HESI RN FUNDAMENTALS EXIT
EXAM LATEST 2024-2025 ACTUAL
EXAM 100 QUESTIONS AND
CORRECT ANSWERS WITH
RATIOANLES (VERIFIED ANSWERS)
Theinurseiisicalleditoitheiwaitingiroomiofiaipediatriciclinic.iTheifranticimotheristates,i"Iithinkimyi4-
month-oldibabyiisichoking!"iWhatistepsiwillitheinurseitake?i(Selectiallithatiapply.)
A.Compressitheichestionceibetweenitheinipplesiwithitwoifingers.
iB.Noteianyiobstructionioriabsenceiofibreathing.
iC.Deliverifiveibackslapsibetweenitheishoulderiblades.
iD.Placeitheiinfantioveritheinurse'siarm.
iE.Performiaiblindifingerisweep.
⚜ANSWER:iB,iC,iD
Rationale:iTheifingersiareiplacediatitheisameilocationionianiinfantiasichesticompressionsiforiCPR;ih
owever,itheinurseimustideliverifiveichestithrusts,iafteritheifiveibackislaps.iBlindisweepsiareinotiuse
diasithisiactionimayipushitheiobjectideeperiintoitheithroat.iTheiremainingistepsiareicorrect.
Whichifluidiwillitheinurseiselectitoiadministeriwithitheiprescribediblooditransfusion?
A.
5%iDextroseiandiwater
iB.
Normalisaline
iC.
LactatediRingersisolution
iD.
5%iDextroseiandilactatediringers
⚜ANSWER:iBi
Rationale:iNormalisalineisolutioniisitheionlyisolutionithatiisicompatibleiwithiblood.
Wheniassistingiaiclientifromitheibeditoiaichair,iwhichiprocedureiisibestiforitheinurseitoifollow?
A.
Placeitheichairiparallelitoitheibed,iwithiitsibackitowarditheiheadiofitheibediandiassistitheiclientiinimo
vingitoitheichair.
iB.
Withitheinurse'sifeetispreadiapartiandikneesialignediwithitheiclient'siknees,istandiandipivotitheiclie
ntiintoitheichair.
,iC.
Assistitheiclientitoiaistandingipositionibyigentlyiliftingiupward,iunderneathitheiaxillae.
iD.
Standibesideitheiclient,iplaceitheiclient'siarmsiarounditheinurse'sineck,iandigentlyimoveitheiclientit
oitheichair.
⚜ANSWER:iB
Rationale:iOptioniBidescribesitheicorrectipositioningiofitheinurseiandiaffordsitheinurseiaiwideibas
eiofisupportiwhileistabilizingitheiclient'sikneesiwheniassistingitoiaistandingiposition.iTheichairishoul
dibeiplacediatiai45-
degreeiangleitoitheibed,iwithitheibackiofitheichairitowarditheiheadiofitheibed.iClientsishouldineveri
beiliftediunderitheiaxillae;ithisicouldidamageinervesiandistrainitheinurse'siback.iTheiclientishouldib
eiinstructeditoiuseitheiarmsiofitheichairiandishouldineveriplaceihisioriheriarmsiarounditheinurse'sin
eck;ithisiplacesiundueistressionitheinurse'sineckiandibackiandiincreasesitheiriskiforiaifall.
HowimanyimLiwillitheinurseidocumentionitheiclient'siintakeiandioutputirecordifromitheiitemsiliste
d?i_____imL
1200imLiwater
4iounceicontaineriofigelatin
8iouncesiofiorangeijuice
355imLicaniofisoda1icupiofisoup
⚜ANSWER:iAnswer:i2155
Rationale:i1200i+i240i(8ioz)i+i240i(1icup)i+i120i(4ioz)i+i355i=i2155
TheinurseiobservesiaiUAPitakingiaiclient'sibloodipressureiinitheiloweriextremity.iWhichiobservati
oniofithisiprocedureirequiresitheinurseitoiinterveneiwithitheiUAP'siapproach?
A.
Theicuffiwrapsiarounditheigirthiofitheileg.
iB.
TheiUAPiauscultatesitheipoplitealipulseiwithitheicuffionitheilowerileg.
iC.
Theiclientiisiplacediiniaiproneiposition.
iD.
Theisystolicireadingiisi20immiHgihigherithanitheibloodipressureiinitheiclient'siarm.
⚜ANSWER:iB
Rationale:iWheniobtainingitheibloodipressureiinitheiloweriextremities,itheipoplitealipulseiisitheisi
teiforiauscultationiwhenitheibloodipressureicuffiisiappliediarounditheithigh.iTheinurseishouldiinter
veneiwithitheiUAPiwhoihasiapplieditheicuffionitheilowerileg.iOptioniAiensuresianiaccurateiassessm
ent,iandioptioniCiprovidesitheibestiaccessitoitheiartery.iSystolicipressureiinitheipoplitealiarteryiisiu
suallyi10itoi40immiHgihigherithaniinitheibrachialiartery.
Duringiaiclinicivisit,itheimotheriofiai7-year-
oldireportsitoitheinurseithatiherichildiisiofteniawakeiuntilimidnightiplayingiandiisitheniveryidifficultit
,oiawakeniinitheimorningiforischool.iWhichiassessmentidataishoulditheinurseiobtainiiniresponseitoi
theimother'siconcern?
A.
Theioccurrenceiofianyiepisodesiofisleepiapnea
iB.
Theichild'sibloodipressure,ipulse,iandirespirations
iC.
Lengthiofirapidieyeimovementi(REM)isleepithatitheichildiisiexperiencing
iD.
Descriptioniofitheifamily'sihomeienvironment
⚜ANSWER:iD
Rationale:iSchool-
ageichildreniofteniresistibedtime.iTheinurseishouldibeginibyiassessingitheienvironmentiofitheihom
eitoidetermineifactorsithatimayinotibeiconduciveitoitheiestablishmentiofibedtimeiritualsithatiprom
oteisleep.iOptioniAioftenicausesidaytimeifatigueiratherithaniresistanceitoigoingitoisleep.iOptioniBii
siunlikelyitoiprovideiusefulidata.iTheinurseicannotidetermineioptioniC.
Theinurseiidentifiesiaipotentialiforiinfectioniiniaiclientiwithipartial-thicknessi(second-
degree)iandifull-thicknessi(third-
degree)iburns.iWhatiactionihasitheihighestipriorityiinidecreasingitheiclient'siriskiofiinfection?
A.
Administrationiofiplasmaiexpanders
iB.
Useioficarefulihandwashingitechnique
iC.
Applicationiofiaitopicaliantibacterialicream
iD.
Limitingivisitorsitoitheiclientiwithiburns
⚜ANSWER:iB
Rationale:iCarefulihandwashingitechniqueiisitheisingleimostieffectiveiinterventioniforitheipreventi
onioficontaminationitoialliclients.iOptioniAireversesitheihypovolemiaithatiinitiallyiaccompaniesibu
rnitraumaibutiisinotirelateditoidecreasingitheiproliferationiofiinfectiveiorganisms.iOptionsiCiandiD
iareirecommendedibyivariousiburnicentersiasipossibleiwaysitoireduceitheichanceiofiinfection.iOpti
oniBiisiaiprovenitechniqueitoipreventiinfection.
Theinurseiassessesiai2-year-
oldiwhoiisiadmittediforidehydrationiandifindsithatitheiperipheraliIVirateibyigravityihasislowed,ieven
ithoughitheivenousiaccessisiteiisihealthy.iWhatishoulditheinurseidoinext?
A.
Applyiaiwarmicompressiproximalitoitheisite.
iB.
CheckiforikinksiinitheitubingiandiraiseitheiIVipole.
iC.
, Adjustitheitapeithatistabilizesitheineedle.
iD.
Flushiwithinormalisalineiandirecountitheidropirate.
⚜ANSWER:iB
Rationale:iTheinurseishouldifirsticheckitheitubingiandiheightiofitheibagionitheiIVipole,iwhichiareico
mmonifactorsithatimayislowitheirate.iGravityiinfusioniratesiareiinfluencedibyitheiheightiofitheibag,it
ubingiclampiclosureiorikinks,ineedleisizeioriposition,ifluidiviscosity,iclientibloodipressurei(cryingiini
theipediatriciclient),iandiinfiltration.iVenospasmicanislowitheirateiandioftenirespondsitoiwarmthio
veritheivessel,ibutitheinurseishouldifirstiadjustitheiIVipoleiheight.iTheinurseimayineeditoiadjustitheis
tabilizingitapeioniaipositionalineedleioriflushitheivenousiaccessiwithinormalisaline,ibutilessiinvasivei
actionsishouldibeiimplementedifirst.
Theinurseimanageriofiaiskilledinursingi(chronicicare)iunitiisiinstructingiUAPsioniwaysitoipreventic
omplicationsiofiimmobility.iWhichiactionishouldibeiincludediinithisiinstruction?
A.
Performirange-of-motioniexercisesitoipreventicontractures.
iB.
Decreaseitheiclient'sifluidiintakeitoipreventidiarrhea.
iC.
Massageitheiclient'silegsitoireduceiembolismioccurrence.
iD.
Turnitheiclientifromisideitoibackieveryishift.
⚜ANSWER:iA
Rationale:iPerformingirange-of-
motioniexercisesiisibeneficialiinireducingicontracturesiaroundijoints.iOptionsiB,iC,iandiDiareiallipo
tentiallyiharmfulipracticesithatiplaceitheiimmobileiclientiatiriskioficomplications.
Theinurseiadministeredi10imgiofidiazepamitoitheipreoperativeiclient.iWhatistepsiwillitheinurseita
keinext?i(Selectiallithatiapply.)
A.
Placeitheiclientiinitheibedinextitoitheinurse'sistation.
iB.
Instructitheiclientinotitoigetioutiofibed.
iC.
Placeitheicallibelliwithinitheiclient'sireach.
iD.
Placeitheisideirailsiup,iaccordingitoiinstitutionalipolicy.
iE.
Assistitheiclientitoitheibathroom
⚜ANSWER:iB,iC,iD
Rationale:iDiazepamiisiaicommonipreoperativeimedication.iCloseiobservationibyiplacingitheiclien
ticloseitoitheinurse'sistationiisinotinecessary.iTheimedicationihasiaisedativeieffectianditheiclientisho
uldinotigetioutiofibed,ieveniwithiassistance.iTheiremainingiselectionsiareicorrect.
EXAM LATEST 2024-2025 ACTUAL
EXAM 100 QUESTIONS AND
CORRECT ANSWERS WITH
RATIOANLES (VERIFIED ANSWERS)
Theinurseiisicalleditoitheiwaitingiroomiofiaipediatriciclinic.iTheifranticimotheristates,i"Iithinkimyi4-
month-oldibabyiisichoking!"iWhatistepsiwillitheinurseitake?i(Selectiallithatiapply.)
A.Compressitheichestionceibetweenitheinipplesiwithitwoifingers.
iB.Noteianyiobstructionioriabsenceiofibreathing.
iC.Deliverifiveibackslapsibetweenitheishoulderiblades.
iD.Placeitheiinfantioveritheinurse'siarm.
iE.Performiaiblindifingerisweep.
⚜ANSWER:iB,iC,iD
Rationale:iTheifingersiareiplacediatitheisameilocationionianiinfantiasichesticompressionsiforiCPR;ih
owever,itheinurseimustideliverifiveichestithrusts,iafteritheifiveibackislaps.iBlindisweepsiareinotiuse
diasithisiactionimayipushitheiobjectideeperiintoitheithroat.iTheiremainingistepsiareicorrect.
Whichifluidiwillitheinurseiselectitoiadministeriwithitheiprescribediblooditransfusion?
A.
5%iDextroseiandiwater
iB.
Normalisaline
iC.
LactatediRingersisolution
iD.
5%iDextroseiandilactatediringers
⚜ANSWER:iBi
Rationale:iNormalisalineisolutioniisitheionlyisolutionithatiisicompatibleiwithiblood.
Wheniassistingiaiclientifromitheibeditoiaichair,iwhichiprocedureiisibestiforitheinurseitoifollow?
A.
Placeitheichairiparallelitoitheibed,iwithiitsibackitowarditheiheadiofitheibediandiassistitheiclientiinimo
vingitoitheichair.
iB.
Withitheinurse'sifeetispreadiapartiandikneesialignediwithitheiclient'siknees,istandiandipivotitheiclie
ntiintoitheichair.
,iC.
Assistitheiclientitoiaistandingipositionibyigentlyiliftingiupward,iunderneathitheiaxillae.
iD.
Standibesideitheiclient,iplaceitheiclient'siarmsiarounditheinurse'sineck,iandigentlyimoveitheiclientit
oitheichair.
⚜ANSWER:iB
Rationale:iOptioniBidescribesitheicorrectipositioningiofitheinurseiandiaffordsitheinurseiaiwideibas
eiofisupportiwhileistabilizingitheiclient'sikneesiwheniassistingitoiaistandingiposition.iTheichairishoul
dibeiplacediatiai45-
degreeiangleitoitheibed,iwithitheibackiofitheichairitowarditheiheadiofitheibed.iClientsishouldineveri
beiliftediunderitheiaxillae;ithisicouldidamageinervesiandistrainitheinurse'siback.iTheiclientishouldib
eiinstructeditoiuseitheiarmsiofitheichairiandishouldineveriplaceihisioriheriarmsiarounditheinurse'sin
eck;ithisiplacesiundueistressionitheinurse'sineckiandibackiandiincreasesitheiriskiforiaifall.
HowimanyimLiwillitheinurseidocumentionitheiclient'siintakeiandioutputirecordifromitheiitemsiliste
d?i_____imL
1200imLiwater
4iounceicontaineriofigelatin
8iouncesiofiorangeijuice
355imLicaniofisoda1icupiofisoup
⚜ANSWER:iAnswer:i2155
Rationale:i1200i+i240i(8ioz)i+i240i(1icup)i+i120i(4ioz)i+i355i=i2155
TheinurseiobservesiaiUAPitakingiaiclient'sibloodipressureiinitheiloweriextremity.iWhichiobservati
oniofithisiprocedureirequiresitheinurseitoiinterveneiwithitheiUAP'siapproach?
A.
Theicuffiwrapsiarounditheigirthiofitheileg.
iB.
TheiUAPiauscultatesitheipoplitealipulseiwithitheicuffionitheilowerileg.
iC.
Theiclientiisiplacediiniaiproneiposition.
iD.
Theisystolicireadingiisi20immiHgihigherithanitheibloodipressureiinitheiclient'siarm.
⚜ANSWER:iB
Rationale:iWheniobtainingitheibloodipressureiinitheiloweriextremities,itheipoplitealipulseiisitheisi
teiforiauscultationiwhenitheibloodipressureicuffiisiappliediarounditheithigh.iTheinurseishouldiinter
veneiwithitheiUAPiwhoihasiapplieditheicuffionitheilowerileg.iOptioniAiensuresianiaccurateiassessm
ent,iandioptioniCiprovidesitheibestiaccessitoitheiartery.iSystolicipressureiinitheipoplitealiarteryiisiu
suallyi10itoi40immiHgihigherithaniinitheibrachialiartery.
Duringiaiclinicivisit,itheimotheriofiai7-year-
oldireportsitoitheinurseithatiherichildiisiofteniawakeiuntilimidnightiplayingiandiisitheniveryidifficultit
,oiawakeniinitheimorningiforischool.iWhichiassessmentidataishoulditheinurseiobtainiiniresponseitoi
theimother'siconcern?
A.
Theioccurrenceiofianyiepisodesiofisleepiapnea
iB.
Theichild'sibloodipressure,ipulse,iandirespirations
iC.
Lengthiofirapidieyeimovementi(REM)isleepithatitheichildiisiexperiencing
iD.
Descriptioniofitheifamily'sihomeienvironment
⚜ANSWER:iD
Rationale:iSchool-
ageichildreniofteniresistibedtime.iTheinurseishouldibeginibyiassessingitheienvironmentiofitheihom
eitoidetermineifactorsithatimayinotibeiconduciveitoitheiestablishmentiofibedtimeiritualsithatiprom
oteisleep.iOptioniAioftenicausesidaytimeifatigueiratherithaniresistanceitoigoingitoisleep.iOptioniBii
siunlikelyitoiprovideiusefulidata.iTheinurseicannotidetermineioptioniC.
Theinurseiidentifiesiaipotentialiforiinfectioniiniaiclientiwithipartial-thicknessi(second-
degree)iandifull-thicknessi(third-
degree)iburns.iWhatiactionihasitheihighestipriorityiinidecreasingitheiclient'siriskiofiinfection?
A.
Administrationiofiplasmaiexpanders
iB.
Useioficarefulihandwashingitechnique
iC.
Applicationiofiaitopicaliantibacterialicream
iD.
Limitingivisitorsitoitheiclientiwithiburns
⚜ANSWER:iB
Rationale:iCarefulihandwashingitechniqueiisitheisingleimostieffectiveiinterventioniforitheipreventi
onioficontaminationitoialliclients.iOptioniAireversesitheihypovolemiaithatiinitiallyiaccompaniesibu
rnitraumaibutiisinotirelateditoidecreasingitheiproliferationiofiinfectiveiorganisms.iOptionsiCiandiD
iareirecommendedibyivariousiburnicentersiasipossibleiwaysitoireduceitheichanceiofiinfection.iOpti
oniBiisiaiprovenitechniqueitoipreventiinfection.
Theinurseiassessesiai2-year-
oldiwhoiisiadmittediforidehydrationiandifindsithatitheiperipheraliIVirateibyigravityihasislowed,ieven
ithoughitheivenousiaccessisiteiisihealthy.iWhatishoulditheinurseidoinext?
A.
Applyiaiwarmicompressiproximalitoitheisite.
iB.
CheckiforikinksiinitheitubingiandiraiseitheiIVipole.
iC.
, Adjustitheitapeithatistabilizesitheineedle.
iD.
Flushiwithinormalisalineiandirecountitheidropirate.
⚜ANSWER:iB
Rationale:iTheinurseishouldifirsticheckitheitubingiandiheightiofitheibagionitheiIVipole,iwhichiareico
mmonifactorsithatimayislowitheirate.iGravityiinfusioniratesiareiinfluencedibyitheiheightiofitheibag,it
ubingiclampiclosureiorikinks,ineedleisizeioriposition,ifluidiviscosity,iclientibloodipressurei(cryingiini
theipediatriciclient),iandiinfiltration.iVenospasmicanislowitheirateiandioftenirespondsitoiwarmthio
veritheivessel,ibutitheinurseishouldifirstiadjustitheiIVipoleiheight.iTheinurseimayineeditoiadjustitheis
tabilizingitapeioniaipositionalineedleioriflushitheivenousiaccessiwithinormalisaline,ibutilessiinvasivei
actionsishouldibeiimplementedifirst.
Theinurseimanageriofiaiskilledinursingi(chronicicare)iunitiisiinstructingiUAPsioniwaysitoipreventic
omplicationsiofiimmobility.iWhichiactionishouldibeiincludediinithisiinstruction?
A.
Performirange-of-motioniexercisesitoipreventicontractures.
iB.
Decreaseitheiclient'sifluidiintakeitoipreventidiarrhea.
iC.
Massageitheiclient'silegsitoireduceiembolismioccurrence.
iD.
Turnitheiclientifromisideitoibackieveryishift.
⚜ANSWER:iA
Rationale:iPerformingirange-of-
motioniexercisesiisibeneficialiinireducingicontracturesiaroundijoints.iOptionsiB,iC,iandiDiareiallipo
tentiallyiharmfulipracticesithatiplaceitheiimmobileiclientiatiriskioficomplications.
Theinurseiadministeredi10imgiofidiazepamitoitheipreoperativeiclient.iWhatistepsiwillitheinurseita
keinext?i(Selectiallithatiapply.)
A.
Placeitheiclientiinitheibedinextitoitheinurse'sistation.
iB.
Instructitheiclientinotitoigetioutiofibed.
iC.
Placeitheicallibelliwithinitheiclient'sireach.
iD.
Placeitheisideirailsiup,iaccordingitoiinstitutionalipolicy.
iE.
Assistitheiclientitoitheibathroom
⚜ANSWER:iB,iC,iD
Rationale:iDiazepamiisiaicommonipreoperativeimedication.iCloseiobservationibyiplacingitheiclien
ticloseitoitheinurse'sistationiisinotinecessary.iTheimedicationihasiaisedativeieffectianditheiclientisho
uldinotigetioutiofibed,ieveniwithiassistance.iTheiremainingiselectionsiareicorrect.