, HESI RN Exit V8
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. The nurse observes an unlicensed assistive personnel (UAP) positioning a newly admitted
client who has a seizure disorder. The client is supine and the UAP is placing soft pillows along
the side rails. What action should the nurse implement?
A Ensure that the UAP has placed the pillows effectively to protect the client
B Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows
C Assume responsibility for placing the pillows while the UAP completes another task
D Ask the UAP to use some of the pillows to prop the client in a side-lying position
Correct Answer: B
,Rationale: Pillows can be a suffocation hazard for clients with seizure disorders. Soft blankets
are safer to pad side rails. The nurse should correct the UAP's action to ensure client safety .
4. Following discharge teaching, a male client with duodenal ulcer tells the nurse he will drink
plenty of dairy products, such as milk, to help coat and protect his ulcer. What is the best follow-
up action by the nurse?
A Praise the client for understanding the discharge teaching
B Remind the client that milk may actually stimulate gastric acid secretion
C Suggest the client drink skim milk instead of whole milk
D Document that the client understands the discharge teaching
Correct Answer: B
Rationale: Milk may provide temporary relief but actually stimulates gastric acid secretion,
which can worsen ulcer symptoms. The nurse should provide corrective teaching.
5. A nurse is caring for a client who has fluid volume excess. Which finding does the nurse
anticipate?
A Tachycardia
B Decreased urine output
C Pitting edema
D Decreased blood pressure
Correct Answer: C
Rationale: Fluid volume excess (hypervolemia) causes pitting edema due to fluid accumulation
in interstitial spaces. Tachycardia and decreased urine output are signs of hypovolemia. Blood
pressure is typically elevated in fluid volume excess .
6. A client has a serum potassium level of 2.9 mEq/L. Which ECG change does the nurse expect?
A Peaked T waves
B Widened QRS
C Flattened T waves and U waves
D Shortened PR interval
Correct Answer: C
, Rationale: Hypokalemia (K+ < 3.5 mEq/L) causes flattened or inverted T waves and prominent U
waves on ECG. Peaked T waves are seen in hyperkalemia .
7. A nurse is caring for a client with a chest tube. Continuous bubbling in the water seal
chamber indicates:
A Normal functioning
B An air leak
C Tension pneumothorax
D The tube is clogged
Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the system.
The nurse should assess for the source of the leak and notify the provider .
8. A client is receiving a blood transfusion and develops chills, fever, and back pain. What is the
priority action?
A Slow the infusion rate
B Stop the transfusion and start normal saline
C Administer an antihistamine
D Notify the healthcare provider
Correct Answer: B
Rationale: Chills, fever, and back pain indicate a transfusion reaction. The transfusion must be
stopped immediately, and the IV line should be kept open with normal saline .
9. 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
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. The nurse observes an unlicensed assistive personnel (UAP) positioning a newly admitted
client who has a seizure disorder. The client is supine and the UAP is placing soft pillows along
the side rails. What action should the nurse implement?
A Ensure that the UAP has placed the pillows effectively to protect the client
B Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows
C Assume responsibility for placing the pillows while the UAP completes another task
D Ask the UAP to use some of the pillows to prop the client in a side-lying position
Correct Answer: B
,Rationale: Pillows can be a suffocation hazard for clients with seizure disorders. Soft blankets
are safer to pad side rails. The nurse should correct the UAP's action to ensure client safety .
4. Following discharge teaching, a male client with duodenal ulcer tells the nurse he will drink
plenty of dairy products, such as milk, to help coat and protect his ulcer. What is the best follow-
up action by the nurse?
A Praise the client for understanding the discharge teaching
B Remind the client that milk may actually stimulate gastric acid secretion
C Suggest the client drink skim milk instead of whole milk
D Document that the client understands the discharge teaching
Correct Answer: B
Rationale: Milk may provide temporary relief but actually stimulates gastric acid secretion,
which can worsen ulcer symptoms. The nurse should provide corrective teaching.
5. A nurse is caring for a client who has fluid volume excess. Which finding does the nurse
anticipate?
A Tachycardia
B Decreased urine output
C Pitting edema
D Decreased blood pressure
Correct Answer: C
Rationale: Fluid volume excess (hypervolemia) causes pitting edema due to fluid accumulation
in interstitial spaces. Tachycardia and decreased urine output are signs of hypovolemia. Blood
pressure is typically elevated in fluid volume excess .
6. A client has a serum potassium level of 2.9 mEq/L. Which ECG change does the nurse expect?
A Peaked T waves
B Widened QRS
C Flattened T waves and U waves
D Shortened PR interval
Correct Answer: C
, Rationale: Hypokalemia (K+ < 3.5 mEq/L) causes flattened or inverted T waves and prominent U
waves on ECG. Peaked T waves are seen in hyperkalemia .
7. A nurse is caring for a client with a chest tube. Continuous bubbling in the water seal
chamber indicates:
A Normal functioning
B An air leak
C Tension pneumothorax
D The tube is clogged
Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the system.
The nurse should assess for the source of the leak and notify the provider .
8. A client is receiving a blood transfusion and develops chills, fever, and back pain. What is the
priority action?
A Slow the infusion rate
B Stop the transfusion and start normal saline
C Administer an antihistamine
D Notify the healthcare provider
Correct Answer: B
Rationale: Chills, fever, and back pain indicate a transfusion reaction. The transfusion must be
stopped immediately, and the IV line should be kept open with normal saline .
9. 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
