HESI RN EXIT EXAM
(750 QUESTIONS AND ANSWERS, RATIONALE OF
EACH ANSWER INCLUDED)
1. Following discharge teaching, a male client with
duodenal ulcer tells the nurse the 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- Remind the client that it is also important to switch to
decaffeinated coffee and tea.
b- Suggest that the client also plan to eat frequent small meals
to reduce discomfort
c- Review with the client the need to avoid foods that are rich in
milk and cream.
d- Reinforce this teaching by asking the client to list a dairy food that
he might select.
Rationale: Diets rich in milk and cream stimulate gastric acid secretion and
should be avoided.
2. A male client with hypertension, who received new antihypertensive
prescriptions at his last visit returns to the clinic
,two weeks later to evaluate his blood pressure (BP). His BP is
158/106 and he admits that he has not been taking the
prescribed medication because the drugs make him “feel bad”.
In explaining the need for hypertension control, the nurse
should stress that an elevated BP places the client at risk for
which pathophysiological condition?
a- Blindness secondary to cataracts b- Acute kidney
injury due to glomerular damage c- Stroke
secondary to hemorrhage d- Heart block due to
myocardial damage
Rationale: Stroke related to cerebral hemorrhage is major risk for
uncontrolled hypertension.
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.
a- Assume responsibility for placing the pillows while the UAP
completes another task.
b- Ask the UAP to use some of the pillows to prop the client in a side
lying position.
Rationale: The nurse should instruct the UAP to pad the side rails with soft
blankest because the use of pillows could result in suffocation and would
need to be removed at the onset of the seizure. The nurse can delegate
paddling the side rails to the UAP
4. An adolescent with major depressive disorder has
been taking duloxetine (Cymbalta) for the past 12
days. Which assessment finding requires immediate
follow-up?
a- Describes life without purpose
b- Complains of nausea and loss of appetite
c- States is often fatigued and drowsy d-
Exhibits an increase in sweating.
Rationale: Cymbalta is a selective serotonin and norepinephrine
reuptake inhibitor that is known to increase the risk of suicidal
thinking in adolescents and young adults with major depressive
, disorder. B, C and D are side effects
5. A 60-year-old female client with a positive family
history of ovarian cancer has developed an
abdominal mass and is being evaluated for possible
ovarian cancer. Her Papanicolau (Pap) smear
results are negative. What information should the
nurse include in the client’s teaching plan?
a- Further evaluation involving surgery may be needed
b- A pelvic exam is also needed before cancer is ruled out c- Pap
smear evaluation should be continued every six month d- One
additional negative pap smear in six months is needed.
Rationale: An abdominal mass in a client with a family history for
ovarian cancer should be evaluated carefully
6. A client who recently underwear a tracheostomy
is being prepared for discharge to home. Which
instructions is most important for the nurse to
include in the discharge plan?
a- Explain how to use communication tools. b-
Teach tracheal suctioning techniques c-
Encourage self-care and independence.
d- Demonstrate how to clean tracheostomy site.
(750 QUESTIONS AND ANSWERS, RATIONALE OF
EACH ANSWER INCLUDED)
1. Following discharge teaching, a male client with
duodenal ulcer tells the nurse the 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- Remind the client that it is also important to switch to
decaffeinated coffee and tea.
b- Suggest that the client also plan to eat frequent small meals
to reduce discomfort
c- Review with the client the need to avoid foods that are rich in
milk and cream.
d- Reinforce this teaching by asking the client to list a dairy food that
he might select.
Rationale: Diets rich in milk and cream stimulate gastric acid secretion and
should be avoided.
2. A male client with hypertension, who received new antihypertensive
prescriptions at his last visit returns to the clinic
,two weeks later to evaluate his blood pressure (BP). His BP is
158/106 and he admits that he has not been taking the
prescribed medication because the drugs make him “feel bad”.
In explaining the need for hypertension control, the nurse
should stress that an elevated BP places the client at risk for
which pathophysiological condition?
a- Blindness secondary to cataracts b- Acute kidney
injury due to glomerular damage c- Stroke
secondary to hemorrhage d- Heart block due to
myocardial damage
Rationale: Stroke related to cerebral hemorrhage is major risk for
uncontrolled hypertension.
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.
a- Assume responsibility for placing the pillows while the UAP
completes another task.
b- Ask the UAP to use some of the pillows to prop the client in a side
lying position.
Rationale: The nurse should instruct the UAP to pad the side rails with soft
blankest because the use of pillows could result in suffocation and would
need to be removed at the onset of the seizure. The nurse can delegate
paddling the side rails to the UAP
4. An adolescent with major depressive disorder has
been taking duloxetine (Cymbalta) for the past 12
days. Which assessment finding requires immediate
follow-up?
a- Describes life without purpose
b- Complains of nausea and loss of appetite
c- States is often fatigued and drowsy d-
Exhibits an increase in sweating.
Rationale: Cymbalta is a selective serotonin and norepinephrine
reuptake inhibitor that is known to increase the risk of suicidal
thinking in adolescents and young adults with major depressive
, disorder. B, C and D are side effects
5. A 60-year-old female client with a positive family
history of ovarian cancer has developed an
abdominal mass and is being evaluated for possible
ovarian cancer. Her Papanicolau (Pap) smear
results are negative. What information should the
nurse include in the client’s teaching plan?
a- Further evaluation involving surgery may be needed
b- A pelvic exam is also needed before cancer is ruled out c- Pap
smear evaluation should be continued every six month d- One
additional negative pap smear in six months is needed.
Rationale: An abdominal mass in a client with a family history for
ovarian cancer should be evaluated carefully
6. A client who recently underwear a tracheostomy
is being prepared for discharge to home. Which
instructions is most important for the nurse to
include in the discharge plan?
a- Explain how to use communication tools. b-
Teach tracheal suctioning techniques c-
Encourage self-care and independence.
d- Demonstrate how to clean tracheostomy site.
