(5 Sets of V1 Exams)
HESI RN Exit Comprehensive V1 Exam
Set 1
1. The nurse is monitoring neurological vital signs for a male client who lost consciousness afterfallin
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g and hitting hishead.Whichassessment finding isthe earliest and most sensitive indication of altere
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d cerebral function?
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a. Unequal pupils. l
b. Loss of central reflexes.
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c. Inability to open the eyes. l l l l
d. Change in level of consciousness
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l ANSD l
(Neurological vital signs include serial assessments of TPR, blood pressure, and components of the
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,Glasgow coma scale (GCS), which includes verbal, muscu- l l l l l l l
l loskeletal, and pupillary responses.A change in the client's level of consciousness,as indicated by re
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sponses to commands during the GCS, is the first and the most sensitive sign of change in cerebral fun
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ction. The other assessment data choices are late signs of altered cerebral function.)
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2. A nurse is planning to teach self-
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care measures to a female client about prevention of yeast infections.Which instructions should the
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nurse provide? l
a. Use a douche preparation no more than once a month.
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b. Increase daily intake of fiber and leafy green vegetables. l l l l l l l l
c. Select nylon underwear that is loose-fitting, white,and comfortable. l l l l l l l l
d. Avoid tight-fitting clothing and do not use bubble-bath or bath salts l l l l l l l l l l
l ANSD l
(A common genital tract infection in females is candidiasis, which is an overgrowthofthe normal vagi
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nal floraofCandidaalbicansthatthrives inanenvironment thatiswarmandmoistandisperpetuated
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bytight- l
fittingclothing,underwear,orpantyhosemadeof nonabsorbent materials.The client should wearcl
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othing thatisloose fittingand absorbent, such as cotton underwear, and avoid using bubble-
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bath or bath salts which further irritate sensitive genital tissue. Douching is not recommended becau
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seitcanirritatevaginaltissue,alterpH,and contribute tofungalgrowth.Whileincreasingdietaryfib
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erintakeencourageshealthy,nutritionalguidelines,itisnotthefocus of the teaching. Cotton, not nylo
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n undergarments, provide absorbancy and reduce moisture in the perineal area.)
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,3. A client who has active tuberculosis (TB) is admitted to the medical unit.
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What action is most important for the nurse to implement?
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a. Place an isolation cart in the hallway.
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b. Fit the client with a respirator mask.
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c. Don a clean gown for client care.
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d. Assign the client to a negative air-flow room
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l ANSD l
, (Active tuberculosis requires implementation of airborne precautions, so the client should be assign
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ed to a negative pressure air-
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flow room.Although isolation gownsand isolation carts should be implemented for clients in isolatio
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n with contact precautions, it is most important that air flow from the room is minimized when theclien
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t has TB. The respirator mask should be implemented when the client leaves the isolation environmen
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t.)
4. Thenurseisplanningtoconductnutritionalassessmentsanddietteachingtoclientsatafamilyhealt
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hclinic.Whichindividualhasthegreatestnutritionaland energy demands?
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a. A pregnant woman. l l
b. A teenager beginning puberty. l l l
c. A 3-month-old infant. l l
d. A school-aged child l l
l ANSA l
A pregnant woman's metabolic demands are 20 to 24% more than the basic meta-
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bolic rate. The other clients require only 15 to 20% more than the basic metabolic rate.
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5. What nursing delivery of care provides the nurse to plan and direct care ofa group of clients ove
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r a 24-hour period?
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a. Teamnursing. l
b. Primary nursing. l
c. Case management l
d. Functional nursing l