NGN 2024 NURSING MORSELS OF EXIT HESI QUESTIONS
L L L L L L L L
AND ANSWERS 2023/2024 BEST EXAM SOLUTION TOP
RANKED A+ FOR SUCCESS L L L
1. ID:L 9476788675
EnalaprilL maleateL isL prescribedL forL aL
hospitalized!!client.!!Which!!assessment!!doesthe!!nurse!!perform!!as!!a!!priority!!
before!!administering!!the!!medication?
A. ! ! Checking!!the!!client's!!blood!!pressure! ! Correct
B. ! ! Checking!!theL client'sL peripheralL pulses
C. CheckingL theL mostL recentL potassiumL level
D. L CheckingL theL client'sL intake-and-outputL recordL forL theL
lastL 24hoursL Incorrect
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor
used to treat hypertension. One common side effect is postural hypotension.
Therefore the nurse would check the client’s blood pressure immediately before
administering each dose. Checking the client’s peripheral pulses, the results of
the most recent potassium level, and the intake and output for the previous 24
hours are not specifically associated with this mediation.
Test-Taking Strategy: Focus on the name of the medication and recall that
medications that end in the letters “pril” are ACE inhibitors and that these
medications are used to treat hypertension. This will direct you to the correct
option. Review the action of enalapril maleate if you had difficulty with this
question.
Reference: Lehne, R. (2013). Pharmacology for nursing care (8th ed., p. 513). St.
Louis: Saunders.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Assessment
Content Area: Pharmacology
Giddens Concepts: Care Coordination, Safety
HESI Concepts:Collaboration/Managing Care, Safety
AwardedL 0.0L pointsL outL ofL 1.0L possibleL points.
2. ID:L 9476754035
AL clientL isL scheduledL toL undergoL anL upperL gastrointestinalL (GI)L series,L
andL theL nurseL providesL instructionsL toL theL clientL aboutL theL test.L WhichL
statementL byL theclientL indicatesL aL needL forL furtherL instruction?
A. L "TheL testL willL takeL aboutL 30L minutes."
B. L "IL needL toL fastL forL 8L hoursL beforeL theL test."L Incorrect
C. "IL needL toL drinkL citrateL ofL magnesiaL theL nightL beforeL theL test
, andgiveL myselfL aL FleetL enemaL onL theL morningL ofL theL test."L Correct
D. L "IL needL toL takeL aL laxativeL afterL theL testL isL completed,L
becauseL theL liquidL thatL I’llL haveL toL drinkL forL theL testL canL beL
Rationale: An upper GI series involves visualization of the esophagus, duodenum,
constipating."
and
series, the jejunum
upper client is by means ofa the
prescribed use of
laxative to ahasten
contrast medium. of
elimination It the
involves
barium.
swallowing a contrast medium (usually barium), which is administered
Barium that remains in the colon may become hard and difficult to expel, in aleading
flavored milkshake.
to fecal impaction. Films are taken at intervals during the test, which takes
about 30 minutes. No special preparation is necessary before a GI
Test-Taking Strategy: Use the process of elimination. Note the strategic words series, except
that
"need for further instruction." These words indicate a negative event query andGI
NPO status must be maintained for 8 hours before the test. After an upper
the need to select the incorrect client statement. Focusing on the word "upper" in
the name of the test will direct you to the correct option. Review preprocedure
care for an upper GI series if you had difficulty with this question.
Reference: Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014). Medical-
surgical nursing: Assessment and management of clinical problems (9th ed., p.
879). St. Louis: Mosby.
Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Adult Health/Gastrointestinal
Giddens Concepts: Client Education, Clinical Judgment
HESI Concepts:Clinical Decision Making/Clinical Judgment, Teaching and
Learning/Patient Education
AwardedL 0.0L pointsL outL ofL 1.0L possibleL points.
3. ID:L 9476790957
AL nurseL onL theL eveningL shiftL checksL aL healthL careL provider'sL
prescriptionsL andL notesL thatL theL doseL ofL aL prescribedL medicationL isL
higherL thanL theL normalL dose.L TheL nurseL callsL theL healthL careL provider'sL
answeringL serviceL andL isL toldL thatL theL healthL careL providerL isL offL forL theL
nightL andL will L beL availableL inL theL morning.L ThenurseL should:
A. L CallL theL nursingL supervisor
B. Ask the answering service to contact the on-call health care
providerL Correct
C. WithholdL theL medicationL untilL theL healthL careL providerL
canL bereachedL inL theL morning
D. L AdministerL theL medication L butL consultL theL healthL careL
providerL whenL heL becomesL available
Rationale: The nurse has a duty to protect the client from harm. A nurse who
believes that a health care provider’s prescription may be in error is responsible
for clarifying the prescription before carrying it out. Therefore the nurse would
not administer the medication; instead, the nurse would withhold the medication
until the dose can be clarified. The nurse would not wait until the next morning to
obtain clarification. It is premature to call the nursing supervisor.
Test-Taking Strategy: Use the process of elimination and your knowledge of the
legal responsibilities of the nurse in regard to medication administration and
health care provider’s prescriptions. Eliminate the options that are comparable or
alike in that they avoid clarification of the prescription (administering the
medication and holding the medication). To select from the remaining options,
note that it is premature to call the nursing supervisor. Also note that the correct
option is the only one that clarifies the prescription. Review legal responsibilities
in regard to medication prescriptions if you had difficulty with this question.
Reference: Potter, P., Perry, A. G., Stockert, P. A., & Hall, A. M.
,Client Needs: Safe and Effective Care Environment
Integrated Process: Nursing Process/Implementation
Content Area: Leadership and Management
Giddens Concepts: Clinical Judgment, Leadership
HESI Concepts:Collaboration/Managing Care, Clinical Decision Making/Clinical
Judgment
AwardedL 1.0L pointsL outL ofL 1.0L possibleL points.
4. ID:L 9476788615
AnL emergencyL departmentL (ED)L nurseL isL monitoringL aL clientL withL
suspectedL acutemyocardialL infarctionL (MI)L whoL isL awaitingL transferL toL theL
coronaryL intensiveL careL unit.L TheL nurseL notesL theL suddenL onsetL ofL
prematureL ventricularL contractionsL (PVCs)L onL theL monitor,L checksL theL
client'sL carotidL pulse,L andL determinesL thatL theL PVCsL areL notL resultingL inL
perfusion.L TheL appropriateL actionL byL theL nurseL is:
A. L DocumentingL theL findings
B. L AskingL theL EDL healthL careL providerL toL checkL theL clientL Correct
C. ContinuingL toL monitorL theL client'sL cardiacL status
D. L InformingL theL clientL thatL PVCsL areL expectedL afterL anL MI
Rationale: PVCs are a result of increased irritability of ventricular cells. Peripheral
pulses may be absent or diminished with the PVCs themselves because the
decreased stroke volume of the premature beats may in turn decrease peripheral
perfusion. Because other rhythms also cause widened QRS complexes, it is
essential that the nurse determine whether the premature beats are resulting in
perfusion of the extremities. This is done by palpating the carotid, brachial, or
femoral artery while observing the monitor for widened complexes or by
auscultating for apical heart sounds. In the situation of acute MI, PVCs may be
considered warning dysrhythmias, possibly heralding the onset of ventricular
tachycardia or ventricular fibrillation. Therefore the nurse would not tell the client
that the PVCs are expected. Although the nurse will continue to monitor the
client and document the findings, these are not the most appropriate actions of
those provided. The most appropriate action would be to ask the ED health care
provider to check the client.
Test-Taking Strategy: Use the process of elimination. Recalling the significance of
PVCs after acute MI and noting the strategic words "not perfusing" will direct you
to the correct option. Review the significance of PVCs after acute MI if you had
difficulty with this question.
Reference: Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014). Medical-
surgical nursing: Assessment and management of clinical problems (9th ed., p.
799). St. Louis: Mosby.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Critical Care
Giddens Concepts: Clinical Judgment, Perfusion
HESI Concepts: Clinical Decision Making/Clinical Judgment, Perfusion
AwardedL 1.0L pointsL outL ofL 1.0L possibleL points.
5. ID:L 9476763527
NPOL statusL isL imposedL 8L hoursL beforeL theL procedureL onL aL clientL scheduledL toL
undergoL electroconvulsiveL therapyL (ECT)L atL 1 L p.m.L OnL theL morningL ofL the
, procedure,L theL nurseL checksL theL client'sL recordL andL notesL thatL theL clientL
routinelytakesL anL oralL antihypertensiveL medicationL eachL morning.L TheL nurseL
should:
A. Administer the antihypertensive with a small sip of water Correct
B. L WithholdL theL antihypertensiveL andL administerL itL atL bedtime
C. AdministerL theL medicationL byL wayL ofL theL intravenousL
(IV)L routeL Incorrect
D. L HoldL theL antihypertensiveL andL resumeL itsL administrationL onL
theL dayafterL theL ECT
Rationale: General anesthesia is required for ECT, so NPO status is imposed for 6
to 8 hours before treatment to help prevent aspiration. Exceptions include clients
who routinely receive cardiac medications, antihypertensive agents, or histamine
(H2) blockers, which should be administered several hours before treatment with
a small sip of water. Withholding the antihypertensive and administering it at
bedtime and withholding the antihypertensive and resuming administration on
the day after the ECT are incorrect actions, because antihypertensives must be
administered on time; otherwise, the risk for rebound hypertension exists. The
nurse would not administer a medication by way of a route that has not been
prescribed.
Test-Taking Strategy: Use the process of elimination. Use your knowledge of the
principles of medication administration to help eliminate the option that involves
administering the medication by way of a route other than the prescribed one.
Recalling that antihypertensives must be administered on a regular schedule will
assist you in eliminating the options that involve withholding the medication.
Review preprocedure care for the client scheduled for ECT if you had difficulty
with this question.
Reference: Stuart, G. (2013). Principles & practice of psychiatric
nursing (10th ed.,p. 597). St. Louis: Mosby.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Mental Health
Giddens Concepts: Clinical Judgment, Safety
HESI Concepts: Clinical Decision Making/Clinical Judgment, Safety
AwardedL 0.0L pointsL outL ofL 1.0L possibleL points.
6. ID:L 9476755914
AL clientL whoL recentlyL underwentL coronaryL arteryL bypassL graftL surgeryL
comesL toL theL healthL careL provider'sL officeL forL aL follow-upL visit.L OnL
assessment,L theL clienttellsL theL nurseL thatL heL isL feelingL depressed.L WhichL
responseL byL the
nurseL isL therapeutic?
A. "Tell me more about what you’re feeling." Correct
B. L "That’sL aL normalL responseL afterL thisL typeL ofL surgery."
C. "ItL willL takeL time,L but,L IL promiseL you,L youL willL getL
overL thisdepression."
L L L L L L L L
AND ANSWERS 2023/2024 BEST EXAM SOLUTION TOP
RANKED A+ FOR SUCCESS L L L
1. ID:L 9476788675
EnalaprilL maleateL isL prescribedL forL aL
hospitalized!!client.!!Which!!assessment!!doesthe!!nurse!!perform!!as!!a!!priority!!
before!!administering!!the!!medication?
A. ! ! Checking!!the!!client's!!blood!!pressure! ! Correct
B. ! ! Checking!!theL client'sL peripheralL pulses
C. CheckingL theL mostL recentL potassiumL level
D. L CheckingL theL client'sL intake-and-outputL recordL forL theL
lastL 24hoursL Incorrect
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor
used to treat hypertension. One common side effect is postural hypotension.
Therefore the nurse would check the client’s blood pressure immediately before
administering each dose. Checking the client’s peripheral pulses, the results of
the most recent potassium level, and the intake and output for the previous 24
hours are not specifically associated with this mediation.
Test-Taking Strategy: Focus on the name of the medication and recall that
medications that end in the letters “pril” are ACE inhibitors and that these
medications are used to treat hypertension. This will direct you to the correct
option. Review the action of enalapril maleate if you had difficulty with this
question.
Reference: Lehne, R. (2013). Pharmacology for nursing care (8th ed., p. 513). St.
Louis: Saunders.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Assessment
Content Area: Pharmacology
Giddens Concepts: Care Coordination, Safety
HESI Concepts:Collaboration/Managing Care, Safety
AwardedL 0.0L pointsL outL ofL 1.0L possibleL points.
2. ID:L 9476754035
AL clientL isL scheduledL toL undergoL anL upperL gastrointestinalL (GI)L series,L
andL theL nurseL providesL instructionsL toL theL clientL aboutL theL test.L WhichL
statementL byL theclientL indicatesL aL needL forL furtherL instruction?
A. L "TheL testL willL takeL aboutL 30L minutes."
B. L "IL needL toL fastL forL 8L hoursL beforeL theL test."L Incorrect
C. "IL needL toL drinkL citrateL ofL magnesiaL theL nightL beforeL theL test
, andgiveL myselfL aL FleetL enemaL onL theL morningL ofL theL test."L Correct
D. L "IL needL toL takeL aL laxativeL afterL theL testL isL completed,L
becauseL theL liquidL thatL I’llL haveL toL drinkL forL theL testL canL beL
Rationale: An upper GI series involves visualization of the esophagus, duodenum,
constipating."
and
series, the jejunum
upper client is by means ofa the
prescribed use of
laxative to ahasten
contrast medium. of
elimination It the
involves
barium.
swallowing a contrast medium (usually barium), which is administered
Barium that remains in the colon may become hard and difficult to expel, in aleading
flavored milkshake.
to fecal impaction. Films are taken at intervals during the test, which takes
about 30 minutes. No special preparation is necessary before a GI
Test-Taking Strategy: Use the process of elimination. Note the strategic words series, except
that
"need for further instruction." These words indicate a negative event query andGI
NPO status must be maintained for 8 hours before the test. After an upper
the need to select the incorrect client statement. Focusing on the word "upper" in
the name of the test will direct you to the correct option. Review preprocedure
care for an upper GI series if you had difficulty with this question.
Reference: Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014). Medical-
surgical nursing: Assessment and management of clinical problems (9th ed., p.
879). St. Louis: Mosby.
Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Adult Health/Gastrointestinal
Giddens Concepts: Client Education, Clinical Judgment
HESI Concepts:Clinical Decision Making/Clinical Judgment, Teaching and
Learning/Patient Education
AwardedL 0.0L pointsL outL ofL 1.0L possibleL points.
3. ID:L 9476790957
AL nurseL onL theL eveningL shiftL checksL aL healthL careL provider'sL
prescriptionsL andL notesL thatL theL doseL ofL aL prescribedL medicationL isL
higherL thanL theL normalL dose.L TheL nurseL callsL theL healthL careL provider'sL
answeringL serviceL andL isL toldL thatL theL healthL careL providerL isL offL forL theL
nightL andL will L beL availableL inL theL morning.L ThenurseL should:
A. L CallL theL nursingL supervisor
B. Ask the answering service to contact the on-call health care
providerL Correct
C. WithholdL theL medicationL untilL theL healthL careL providerL
canL bereachedL inL theL morning
D. L AdministerL theL medication L butL consultL theL healthL careL
providerL whenL heL becomesL available
Rationale: The nurse has a duty to protect the client from harm. A nurse who
believes that a health care provider’s prescription may be in error is responsible
for clarifying the prescription before carrying it out. Therefore the nurse would
not administer the medication; instead, the nurse would withhold the medication
until the dose can be clarified. The nurse would not wait until the next morning to
obtain clarification. It is premature to call the nursing supervisor.
Test-Taking Strategy: Use the process of elimination and your knowledge of the
legal responsibilities of the nurse in regard to medication administration and
health care provider’s prescriptions. Eliminate the options that are comparable or
alike in that they avoid clarification of the prescription (administering the
medication and holding the medication). To select from the remaining options,
note that it is premature to call the nursing supervisor. Also note that the correct
option is the only one that clarifies the prescription. Review legal responsibilities
in regard to medication prescriptions if you had difficulty with this question.
Reference: Potter, P., Perry, A. G., Stockert, P. A., & Hall, A. M.
,Client Needs: Safe and Effective Care Environment
Integrated Process: Nursing Process/Implementation
Content Area: Leadership and Management
Giddens Concepts: Clinical Judgment, Leadership
HESI Concepts:Collaboration/Managing Care, Clinical Decision Making/Clinical
Judgment
AwardedL 1.0L pointsL outL ofL 1.0L possibleL points.
4. ID:L 9476788615
AnL emergencyL departmentL (ED)L nurseL isL monitoringL aL clientL withL
suspectedL acutemyocardialL infarctionL (MI)L whoL isL awaitingL transferL toL theL
coronaryL intensiveL careL unit.L TheL nurseL notesL theL suddenL onsetL ofL
prematureL ventricularL contractionsL (PVCs)L onL theL monitor,L checksL theL
client'sL carotidL pulse,L andL determinesL thatL theL PVCsL areL notL resultingL inL
perfusion.L TheL appropriateL actionL byL theL nurseL is:
A. L DocumentingL theL findings
B. L AskingL theL EDL healthL careL providerL toL checkL theL clientL Correct
C. ContinuingL toL monitorL theL client'sL cardiacL status
D. L InformingL theL clientL thatL PVCsL areL expectedL afterL anL MI
Rationale: PVCs are a result of increased irritability of ventricular cells. Peripheral
pulses may be absent or diminished with the PVCs themselves because the
decreased stroke volume of the premature beats may in turn decrease peripheral
perfusion. Because other rhythms also cause widened QRS complexes, it is
essential that the nurse determine whether the premature beats are resulting in
perfusion of the extremities. This is done by palpating the carotid, brachial, or
femoral artery while observing the monitor for widened complexes or by
auscultating for apical heart sounds. In the situation of acute MI, PVCs may be
considered warning dysrhythmias, possibly heralding the onset of ventricular
tachycardia or ventricular fibrillation. Therefore the nurse would not tell the client
that the PVCs are expected. Although the nurse will continue to monitor the
client and document the findings, these are not the most appropriate actions of
those provided. The most appropriate action would be to ask the ED health care
provider to check the client.
Test-Taking Strategy: Use the process of elimination. Recalling the significance of
PVCs after acute MI and noting the strategic words "not perfusing" will direct you
to the correct option. Review the significance of PVCs after acute MI if you had
difficulty with this question.
Reference: Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014). Medical-
surgical nursing: Assessment and management of clinical problems (9th ed., p.
799). St. Louis: Mosby.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Critical Care
Giddens Concepts: Clinical Judgment, Perfusion
HESI Concepts: Clinical Decision Making/Clinical Judgment, Perfusion
AwardedL 1.0L pointsL outL ofL 1.0L possibleL points.
5. ID:L 9476763527
NPOL statusL isL imposedL 8L hoursL beforeL theL procedureL onL aL clientL scheduledL toL
undergoL electroconvulsiveL therapyL (ECT)L atL 1 L p.m.L OnL theL morningL ofL the
, procedure,L theL nurseL checksL theL client'sL recordL andL notesL thatL theL clientL
routinelytakesL anL oralL antihypertensiveL medicationL eachL morning.L TheL nurseL
should:
A. Administer the antihypertensive with a small sip of water Correct
B. L WithholdL theL antihypertensiveL andL administerL itL atL bedtime
C. AdministerL theL medicationL byL wayL ofL theL intravenousL
(IV)L routeL Incorrect
D. L HoldL theL antihypertensiveL andL resumeL itsL administrationL onL
theL dayafterL theL ECT
Rationale: General anesthesia is required for ECT, so NPO status is imposed for 6
to 8 hours before treatment to help prevent aspiration. Exceptions include clients
who routinely receive cardiac medications, antihypertensive agents, or histamine
(H2) blockers, which should be administered several hours before treatment with
a small sip of water. Withholding the antihypertensive and administering it at
bedtime and withholding the antihypertensive and resuming administration on
the day after the ECT are incorrect actions, because antihypertensives must be
administered on time; otherwise, the risk for rebound hypertension exists. The
nurse would not administer a medication by way of a route that has not been
prescribed.
Test-Taking Strategy: Use the process of elimination. Use your knowledge of the
principles of medication administration to help eliminate the option that involves
administering the medication by way of a route other than the prescribed one.
Recalling that antihypertensives must be administered on a regular schedule will
assist you in eliminating the options that involve withholding the medication.
Review preprocedure care for the client scheduled for ECT if you had difficulty
with this question.
Reference: Stuart, G. (2013). Principles & practice of psychiatric
nursing (10th ed.,p. 597). St. Louis: Mosby.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Mental Health
Giddens Concepts: Clinical Judgment, Safety
HESI Concepts: Clinical Decision Making/Clinical Judgment, Safety
AwardedL 0.0L pointsL outL ofL 1.0L possibleL points.
6. ID:L 9476755914
AL clientL whoL recentlyL underwentL coronaryL arteryL bypassL graftL surgeryL
comesL toL theL healthL careL provider'sL officeL forL aL follow-upL visit.L OnL
assessment,L theL clienttellsL theL nurseL thatL heL isL feelingL depressed.L WhichL
responseL byL the
nurseL isL therapeutic?
A. "Tell me more about what you’re feeling." Correct
B. L "That’sL aL normalL responseL afterL thisL typeL ofL surgery."
C. "ItL willL takeL time,L but,L IL promiseL you,L youL willL getL
overL thisdepression."
