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HESI EXIT V1 ACTUAL RETAKE EXAM
with NGN Questions and Rationalized Answers,
100% VERIFIED NEWEST VERSION.
The exam has: 1 s0 Multiple-choice questions
Performance Score is Above 1100
1. Well making rounds, the charge nurse notices that a young adult client with
asthma who has admitted yesterday is sitting on the side of the bed and leaning
over the side table. The client is currently receiving oxygen at 2 L per minute via
nasal cannula. The client is wheezing and is using purse lips breathing. Which
intervention should the nurse implement?
A) Increase oxygen to s L per minute.
B) Call for an Ambu resuscitation bag.
C) This is the client to lie back in bed.
D) Administer a nebulizer treatment
Ans>> D) Administer a nebulizer treatment.
The client with asthma is exhibiting signs of respiratory distress, including wheezing and
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using accessory muscles for breathing. Administering a nebulizer treatment with a
bronchodilator medication such as albuterol is a priority intervention in managing acute
asthma exacerbations. Nebulizer treatments help dilate the airways, relieve
bronchospasm, and improve airflow, which can alleviate respiratory distress and
improve the client's breathing
2. Which Client should the nurse assess frequently because of the risk for
overflow incontinence?
A) a client with hematuria and decreasing hemoglobin and hematocrit levels.
B) A client who has been fast, with increased serum creatinine levels.
C) A client who is confused and frequently forgets to go to the bathroom.
D) A client who has a history of frequent urinary tract infections
Ans>> C) A client who is confused and frequently forgets to go to the bathroom.
Overflow incontinence occurs when the bladder is unable to empty completely, leading
to frequent dribbling or leakage of urine. It often occurs in situations where there is an
obstruction or impairment of bladder emptying.
3. When preparing to administer a prescribed medication to a homeless client at a
community psychiatric clinic. The client tells the nurse that the usual dosage taken
is different from the dose the nurse is giving. Which action should the nurse take?
A) Inform the client that he may refuse the medication and document whether or
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not the client takes it.
B) Withhold the medication until the dosage can be confirmed.
C) Explain to the client that the dosage has been changed.
D) Tell the client to take the medication then verify the dosage at the next
healthcare team meeting
Ans>> B) Withhold the medication until the dosage can be
confirmed.
4. The charge nurse is making assignments for one practical nurse and three
registered nurses who are caring for neurologically compromised clients. Which
client with which change in status is best to assign to the LPN?
A) Subdural hematoma whose blood pressure changed from 150/80 to 170/50.
B) Viral meningitis whose temperature change from 101 S to 102F.
C) Diabetic keto acidosis who is Glasgow coma scale score changed from 10 to 7.
D) Myxedema, whose blood pressure change from 80/50 to 70/40
Ans>> B) Viral meningitis whose temperature change from 1 01 F to 1 02F.
(changing temperature requires low risk medication)
5. The nurse is caring for a client with pneumonia who now develops initial signs of
septic shock and multi organ failure. The healthcare provider pre- scribes a sepsis
protocol. Which intervention is most important for the nurse to include in the plan
of care?
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A) Maintain strict intake and output.
B) Keep head of bed raised 45º.
C) Excess warmth of extremities.
D) Monitor blood glucose level
Ans>> A) Maintain strict intake and output.
(septic shock causes extreme vasodilation which lowers BP resulting in low 02
distribution to the tissue. Need to monitor Fluid levels to keep BP up for adequate
perfusion)
6. And adolescent client is admitted to the hospital because of writing a suicide
note to a teacher at school. On the second day of hospitalization, the nurse asked
the client to meet with the treatment team. After the team meeting, the client
leaves in tears and goes to their room. Which nursing intervention is best?
A) Let the client rest quietly in their room for a while.
B) Explore the clients goals and desire for treatment.
C) Ask the treatment team about the clients behavior.
D) Go to the clients room and ask what happened
Ans>> D) Go to the clients room and ask what happened.
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Distribution of this document is illegal extra per year?
HESI EXIT V1 ACTUAL RETAKE EXAM
with NGN Questions and Rationalized Answers,
100% VERIFIED NEWEST VERSION.
The exam has: 1 s0 Multiple-choice questions
Performance Score is Above 1100
1. Well making rounds, the charge nurse notices that a young adult client with
asthma who has admitted yesterday is sitting on the side of the bed and leaning
over the side table. The client is currently receiving oxygen at 2 L per minute via
nasal cannula. The client is wheezing and is using purse lips breathing. Which
intervention should the nurse implement?
A) Increase oxygen to s L per minute.
B) Call for an Ambu resuscitation bag.
C) This is the client to lie back in bed.
D) Administer a nebulizer treatment
Ans>> D) Administer a nebulizer treatment.
The client with asthma is exhibiting signs of respiratory distress, including wheezing and
Downloaded by: LectHarrison | Want to earn $1.236
Distribution of this document is illegal extra per year?
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
using accessory muscles for breathing. Administering a nebulizer treatment with a
bronchodilator medication such as albuterol is a priority intervention in managing acute
asthma exacerbations. Nebulizer treatments help dilate the airways, relieve
bronchospasm, and improve airflow, which can alleviate respiratory distress and
improve the client's breathing
2. Which Client should the nurse assess frequently because of the risk for
overflow incontinence?
A) a client with hematuria and decreasing hemoglobin and hematocrit levels.
B) A client who has been fast, with increased serum creatinine levels.
C) A client who is confused and frequently forgets to go to the bathroom.
D) A client who has a history of frequent urinary tract infections
Ans>> C) A client who is confused and frequently forgets to go to the bathroom.
Overflow incontinence occurs when the bladder is unable to empty completely, leading
to frequent dribbling or leakage of urine. It often occurs in situations where there is an
obstruction or impairment of bladder emptying.
3. When preparing to administer a prescribed medication to a homeless client at a
community psychiatric clinic. The client tells the nurse that the usual dosage taken
is different from the dose the nurse is giving. Which action should the nurse take?
A) Inform the client that he may refuse the medication and document whether or
Downloaded by: LectHarrison | Want to earn $1.236
Distribution of this document is illegal extra per year?
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
not the client takes it.
B) Withhold the medication until the dosage can be confirmed.
C) Explain to the client that the dosage has been changed.
D) Tell the client to take the medication then verify the dosage at the next
healthcare team meeting
Ans>> B) Withhold the medication until the dosage can be
confirmed.
4. The charge nurse is making assignments for one practical nurse and three
registered nurses who are caring for neurologically compromised clients. Which
client with which change in status is best to assign to the LPN?
A) Subdural hematoma whose blood pressure changed from 150/80 to 170/50.
B) Viral meningitis whose temperature change from 101 S to 102F.
C) Diabetic keto acidosis who is Glasgow coma scale score changed from 10 to 7.
D) Myxedema, whose blood pressure change from 80/50 to 70/40
Ans>> B) Viral meningitis whose temperature change from 1 01 F to 1 02F.
(changing temperature requires low risk medication)
5. The nurse is caring for a client with pneumonia who now develops initial signs of
septic shock and multi organ failure. The healthcare provider pre- scribes a sepsis
protocol. Which intervention is most important for the nurse to include in the plan
of care?
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Distribution of this document is illegal extra per year?
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A) Maintain strict intake and output.
B) Keep head of bed raised 45º.
C) Excess warmth of extremities.
D) Monitor blood glucose level
Ans>> A) Maintain strict intake and output.
(septic shock causes extreme vasodilation which lowers BP resulting in low 02
distribution to the tissue. Need to monitor Fluid levels to keep BP up for adequate
perfusion)
6. And adolescent client is admitted to the hospital because of writing a suicide
note to a teacher at school. On the second day of hospitalization, the nurse asked
the client to meet with the treatment team. After the team meeting, the client
leaves in tears and goes to their room. Which nursing intervention is best?
A) Let the client rest quietly in their room for a while.
B) Explore the clients goals and desire for treatment.
C) Ask the treatment team about the clients behavior.
D) Go to the clients room and ask what happened
Ans>> D) Go to the clients room and ask what happened.
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Distribution of this document is illegal extra per year?
