hypothyroidismS?
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2023 [NGN] HESI Exit
Exam
1. A female client has been taking a high dose of prednisone, a corticosteroid, for
several months. After stopping the medication abruptly, the client reports feeling
“very tired”. Which nursing intervention is most important for the nurse to implement?
A. Measure vital signs
B. Auscultate breath sounds
C. Palpate the abdomen
D. Observe the skin for bruising
2. A male client reports the onset of numbness and tingling in his fingers and
around his mouth. Which lab is important for the nurse to review before
contacting the health care provider?
A. capillary glucose
B. urine specific gravity
C. Serum calcium
D. white blood cell count
3. What explanation is best for the nurse to provide a client who asks the purpose
of using the log-rolling technique for turning?
A. working together can decrease the risk for back injury
B. The technique is intended to maintain straight spinal alignment.
C. Using two or three people increases client safety.
D. turning instead of pulling reduces the likelihood of skin damage
4. A client receiving chemotherapy has severe neutropenia. Which snack is
best for the nurse to recommend to the client?
A. Baked apples topped with dried raisins
5. Which action should the school nurse take first when conducting a
screening for scoliosis?
A. Inspect for symmetrical shoulder height.
6. An unlicensed assistive personnel (UAP) assigned to obtain client vital signs
reports to the charge nurse that a client has a weak pulse with a rate of 44
beat/ minutes. What action should the charge nurse implement?
A. Assign a practical nurse (LPN) to determine if an apical radial deficit is present
7. After a sudden loss of consciousness, a female client is taken to the ED and
initial assessment indicate that her blood glucose level is critically low. Once
her glucose level is stabilized, the client reports that was recently diagnosed
with anorexia nervosa and is being treated at an outpatient clinic. Which
intervention is more important to include in this client’s discharge plan?
A. Encourage a low-carbohydrate and high-protein diet
8. A client with a peripherally inserted central catheter (PICC) line has a fever.
What client assessment is most important for the nurse to perform?
A. Observe the antecubital fossa for inflammation.
9. The nurse administers an antibiotic to a client with respiratory tract infection. To evaluate the
medication’s effectiveness, which laboratory values should the nurse monitor? Select
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all that apply
A. White blood cell (WBC) count
B. Sputum culture and sensitivity
10. AA client is admitted to isolation with the diagnosis of active
tuberculosis.Which infection control measures should the nurse implement?
A. Negative pressure environment
B. contact precautions
C. droplet precautions
D. protective environment
11. A school nurse is called to the soccer field because a child has a nose bleed
(epistaxis). In what position should the nurse place the child?
A. Sitting up and leaning forward
12. AA young adult who is hit with a baseball bat on the temporal area of the
left skull is conscious when admitted to the ED and is transferred to the
Neurological Unit to be monitored for signs of closed head injury. Which
assessment finding is indicative of a developing epidural hematoma?
A. Altered consciousness within the first 24 hours after injury.
13. AA female client with breast cancer who completed her first
chemotherapy treatment today at an out-patient center is preparing
for discharge. Which behavior indicates that the client understands her
care needs
A. Rented movies and borrowed books to use while passing time at home
14. Which instruction should the nurse provide a pregnant client who is
complaining of heartburn?
A. Eat small meal throughout the day to avoid a full stomach.
15. A client is admitted to the intensive care unit with diabetes insipidus due to a pituitary
gland tumor. Which potential complication should the nurse monitor closely?
A. Hypokalemia
B. Ketonuria.
C. Peripheral edema
D. Elevated blood pressure
E. Rational: pituitary tumors that suppress antidiuretic hormone (ADH) result in
diabetes insipidus, which causes massive polyuria and serum electrolyte
imbalances, including hypokalemia, which can lead to lethal arrhythmias.
16. A female client reports she has not had a bowel movement for 3 days,
but now is defecating frequent small amount of liquid stool. Which action
should the nurse implement?
A. Digitally check the client for a fecal impaction
17. After changing to a new brand of laundry detergent, an adult male reports that he has a fine
itchy rash. Which assessment finding warrants immediate intervention by the nurse?
A. Bilateral Wheezing.
18. The nurse should teach the parents of a 6 year-old recently diagnosed with asthma that
the symptom of acute episode of asthma are due to which physiological response?
A. Inflammation of the mucous membrane & bronchospasm
19. AA 10 year old who has terminal brain cancer asks the nurse,
"Whatwill happen to my body when I die?" How should the nurse respond?
A. "The heart will stop beating & you will stop breathing."
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,6 . The nurse is aSstsuveias.scoin
mg- Tahe3Marko
-m etn
ptlahc-eoto
ldBuiny faann
d tSe
wll hyoourhSatuddyaMaptyerlio
alrotomy yesterday. This
child should be medicated for pain based on which findings? Select all that apply:
A. Restlessness
B. Clenched Fist
C. Increased pulse rate
D. Increased respiratory rate.
E. Increased temperature
F. Peripheral pallor of the skin
66. The nurse is preparing to administer an oral antibiotic to a client with
unilateralweakness, ptosis, mouth drooping and, aspiration pneumonia. What is the
priority nursing assessment that should be done before administering this
medication?
A. Determine which side of the body is weak.
67. The nurse who is working on a surgical unit receives change of shift report on a
group of clients for the upcoming shift. A client with which condition requires the
most immediate attention by the nurse?
A. Gunshot wound three hours ago with dark drainage of 2 cm noted on the dressing.
Mastectomy 2 days ago with 50 ml bloody drainage noted in the
B. Jackson-pratt drain.
Collapsed lung after a fall 8h ago with 100 ml blood in the chest tube
C. collection container
Abdominal-perineal resection 2 days ago with no drainage on
D. dressing who has fever and chills.
Rationale: the client with an abdominal- perineal resection is at risk for peritonitis
E. and needs to be immediately assessed for other signs and symptoms for sepsis.
68. The nurse is caring for a client who had gastric bypass surgery
yesterday. Which intervention is most important for the nurse to
implement during the first 24 postoperative hours?
A. Measure hourly urinary output.
Rationale: a serious early complications of gastric bypass
B. surgery is an anastomoses leak, often resulting in death.
69. When preparing to discharge a male client who has been hospitalized for an
adrenal crisis, the client expresses concern about having another crisis. He tells
the nurse that he wants to stay in the hospital a few more days. Which
intervention should the nurse implement?
A. Schedule an appointment for an out-patient psychosocial assessment.
70. An adult female client tells the nurse that though she is afraid her abusive
boyfriend might one day kill her, she keeps hoping that he will change. What
action should the nurse take first?
A. Explore client’s readiness to discuss the situation.
71. In caring for a client with Cushing syndrome, which serum laboratory value
is most important for the nurse to monitor?
A. Lactate
B. Glucose
C. Hemoglobin
D. Creatinine
72. Azithromycin is prescribed for an adolescent female who has lower lobe pneumonia and
recurrent chlamydia. What information is most important for the nurse to
provide to this client?
A. Use two forms of contraception while taking this drug.
73. A client in the emergency center demonstrates rapid speech, flight of ideas, and
reports sleeping only three hours during the past 48h. Based on these finding, it is
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, most important for the nurse to review the laboratory value for which medication?
A. DivalprSotuv
exia..com - The Marketplace to Buy and Sell your Study Material
Rationale: divalproex is the first line of treatment for bipolar disorder BPD
B. because it has a high therapeutic index, few side effects, and a rapid
onset in controlling symptoms and preventing recurrent episodes of mania
and depression. The serum value of divalproex should be determined
since the client is exhibiting symptoms of mania, which may indicate non-
compliance with the medication regimen.
74. A male client who is admitted to the mental health unit for treatment of bipolar disorder
has a slightly slurred speech pattern and an unsteady gait. Which assessment finding
is most important for the nurse to report to the healthcare provider?
A. Serum lithium level of 1.6 mEq/L or mmol/l (SI)
B. Rationale: The therapeutic level of Serum lithium is 0.8 to 1.5 mEq/L or
mmol/l (SI). Slurred speech and ataxia are sign of lithium toxicity.
75. A client was admitted to the cardiac observation unit 2 hours ago complaining of chest pain.
On admission, the client’s EKG showed bradycardia, ST depression, but no ventricular
ectopy. The client suddenly reports a sharp increase in pain, telling the nurse, “I feel like an
elephant just stepped
on my chest” The EKG now shows Q waves and ST segment elevations in the anterior
leads. What intervention should the nurse perform?
A. Administer prescribed morphine sulfate IV and provide oxygen at 2
L/min per nasal cannula.
76. The nurse is developing a teaching program for the community. What
population characteristic is most influential when choosing strategies for
implementing a teaching plan?
A. Literacy level
77. A client is being discharged with a prescription for warfarin (Coumadin).
What instruction should the nurse provide this client regarding diet?
A. Eat approximated the same amount of leafy green vegetables daily so
the amount of vitamin K consumed is consistent.
78. A client who had a small bowel resection acquired methicillin resistant
staphylococcus aureus (MRSA) while hospitalized. He treated and released,
but is readmitted today because of diarrhea and dehydration. It is most
important for the nurse to implement which intervention.
A. Maintain contact transmission precaution
79. A postoperative female client has a prescription for morphine sulfate 10 mg IV q3 hours for
pain. One dose of morphine was administered when the client was admitted to the post
anesthesia care unit (PACU) and 3 hours later, the client is again complaining of
Downloaded by: sierrabothwell |
Distribution of this document is illegal
tuvia.com - The Marketplace to Buy and Sell your Study Material
2023 [NGN] HESI Exit
Exam
1. A female client has been taking a high dose of prednisone, a corticosteroid, for
several months. After stopping the medication abruptly, the client reports feeling
“very tired”. Which nursing intervention is most important for the nurse to implement?
A. Measure vital signs
B. Auscultate breath sounds
C. Palpate the abdomen
D. Observe the skin for bruising
2. A male client reports the onset of numbness and tingling in his fingers and
around his mouth. Which lab is important for the nurse to review before
contacting the health care provider?
A. capillary glucose
B. urine specific gravity
C. Serum calcium
D. white blood cell count
3. What explanation is best for the nurse to provide a client who asks the purpose
of using the log-rolling technique for turning?
A. working together can decrease the risk for back injury
B. The technique is intended to maintain straight spinal alignment.
C. Using two or three people increases client safety.
D. turning instead of pulling reduces the likelihood of skin damage
4. A client receiving chemotherapy has severe neutropenia. Which snack is
best for the nurse to recommend to the client?
A. Baked apples topped with dried raisins
5. Which action should the school nurse take first when conducting a
screening for scoliosis?
A. Inspect for symmetrical shoulder height.
6. An unlicensed assistive personnel (UAP) assigned to obtain client vital signs
reports to the charge nurse that a client has a weak pulse with a rate of 44
beat/ minutes. What action should the charge nurse implement?
A. Assign a practical nurse (LPN) to determine if an apical radial deficit is present
7. After a sudden loss of consciousness, a female client is taken to the ED and
initial assessment indicate that her blood glucose level is critically low. Once
her glucose level is stabilized, the client reports that was recently diagnosed
with anorexia nervosa and is being treated at an outpatient clinic. Which
intervention is more important to include in this client’s discharge plan?
A. Encourage a low-carbohydrate and high-protein diet
8. A client with a peripherally inserted central catheter (PICC) line has a fever.
What client assessment is most important for the nurse to perform?
A. Observe the antecubital fossa for inflammation.
9. The nurse administers an antibiotic to a client with respiratory tract infection. To evaluate the
medication’s effectiveness, which laboratory values should the nurse monitor? Select
Downloaded by: sierrabothwell |
Distribution of this document is illegal
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
all that apply
A. White blood cell (WBC) count
B. Sputum culture and sensitivity
10. AA client is admitted to isolation with the diagnosis of active
tuberculosis.Which infection control measures should the nurse implement?
A. Negative pressure environment
B. contact precautions
C. droplet precautions
D. protective environment
11. A school nurse is called to the soccer field because a child has a nose bleed
(epistaxis). In what position should the nurse place the child?
A. Sitting up and leaning forward
12. AA young adult who is hit with a baseball bat on the temporal area of the
left skull is conscious when admitted to the ED and is transferred to the
Neurological Unit to be monitored for signs of closed head injury. Which
assessment finding is indicative of a developing epidural hematoma?
A. Altered consciousness within the first 24 hours after injury.
13. AA female client with breast cancer who completed her first
chemotherapy treatment today at an out-patient center is preparing
for discharge. Which behavior indicates that the client understands her
care needs
A. Rented movies and borrowed books to use while passing time at home
14. Which instruction should the nurse provide a pregnant client who is
complaining of heartburn?
A. Eat small meal throughout the day to avoid a full stomach.
15. A client is admitted to the intensive care unit with diabetes insipidus due to a pituitary
gland tumor. Which potential complication should the nurse monitor closely?
A. Hypokalemia
B. Ketonuria.
C. Peripheral edema
D. Elevated blood pressure
E. Rational: pituitary tumors that suppress antidiuretic hormone (ADH) result in
diabetes insipidus, which causes massive polyuria and serum electrolyte
imbalances, including hypokalemia, which can lead to lethal arrhythmias.
16. A female client reports she has not had a bowel movement for 3 days,
but now is defecating frequent small amount of liquid stool. Which action
should the nurse implement?
A. Digitally check the client for a fecal impaction
17. After changing to a new brand of laundry detergent, an adult male reports that he has a fine
itchy rash. Which assessment finding warrants immediate intervention by the nurse?
A. Bilateral Wheezing.
18. The nurse should teach the parents of a 6 year-old recently diagnosed with asthma that
the symptom of acute episode of asthma are due to which physiological response?
A. Inflammation of the mucous membrane & bronchospasm
19. AA 10 year old who has terminal brain cancer asks the nurse,
"Whatwill happen to my body when I die?" How should the nurse respond?
A. "The heart will stop beating & you will stop breathing."
Downloaded by: sierrabothwell |
Distribution of this document is illegal
,6 . The nurse is aSstsuveias.scoin
mg- Tahe3Marko
-m etn
ptlahc-eoto
ldBuiny faann
d tSe
wll hyoourhSatuddyaMaptyerlio
alrotomy yesterday. This
child should be medicated for pain based on which findings? Select all that apply:
A. Restlessness
B. Clenched Fist
C. Increased pulse rate
D. Increased respiratory rate.
E. Increased temperature
F. Peripheral pallor of the skin
66. The nurse is preparing to administer an oral antibiotic to a client with
unilateralweakness, ptosis, mouth drooping and, aspiration pneumonia. What is the
priority nursing assessment that should be done before administering this
medication?
A. Determine which side of the body is weak.
67. The nurse who is working on a surgical unit receives change of shift report on a
group of clients for the upcoming shift. A client with which condition requires the
most immediate attention by the nurse?
A. Gunshot wound three hours ago with dark drainage of 2 cm noted on the dressing.
Mastectomy 2 days ago with 50 ml bloody drainage noted in the
B. Jackson-pratt drain.
Collapsed lung after a fall 8h ago with 100 ml blood in the chest tube
C. collection container
Abdominal-perineal resection 2 days ago with no drainage on
D. dressing who has fever and chills.
Rationale: the client with an abdominal- perineal resection is at risk for peritonitis
E. and needs to be immediately assessed for other signs and symptoms for sepsis.
68. The nurse is caring for a client who had gastric bypass surgery
yesterday. Which intervention is most important for the nurse to
implement during the first 24 postoperative hours?
A. Measure hourly urinary output.
Rationale: a serious early complications of gastric bypass
B. surgery is an anastomoses leak, often resulting in death.
69. When preparing to discharge a male client who has been hospitalized for an
adrenal crisis, the client expresses concern about having another crisis. He tells
the nurse that he wants to stay in the hospital a few more days. Which
intervention should the nurse implement?
A. Schedule an appointment for an out-patient psychosocial assessment.
70. An adult female client tells the nurse that though she is afraid her abusive
boyfriend might one day kill her, she keeps hoping that he will change. What
action should the nurse take first?
A. Explore client’s readiness to discuss the situation.
71. In caring for a client with Cushing syndrome, which serum laboratory value
is most important for the nurse to monitor?
A. Lactate
B. Glucose
C. Hemoglobin
D. Creatinine
72. Azithromycin is prescribed for an adolescent female who has lower lobe pneumonia and
recurrent chlamydia. What information is most important for the nurse to
provide to this client?
A. Use two forms of contraception while taking this drug.
73. A client in the emergency center demonstrates rapid speech, flight of ideas, and
reports sleeping only three hours during the past 48h. Based on these finding, it is
Downloaded by: sierrabothwell |
Distribution of this document is illegal
, most important for the nurse to review the laboratory value for which medication?
A. DivalprSotuv
exia..com - The Marketplace to Buy and Sell your Study Material
Rationale: divalproex is the first line of treatment for bipolar disorder BPD
B. because it has a high therapeutic index, few side effects, and a rapid
onset in controlling symptoms and preventing recurrent episodes of mania
and depression. The serum value of divalproex should be determined
since the client is exhibiting symptoms of mania, which may indicate non-
compliance with the medication regimen.
74. A male client who is admitted to the mental health unit for treatment of bipolar disorder
has a slightly slurred speech pattern and an unsteady gait. Which assessment finding
is most important for the nurse to report to the healthcare provider?
A. Serum lithium level of 1.6 mEq/L or mmol/l (SI)
B. Rationale: The therapeutic level of Serum lithium is 0.8 to 1.5 mEq/L or
mmol/l (SI). Slurred speech and ataxia are sign of lithium toxicity.
75. A client was admitted to the cardiac observation unit 2 hours ago complaining of chest pain.
On admission, the client’s EKG showed bradycardia, ST depression, but no ventricular
ectopy. The client suddenly reports a sharp increase in pain, telling the nurse, “I feel like an
elephant just stepped
on my chest” The EKG now shows Q waves and ST segment elevations in the anterior
leads. What intervention should the nurse perform?
A. Administer prescribed morphine sulfate IV and provide oxygen at 2
L/min per nasal cannula.
76. The nurse is developing a teaching program for the community. What
population characteristic is most influential when choosing strategies for
implementing a teaching plan?
A. Literacy level
77. A client is being discharged with a prescription for warfarin (Coumadin).
What instruction should the nurse provide this client regarding diet?
A. Eat approximated the same amount of leafy green vegetables daily so
the amount of vitamin K consumed is consistent.
78. A client who had a small bowel resection acquired methicillin resistant
staphylococcus aureus (MRSA) while hospitalized. He treated and released,
but is readmitted today because of diarrhea and dehydration. It is most
important for the nurse to implement which intervention.
A. Maintain contact transmission precaution
79. A postoperative female client has a prescription for morphine sulfate 10 mg IV q3 hours for
pain. One dose of morphine was administered when the client was admitted to the post
anesthesia care unit (PACU) and 3 hours later, the client is again complaining of
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