HESI EXIT EXAM QUESTIONS AND ANSWERS

HESI EXIT EXAM QUESTIONS AND ANSWERS The nurse should question a prescription for docusate sodium (Colace) for a client with which problem? a. First day post myocardial infarction. b. Two days following a knee replacement. c. Abdominal pain of unknown etiology. d. History of liver disease. 2. The nurse working on a medical unit is assigned to care for four clients. Which client should the nurse assess first? a. A client who is quadriplegic and is complaining of a severe headache. b. A client who had a stroke and now has right-sided weakness. c. A client who has a pressure ulcer and now has a temperature of 102.3° F. d. An elderly client who is requesting medication for constipation. 3. A male client is accompanied to the emergency department by the police after trying to jump off a bridge. As the nurse begins the initial evaluation, what is the priority assessment? a. Assess to see if the client is having command hallucinations. b. Determine where the client usually seeks healthcare treatment. c. Assess if the client has a history of aggression. d. Determine if the client has a history of depression. 4. Prior to discharge, the parents of a child with cystic fibrosis are demonstrating chest physiotherapy (CPT) that they will perform for their child at home. Which action requires intervention by the nurse? a. A bronchodilator is administered before starting CPT. b. The child is placed in a supine position to begin percussions. c. A cupped hand is used when percussing the lung fields. d. Plan to perform CPT when the child awakens in the morning. 5. A client at 29-weeks gestation is receiving magnesium sulfate 3 grams/hour for pre-term labor. After administering the loading dose, what assessment finding should the nurse report to the healthcare provider immediately? a. A decrease in respirations from 20 to 17 breaths/minute. b. An increase in temperature from 98.9° to 99.9° F. c. An increase in blood pressure from 110/65 to 120/85. d. A decrease in deep tendon reflexes from 3+ to 1+. 6. Based on the change of shift report, the client with which signs and symptoms should be assessed by the nurse first? a. Epigastric pain, no bowel sounds. b. Chest pressure, diaphoresis, nausea. c. Chest tightness, wheezing, coughing. d. Calf pain, positive Homan's sign. 7. A client who is diaphoretic and talking incoherently presents in the emergency department triage area. What assessment should the triage nurse obtain first? a. A finger-stick glucose. b. A blood pressure. c. Temperature d. Arterial blood gases. 8. A 59-year-old male client is brought to the emergency room where he is assessed to have a Glasgow Coma Scale of 3. Based on this assessment, how should the nurse characterize the client's condition? a. He is in a coma, and has a very poor prognosis. b. This client is conscious, but is not oriented to time and place. c. He has a good prognosis for recovery. d. The client has increased intracranial pressure. 9. Three days postoperative, a client's wound drainage changes in appearance from sanguineous to serous. Based on this finding, what nursing intervention should the nurse implement? a. Continue to monitor the wound. b. Monitor the client's vital signs. c. Apply pressure to the wound. d. Obtain a wound culture. 10. A client with heart failure has developed a large pleural effusion and the healthcare provider plans to perform a thoracentesis. In preparing the client for this procedure, what intervention should the nurse implement? a. Notify the operating room personnel to schedule the procedure. b. Contact the client's next of kin to sign the operative consent. c. Determine if the client is allergic to antibiotics. d. Instruct the client to remain immobile during the procedure. 11. A young adult male client is admitted to the emergency room with a bleeding abdominal wound following a motor vehicle collision. He is crying out with pain. His friends report that he often uses cocaine. What nursing diagnosis has the greatest priority? a. High risk for injury related to cocaine withdrawal. b. High risk for injury related to hemorrhage.