HESI EXIT RN EXAM (V1-V7) (QUESTIONS AND ANSWERS)
(Latest- 2024 ,Solved Q & A)
Which intervention should the nurse include in the plan of care for a child
with tetanus?
A. Encourage coughing and deep breathing
B. Minimize the amount of stimuli in the room
C. Reposition from side to side every hour
D. Open window shades to provide natural light
(Ans- B. Minimize the amount of stimuli in the room
An adolescent who was diagnosed with diabetes mellitus Type 1 at the age
of 9, is admitted to the hospital in diabetic ketoacidosis. Which occurrence
is the most likely cause of the ketoacidosis?
A. Ate an extra peanut butter sandwich before gym class
B. incorrectly administered too much insulin
C. Had a cold and ear infection for the past two days
D. Skipped eating lunch
(Ans- C. Had a cold and ear infection for the past two days
A client with a prescription for "do not resuscitate" (DNR) begins to
manifest signs of impending death. After notifying the family of the client's
status, what priority action should the nurse implement? A. The
impending signs of death should be documented
B. The client's status should be conveyed to the chaplain
C. The client's need for pain medication should be determined
,D. The nurse manager should be updated on the client's status
(Ans- C. The client's need for pain medication should be determined
Which self care measure is most important for the nurse to include in the
plan of care of a client recently diagnosed with type 2 diabetes mellitus?
A. Self-injection techniques
B. Blood glucose monitoring
C. Diabetic diet meal planning
D. A realistic exercise plan (Ans- B. Blood glucose monitoring
A client who gave birth 48 hours ago has decided to bottle feed the infant.
During the assessment, the nurse observes that both breasts are swollen,
warm, and tender on palpation. Which instruction should the nurse
provide?
A. Apply ice to the breasts for comfort
B. Wear a loose-fitting bra during the day to prevent nipple irritation
C. Run warm water over breasts
D. Express small amounts of milk from the breasts to relieve pressure
(Ans- A. Apply ice to the breasts for comfort
The nurse is preparing a client who had a below-the-knee (BKA)
amputation for discharge to home. Which recommendations should the
nurse provide this client? (Select all that apply)
A. Avoid range of motion exercises
B. Use a residual limb shrinker
C. Apply alcohol to the stump after bathing
D. Inspect skin for redness
E. Wash the stump with soap and water
,(Ans-
B. Use a residual limb shrinker
D. Inspect skin for redness
E. Wash the stump with soap and water
A toddler presenting with a history of intermittent skin rashes, hives,
abdominal pain, and vomiting that occurs after ingesting of milk products
arrives to the clinic accompanied by the parents. Which type of testing
should the nurse provide education to the toddler's family about?
A. Serum immunoglobulin E (IgE)
B. Intradermal test
C. Atopy patch test
D. Placebo-controlled food challenge
(Ans- A. Serum immunoglobulin E (IgE)
A client who is scheduled for a bronchoscopy in the morning is anxious and
asking the nurse numerous questions about the procedure. In preparing the
client for the procedure, which intervention has the highest priority?
A. Allow client to gargle with warm salt water
B. Administer a sedative to alleviate anxiety
C. Instruct client to write down the questions
D. Deny client's request for a midnight snack
(Ans- C. Instruct client to write down the questions
The nurse assesses a client one hour after starting a transfusion of packed
red blood cells and determines that there are no indications of a transfusion
, reaction. What instruction should the nurse provide the unlicensed assistive
personnel (UAP) who is working with the nurse?
A. Notify the nurse when the transfusion has finished, so further client
assessment can be done
B. Continue to measure the client's vital signs every thirty minutes until
the transfusion is complete
C. Monitor the client carefully for the next three hours and report the
onset of a reaction immediately
D. Since a reaction did not occur, the priority is to maintain client comfort
during the transfusion
(Ans- B. Continue to measure the client's vital signs every thirty minutes
until the transfusion is complete
The healthcare provider prescribes a sepsis protocol for a client with
multiorgan failure caused by a ruptured appendix. Which intervention is
most important for the nurse to include in the plan of care?
A. Assess warmth of extremities
B. Keep head of bed raised 45 degrees
C. Monitor blood glucose level
D. Maintain strict intake and output
(Ans- D. Maintain strict intake and output
The nurse is completing the admission assessment of a 3-year old who is
admitted with bacterial meningitis and hydrocephalus. Which assessment
finding is evidence that the child is experiencing increased intracranial
pressure (ICP)?
A. Tachycardia and tachypnea
(Latest- 2024 ,Solved Q & A)
Which intervention should the nurse include in the plan of care for a child
with tetanus?
A. Encourage coughing and deep breathing
B. Minimize the amount of stimuli in the room
C. Reposition from side to side every hour
D. Open window shades to provide natural light
(Ans- B. Minimize the amount of stimuli in the room
An adolescent who was diagnosed with diabetes mellitus Type 1 at the age
of 9, is admitted to the hospital in diabetic ketoacidosis. Which occurrence
is the most likely cause of the ketoacidosis?
A. Ate an extra peanut butter sandwich before gym class
B. incorrectly administered too much insulin
C. Had a cold and ear infection for the past two days
D. Skipped eating lunch
(Ans- C. Had a cold and ear infection for the past two days
A client with a prescription for "do not resuscitate" (DNR) begins to
manifest signs of impending death. After notifying the family of the client's
status, what priority action should the nurse implement? A. The
impending signs of death should be documented
B. The client's status should be conveyed to the chaplain
C. The client's need for pain medication should be determined
,D. The nurse manager should be updated on the client's status
(Ans- C. The client's need for pain medication should be determined
Which self care measure is most important for the nurse to include in the
plan of care of a client recently diagnosed with type 2 diabetes mellitus?
A. Self-injection techniques
B. Blood glucose monitoring
C. Diabetic diet meal planning
D. A realistic exercise plan (Ans- B. Blood glucose monitoring
A client who gave birth 48 hours ago has decided to bottle feed the infant.
During the assessment, the nurse observes that both breasts are swollen,
warm, and tender on palpation. Which instruction should the nurse
provide?
A. Apply ice to the breasts for comfort
B. Wear a loose-fitting bra during the day to prevent nipple irritation
C. Run warm water over breasts
D. Express small amounts of milk from the breasts to relieve pressure
(Ans- A. Apply ice to the breasts for comfort
The nurse is preparing a client who had a below-the-knee (BKA)
amputation for discharge to home. Which recommendations should the
nurse provide this client? (Select all that apply)
A. Avoid range of motion exercises
B. Use a residual limb shrinker
C. Apply alcohol to the stump after bathing
D. Inspect skin for redness
E. Wash the stump with soap and water
,(Ans-
B. Use a residual limb shrinker
D. Inspect skin for redness
E. Wash the stump with soap and water
A toddler presenting with a history of intermittent skin rashes, hives,
abdominal pain, and vomiting that occurs after ingesting of milk products
arrives to the clinic accompanied by the parents. Which type of testing
should the nurse provide education to the toddler's family about?
A. Serum immunoglobulin E (IgE)
B. Intradermal test
C. Atopy patch test
D. Placebo-controlled food challenge
(Ans- A. Serum immunoglobulin E (IgE)
A client who is scheduled for a bronchoscopy in the morning is anxious and
asking the nurse numerous questions about the procedure. In preparing the
client for the procedure, which intervention has the highest priority?
A. Allow client to gargle with warm salt water
B. Administer a sedative to alleviate anxiety
C. Instruct client to write down the questions
D. Deny client's request for a midnight snack
(Ans- C. Instruct client to write down the questions
The nurse assesses a client one hour after starting a transfusion of packed
red blood cells and determines that there are no indications of a transfusion
, reaction. What instruction should the nurse provide the unlicensed assistive
personnel (UAP) who is working with the nurse?
A. Notify the nurse when the transfusion has finished, so further client
assessment can be done
B. Continue to measure the client's vital signs every thirty minutes until
the transfusion is complete
C. Monitor the client carefully for the next three hours and report the
onset of a reaction immediately
D. Since a reaction did not occur, the priority is to maintain client comfort
during the transfusion
(Ans- B. Continue to measure the client's vital signs every thirty minutes
until the transfusion is complete
The healthcare provider prescribes a sepsis protocol for a client with
multiorgan failure caused by a ruptured appendix. Which intervention is
most important for the nurse to include in the plan of care?
A. Assess warmth of extremities
B. Keep head of bed raised 45 degrees
C. Monitor blood glucose level
D. Maintain strict intake and output
(Ans- D. Maintain strict intake and output
The nurse is completing the admission assessment of a 3-year old who is
admitted with bacterial meningitis and hydrocephalus. Which assessment
finding is evidence that the child is experiencing increased intracranial
pressure (ICP)?
A. Tachycardia and tachypnea
