EXIT HESI -PN Exam A PRACTICE
QUESTION
A 2-day postpartum mom who's breastfeeding asks, "Why do I feel this tingling in my breasts
after the baby sucks for a couple of minutes?" Which information should the nurse offer?
A.This feeling takes place in the course of feeding with a breast contamination.
B.This sensation occurs as breast milk moves to the nipple.
C.The child does no longer have appropriate latch-on.
D.The toddler isn't positioned correctly. - ANS-B
When the mom's milk is available in, commonly 2 to 3 days after transport, ladies often report
they sense a tingling sensation of their nipples (B) whilst let-down happens. (A, C, and D)
provide misguided data.
A 40-yr-vintage workplace employee who is at 36 weeks' gestation provides to the occupational
health health center complaining of a pounding headache, blurry imaginative and prescient, and
swollen ankles. Which intervention should the nurse implement first?
A.Check the client's blood stress.
B.Teach her to raise her ft whilst sitting.
C.Obtain a 24-hour weight-reduction plan records to evaluate for the intake of salty meals.
D.Assess the fetal heart charge. - ANS-A
The blood pressure (A) ought to be assessed first. Preeclampsia is a multisystem disease, and
girls older than 35 years and have continual hypertension are at increased risk. Classic
symptoms include headache, visual modifications, edema, current speedy weight gain, and
elevated blood strain. (B, C, and D) can be done if the blood strain is regular.
A 50-year-old guy arrives on the health facility with complaints of ache on ejaculation. Which
motion need to the nurse implement?
A.Teach the customer testicular self-examination (TSE).
B.Assess for the presence of blood within the urine.
C.Ask approximately scrotal ache or blood in the semen.
D.Inquire about a records of kidney stones. - ANS-C
Orchitis is an acute testicular infection on account of recurrent urinary tract infection, recurrent
sexually transmitted ailment (STD), or an indwelling urethral urinary catheter inflicting pain on
ejaculation, scrotal pain, blood in the semen, and penile discharge, so the nurse have to
determine the presence of different signs and symptoms (C). Although all men must exercise
TSE, the client's signs and symptoms are suggestive of an inflammatory syndrome in
,preference to testicular most cancers (A). Although hematuria (B) is related to renal sickness or
calculi (D), the consumer's ache is associated with ejaculate, no longer urine.
A seventy seven-yr-vintage girl purchaser states that she has by no means been so huge
across the waist and that she has frequent durations of constipation. Colon disease has been
ruled out with a bendy sigmoidoscopy. Which facts ought to the nurse provide to this consumer?
A.As women age, they regularly emerge as rounder within the middle due to the fact they do
now not exercise nicely.
B.Further assessment is indicated due to the fact loss of abdominal muscle tone and
constipation do no longer occur with growing older.
C.With age, more fatty tissue develops within the stomach and reduced intestinal movement
can motive constipation.
D.Because there's no proof of a diseased colon, there is no need to fear about belly length -
ANS-C
With growing older, the abdominal muscle groups weaken as fatty tissue is deposited around
the trunk and waist. Slowing peristalsis also affects the emptying of the colon, resulting in
constipation (C). (A) isn't the number one cause for the adjustments in frame shape. (B) is not
indicated due to the fact loss of muscle tone and constipation are age-associated adjustments.
(D) dismisses the patron's worries and does now not help her recognize the changes that she is
experiencing.
A child is having a generalized tonic-clonic seizure. Which movement should the nurse take?
A.Move objects out of the child's immediately vicinity.
B.Quickly slip tender restraints on the child's wrists.
C.Insert a padded tongue blade between the enamel.
D.Place in the recuperation position before going for help. - ANS-A
The first precedence throughout a seizure is to provide a secure environment, so the nurse
have to clear the vicinity (A) to reduce the risk of trauma. The child ought to not be limited (B)
because this may purpose more trauma. Objects need to no longer be located in the toddler's
mouth (C) because it is able to pose a choking chance. Although (D) ought to be applied after
the seizure, the nurse should no longer leave the child all through a seizure to get assist.
A baby with nephrotic syndrome is receiving prednisone (Deltasone). Which preference of
breakfast meals at a fast meals eating place suggests that the mother is familiar with the
nutritional guidelines important for her baby?
A.French toast sticks and orange juice
B.Sausage egg muffin and grape juice
C.Canadian bacon slices and hot chocolate
D.Toasted oat cereal and coffee-fat milk - ANS-D
,A child receiving a corticosteroid for nephrotic syndrome should follow a low-sodium, low-fat,
and low-sugar eating regimen. Based on these guidelines, the fine breakfast desire is (D). (A) is
high in fat and sugar. (B and C) are high in fat and sodium.
A client has been on a mechanical ventilator for several days. What ought to the nurse use to
report and file this client's respirations?
A.The respiratory settings on the ventilator
B.Only the patron's spontaneous respirations
C.The ventilator-assisted respirations minus the customer's independent breaths
D.The ventilator setting for respiratory fee and the consumer-initiated respirations - ANS-D
The nurse must matter the patron's respirations, and document each the breathing charge set
by using the ventilator and the customer's impartial breathing price (D). Never rely strictly on (A).
Although the client's spontaneous breaths will be shallow and machine-assisted breaths can be
deep, it is essential to document machine-assisted breaths as well as the purchaser's
spontaneous breaths to get an typical respiration image of the client (B and C).
A patron has been receiving levofloxacin (Levaquin), 500 mg IV piggyback q24h for 7 days. The
UAP reviews to the nurse that the customer has had three unfastened foul-smelling stools this
morning. Which intervention is maximum critical for the nurse to implement?
A.Perform a virtual evaluation for fecal impaction.
B.Administer a PRN dose of psyllium (Metamucil).
C.Obtain a stool specimen for subculture and sensitivity.
D.Instruct the UAP to attain incontinent pads for the consumer. - ANS-C
Long-time period use of levofloxacin (Levaquin) can motive foul-smelling diarrhea due to
Clostridium difficile infection or related colitis, so it is most critical to obtain a stool specimen (C).
Impaction is not likely, so (A) is of much less priority and might not be vital. (B) is a bulk-forming
agent that may be used for constipation or diarrhea. Treatment of the diarrhea and customer
comfort (D) are essential interventions but of much less precedence than figuring out the
purpose of the purchaser's diarrhea.
A patron hospitalized for meningitis is demonstrating nuchal rigidity. Which symptom is that this
patron probably to be showing?
A.Hyperexcitability of reflexes
B.Hyperextension of the head and again
C.Inability to flex the chin to the chest
D.Lateral facial paralysis - ANS-C
Nuchal pressure (neck stiffness) is a characteristic of meningeal inflammation and is elicited
through attempting to flex the neck and location the chin to the chest (C). Although (A, B, and D)
may also arise in meningitis, (A) describes exaggerated spinal nerve reflex responses, (B)
describes opisthotonus, and (D) can be related to cranial nerve pathology of the trigeminal
nerve.
, A consumer is admitted to the intellectual health unit with a first-rate grievance of crying,
depressed temper, and drowsing difficulties. While speakme approximately the dying of a friend,
the patron states, "I cannot trust this befell." Which announcement via the nurse is maximum
healing?
A."It sounds like you are feeling very unhappy."
B."Tell me greater about how you are feeling."
C."How frequently do you have crying spells?"
D."Do you need to talk about those feelings?" - ANS-B
It is most healing to ask an open-ended question and inspire the consumer to discover his or
her feelings (B). (A) is a leading response, and the client won't be feeling sad. (C and D) are
close-ended questions that don't facilitate communication.
A patron reports experiencing dysuria and urinary frequency. Which client teaching have to the
nurse provide?
A.Save the subsequent urine pattern.
B.Restrict oral fluid intake.
C.Strain all voided urine.
D.Reduce physical interest. - ANS-A
The nurse should coach the consumer to keep the next urine pattern (A) for observation of its
look and for viable urinalysis. The customer is reporting signs which can indicate the onset of a
urinary tract infection. Increased fluid consumption need to be recommended, until
contraindicated (B). (C) is handiest essential if a calculus (stone) is suspected. (D) is not
indicated by this consumer's signs and symptoms.
A client tells the nurse that he's suffering from insomnia. Which facts is most essential for the
nurse to achieve?
A.The customer's normal sound asleep sample
B.Whether the consumer smokes
C.How a whole lot liquid the client consumes earlier than bedtime
D.The amount of caffeine that the patron consumes at some stage in the day - ANS-A
The first element to determine is the purchaser's common napping sample and how it has
modified to turn out to be what the consumer describes as insomnia (A). (B, C, and D) provide
extra statistics after (A) is ascertained.
A consumer who's admitted with emphysema is having issue respiratory. In which position must
the nurse region the client?
A.High Fowler's position with out a pillow at the back of the top
B.Semi-Fowler's function with a unmarried pillow behind the top
C.Right facet-lying role with the top of the bed multiplied forty five tiers
QUESTION
A 2-day postpartum mom who's breastfeeding asks, "Why do I feel this tingling in my breasts
after the baby sucks for a couple of minutes?" Which information should the nurse offer?
A.This feeling takes place in the course of feeding with a breast contamination.
B.This sensation occurs as breast milk moves to the nipple.
C.The child does no longer have appropriate latch-on.
D.The toddler isn't positioned correctly. - ANS-B
When the mom's milk is available in, commonly 2 to 3 days after transport, ladies often report
they sense a tingling sensation of their nipples (B) whilst let-down happens. (A, C, and D)
provide misguided data.
A 40-yr-vintage workplace employee who is at 36 weeks' gestation provides to the occupational
health health center complaining of a pounding headache, blurry imaginative and prescient, and
swollen ankles. Which intervention should the nurse implement first?
A.Check the client's blood stress.
B.Teach her to raise her ft whilst sitting.
C.Obtain a 24-hour weight-reduction plan records to evaluate for the intake of salty meals.
D.Assess the fetal heart charge. - ANS-A
The blood pressure (A) ought to be assessed first. Preeclampsia is a multisystem disease, and
girls older than 35 years and have continual hypertension are at increased risk. Classic
symptoms include headache, visual modifications, edema, current speedy weight gain, and
elevated blood strain. (B, C, and D) can be done if the blood strain is regular.
A 50-year-old guy arrives on the health facility with complaints of ache on ejaculation. Which
motion need to the nurse implement?
A.Teach the customer testicular self-examination (TSE).
B.Assess for the presence of blood within the urine.
C.Ask approximately scrotal ache or blood in the semen.
D.Inquire about a records of kidney stones. - ANS-C
Orchitis is an acute testicular infection on account of recurrent urinary tract infection, recurrent
sexually transmitted ailment (STD), or an indwelling urethral urinary catheter inflicting pain on
ejaculation, scrotal pain, blood in the semen, and penile discharge, so the nurse have to
determine the presence of different signs and symptoms (C). Although all men must exercise
TSE, the client's signs and symptoms are suggestive of an inflammatory syndrome in
,preference to testicular most cancers (A). Although hematuria (B) is related to renal sickness or
calculi (D), the consumer's ache is associated with ejaculate, no longer urine.
A seventy seven-yr-vintage girl purchaser states that she has by no means been so huge
across the waist and that she has frequent durations of constipation. Colon disease has been
ruled out with a bendy sigmoidoscopy. Which facts ought to the nurse provide to this consumer?
A.As women age, they regularly emerge as rounder within the middle due to the fact they do
now not exercise nicely.
B.Further assessment is indicated due to the fact loss of abdominal muscle tone and
constipation do no longer occur with growing older.
C.With age, more fatty tissue develops within the stomach and reduced intestinal movement
can motive constipation.
D.Because there's no proof of a diseased colon, there is no need to fear about belly length -
ANS-C
With growing older, the abdominal muscle groups weaken as fatty tissue is deposited around
the trunk and waist. Slowing peristalsis also affects the emptying of the colon, resulting in
constipation (C). (A) isn't the number one cause for the adjustments in frame shape. (B) is not
indicated due to the fact loss of muscle tone and constipation are age-associated adjustments.
(D) dismisses the patron's worries and does now not help her recognize the changes that she is
experiencing.
A child is having a generalized tonic-clonic seizure. Which movement should the nurse take?
A.Move objects out of the child's immediately vicinity.
B.Quickly slip tender restraints on the child's wrists.
C.Insert a padded tongue blade between the enamel.
D.Place in the recuperation position before going for help. - ANS-A
The first precedence throughout a seizure is to provide a secure environment, so the nurse
have to clear the vicinity (A) to reduce the risk of trauma. The child ought to not be limited (B)
because this may purpose more trauma. Objects need to no longer be located in the toddler's
mouth (C) because it is able to pose a choking chance. Although (D) ought to be applied after
the seizure, the nurse should no longer leave the child all through a seizure to get assist.
A baby with nephrotic syndrome is receiving prednisone (Deltasone). Which preference of
breakfast meals at a fast meals eating place suggests that the mother is familiar with the
nutritional guidelines important for her baby?
A.French toast sticks and orange juice
B.Sausage egg muffin and grape juice
C.Canadian bacon slices and hot chocolate
D.Toasted oat cereal and coffee-fat milk - ANS-D
,A child receiving a corticosteroid for nephrotic syndrome should follow a low-sodium, low-fat,
and low-sugar eating regimen. Based on these guidelines, the fine breakfast desire is (D). (A) is
high in fat and sugar. (B and C) are high in fat and sodium.
A client has been on a mechanical ventilator for several days. What ought to the nurse use to
report and file this client's respirations?
A.The respiratory settings on the ventilator
B.Only the patron's spontaneous respirations
C.The ventilator-assisted respirations minus the customer's independent breaths
D.The ventilator setting for respiratory fee and the consumer-initiated respirations - ANS-D
The nurse must matter the patron's respirations, and document each the breathing charge set
by using the ventilator and the customer's impartial breathing price (D). Never rely strictly on (A).
Although the client's spontaneous breaths will be shallow and machine-assisted breaths can be
deep, it is essential to document machine-assisted breaths as well as the purchaser's
spontaneous breaths to get an typical respiration image of the client (B and C).
A patron has been receiving levofloxacin (Levaquin), 500 mg IV piggyback q24h for 7 days. The
UAP reviews to the nurse that the customer has had three unfastened foul-smelling stools this
morning. Which intervention is maximum critical for the nurse to implement?
A.Perform a virtual evaluation for fecal impaction.
B.Administer a PRN dose of psyllium (Metamucil).
C.Obtain a stool specimen for subculture and sensitivity.
D.Instruct the UAP to attain incontinent pads for the consumer. - ANS-C
Long-time period use of levofloxacin (Levaquin) can motive foul-smelling diarrhea due to
Clostridium difficile infection or related colitis, so it is most critical to obtain a stool specimen (C).
Impaction is not likely, so (A) is of much less priority and might not be vital. (B) is a bulk-forming
agent that may be used for constipation or diarrhea. Treatment of the diarrhea and customer
comfort (D) are essential interventions but of much less precedence than figuring out the
purpose of the purchaser's diarrhea.
A patron hospitalized for meningitis is demonstrating nuchal rigidity. Which symptom is that this
patron probably to be showing?
A.Hyperexcitability of reflexes
B.Hyperextension of the head and again
C.Inability to flex the chin to the chest
D.Lateral facial paralysis - ANS-C
Nuchal pressure (neck stiffness) is a characteristic of meningeal inflammation and is elicited
through attempting to flex the neck and location the chin to the chest (C). Although (A, B, and D)
may also arise in meningitis, (A) describes exaggerated spinal nerve reflex responses, (B)
describes opisthotonus, and (D) can be related to cranial nerve pathology of the trigeminal
nerve.
, A consumer is admitted to the intellectual health unit with a first-rate grievance of crying,
depressed temper, and drowsing difficulties. While speakme approximately the dying of a friend,
the patron states, "I cannot trust this befell." Which announcement via the nurse is maximum
healing?
A."It sounds like you are feeling very unhappy."
B."Tell me greater about how you are feeling."
C."How frequently do you have crying spells?"
D."Do you need to talk about those feelings?" - ANS-B
It is most healing to ask an open-ended question and inspire the consumer to discover his or
her feelings (B). (A) is a leading response, and the client won't be feeling sad. (C and D) are
close-ended questions that don't facilitate communication.
A patron reports experiencing dysuria and urinary frequency. Which client teaching have to the
nurse provide?
A.Save the subsequent urine pattern.
B.Restrict oral fluid intake.
C.Strain all voided urine.
D.Reduce physical interest. - ANS-A
The nurse should coach the consumer to keep the next urine pattern (A) for observation of its
look and for viable urinalysis. The customer is reporting signs which can indicate the onset of a
urinary tract infection. Increased fluid consumption need to be recommended, until
contraindicated (B). (C) is handiest essential if a calculus (stone) is suspected. (D) is not
indicated by this consumer's signs and symptoms.
A client tells the nurse that he's suffering from insomnia. Which facts is most essential for the
nurse to achieve?
A.The customer's normal sound asleep sample
B.Whether the consumer smokes
C.How a whole lot liquid the client consumes earlier than bedtime
D.The amount of caffeine that the patron consumes at some stage in the day - ANS-A
The first element to determine is the purchaser's common napping sample and how it has
modified to turn out to be what the consumer describes as insomnia (A). (B, C, and D) provide
extra statistics after (A) is ascertained.
A consumer who's admitted with emphysema is having issue respiratory. In which position must
the nurse region the client?
A.High Fowler's position with out a pillow at the back of the top
B.Semi-Fowler's function with a unmarried pillow behind the top
C.Right facet-lying role with the top of the bed multiplied forty five tiers
