PN HESI EXIT EXAM COMPREHENSIVE
PRACTICE QUESTIONS AND ANSWERS
1. A nurse is caring for a client with Addison’s disease. Which assessment finding should the
nurse prioritize?
A. Hyperpigmentation of the skin
B. Serum potassium level of 6.2 mEq/L
C. Weight loss of 2 lbs in a week
D. Craving for salty snacks
Answer: B
Conceptual Explanation: Hyperkalemia (potassium > 5.0) is a life-threatening
complication of Addison’s disease due to lack of aldosterone, potentially leading to cardiac
arrhythmias.
2. Which action is most important for the nurse to perform before administering Digoxin?
A. Assess the apical pulse for 60 seconds
B. Review the client’s serum creatinine
C. Check the client’s blood pressure
,D. Measure the client’s urine output
Answer: A
Conceptual Explanation: Digoxin decreases heart rate. The apical pulse must be checked
for a full minute, and the dose held if the heart rate is below 60 bpm in adults.
3. A client is prescribed Lithium for bipolar disorder. Which instruction is vital for the nurse to
include in the discharge teaching?
A. Maintain a low-sodium diet
B. Restrict fluid intake to 1 liter per day
C. Take the medication only during manic episodes
D. Ensure adequate intake of sodium and fluids
Answer: D
Conceptual Explanation: Lithium is a salt. Low sodium levels or dehydration can lead to
lithium toxicity, so consistent sodium and fluid intake are required.
4. The nurse is assigned to four clients. Which client should be assessed first?
A. A client with a leg cast who reports itching under the cast
B. A client post-op day 1 following a cholecystectomy with a pain rating of 7/10
C. A client with Type 2 diabetes whose morning blood glucose is 180 mg/dL
D. A client with a history of asthma reporting shortness of breath after using a rescue
inhaler
, Answer: D
Conceptual Explanation: Airway and breathing are priorities. A client with asthma who is
not responding to a rescue inhaler is at risk for respiratory failure.
5. Which clinical manifestation is characteristic of a client experiencing autonomic
dysreflexia?
A. Severe pounding headache and hypertension
B. Tachycardia and hypotension
C. Flaccid paralysis below the level of injury
D. Extreme diaphoresis on the lower extremities
Answer: A
Conceptual Explanation: Autonomic dysreflexia occurs in spinal cord injuries above T6,
characterized by sudden severe hypertension, bradycardia, and a pounding headache.
6. A client with Clostridium difficile (C-diff) is placed on precautions. What must the nurse do
for proper hand hygiene?
A. Use alcohol-based hand sanitizer before exiting the room
B. Use a surgical scrub brush for 2 minutes
C. Wear double gloves during all client contact
D. Wash hands with soap and water
Answer: D
PRACTICE QUESTIONS AND ANSWERS
1. A nurse is caring for a client with Addison’s disease. Which assessment finding should the
nurse prioritize?
A. Hyperpigmentation of the skin
B. Serum potassium level of 6.2 mEq/L
C. Weight loss of 2 lbs in a week
D. Craving for salty snacks
Answer: B
Conceptual Explanation: Hyperkalemia (potassium > 5.0) is a life-threatening
complication of Addison’s disease due to lack of aldosterone, potentially leading to cardiac
arrhythmias.
2. Which action is most important for the nurse to perform before administering Digoxin?
A. Assess the apical pulse for 60 seconds
B. Review the client’s serum creatinine
C. Check the client’s blood pressure
,D. Measure the client’s urine output
Answer: A
Conceptual Explanation: Digoxin decreases heart rate. The apical pulse must be checked
for a full minute, and the dose held if the heart rate is below 60 bpm in adults.
3. A client is prescribed Lithium for bipolar disorder. Which instruction is vital for the nurse to
include in the discharge teaching?
A. Maintain a low-sodium diet
B. Restrict fluid intake to 1 liter per day
C. Take the medication only during manic episodes
D. Ensure adequate intake of sodium and fluids
Answer: D
Conceptual Explanation: Lithium is a salt. Low sodium levels or dehydration can lead to
lithium toxicity, so consistent sodium and fluid intake are required.
4. The nurse is assigned to four clients. Which client should be assessed first?
A. A client with a leg cast who reports itching under the cast
B. A client post-op day 1 following a cholecystectomy with a pain rating of 7/10
C. A client with Type 2 diabetes whose morning blood glucose is 180 mg/dL
D. A client with a history of asthma reporting shortness of breath after using a rescue
inhaler
, Answer: D
Conceptual Explanation: Airway and breathing are priorities. A client with asthma who is
not responding to a rescue inhaler is at risk for respiratory failure.
5. Which clinical manifestation is characteristic of a client experiencing autonomic
dysreflexia?
A. Severe pounding headache and hypertension
B. Tachycardia and hypotension
C. Flaccid paralysis below the level of injury
D. Extreme diaphoresis on the lower extremities
Answer: A
Conceptual Explanation: Autonomic dysreflexia occurs in spinal cord injuries above T6,
characterized by sudden severe hypertension, bradycardia, and a pounding headache.
6. A client with Clostridium difficile (C-diff) is placed on precautions. What must the nurse do
for proper hand hygiene?
A. Use alcohol-based hand sanitizer before exiting the room
B. Use a surgical scrub brush for 2 minutes
C. Wear double gloves during all client contact
D. Wash hands with soap and water
Answer: D
