. Take the medication with a meal containing dairy.
E. N/A
Answer: A
Conceptual Explanation: Alendronate must be taken on an empty stomach with a full
glass of water, and the client must remain upright for at least 30 minutes to prevent
esophageal irritation and ensure absorption.
5. The nurse is caring for a client with a chest tube. What is the correct action if the chest tube
becomes accidentally dislodged?
A. Clamp the tube immediately.
B. Cover the site with a sterile occlusive dressing taped on three sides.
C. Perform a Valsalva maneuver on the client.
D. Attempt to re-insert the tube into the pleural space.
Answer: B
Conceptual Explanation: Covering the site with a sterile occlusive dressing taped on three
sides allows air to escape but prevents air from entering the pleural space, preventing a
tension pneumothorax.
PRACTICE QUESTIONS AND ANSWERS
1. A nurse is caring for a client with a new prescription for lithium carbonate to treat bipolar
disorder. Which laboratory value is most important for the nurse to monitor to prevent
toxicity?
A. Blood glucose level
B. Serum calcium level
C. Serum sodium level
D. Hemoglobin A1C
Answer: C
Conceptual Explanation: Lithium is a salt, and its excretion is closely tied to sodium. Low
sodium levels lead to decreased lithium excretion, which can result in toxic levels of lithium
in the blood.
2. The nurse is prioritizing care for four assigned clients. Which client should the nurse assess
first?
A. A client with a history of asthma reporting a sore throat
B. A client with diabetes reporting a headache and hunger
,C. A client with chronic obstructive pulmonary disease (COPD) and an oxygen saturation of
90%
D. A client post-thyroidectomy with a high-pitched inspiratory sound
Answer: D
Conceptual Explanation: A high-pitched inspiratory sound (stridor) post-thyroidectomy
indicates possible airway obstruction due to edema or nerve damage, representing a life-
threatening emergency (Airway).
3. A client is diagnosed with right-sided heart failure. Which clinical manifestation should the
nurse expect to observe?
A. Crackles in the lungs
B. Peripheral edema
C. Dyspnea on exertion
D. Pink, frothy sputum
Answer: B
Conceptual Explanation: Right-sided heart failure results in systemic congestion, leading
to peripheral edema, jugular venous distention, and hepatomegaly. Left-sided failure
affects the lungs.
4. Which instruction should the nurse provide to a client taking alendronate for osteoporosis?
A. Take the medication with a full glass of water on an empty stomach.
, B. Lie down for 30 minutes after taking the pill.
C. Take the medication right before bedtime.
D. Take the medication with a meal containing dairy.
E. N/A
Answer: A
Conceptual Explanation: Alendronate must be taken on an empty stomach with a full
glass of water, and the client must remain upright for at least 30 minutes to prevent
esophageal irritation and ensure absorption.
5. The nurse is caring for a client with a chest tube. What is the correct action if the chest tube
becomes accidentally dislodged?
A. Clamp the tube immediately.
B. Cover the site with a sterile occlusive dressing taped on three sides.
C. Perform a Valsalva maneuver on the client.
D. Attempt to re-insert the tube into the pleural space.
Answer: B
Conceptual Explanation: Covering the site with a sterile occlusive dressing taped on three
sides allows air to escape but prevents air from entering the pleural space, preventing a
tension pneumothorax.
