PN HESI EXIT EXAM 3 2026 HIGH-YIELD
REVIEW MODULES AND ASSESSMENT
PREPARATION MATERIALS
◉ A client who is admitted with emphysema is having difficulty
breathing. In which position should the nurse place the client?
A.High Fowler's position without a pillow behind the head
B.Semi-Fowler's position with a single pillow behind the head
C.Right side-lying position with the head of the bed elevated 45
degrees
D.Sitting upright and forward with both arms supported on an over
the bed table.
Answer: D
Adequate lung expansion is dependent on deep breaths that allow
the respiratory muscles to increase the longitudinal and anterior-
posterior size of the thoracic cage. Sitting upright and leaning
forward with the arms supported on an over the bed table (D)
allows the thoracic cage to expand in all four directions and reduces
dyspnea. A high Fowler's position does not allow maximum
expansion of the posterior lobes of the lungs (A). A semi-Fowler's
position restricts expansion of the anterior-posterior diameter of
the thoracic cage (B). Positioning a client on the right side with the
head of the bed elevated (C) does not facilitate lung expansion.
,◉ A client with chronic renal insufficiency (CRI) is taking 25 mg of
hydrochlorothiazide (HCTZ) PO and 40 mg of furosemide (Lasix) PO
daily. Today, at a routine clinic visit, the client's serum potassium
level is 4 mEq/L. What is the most likely cause of this client's
potassium level?
A.The client is noncompliant with his medications.
B.The client recently consumed large quantities of pears or nuts.
C.The client's renal function has affected his potassium level.
D.The client needs to be started on a potassium supplement..
Answer: C
The client has a normalized potassium level despite diuretic use (C).
The kidney automatically secretes 90% of potassium consumed, but
in chronic renal insufficiency (CRI), less potassium is excreted than
normal. Therefore, the two potassium-wasting drugs, a thiazide
diuretic and loop diuretic, are not likely to affect potassium levels.
The normal potassium level is 3.5 to 5 mEq/L, and with a potassium
level of 4 mEq/L, there is no reason to believe that the client is
noncompliant with his treatment (A). Pears and nuts do not affect
the serum potassium level (B). There is no need for a potassium
supplement (D) because the client's potassium level is within the
normal range.
◉ A registered nurse (RN) delivers telehealth services to clients via
electronic communication. Which nursing action creates the greatest
,risk for professional liability and has the potential for a malpractice
lawsuit?
A.Participating in telephone consultations with clients
B.Identifying oneself by name and title to clients in telehealth
communications
C.Sending medical records to health care providers via the Internet
D.Answering a client-initiated health question via electronic mail.
Answer: C
Sending medical records over the Internet, even with the latest
security protection, creates the greatest risk for liability because of
the high potential of breaching client confidentiality and the amount
of information being transferred (C). Client confidentiality is
protected by federal wiretapping laws making telephone
consultation (A) a private and protected form of communication. By
stating one's name and credentials in telehealth communication (B),
one is taking responsibility for the encounter. E-mail initiated by the
client (D) poses less risk than sending records via the Internet.
◉ Which pathophysiologic response supports the contraindication
for opioids, such as morphine, in clients with increased intracranial
pressure (ICP)?
A.Sedation produced by opioids is a result of a prolonged half-life
when the ICP is elevated.
, B.Higher doses of opioids are required when cerebral blood flow is
reduced by an elevated ICP.
C.Dysphoria from opioids contributes to altered levels of
consciousness with an elevated ICP.
D.Opioids suppress respirations, which increases Pco2 and
contributes to an elevated ICP..
Answer: D
The greatest risk associated with opioids such as morphine (D) is
respiratory depression that causes an increase in Pco2, which
increases ICP and masks the early signs of intracranial bleeding in
head injury. (A, B, and C) do not support the risks associated with
opioid use in a client with increased ICP.
◉ The charge nurse of a medical surgical unit is alerted to an
impending disaster requiring implementation of the hospital's
disaster plan. Specific facts about the nature of this disaster are not
yet known. Which instruction should the charge nurse give to the
other staff members at this time?
A.Prepare to evacuate the unit, starting with the bedridden clients.
B.UAPs should report to the emergency center to handle transports.
C.The licensed staff should begin counting wheelchairs and IV poles
on the unit.
D.Continue with current assignments until more instructions are
received..
REVIEW MODULES AND ASSESSMENT
PREPARATION MATERIALS
◉ A client who is admitted with emphysema is having difficulty
breathing. In which position should the nurse place the client?
A.High Fowler's position without a pillow behind the head
B.Semi-Fowler's position with a single pillow behind the head
C.Right side-lying position with the head of the bed elevated 45
degrees
D.Sitting upright and forward with both arms supported on an over
the bed table.
Answer: D
Adequate lung expansion is dependent on deep breaths that allow
the respiratory muscles to increase the longitudinal and anterior-
posterior size of the thoracic cage. Sitting upright and leaning
forward with the arms supported on an over the bed table (D)
allows the thoracic cage to expand in all four directions and reduces
dyspnea. A high Fowler's position does not allow maximum
expansion of the posterior lobes of the lungs (A). A semi-Fowler's
position restricts expansion of the anterior-posterior diameter of
the thoracic cage (B). Positioning a client on the right side with the
head of the bed elevated (C) does not facilitate lung expansion.
,◉ A client with chronic renal insufficiency (CRI) is taking 25 mg of
hydrochlorothiazide (HCTZ) PO and 40 mg of furosemide (Lasix) PO
daily. Today, at a routine clinic visit, the client's serum potassium
level is 4 mEq/L. What is the most likely cause of this client's
potassium level?
A.The client is noncompliant with his medications.
B.The client recently consumed large quantities of pears or nuts.
C.The client's renal function has affected his potassium level.
D.The client needs to be started on a potassium supplement..
Answer: C
The client has a normalized potassium level despite diuretic use (C).
The kidney automatically secretes 90% of potassium consumed, but
in chronic renal insufficiency (CRI), less potassium is excreted than
normal. Therefore, the two potassium-wasting drugs, a thiazide
diuretic and loop diuretic, are not likely to affect potassium levels.
The normal potassium level is 3.5 to 5 mEq/L, and with a potassium
level of 4 mEq/L, there is no reason to believe that the client is
noncompliant with his treatment (A). Pears and nuts do not affect
the serum potassium level (B). There is no need for a potassium
supplement (D) because the client's potassium level is within the
normal range.
◉ A registered nurse (RN) delivers telehealth services to clients via
electronic communication. Which nursing action creates the greatest
,risk for professional liability and has the potential for a malpractice
lawsuit?
A.Participating in telephone consultations with clients
B.Identifying oneself by name and title to clients in telehealth
communications
C.Sending medical records to health care providers via the Internet
D.Answering a client-initiated health question via electronic mail.
Answer: C
Sending medical records over the Internet, even with the latest
security protection, creates the greatest risk for liability because of
the high potential of breaching client confidentiality and the amount
of information being transferred (C). Client confidentiality is
protected by federal wiretapping laws making telephone
consultation (A) a private and protected form of communication. By
stating one's name and credentials in telehealth communication (B),
one is taking responsibility for the encounter. E-mail initiated by the
client (D) poses less risk than sending records via the Internet.
◉ Which pathophysiologic response supports the contraindication
for opioids, such as morphine, in clients with increased intracranial
pressure (ICP)?
A.Sedation produced by opioids is a result of a prolonged half-life
when the ICP is elevated.
, B.Higher doses of opioids are required when cerebral blood flow is
reduced by an elevated ICP.
C.Dysphoria from opioids contributes to altered levels of
consciousness with an elevated ICP.
D.Opioids suppress respirations, which increases Pco2 and
contributes to an elevated ICP..
Answer: D
The greatest risk associated with opioids such as morphine (D) is
respiratory depression that causes an increase in Pco2, which
increases ICP and masks the early signs of intracranial bleeding in
head injury. (A, B, and C) do not support the risks associated with
opioid use in a client with increased ICP.
◉ The charge nurse of a medical surgical unit is alerted to an
impending disaster requiring implementation of the hospital's
disaster plan. Specific facts about the nature of this disaster are not
yet known. Which instruction should the charge nurse give to the
other staff members at this time?
A.Prepare to evacuate the unit, starting with the bedridden clients.
B.UAPs should report to the emergency center to handle transports.
C.The licensed staff should begin counting wheelchairs and IV poles
on the unit.
D.Continue with current assignments until more instructions are
received..
