, HESI EXIT V10
1. Which information is a priority for the RN to reinforce to an older client after intravenous
pyelography?
A Eat a light diet for the rest of the day
B Rest for the next 24 hours since the preparation and the test is tiring
C During waking hours drink at least one 8-ounce glass of fluid every hour for the next 2 days
D Measure the urine output for the next day and immediately notify the healthcare provider if it
should decrease
Correct Answer: D
Rationale: Intravenous pyelography (IVP) uses contrast dye that can be nephrotoxic. The priority
is monitoring for decreased urine output, which may indicate acute kidney injury.
2. A client has altered renal function and is being treated at home. The nurse recognizes that
the most accurate indicator of fluid balance during weekly visits is:
A Difference in the intake and output
B Changes in the mucous membranes
C Skin turgor
D Weekly weight
Correct Answer: D
Rationale: Weekly weight is the most accurate indicator of fluid balance. A weight change of 1
kg (2.2 lb) equals approximately 1 L of fluid. Intake/output records are often inaccurate, and
mucous membrane assessment and skin turgor are subjective and less reliable.
3. A client has been diagnosed with Zollinger-Ellison syndrome. Which information is most
important for the nurse to reinforce with the client?
A It is a condition in which one or more tumors called gastrinomas form in the pancreas or in
the upper part of the small intestine (duodenum)
B It is critical to report promptly to your healthcare provider any findings of peptic ulcers
C Treatment consists of medications to reduce acid and heal any peptic ulcers and, if possible,
,surgery to remove any tumors
D With the average age at diagnosis at 50 years, the peptic ulcers may occur at unusual areas of
the stomach or intestine
Correct Answer: B
Rationale: Prompt reporting of peptic ulcers is critical in Zollinger-Ellison syndrome because
ulcers can lead to serious complications such as perforation or hemorrhage. Early intervention
can prevent life-threatening outcomes.
4. The practical nurse enters a male client's room to administer routine morning medications,
and the client is on the phone. Which action is best for the PN to take?
A Ask another nurse to return with the medication when the client has hung up
B Wait for the client to excuse himself from the telephone conversation, and observe the client
taking the medication
C Return the medication to the client's drawer on the cart and document the client refused the
dose
D Leave the medication with the client, and let him take it when he finishes the conversation
Correct Answer: B
Rationale: The nurse should wait for the client to complete the phone call, then administer the
medication and observe the client take it. This ensures medication safety and proper
documentation.
5. A client is scheduled for a thoracentesis that will be done at the bedside. What should the
practical nurse prepare before the healthcare provider arrives on the unit to perform the
procedure?
A Cleanse the site and cover with a sterile towel
B Gather the procedure tray and equipment
C Place the client in an orthopneic position
D Keep the client NPO and encourage to void
Correct Answer: B
Rationale: The nurse should gather the procedure tray and equipment before the provider
arrives to perform the thoracentesis. This ensures the procedure can be performed without
delay and all necessary supplies are available.
, 6. A male client is on contact precautions due to an infected draining wound and is being
discharged home. The client lives at home with his wife and their adolescent daughter. What
discharge instruction should the nurse include for the client?
A Use disposable plates and utensils
B Stay in a room with the door closed
C Require the use of a face mask by staff when providing care requiring close contact
D Assess and document skin condition around the incision and IV site at each shift
Correct Answer: D
Rationale: Early identification of infection leads to prompt treatment and decreased
transmission to others, so the condition of any invasive lines or breaks in the skin should be
assessed and documented during each shift.
7. A client is receiving continuous feedings through a gastrostomy tube and reports experiencing
frequent diarrhea. Which instruction should the nurse provide?
A Decrease the rate at which the feeding is given
B Do not allow the feeding to sit at room temperature
C Increase the concentration of the feedings
D Elevate the head of the bed to ninety degrees
Correct Answer: A
Rationale: Rapid feeding rates can overwhelm intestinal absorption, causing diarrhea. Slowing
the rate often helps. Maintaining HOB elevation reduces aspiration risk but will not necessarily
solve diarrhea. Increasing concentration could worsen diarrhea.
8. The nurse is analyzing the waveforms of a client's electrocardiogram. What finding indicates a
disturbance in electrical conduction in the ventricles?
A T wave of 0.16 second
B PR interval of 0.18 second
C QT interval of 0.34 second
D QRS interval of 0.14 second
Correct Answer: D
1. Which information is a priority for the RN to reinforce to an older client after intravenous
pyelography?
A Eat a light diet for the rest of the day
B Rest for the next 24 hours since the preparation and the test is tiring
C During waking hours drink at least one 8-ounce glass of fluid every hour for the next 2 days
D Measure the urine output for the next day and immediately notify the healthcare provider if it
should decrease
Correct Answer: D
Rationale: Intravenous pyelography (IVP) uses contrast dye that can be nephrotoxic. The priority
is monitoring for decreased urine output, which may indicate acute kidney injury.
2. A client has altered renal function and is being treated at home. The nurse recognizes that
the most accurate indicator of fluid balance during weekly visits is:
A Difference in the intake and output
B Changes in the mucous membranes
C Skin turgor
D Weekly weight
Correct Answer: D
Rationale: Weekly weight is the most accurate indicator of fluid balance. A weight change of 1
kg (2.2 lb) equals approximately 1 L of fluid. Intake/output records are often inaccurate, and
mucous membrane assessment and skin turgor are subjective and less reliable.
3. A client has been diagnosed with Zollinger-Ellison syndrome. Which information is most
important for the nurse to reinforce with the client?
A It is a condition in which one or more tumors called gastrinomas form in the pancreas or in
the upper part of the small intestine (duodenum)
B It is critical to report promptly to your healthcare provider any findings of peptic ulcers
C Treatment consists of medications to reduce acid and heal any peptic ulcers and, if possible,
,surgery to remove any tumors
D With the average age at diagnosis at 50 years, the peptic ulcers may occur at unusual areas of
the stomach or intestine
Correct Answer: B
Rationale: Prompt reporting of peptic ulcers is critical in Zollinger-Ellison syndrome because
ulcers can lead to serious complications such as perforation or hemorrhage. Early intervention
can prevent life-threatening outcomes.
4. The practical nurse enters a male client's room to administer routine morning medications,
and the client is on the phone. Which action is best for the PN to take?
A Ask another nurse to return with the medication when the client has hung up
B Wait for the client to excuse himself from the telephone conversation, and observe the client
taking the medication
C Return the medication to the client's drawer on the cart and document the client refused the
dose
D Leave the medication with the client, and let him take it when he finishes the conversation
Correct Answer: B
Rationale: The nurse should wait for the client to complete the phone call, then administer the
medication and observe the client take it. This ensures medication safety and proper
documentation.
5. A client is scheduled for a thoracentesis that will be done at the bedside. What should the
practical nurse prepare before the healthcare provider arrives on the unit to perform the
procedure?
A Cleanse the site and cover with a sterile towel
B Gather the procedure tray and equipment
C Place the client in an orthopneic position
D Keep the client NPO and encourage to void
Correct Answer: B
Rationale: The nurse should gather the procedure tray and equipment before the provider
arrives to perform the thoracentesis. This ensures the procedure can be performed without
delay and all necessary supplies are available.
, 6. A male client is on contact precautions due to an infected draining wound and is being
discharged home. The client lives at home with his wife and their adolescent daughter. What
discharge instruction should the nurse include for the client?
A Use disposable plates and utensils
B Stay in a room with the door closed
C Require the use of a face mask by staff when providing care requiring close contact
D Assess and document skin condition around the incision and IV site at each shift
Correct Answer: D
Rationale: Early identification of infection leads to prompt treatment and decreased
transmission to others, so the condition of any invasive lines or breaks in the skin should be
assessed and documented during each shift.
7. A client is receiving continuous feedings through a gastrostomy tube and reports experiencing
frequent diarrhea. Which instruction should the nurse provide?
A Decrease the rate at which the feeding is given
B Do not allow the feeding to sit at room temperature
C Increase the concentration of the feedings
D Elevate the head of the bed to ninety degrees
Correct Answer: A
Rationale: Rapid feeding rates can overwhelm intestinal absorption, causing diarrhea. Slowing
the rate often helps. Maintaining HOB elevation reduces aspiration risk but will not necessarily
solve diarrhea. Increasing concentration could worsen diarrhea.
8. The nurse is analyzing the waveforms of a client's electrocardiogram. What finding indicates a
disturbance in electrical conduction in the ventricles?
A T wave of 0.16 second
B PR interval of 0.18 second
C QT interval of 0.34 second
D QRS interval of 0.14 second
Correct Answer: D
