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Exit Exam Study Guide – Fundamentals Concepts in Nursing 2025 – Complete NCLEX and HESI Prep

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This study guide provides a thorough review of fundamental nursing concepts essential for success on the Exit Exam, NCLEX, and HESI assessments. Topics include infection control, vital signs, safety and emergency preparedness, hygiene, mobility, nutrition, elimination, oxygenation, and perioperative care. It covers patient education, legal and ethical considerations, cultural competence, and therapeutic communication. The guide integrates key lab values, nursing process applications, and NCLEX-style review questions with rationales to strengthen critical thinking and clinical judgment.

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Fundamentals Concepts In Nursing
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Fundamentals concepts in nursing

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Exit Exam Study Guide Fundamentals concepts in
nursing 2025

1. Labs; evaluate nutritional status? – Serum Albumin
2. Carbidopa – Levodopa, teaching to include? – Change positions slowly
3. To prevent neural tube defects? – Folate
4. Dementia, Nursing Action to reduce risk of injury? – Assist the client to the toilet frequently
5. Febrile patient: to reduce fever applies cooling blanket, Adverse reaction finding? – Shivering
6. Community health, family home visit, First Nursing Action? – Clarify the source of the referral
7. Thyroidectomy, complication that indicates need for further assessment? – Laryngeal Stridor
8. Diarrhea, intermittent enteral feedings, nursing action? – Administer feedings at slower rate
9. 3-day old newborn, congenital heart defect, intervention to decrease cardiac demand? – Maintain
the infant’s temperature at 37 C.
10. Fine hair, exophthalmos, intolerance to heat, endocrine disorders associated with finding? –
Hyperthyroidism
11. Fetal Heart Tones, 12 weeks gestation, Nursing action? – Leopold’s Maneuver
12. Toddler w/ Retinoblastoma, Expected Finding? – White eye reflex
13. Toddler w/ Coarctation of the Aorta, Expected Finding? – Weak Femoral Pulses
14. Nutritional care plan, Pt. W/ COPD and Severe Dyspnea; Nursing Action to promote intake? – Limit
Fluid Intake with meals
15. Postpartum, Methylergonovine Contraindication? – Hypertension
16. Teaching about Exercise, 28 weeks gestation, Indicates Understanding? – Drink more water after
exercise.
17. Teaching, parents of infant w/ positional Plagiocephaly, Indicates Understanding? – “I should keep
the helmet on my baby for 23 hours a day.”
18. Teaching Self-Administration; Insulin Glargine, Type 1 DM, Indicates Understanding? – “I will not
mix this insulin with other types of insulin.”
19. Metoprolol; monitor and Report to Provider? – Bradycardia
20. Teaching parents of a newborn, Genetic Screening, Include in Teaching? – “This test should be
performed after your baby is 24 hours old.”

21. Misoprostol: for Labor Induction, Include in Teaching? – “You will have intermittent fetal
monitoring while you receive the medication.”

22. Plan of Care, Pt. W/ Preeclampsia and to receive Mag Sulfate, Nursing Action? – Measure the
client’s urine output every hour.
23. ER, Which Pt. To see First? – Hypertension and reports a headache
24. Monitoring Newly Licensed Nurse, Indicates Need for Intervention? – Crushes a sublingual tablet
to administer into a client’s feeding tube




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25. Rheumatoid Arthritis, 1-day postop Total Hip Arthroplasty. Med that delays wound healing? –
Prednisone

26. Psych unit, pt. Muttering “The voices are telling me to jump.” Appropriate Response? – “I
understand that the voices are frightening you, but I do not hear any voices.”

27. Change of shift. Client w/ Priority Finding? – 2 hours post cast placement with +2 pitting edema
and pallor.

28. Punctures IV bag, medication leaks onto counter. Medication for biohazard spill protocol? –
Doxorubicin Hydrochloride
29. School-age child, postop received Morphine IV bolus 10 min ago, Priority Finding? – Bradypnea
30. Psychotherapy: wants to obtain therapist’s notes, Appropriate Response? – “We can provide a copy
of your records, but the therapist’s notes are not included.”

31. Electrical cord frayed, First Nursing Action? – Remove the device from the room
32. Migraines past 4 months, First Nursing Action? – Review the child’s electronic pain diary.
33. Group of clients, Greatest risk for developing Acute Post Streptococcal Glomerulonephritis? –
7year-old boy who is recovering from Impetigo

34. Pulmonary Embolism, Manifestations? – Dyspnea
35. Change of shift, Client to Assess First? – A client who has a hip fracture and new onset of
Tachypnea

36. Chest tube w/ water seal drainage. Tidaling noted, explanation? – The system is working properly.
37. New staff Teaching, Risk Factors to becoming Violent? – Previous violent behavior.
38. Indwelling Urinary Catheter – Male, Nursing Action? – Lift the penis so that it is perpendicular to
the client’s body.

39. Labs prior to surgery, Which to Report? – Sodium 160
40. 6-year-old; Sickle Cell Anemia management, Importance of which factor? – Adequate hydration
41. Coworker is impaired, Charge Nurse First Action? – Report to the charge nurse
42. 11 weeks gestation, Immunization to recommend? – Influenza
43. Intermittent Enteral Feedings, places client at Aspiration Risk? – History of GERD
44. Child, new onset of Seizures. Undergoing ECG. Teaching? – “Ensure the child’s hair is clean and
without conditioner before preprocedure.”

45. 99 lb. Patient. 1.5g protein/kg/day. How many g per day? (Round to nearest whole) – 68 g/day.
46. Cardiac Catheterization, tasks to do prior to procedure? – Obtain a CBC with differential
47. 33 weeks gestation following amniocentesis, monitor for which complication? – Contractions
48. Change of Shift. Assess which Patient First? – A client who has leukemia and platelet level of
95 ,000/mm 3




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49. Modified Radical Mastectomy, Closed Suction Drain. Nursing Action? – Position the client’s
affected extremity below heart level.
50. Bipolar disorder, experiencing mania. Interventions to include? – Encourage the client to take
frequent rest periods.

51. Electroconvulsive Therapy: Refusing treatment now. Appropriate Response? – “You don’t have
to go through with the treatment.”

52. Labs. Osteomyelitis, receiving Tobramycin, Adverse Effect Finding? – BUN 30 mg/dl
53. Pneumonia pt. “I feel like an elephant is sitting on my chest.” Weak and unable to walk after pain
protocol. Priority diagnostic test? – 12- Leak EKG

54. Indwelling Urinary Catheter. Nursing Action? – Provide perineal hygiene after defecation.
55. Contraindication to Oral Contraceptive use. Include in Teaching? – Fibrocystic breast disease
56. ER, new diagnosis of acute MI. Treated with thrombolytic, aspirin, and IV heparin. Finding that
indicates satisfactory response to intervention? – Q wave is noted on the cardiac monitor tracing.

57. Acute Angle-closure Glaucoma. Expected Findings? – Severe Periocular Pain.
58. Following abdominal surgery. Finding to report? – Urinary output 20 ml/hr.
59. X
60. Bed rest patient. Which is a complication of Immobility? – Swollen area on calf.
61. PICC in arm. Intervention that is appropriate in plan of care? – Measure the arm circumference
above insertion site daily.

62. Client is homeless and has Decubitus Ulcer. Nursing Action? – Contact the facility’s case
management department.

63. Charge nurse evaluating advance directives. Statement from Newly Licensed Nurse that Indicates
Understanding? – “I have to witness a client’s signature on his advance directives.”
64. X
65. Long-term care facility. Managing older adult client. Occasional choking during meals. Refer to? –
Speech-language pathologist.
66. X
67. History of Atrial Fibrillation. Places client at risk for? – Pulmonary emboli.
68. X
69. RN working w/ LVN and UAP. Delegation to manage time efficiently? – Determine goals of the
day.
70. Thrombocytopenia. Teaching following chemotherapy. Indicates understanding? – “I will wipe my
nose instead of blowing it.”

71. 3-year-old. Typical developmental expectations? – “Can your child ride a tricycle?”
72. 41 weeks gestations. NST. Include in Teaching? – “You will have a Doppler transducer applied to
your abdomen during the test.”




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73. Acute mania. Food to provide? – Peanut butter sandwich
74. COPD patient. Using compressed oxygen system in home. Nursing Action? – Place the oxygen
tank away from curtains or drapes.

75. Nursing activity that requires use of sterile gloves? – Performing tracheostomy care.
76. L&D, new onset of contractions, which finding indicates False Labor? – Intermittent, painless
contractions.

77. Discharge Teaching. Parents of toddler w/ Cystic Fibrosis. Include in Teaching? – Perform chest
percussion and postural drainage twice a day.”

78. ER. Labs. First Nursing Action? – Elevate head of bed to 30 degrees.
79. Delegating to AP. Which is in the scope of practice? – Performing postmortem care.
80. Cefazolin. First Administration. Nursing Action? – Review the client’s allergy history.
81. Depressive disorders. Phenelzine. Food to avoid? – Smoked Salmon
82. Emergency Response. Client to recommend for early discharge? – A client who is 1-day postop
following Vertebroplasty

83. Schizophrenia. Auditory Hallucinations, Action to include in plan of care? – Ask the client
directly what he is hearing.

84. Child. Acute care medical unit. Labs for Rheumatic Fever? – Elevated sedimentation rate and
Creactive protein.

85. Seizure disorder. Phenytoin. Which instruction is appropriate? – “Increase your intake of Vitamin D
while taking this medication.”

86. Leaving because facility prohibits smoking. Nursing Action? – Inform the client of the risks
involved if she leaves

87. SATA – C. Diff. Nursing Action? – Change gloves after contact with infectious material. Wear a
gown when providing care.

88. Home safety. Indicates effective teaching? – “I have grab bars next to my tub.”
89. Acute mental health facility. Which patient do you see first? – A client who is taking Clozapine to
treat Schizophrenia and reports Sore Throat

90. X
91. SATA - 4 days postpartum; Assessment Findings? - Fundus displaced to the right. Lochia serosa.
92. Preparing to feed client with Dysphagia. Nursing Action? – Sit at or below the client’s eye level
during feedings.

93. A nurse manager updates protocol for use of belt restrains. Nursing Guidelines to include? –
Document the client’s restraint every 4 hours.
94. Preop assessment. Reports allergy to several foods. Which food indicates Latex Allergy? – Banana




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Fundamentals concepts in nursing
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Fundamentals concepts in nursing

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2025/2026
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