RN HESI EXIT EXAM VERSION 5
COMPREHENSIVE QUESTIONS AND
ANSWERS
1. A client with a history of heart failure is prescribed digoxin and furosemide. Which
laboratory value should the nurse monitor most closely to prevent digoxin toxicity?
A. Serum sodium level
B. Serum calcium level
C. Serum potassium level
D. Serum glucose level
Answer: C
Conceptual Explanation: Hypokalemia, often caused by loop diuretics like furosemide,
sensitizes the myocardium to digoxin, significantly increasing the risk of digoxin toxicity
even if the digoxin level is within therapeutic range.
2. The nurse is caring for a client with increased intracranial pressure (ICP). Which position is
most appropriate to promote venous drainage from the head?
A. Supine with the head of the bed flat
,B. Semi-Fowler’s with head midline
C. Trendelenburg position
D. Side-lying with knees flexed
Answer: B
Conceptual Explanation: Elevating the head of the bed to 30-45 degrees (Semi-Fowler’s)
and keeping the head in a neutral midline position helps facilitate venous outflow from the
brain, thereby reducing ICP.
3. A client is admitted with a diagnosis of Addisonian Crisis. Which clinical manifestation
should the nurse anticipate?
A. Hypertension and hypokalemia
B. Severe hypotension and hyperkalemia
C. Hyperglycemia and moon face
D. Bradycardia and fluid volume excess
Answer: B
Conceptual Explanation: Addisonian Crisis is an acute adrenal insufficiency characterized
by severe hypotension due to lack of aldosterone and cortisol, along with hyperkalemia and
hyponatremia.
, 4. Which assessment finding in a patient receiving a blood transfusion requires the nurse to
stop the infusion immediately?
A. A temperature increase of 0.2 degrees F
B. Complaint of being thirsty
C. Back pain and reddish-brown urine
D. Heart rate increasing from 80 to 88
Answer: C
Conceptual Explanation: Back pain and hematuria are signs of a hemolytic transfusion
reaction, a life-threatening emergency that requires immediate cessation of the blood
product.
5. A client with Type 1 Diabetes Mellitus is found unconscious and clammy. The nurse should
immediately prepare to administer which medication?
A. Glucagon IM or IV D50
B. Regular Insulin subcutaneously
C. Metformin orally
D. Normal saline bolus
Answer: A
COMPREHENSIVE QUESTIONS AND
ANSWERS
1. A client with a history of heart failure is prescribed digoxin and furosemide. Which
laboratory value should the nurse monitor most closely to prevent digoxin toxicity?
A. Serum sodium level
B. Serum calcium level
C. Serum potassium level
D. Serum glucose level
Answer: C
Conceptual Explanation: Hypokalemia, often caused by loop diuretics like furosemide,
sensitizes the myocardium to digoxin, significantly increasing the risk of digoxin toxicity
even if the digoxin level is within therapeutic range.
2. The nurse is caring for a client with increased intracranial pressure (ICP). Which position is
most appropriate to promote venous drainage from the head?
A. Supine with the head of the bed flat
,B. Semi-Fowler’s with head midline
C. Trendelenburg position
D. Side-lying with knees flexed
Answer: B
Conceptual Explanation: Elevating the head of the bed to 30-45 degrees (Semi-Fowler’s)
and keeping the head in a neutral midline position helps facilitate venous outflow from the
brain, thereby reducing ICP.
3. A client is admitted with a diagnosis of Addisonian Crisis. Which clinical manifestation
should the nurse anticipate?
A. Hypertension and hypokalemia
B. Severe hypotension and hyperkalemia
C. Hyperglycemia and moon face
D. Bradycardia and fluid volume excess
Answer: B
Conceptual Explanation: Addisonian Crisis is an acute adrenal insufficiency characterized
by severe hypotension due to lack of aldosterone and cortisol, along with hyperkalemia and
hyponatremia.
, 4. Which assessment finding in a patient receiving a blood transfusion requires the nurse to
stop the infusion immediately?
A. A temperature increase of 0.2 degrees F
B. Complaint of being thirsty
C. Back pain and reddish-brown urine
D. Heart rate increasing from 80 to 88
Answer: C
Conceptual Explanation: Back pain and hematuria are signs of a hemolytic transfusion
reaction, a life-threatening emergency that requires immediate cessation of the blood
product.
5. A client with Type 1 Diabetes Mellitus is found unconscious and clammy. The nurse should
immediately prepare to administer which medication?
A. Glucagon IM or IV D50
B. Regular Insulin subcutaneously
C. Metformin orally
D. Normal saline bolus
Answer: A
