HESI RN Exit Exam Questions With Correct Answers || Graded A+

HESI RN Exit Exam Questions With Correct Answers || Graded A+ 1. A newly admitted adult client has a diagnosis of hepatitis A. The charge nurse should reinforce to the staff members that the most significant routine infection control strategy, in addition to hand washing, to be implemented is which of these? - ANSWER D) Have gloves on while handling bedpans with feces 2. Which of these clients with associated lab reports is a priority for the nurse to report to the public health department within the next 24 hours? - ANSWER An elderly factory worker with a lab report that is positive for acid-fast bacillus smear 3. A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia. What type of isolation is most appropriate for this client? - ANSWER D) Contact 4. The school nurse is teaching the faculty the most effective methods to prevent the spread of lice in the school. The information that would be most important to include would be which of these statements? - ANSWER C) Children are not to share hats, scarves and combs. 5. An older adult resident of a long-term care facility has a 5-year history of hypertension. The client has a headache and rate the pain 5 on a pain scale 0 to 10. The client's blood pressure is currently 142/89. Which interventions should the nurse implement? (Select all that apply) - ANSWER Administer a daily dose of lisinopril as scheduled. Provide a PRN dose of acetaminophen for headache 6. An older adult client is admitted to the stroke unit after recovery from the acute phrase of an ischemic cerebral vascular accident (CAV). Which interventions should the nurse include in the plan of care during convalescence and rehabilitation? (Select all that apply.) - ANSWER Measure neurological vital signs every 4 hours Encourage family participate in the client's care E) Play classical music in room while client is awake 7. A client is receiving ophthalmic drops preoperatively for a cataract extraction and asks the nurse why the healthcare provider has prescribed all these medications. Which information should the nurse included when responding to this client? (Select all that apply.) - ANSWER A) One of the medications is used to anesthetize the corneal surface B) Pupillary dilation is necessary to access the eye chamber for lens removal C) The iris must be paralyzed during surgery to prevent it from reacting to light 8. The nurse is interacting with a female client who is diagnostic with postpartum depression. Which findings should the nurse document as an objective signs of depression? (Select all that apply) - ANSWER B) Avoid eyes contact D) Has a disheveled appearance E) Interacts with felt effect 9. A client who is hospitalized and recently diagnosed with Addison's disease is now confused and lethargic. Which actions should the nurse implement? (Select all that apply) - ANSWER A) Measure capillary glucose level B) Monitor cardiac telemetry pattern E) Initiate fall risk precautions 10. 61-An older client is admitted for repair of a broken hip. To reduce the risk for infection in the postoperative period, which nursing care interventions should the nurse include in the client's plan of care? (Select all that apply) - ANSWER A) Teach client to use incentive spirometer q2 hours while awake B) Remove urinary catheter as soon as possible and encourage voiding 11. An older adult client admitted to the stroke unit after recovery from the acute phrase of an ischemic cerebral vascular accident (CVA). Which intervention should the nurse include in the plan of care during convalescence and rehabilitation? (Select all that apply.) - ANSWER Measure neurological vital signs every 4 hours D) Encourage family to participate in the client's care E) Play classical music in room while client is awake 12. To reduce the risk of symptoms exacerbation for a client with multiple sclerosis (MS), which instructions should the nurse include in the client's discharge plan? (Select all that apply). - ANSWER A) Practice relaxation exercises C) Space activities to allow for rest periods D) Avoid persons with infections 13. While assessing a client's chest tube (CT), the nurse discovers bubbling in the water seal chamber of the chest tube collection device. The client's vital signs are: blood pressure of 80/40 mmHg, heart rate 120 beats/minutes, respiratory rate 32 breaths/minutes, oxygen saturation 88%. Which interventions should the nurse implement? (Select all that apply). - ANSWER A) Provide supplemental oxygen B) Auscultate bilateral lung fields D) Reinforce occlusive CT dressing 14. After an explosion at a factory one of the workers approaches the nurse and says "I am an unlicensed assistive personnel (UAP) at the local hospital." Which of these tasks should the nurse assign to this worker who wants to help during the care of the wounded workers? - ANSWER C) Palpate pulses 15. Which of these clients would the nurse recommend to keep in the hospital during an internal disaster at the agency? - ANSWER D) A young adult in the second day of treatment for an overdose of acetometaphen 16. The mother of a toddler who is being treated for pesticide poisoning asks: "Why is activated charcoal used? What does it do?" What is the nurse's best response? - ANSWER "The charcoal absorbs the poison and forms a compound that doesn't hurt your child." 17. The nurse is to administer a new medication to a client. Which actions are in the best interest of the client? Verify the order for the medication. Prior to giving the medication the nurse should say - ANSWER B) "What is your name? What allergies do you have?" then check the client's name band and allergy band As the room is entered say 18. Several clients are admitted to an adult medical unit. The nurse would ensure airborne precautions for a client with which medical condition? - ANSWER B) A positive purified protein derivative with an abnormal chest x-ray 19. After an unsuccessful resuscitation attempt, the nurse calls the family of the deceased. The family wish to see the body before it is taken to the funeral home. Which interventions should the nurse take to prepare the body before the family enters the room? (Select all that apply) - ANSWER C) Place a small pillow under the head D) Remove resuscitation equipment from the room E) Gently close the eyes 20. A client is scheduled to receive an oral solution of radioactive iodine (131I). In order to reduce hazards, the priority information for the nurse to include during the instructions to the client is which of these statements? - ANSWER In the initial 48 hours avoid contact with children and pregnant women, and after urination or defecation flush the commode twice. 21. The nurse is assigned to a client newly diagnosed with active tuberculosis. Which of these protocols would be a priority for the nurse to implement? - ANSWER Place client in a negative pressure private room and have all who enter the room use masks with shields 22. The charge nurse is planning assignments on a medical unit. Which client should be assigned to the PN? - ANSWER C) Irrigate and redress a leg wound 23. When assessing a client, it is important for the nurse to be informed about cultural issues related to the client's background because - ANSWER Normal patterns of behavior may be labeled as deviant, immoral, or insane 24. A client who is newly diagnosed with type 2 diabetes mellitus (DM) receives a prescription for metformin (Glucophage) 500 mg PO twice daily. What information should the nurse include in this client's teaching plan? (Select all that apply.) - ANSWER B) Recognize signs and symptoms of hypoglycemia. Report persist polyuria to the healthcare provider Take Glucophage with the morning and evening meal. 25. After working with a very demanding client, an unlicensed assistive personnel (UAP) tells the nurse, "I have had it with that client. I just can't do anything that pleases him. I'm not going in there again." The nurse should respond by saying - ANSWER C) "He is scared and taking it out on you. Let's talk to figure out what to do." 26. A client with a diagnosis of bipolar disorder has been referred to a local boarding home for consideration for placement. The social worker telephoned the hospital unit for information about the client's mental status and adjustment. The appropriate response of the nurse should be which of these statements? - ANSWER D) I need to get the client's written consent before I release any information to you. 27. A client is admitted with a diagnosis of schizophrenia. The client refuses to take medication and states "I don't think I need those medications. They make me too sleepy and drowsy. I insist that you explain their use and side effects." The nurse should understand that - ANSWER B) The client has a right to know about the prescribed medications 28. A nurse is administering diazepam, a benzodiazepine, 10 mg IV push PRN, as prescribed to a client with alcohol withdrawal symptoms. Which actions should the nurse implement when administering the medication? (Select all that apply) - ANSWER B) Monitor for changes in level of consciousness D) Perform ongoing assessment of respiratory status E) Administer slowly over at least two minutes 29. A client newly diagnosed with diabetes mellitus suddenly becomes confused and weak. Which interventions should the nurse implement? (Select all that apply) - ANSWER A) Give the client 4 ounces of orange juice B) Obtain blood pressure and pulse rate E) Check the client's current finger stick blood glucose 30. The nurse is interacting with a female client who is diagnosed with postpartum depression. Which finding should the nurse document as an objective sign of depression? (Select all that apply) - ANSWER A. Interacts with a flat affect B. Avoids eye contact C. Has a disheveled appearance 31. A client who is hospitalized and recently is now confused and lethargic. Which actions should the nurse implement? (Select all that apply) - ANSWER A) Measure capillary glucose level B) Monitor cardiac telemetry pattern E) Initiate fall risk precautions Following discharge teaching, a male client with duodenal ulcer tells the nurse the he will drink plenty of dairy products, such as milk, to help coat and protect his ulcer. What is the best follow-up action by the nurse? a. Remind the client that it is also important to switch to decaffeinated coffee and tea. b. Suggest that the client also plan to eat frequent small meals to reduce discomfort c. Review with the client the need to avoid foods that are rich in milk and cream. d. Reinforce this teaching by asking the client to list a dairy food that he might select. Review with the client the need to avoid foods that are rich in milk and cream Rationale: Diets rich in milk and cream stimulate gastric acid secretion and should be avoided. A male client with hypertension, who received new antihypertensive prescriptions at his last visit returns to the clinic two weeks later to evaluate his blood pressure (BP). His BP is 158/106 and he admits that he has not been taking the prescribed medication because the drugs make him "feel bad". In explaining the need for hypertension control, the nurse should stress that an elevated BP places the client at risk for which pathophysiological condition? a. Blindness secondary to cataracts b. Acute kidney injury due to glomerular damage c. Stroke secondary to hemorrhage d. Heart block due to myocardial damage Stroke secondary to hemorrhage Rationale: Stroke related to cerebral hemorrhage is major risk for uncontrolled hypertension. Brainpower Read More The nurse observes an unlicensed assistive personnel (UAP) positioning a newly admitted client who has a seizure disorder. The client is supine and the UAP is placing soft pillows along the side rails. What action should the nurse implement? a. Ensure that the UAP has placed the pillows effectively to protect the client. b. Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows. c. Assume responsibility for placing the pillows while the UAP completes another task. d. Ask the UAP to use some of the pillows to prop the client in a side lying position. Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows Rationale: The nurse should instruct the UAP to pad the side rails with soft blankest because the use of pillows could result in suffocation and would need to be removed at the onset of the seizure. The nurse can delegate paddling the side rails to the UA An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for the past 12 days. Which assessment finding requires immediate follow-up a. Describes life without purpose b. Complains of nausea and loss of appetite c. States is often fatigued and drowsy d. Exhibits an increase in sweating. Describes life without purpose Rationale: Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor that is known to increase the risk of suicidal thinking in adolescents and young adults with major depressive disorder. B, C and D are side effects A 60-year-old female client with a positive family history of ovarian cancer has developed an abdominal mass and is being evaluated for possible ovarian cancer. Her Papanicolau (Pap) smear results are negative. What information should the nurse include in the client's teaching plan a. Further evaluation involving surgery may be needed b. A pelvic exam is also needed before cancer is ruled out c. Pap smear evaluation should be continued every six month d. One additional negative pap smear in six months is needed. Further evaluation involving surgery may be needed Rationale: An abdominal mass in a client with a family history for ovarian cancer should be evaluated carefully A client who recently underwent a tracheostomy is being prepared for discharge to home. Which instructions is most important for the nurse to include in the discharge plan? a. Explain how to use communication tools. b. Teach tracheal suctioning techniques c. Encourage self-care and independence. d. Demonstrate how to clean tracheostomy site. Teach tracheal suctioning techniques Rationale: Suctioning helps to clear secretions and maintain an open airway, which is critical. In assessing an adult client with a partial rebreather mask, the nurse notes that the oxygen reservoir bag does not deflate completely during inspiration and the client's respiratory rate is 14 breaths / minute. What action should the nurse implement a. Encourage the client to take deep breaths b. Remove the mask to deflate the bag c. Increase the liter flow of oxygen d. Document the assessment data Document the assessment data Rational: reservoir bag should not deflate completely during inspiration and the client's respiratory rate is within normal limits.