, HESI EXIT V9
1. A newly admitted client complains of pain rating a 7 on a scale of 0 to 10. The client has not
been sleeping well lately and is experiencing labored breathing. List the client's problems in
order of priority for the nurse. (Rank in priority order from highest to lowest.)
A Definitive therapy
B Airway and breathing
C Pain management
D Sleep and rest
Correct Answer: B, C, D, A (Airway and breathing → Pain management → Sleep and rest →
Definitive therapy)
Rationale: First-level problems are immediate priorities (airway, breathing, and circulation). In
this scenario, airway and breathing are the first priority, followed by pain management,
Maslow's hierarchy of basic needs for rest and sleep, and then definitive drug therapies .
2. 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 the phone
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 .
3. 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 .
4. 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 .
5. The practical nurse palpates a client's radial pulse and notes that the pulse disappears when
light pressure is applied. How should the PN document this finding?
A Missing pulse
B Thready pulse volume
C Light pressure applied to pulse
D Pulse skips beats
Correct Answer: B
Rationale: A pulse that disappears with light pressure indicates a thready pulse volume, which is
documented as such. This finding may indicate decreased cardiac output or peripheral
perfusion .
, 6. 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.
7. 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
Rationale: The normal duration of the QRS is 0.04 to 0.12 second, so a prolonged QRS indicates
an electrical anomaly in the ventricles. The T wave is normally 0.16 seconds. The PR interval
range is 0.12 to 0.20 second. The QT interval should be 0.31 to 0.38 second .
8. The nurse is assigned a client with numerous treatments and decides it is not possible to
complete all the needed treatments in the time scheduled for this shift. Which process should
the nurse use?
A Delegate tasks to competent team members
B Prioritize tasks with the most crucial needs first
C Report the incomplete treatments to next shift nurse
D Start with the easiest treatment first
Correct Answer: B
Rationale: Planning care for a client with numerous treatments should be prioritized with the
most crucial client needs first to the least. Delegating to others or reporting displace the nurse's
1. A newly admitted client complains of pain rating a 7 on a scale of 0 to 10. The client has not
been sleeping well lately and is experiencing labored breathing. List the client's problems in
order of priority for the nurse. (Rank in priority order from highest to lowest.)
A Definitive therapy
B Airway and breathing
C Pain management
D Sleep and rest
Correct Answer: B, C, D, A (Airway and breathing → Pain management → Sleep and rest →
Definitive therapy)
Rationale: First-level problems are immediate priorities (airway, breathing, and circulation). In
this scenario, airway and breathing are the first priority, followed by pain management,
Maslow's hierarchy of basic needs for rest and sleep, and then definitive drug therapies .
2. 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 the phone
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 .
3. 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 .
4. 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 .
5. The practical nurse palpates a client's radial pulse and notes that the pulse disappears when
light pressure is applied. How should the PN document this finding?
A Missing pulse
B Thready pulse volume
C Light pressure applied to pulse
D Pulse skips beats
Correct Answer: B
Rationale: A pulse that disappears with light pressure indicates a thready pulse volume, which is
documented as such. This finding may indicate decreased cardiac output or peripheral
perfusion .
, 6. 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.
7. 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
Rationale: The normal duration of the QRS is 0.04 to 0.12 second, so a prolonged QRS indicates
an electrical anomaly in the ventricles. The T wave is normally 0.16 seconds. The PR interval
range is 0.12 to 0.20 second. The QT interval should be 0.31 to 0.38 second .
8. The nurse is assigned a client with numerous treatments and decides it is not possible to
complete all the needed treatments in the time scheduled for this shift. Which process should
the nurse use?
A Delegate tasks to competent team members
B Prioritize tasks with the most crucial needs first
C Report the incomplete treatments to next shift nurse
D Start with the easiest treatment first
Correct Answer: B
Rationale: Planning care for a client with numerous treatments should be prioritized with the
most crucial client needs first to the least. Delegating to others or reporting displace the nurse's
