HESI PN EXIT EXAM V1 – Practical Nursing Comprehensive Exit
Exam | Advanced Practice Questions with Detailed Rationales |
Graded A+
1. A client with type 1 diabetes mellitus is admitted with diabetic ketoacidosis (DKA). Which
laboratory finding is consistent with this diagnosis?
A. Serum pH of 7.45
B. Serum bicarbonate of 22 mEq/L
C. Blood glucose of 350 mg/dL with positive serum ketones
D. Serum potassium of 5.5 mEq/L
☑ Correct Answer: C
☑ Explanation: Diabetic ketoacidosis is characterized by hyperglycemia (blood glucose
>250 mg/dL), metabolic acidosis (pH <7.35), low bicarbonate (<15 mEq/L), and the presence of
serum and urine ketones. Option A shows normal pH, B shows normal bicarbonate, and D shows
hyperkalemia, which can occur but is not the defining diagnostic finding.
,2. A nurse is caring for a postoperative client who has a nasogastric (NG) tube set to low
intermittent suction. Which assessment finding indicates the NG tube is functioning properly?
A. Absence of bowel sounds
B. Client reports nausea
C. Gastric output of 800 mL in 8 hours
D. The tube is draining greenish-yellow fluid
☑ Correct Answer: D
☑ Explanation: Proper NG tube function is indicated by drainage of gastric contents, which
is typically greenish-yellow or tan. Absence of bowel sounds (A) is expected postoperatively but
does not confirm tube function. Nausea (B) may indicate tube malfunction or other issues. High
output (C) may be normal postoperatively but does not confirm proper placement.
3. A client with heart failure is prescribed furosemide. Which laboratory value should the
nurse monitor most closely?
A. Serum sodium
B. Serum potassium
,C. Serum calcium
D. Serum magnesium
☑ Correct Answer: B
☑ Explanation: Furosemide is a loop diuretic that can cause significant potassium loss,
leading to hypokalemia. While sodium, calcium, and magnesium may also be affected,
potassium monitoring is the highest priority due to the risk of cardiac arrhythmias from
hypokalemia.
4. A client who is receiving a blood transfusion develops chills, fever, and back pain 30
minutes after the infusion started. What should the nurse do first?
A. Slow the infusion rate
B. Stop the transfusion
C. Administer an antihistamine
D. Check the client's vital signs
☑ Correct Answer: B
☑ Explanation: These symptoms indicate a possible acute hemolytic transfusion reaction.
, The nurse's priority is to stop the transfusion immediately to prevent further complications.
After stopping the transfusion, the nurse should maintain IV access with normal saline, notify
the provider, and monitor vital signs.
5. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. Which nursing intervention is most important for this client?
A. Encourage coughing and deep breathing every 2 hours
B. Assess for signs of oxygen toxicity
C. Monitor the client's respiratory rate and oxygen saturation continuously
D. Maintain the prescribed oxygen flow rate and monitor for hypoventilation
☑ Correct Answer: D
☑ Explanation: Clients with COPD often have a hypoxic drive to breathe. Administering
high-flow oxygen can suppress this drive and cause respiratory depression. Maintaining the
prescribed low flow rate and monitoring for hypoventilation is the priority. While A and C are
appropriate interventions, D addresses the specific risk for COPD clients.
Exam | Advanced Practice Questions with Detailed Rationales |
Graded A+
1. A client with type 1 diabetes mellitus is admitted with diabetic ketoacidosis (DKA). Which
laboratory finding is consistent with this diagnosis?
A. Serum pH of 7.45
B. Serum bicarbonate of 22 mEq/L
C. Blood glucose of 350 mg/dL with positive serum ketones
D. Serum potassium of 5.5 mEq/L
☑ Correct Answer: C
☑ Explanation: Diabetic ketoacidosis is characterized by hyperglycemia (blood glucose
>250 mg/dL), metabolic acidosis (pH <7.35), low bicarbonate (<15 mEq/L), and the presence of
serum and urine ketones. Option A shows normal pH, B shows normal bicarbonate, and D shows
hyperkalemia, which can occur but is not the defining diagnostic finding.
,2. A nurse is caring for a postoperative client who has a nasogastric (NG) tube set to low
intermittent suction. Which assessment finding indicates the NG tube is functioning properly?
A. Absence of bowel sounds
B. Client reports nausea
C. Gastric output of 800 mL in 8 hours
D. The tube is draining greenish-yellow fluid
☑ Correct Answer: D
☑ Explanation: Proper NG tube function is indicated by drainage of gastric contents, which
is typically greenish-yellow or tan. Absence of bowel sounds (A) is expected postoperatively but
does not confirm tube function. Nausea (B) may indicate tube malfunction or other issues. High
output (C) may be normal postoperatively but does not confirm proper placement.
3. A client with heart failure is prescribed furosemide. Which laboratory value should the
nurse monitor most closely?
A. Serum sodium
B. Serum potassium
,C. Serum calcium
D. Serum magnesium
☑ Correct Answer: B
☑ Explanation: Furosemide is a loop diuretic that can cause significant potassium loss,
leading to hypokalemia. While sodium, calcium, and magnesium may also be affected,
potassium monitoring is the highest priority due to the risk of cardiac arrhythmias from
hypokalemia.
4. A client who is receiving a blood transfusion develops chills, fever, and back pain 30
minutes after the infusion started. What should the nurse do first?
A. Slow the infusion rate
B. Stop the transfusion
C. Administer an antihistamine
D. Check the client's vital signs
☑ Correct Answer: B
☑ Explanation: These symptoms indicate a possible acute hemolytic transfusion reaction.
, The nurse's priority is to stop the transfusion immediately to prevent further complications.
After stopping the transfusion, the nurse should maintain IV access with normal saline, notify
the provider, and monitor vital signs.
5. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. Which nursing intervention is most important for this client?
A. Encourage coughing and deep breathing every 2 hours
B. Assess for signs of oxygen toxicity
C. Monitor the client's respiratory rate and oxygen saturation continuously
D. Maintain the prescribed oxygen flow rate and monitor for hypoventilation
☑ Correct Answer: D
☑ Explanation: Clients with COPD often have a hypoxic drive to breathe. Administering
high-flow oxygen can suppress this drive and cause respiratory depression. Maintaining the
prescribed low flow rate and monitoring for hypoventilation is the priority. While A and C are
appropriate interventions, D addresses the specific risk for COPD clients.
