HESI EXIT EXAM ADVANCED REVIEW
QUESTIONS AND CORRECT DETAILED
ANSWERS
1. A client with chronic kidney disease (CKD) has a serum potassium level of 6.2 mEq/L. Which
cardiac monitor finding should the nurse prioritize?
A. U waves and ST segment depression
B. Shortened PR interval and prominent P waves
C. Tall, peaked T waves and widened QRS complex
D. Presence of a Delta wave and prolonged QT interval
Answer: C
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) causes peaked T waves,
widened QRS, and potentially cardiac arrest. U waves are seen in hypokalemia.
2. A nurse is caring for a client with preeclampsia who is receiving a magnesium sulfate
infusion. The client’s respiratory rate is 10 breaths/minute and deep tendon reflexes are
absent. What is the priority nursing action?
A. Stop the magnesium sulfate infusion
B. Notify the healthcare provider immediately
C. Increase the infusion rate to prevent seizures
,D. Prepare for an emergency cesarean section
Answer: A
Conceptual Explanation: Absent deep tendon reflexes and respiratory depression are
signs of magnesium toxicity. The priority is to stop the infusion first to prevent further
toxicity.
3. Which clinical manifestation should the nurse expect to find in a child diagnosed with
pyloric stenosis?
A. Currant jelly-like stools
B. Bile-stained emesis and weight gain
C. Steatorrhea and abdominal distension
D. Projectile vomiting after feedings
Answer: D
Conceptual Explanation: Pyloric stenosis is characterized by projectile, non-bilious
vomiting and an olive-shaped mass in the epigastrium. Currant jelly stools are associated
with intussusception.
4. A client is admitted with a suspected thyroid storm. Which assessment finding requires
immediate intervention by the nurse?
A. Temperature of 105.2 F (40.7 C)
B. Hyperactive bowel sounds
, C. Heart rate of 90 beats/minute
D. Increased appetite and weight loss
Answer: A
Conceptual Explanation: Hyperpyrexia (extreme fever) is a hallmark of thyroid storm and
can lead to vascular collapse and death if not treated immediately.
5. A client is prescribed lithium carbonate for bipolar disorder. Which instruction is most
important for the nurse to include in the discharge teaching?
A. Ensure an adequate intake of sodium and fluids
B. Restrict fluid intake to 1000 mL per day
C. Maintain a low-sodium diet to prevent edema
D. Take the medication on an empty stomach
Answer: A
Conceptual Explanation: Lithium is a salt. Sodium depletion can lead to lithium retention
and toxicity. Clients must maintain consistent salt and fluid intake.
6. The nurse is reviewing arterial blood gas (ABG) results: pH 7.25, PaCO2 55, HCO3 24. How
should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
QUESTIONS AND CORRECT DETAILED
ANSWERS
1. A client with chronic kidney disease (CKD) has a serum potassium level of 6.2 mEq/L. Which
cardiac monitor finding should the nurse prioritize?
A. U waves and ST segment depression
B. Shortened PR interval and prominent P waves
C. Tall, peaked T waves and widened QRS complex
D. Presence of a Delta wave and prolonged QT interval
Answer: C
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) causes peaked T waves,
widened QRS, and potentially cardiac arrest. U waves are seen in hypokalemia.
2. A nurse is caring for a client with preeclampsia who is receiving a magnesium sulfate
infusion. The client’s respiratory rate is 10 breaths/minute and deep tendon reflexes are
absent. What is the priority nursing action?
A. Stop the magnesium sulfate infusion
B. Notify the healthcare provider immediately
C. Increase the infusion rate to prevent seizures
,D. Prepare for an emergency cesarean section
Answer: A
Conceptual Explanation: Absent deep tendon reflexes and respiratory depression are
signs of magnesium toxicity. The priority is to stop the infusion first to prevent further
toxicity.
3. Which clinical manifestation should the nurse expect to find in a child diagnosed with
pyloric stenosis?
A. Currant jelly-like stools
B. Bile-stained emesis and weight gain
C. Steatorrhea and abdominal distension
D. Projectile vomiting after feedings
Answer: D
Conceptual Explanation: Pyloric stenosis is characterized by projectile, non-bilious
vomiting and an olive-shaped mass in the epigastrium. Currant jelly stools are associated
with intussusception.
4. A client is admitted with a suspected thyroid storm. Which assessment finding requires
immediate intervention by the nurse?
A. Temperature of 105.2 F (40.7 C)
B. Hyperactive bowel sounds
, C. Heart rate of 90 beats/minute
D. Increased appetite and weight loss
Answer: A
Conceptual Explanation: Hyperpyrexia (extreme fever) is a hallmark of thyroid storm and
can lead to vascular collapse and death if not treated immediately.
5. A client is prescribed lithium carbonate for bipolar disorder. Which instruction is most
important for the nurse to include in the discharge teaching?
A. Ensure an adequate intake of sodium and fluids
B. Restrict fluid intake to 1000 mL per day
C. Maintain a low-sodium diet to prevent edema
D. Take the medication on an empty stomach
Answer: A
Conceptual Explanation: Lithium is a salt. Sodium depletion can lead to lithium retention
and toxicity. Clients must maintain consistent salt and fluid intake.
6. The nurse is reviewing arterial blood gas (ABG) results: pH 7.25, PaCO2 55, HCO3 24. How
should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
