HESI RN COMPREHENSIVE EXAM A 2023-2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
The nurse is providing care to an 86-year-old admitted with generalized weakness. Dietary modifications
and levothyroxine are prescribed. Which physiologic finding in an older adult could precipitate an
adverse reaction to the medication?
A.
Reduced renal excretion
B.
Reduced gastrointestinal motility
C.
Increased hepatic metabolism
D.
Increased risk of autoimmune disorders - (answer) A
Rationale: During the aging process, reduced renal function is common and contributes to drug
accumulation that contributes to adverse reactions. Reduced hepatic function, not option C, predisposes
an older adult to an increase in adverse drug reactions. Option B may occur frequently in an older client
but does not impact the bioavailability of drugs. Although an older adult may have a decreased immune
response, the aging client's risk for autoimmune disorders is not increased, nor does it affect drug
pharmacotherapeutics
The charge nurse of a 16-bed medical unit is making 0700 to 1900 shift assignments. The team consists
of two RNs, two PN/VNs, and two UAP. Which assignment is the most effective use of the available team
members?
A.
Assign the PNs to perform am care and assist with feeding the clients.
B.
Assign the UAPs to take vital signs and obtain daily weights.
C.
Assign the RNs to answer the call lights and administer all medications.
D.
Assign the PN/VNs to assist health care providers on rounds and perform glucometer checks. - (answer)
B
,HESI RN COMPREHENSIVE EXAM A 2023-2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
Rationale: A UAP can take vital signs and daily weights on stable clients. UAPs can perform am care and
feed clients, which is a better use of personnel than assigning the task to the PN. All team members can
answer call lights, and PNs can administer some of the medications, so assigning the RN these tasks is
not an effective use of the available personnel. The RN is the best team member to assist on rounds, and
the UAP can perform glucometer checks, so assigning the PN these tasks is not an effective use of
available personnel.
A client is admitted to the mental health unit with a chief complaint of crying, depressed mood, and
sleeping difficulties. While talking about the death of a friend, the client states, "I can't believe this
happened." Which statement by the nurse is most therapeutic?
A.
"It sounds like you're feeling very sad."
B.
"Tell me more about how you're feeling."
C.
"How often do you have crying spells?"
D.
"Do you want to talk about these feelings?" - (answer) B
Rationale: It is most therapeutic to ask an open-ended question and encourage the client to explore his
or her feelings. Option A is a leading response, and the client may not be feeling sad. Options C and D
are closed-ended questions that do not facilitate communication.
When the nurse manager posts a schedule for volunteers to be on call, one staff member immediately
signs up for all available 7-to-3 day shifts. Other staff members complain to the charge nurse that they
were not permitted the opportunity to be on call for the day shift. What action should the nurse
manager implement?
A.
Speak privately with the nurse.
B.
Hold a staff meeting to discuss this issue.
C.
Review the nurse's current salary.
,HESI RN COMPREHENSIVE EXAM A 2023-2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
D.
Nominate the nurse for employee of the month. - (answer) A
Rationale: The nurse manager should speak privately with the nurse to assess the nurse's motives and to
discuss allowing other team members the opportunity to be on call for the day shift. Option B might
become confrontational. Option C is irrelevant. Option D is not warranted.
At 0800 the nurse placed a 1 inch/2.54 cm of 2% nitroglycerin paste to a client's right thigh. The nurse
placed the time, date and initials on the patch when it was applied. An hour later the client was
complaining of a sudden onset of dizziness; the blood pressure was 90/50 mm Hg. Upon further
assessment, a nitroglycerine patch was noted on the client's back with the same date, and the time was
0830. What are the nurse's next actions? (Select all that apply.)
A.
Take the clients vital signs every 15 minutes.
B.
Find out who applied the second dose of ointment.
C.
Have the client stay in bed.
D.
Complete an occurrence/incident report.
E.
Notify the health care provider.
F.
Chart, occurrence report complete. - (answer) A, C, D, E
Rationale: The nurse's priority is the safety of the client who is going to require frequent vital signs. The
client's blood pressure is low and is at risk for falling. Notify the health care provider of the event for any
alternative prescriptions that may be necessary. Complete the occurrence report to document the
objective findings. Do not place in the client's chart "occurrence report completed." Only chart the
findings and the client's physiologic responses to the treatments. The manager will complete the
investigation.
, HESI RN COMPREHENSIVE EXAM A 2023-2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
A registered nurse (RN) delivers telehealth services to clients via electronic communication. Which
nursing action creates the greatest risk for professional liability and has the potential for a malpractice
lawsuit?
A.
Participating in telephone consultations with clients
B.
Identifying oneself by name and title to clients in telehealth communications
C.
Sending medical records to health care providers via the Internet
D.
Answering a client-initiated health question via electronic mail - (answer) C
Rationale: Sending medical records over the Internet, even with the latest security protection, creates
the greatest risk for liability because of the high potential of breaching client confidentiality and the
amount of information being transferred. Client confidentiality is protected by federal wiretapping laws
making telephone consultation a private and protected form of communication. By stating one's name
and credentials in telehealth communication, one is taking responsibility for the encounter. E-mail
initiated by the client poses less risk than sending records via the Internet.
A client with arterial peripheral vascular disease (PVD) complains of pain in the feet. Which instruction
should the nurse give to the UAP to relieve the client's pain quickly?
A.
Help the client dangle legs.
B.
Apply compression stockings.
C.
Assist with passive leg exercises.
D.
Ambulate three times a day. - (answer) A
Rationale: The client who has arterial PVD may benefit from dependent positioning, and this can be
achieved with bedside dangling, which will promote gravitation of blood to the feet, improve blood flow,
ANSWERS
The nurse is providing care to an 86-year-old admitted with generalized weakness. Dietary modifications
and levothyroxine are prescribed. Which physiologic finding in an older adult could precipitate an
adverse reaction to the medication?
A.
Reduced renal excretion
B.
Reduced gastrointestinal motility
C.
Increased hepatic metabolism
D.
Increased risk of autoimmune disorders - (answer) A
Rationale: During the aging process, reduced renal function is common and contributes to drug
accumulation that contributes to adverse reactions. Reduced hepatic function, not option C, predisposes
an older adult to an increase in adverse drug reactions. Option B may occur frequently in an older client
but does not impact the bioavailability of drugs. Although an older adult may have a decreased immune
response, the aging client's risk for autoimmune disorders is not increased, nor does it affect drug
pharmacotherapeutics
The charge nurse of a 16-bed medical unit is making 0700 to 1900 shift assignments. The team consists
of two RNs, two PN/VNs, and two UAP. Which assignment is the most effective use of the available team
members?
A.
Assign the PNs to perform am care and assist with feeding the clients.
B.
Assign the UAPs to take vital signs and obtain daily weights.
C.
Assign the RNs to answer the call lights and administer all medications.
D.
Assign the PN/VNs to assist health care providers on rounds and perform glucometer checks. - (answer)
B
,HESI RN COMPREHENSIVE EXAM A 2023-2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
Rationale: A UAP can take vital signs and daily weights on stable clients. UAPs can perform am care and
feed clients, which is a better use of personnel than assigning the task to the PN. All team members can
answer call lights, and PNs can administer some of the medications, so assigning the RN these tasks is
not an effective use of the available personnel. The RN is the best team member to assist on rounds, and
the UAP can perform glucometer checks, so assigning the PN these tasks is not an effective use of
available personnel.
A client is admitted to the mental health unit with a chief complaint of crying, depressed mood, and
sleeping difficulties. While talking about the death of a friend, the client states, "I can't believe this
happened." Which statement by the nurse is most therapeutic?
A.
"It sounds like you're feeling very sad."
B.
"Tell me more about how you're feeling."
C.
"How often do you have crying spells?"
D.
"Do you want to talk about these feelings?" - (answer) B
Rationale: It is most therapeutic to ask an open-ended question and encourage the client to explore his
or her feelings. Option A is a leading response, and the client may not be feeling sad. Options C and D
are closed-ended questions that do not facilitate communication.
When the nurse manager posts a schedule for volunteers to be on call, one staff member immediately
signs up for all available 7-to-3 day shifts. Other staff members complain to the charge nurse that they
were not permitted the opportunity to be on call for the day shift. What action should the nurse
manager implement?
A.
Speak privately with the nurse.
B.
Hold a staff meeting to discuss this issue.
C.
Review the nurse's current salary.
,HESI RN COMPREHENSIVE EXAM A 2023-2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
D.
Nominate the nurse for employee of the month. - (answer) A
Rationale: The nurse manager should speak privately with the nurse to assess the nurse's motives and to
discuss allowing other team members the opportunity to be on call for the day shift. Option B might
become confrontational. Option C is irrelevant. Option D is not warranted.
At 0800 the nurse placed a 1 inch/2.54 cm of 2% nitroglycerin paste to a client's right thigh. The nurse
placed the time, date and initials on the patch when it was applied. An hour later the client was
complaining of a sudden onset of dizziness; the blood pressure was 90/50 mm Hg. Upon further
assessment, a nitroglycerine patch was noted on the client's back with the same date, and the time was
0830. What are the nurse's next actions? (Select all that apply.)
A.
Take the clients vital signs every 15 minutes.
B.
Find out who applied the second dose of ointment.
C.
Have the client stay in bed.
D.
Complete an occurrence/incident report.
E.
Notify the health care provider.
F.
Chart, occurrence report complete. - (answer) A, C, D, E
Rationale: The nurse's priority is the safety of the client who is going to require frequent vital signs. The
client's blood pressure is low and is at risk for falling. Notify the health care provider of the event for any
alternative prescriptions that may be necessary. Complete the occurrence report to document the
objective findings. Do not place in the client's chart "occurrence report completed." Only chart the
findings and the client's physiologic responses to the treatments. The manager will complete the
investigation.
, HESI RN COMPREHENSIVE EXAM A 2023-2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
A registered nurse (RN) delivers telehealth services to clients via electronic communication. Which
nursing action creates the greatest risk for professional liability and has the potential for a malpractice
lawsuit?
A.
Participating in telephone consultations with clients
B.
Identifying oneself by name and title to clients in telehealth communications
C.
Sending medical records to health care providers via the Internet
D.
Answering a client-initiated health question via electronic mail - (answer) C
Rationale: Sending medical records over the Internet, even with the latest security protection, creates
the greatest risk for liability because of the high potential of breaching client confidentiality and the
amount of information being transferred. Client confidentiality is protected by federal wiretapping laws
making telephone consultation a private and protected form of communication. By stating one's name
and credentials in telehealth communication, one is taking responsibility for the encounter. E-mail
initiated by the client poses less risk than sending records via the Internet.
A client with arterial peripheral vascular disease (PVD) complains of pain in the feet. Which instruction
should the nurse give to the UAP to relieve the client's pain quickly?
A.
Help the client dangle legs.
B.
Apply compression stockings.
C.
Assist with passive leg exercises.
D.
Ambulate three times a day. - (answer) A
Rationale: The client who has arterial PVD may benefit from dependent positioning, and this can be
achieved with bedside dangling, which will promote gravitation of blood to the feet, improve blood flow,
