RN HESI EXIT 2025
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2025 HESI Exit Exam HESI RN 2024 EXIT EXAM diagnosing ch 11
Teacher 160 terms 130 terms 32 terms
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A group of nursing students is touring an in-patient psychiatric
unit when a male client who is in a manic state shouts, "Want to
see a crazy person?" and begins
to jump up and down, flap his arms, and cluck like a chicken.
Which action is best for the nurse to take?
Redirect the client's acting out
A Direct the students to continue the tour without responding to
behavior by asking him to
the client's behavior.
perform a unit task.
B Medicate the client with a PRN prescription for an antianxiety
agent.
C Restrict the client to his room until he can control his
behaviors.
D Redirect the client's acting out behavior by asking him to
perform a unit task.
An adult male client is brought to the emergency department
(ED) by ambulance following a motorcycle collision. He was not
wearing a helmet and presents with periorbital bruising and
bloody drainage from both ears. Which assessment finding
warrants immediate intervention by the nurse?
Nausea with projectile vomiting.
A Rebound abdominal tenderness.
B Diminished bilateral breath sounds.
C Nausea with projectile vomiting.
D Rib pain with deep inspiration.
, A client diagnosed with Parkinson's disease receives a
prescription for carbidopa-levodopa, controlled release (CR)
25/100 mg PO daily each morning. Which information should the
C A change in urine color to nurse include in the client's teaching plan? Select all that apply.
dark red often occurs while
taking this drug. A Parkinson symptoms should diminish within one week.
D An upset stomach may occur B Avoid sunlight and wear sunglasses while outdoors.
as a side effect of this C A change in urine color to dark red often occurs while taking
medication. this drug.
D An upset stomach may occur as a side effect of this
medication.
E The medication should only be taken during a meal.
The healthcare provider (HCP) prescribes 500 mL of 0.45%
normal saline with 100 units regular insulin to infuse at 15
25 gtt/min units/hour. The drop factor is 20 gtt/mL.
The nurse should regulate the IV to deliver how many
gtt/minute? (Enter numerical value only.)
A client with generalized anxiety disorder does not want to
communicate with friends, smokes 2 to 3 packages of cigarettes
a day, and describes difficulty concentrating at work. Which
coping strategy should the nurse include in the plan of care
Focus on small achievable tasks,
(POC)?
not taxing problems.
A Focus on small achievable tasks, not taxing problems.
B Concentrate on and ventilate emotions when distressed.
C Relax and reduce the amount of effort to solve the problem.
D Analyze past hurts and resentments to identify the source.
The nurse is caring for a client who reports sudden right sided
numbness and weakness of the arm and leg. The nurse also
observes a distinct right sided facial droop. After reporting the
findings to the healthcare provider (HCP), the nurse receives
several prescriptions for the client, including a STAT
computerized tomography (CT) scan of the head. Which action
A Raise the head of the bed to should the nurse take first?
30° keeping head and neck in • A Raise the head of the bed to 30° keeping head and neck in
neutral alignment. neutral alignment.
• B Start two large bore peripheral IV (PIV) catheters and review
inclusion criteria for IV fibrinolytic therapy.
• C Administer aspirin to prevent further clot formation and
platelet clumping.
• D Begin continuous observation for transient episodes of
neurologic dysfunction.
An older adult client is admitted with pneumonia, and the
healthcare provider (HCP) prescribes penicillinG potassium IV.
Which assessment finding increases the risk of adverse reactions
Daily use of spironolactone for in this client?
hypertension. A Previous treatment with penicillin for pneumonia.
B Daily use of spironolactone for hypertension.
C Documented allergy to sulfonamides.
D Sputum culture results of Streptococcus pneumoniae.
, The nurse is preparing to administer 1.6 mL of medication IM to a
4-month-old infant. Which action should the nurse include?
A Select a 22 gauge 1 1/2 inch (3.8 cm) needle for the
Divide the medication into two intramuscular injection.
injections with volumes under 1 B Administer into the deltoid muscle while the parent holds the
mL. infant securely.
C Use a quick dart like motion to inject into the dorsogluteal site
D Divide the medication into two injections with volumes under 1
mL.
An infant who weighs 22 Ibs. receives a prescription for
amoxicillin 20 mg/kg/day PO in divided doses every 8 hours. The
bottle is labeled, "Amoxicillin for Oral Suspension, USP 250 mg
1.3 mL
per 5 mL." How many mL should the nurse administer with each
dose? (Enter numerical value only. If rounding is necessary,
round to the nearest tenth.)
A client who is homebound and is receiving continuous feedings
through a gastrostomy tube reports experiencing frequent
diarrhea. Which instructions should the nurse provide
Decrease the rate at which the
feeding is given A. Decrease the rate at which the feeding is given.
B. Do not allow the feeding to sit at room temperature.
C. Increase the concentration of the teedings.
D. Elevate the head of the bed to ninety degrees.
The nurse is preparing a client who had a below-the-knee (BKA)
amputation for discharge to home. Which recommendations)
B. Wash the residual limb with should the nurse provide this client? Select all that apply.
soap and water A. Avoid range of motion exercises
C. Use a residual limb shrinker B. Wash the residual limb with soap and water
D. Inspect skin for redness. C. Use a residual limb shrinker
D. Inspect skin for redness.
E. Apply alcohol to the residual limb after bathing
Following laser trabeculoplasty surgery for open-angle
glaucoma, the client reports acute pain deep within the eye.
Which action should the nurse take?
Report the eye pain to the
• A Report the eye pain to the surgeon.
surgeon.
• B Administer an antiemetic to prevent vomiting.
• C Apply bilateral eye shields to reduce photosensitivity.
• D Begin postoperative prophylactic antibiotics.
an unlicensed assistive personnel (UAP) leaves the unit without
Note date and time of the notifying the staff. In which order should the unit manager
behavior. Implement these Interventions address the UAP's behavior?
Discuss the issue privately with (Place the actions in order from first on top to last on bottom.
the UAP
Plan for scheduled break times Evaluate the UAP for signs of improvement.
Evaluate the UAP for signs of Discuss the issue privately with the UAP
improvement. Plan for scheduled break times.
Note date and time of the behavior.