2022 HESI RN EXIT EXAM V3 NGN QUESTIONS AND
VERIFIED ANSWERS SCORED A+
1. A male patient with stomach cancer returns to the unit following a total gastrectomy. He has
a nasogastric tube to suction and is receiving Lactated Ringer’s solution at 75 mL/hour IV.
One hour after admission to the unit, the practicing nurse notes 300 mL of blood in the
suction canister, thepatient’s heart rate is 155 beats/minute, and his blood pressure is 78/48
mmHg. In addition toreporting the finding to the surgeon. Which action should the practicing
nurse implement first?
a. Measure and document the patient’s urinary output.
b. Request the patient’s reserved unit if packed red blood cells.
c. Prepare the placement of a central venous catheter.
d. Increase the infusion rate of Lactated Ringer’s solution.
2. an adult male who fell 20 feet from the roof of this home has multiple injuries, including a right
pneumothorax. Chest tubes were inserted in the emergency department prior to his transfer to
the intensive care unit (ICU). the practicing nurse notes that the suction control chamber is
bubbling at the
- 10 cm H2O mark, with fluctuation in the water seal, and over the past hour 75 ml of bright red
blood is measured in the collection chamber. Which intervention should the practicing nurse
implement?
a. Add sterile water to the suction control chamber.
b. Give blood from the collection chamber as autotransfusion
c. Manipulate blood in tubing to drain into chamber.
d. Increase wall suction to eliminate fluctuation in water seal.
3. A patient who received hemodialysis yesterday is experiencing a blood pressure of 200/100
mmHg, heart rate 110 beats/minute, and respiratory rate 36 breaths/minute. The patient is
manifesting shortness of breath, bilateral 2+ pedal edema, and an oxygen saturation on room air
of 89%. Which action should the practicing nurse take first?
a. Elevate the foot of the bed.
b. Restrict the patient’s
fluid. c. Begin
supplemental oxygen.
d. Prepare the patient for hemodialysis.
,4. A patient with Addison’s crisis is admitted for treatment with adrenal cortical supplementation.
Based on the patient’s admitting diagnosis, which findings require immediate action by the
practicing nurse?
(Select all that apply)
a. Headache and tremors
b. Irregular heart rate
c. Skin hyperpigmentation
d. Postural hypotension
e. Pallor and diaphoresis
5. An older patient is admitted with fluid volume deficit and dehydration. Which assessment
findingis the best indicator of hydration that the practicing nurse should report to the
healthcare provider?
a. Urine specific gravity is 1.040
b. Systolic blood pressure decreases 10 points when standing.
c. The patient denies being thirsty.
d. Skin tenting occurs when the patient’s forearm is pinched.
6. After an inservice about electronic health record (EHR) security and safeguarding
patientinformation, the practicing nurse observes a colleague going home with printed
copies of patient information in a uniform pocket. Which action should the practicing
nurse take?
a. File a detailed incident report with the specific hiring facility.
b. Warn the colleague that their actions are unprofessional.
c. Comment anonymously about the action of a staff discussion board.
d. Communicate the colleague’s actions to the unit charge practicing nurse.
,7. The practicing nurse is evaluating a tertiary prevention program for patients with
cardiovascular diseaseimplemented in a rural health clinic. Which outcome indicate the
program is effective?
a. At-risk patients received an increased number of routine health screenings.
b. Patients reported having new confidence in making healthy food choices.
c. Patients who incurred disease complications promptly received rehabilitation.
d. Patient relapse rate of 30% in a 5-year community-wide anti-smoking campaign.
8. The practicing nurse is caring for a patient with chronic obstructive pulmonary disease
(COPD) who usesoxygen at 2 L/minute per nasal cannula continuously. The practicing nurse
observes that the patient is having increased shortness of breath with respirations at 23
breaths/minute. Which action should the practicing nurse implement first?
a. Determine if the patient is experiencing any anxiety.
b. Auscultate the patient’s bilateral lung sounds and oxygen saturation.
c. Notify the healthcare provider about the patient’s distress.
d. Assess the delivery mechanism of the oxygen tank, tubing, and cannula.
9. Which statement by a patient who is 24 hours post-subtotal thyroidectomy requires
animmediate investigation by the practicing nurse?
a. “When I get out of bed quickly, I feel a little dizzy.”
b. “The dressing over my incision feels like it is too tight.”
c. “I’m most comfortable when the head of the bed is raised.”
d. “This IV infusion makes me urinate more often than usual.”
, 10. An older adult male who is in his early 70’s is admitted to the emergency department because of
a COPD exacerbation. This patient is struggling to breathe and the healthcare team is preparing
for endotracheal intubation. The spouse’s wife, who is 30 years younger than the patient, asks
thepracticing nurse to stop the procedure and provide the practicing nurse a copy of the
patient’s living will. Which action should the practicing nurse take?
a. Facilitate a family meeting with the palliative care team.
b. Notify the healthcare provider of the patient’s wishes.
c. Place a certified copy of the living will in the patient’s record.
d. Alert the nursing staff of the patient’s don’t resuscitate status.
11. An unlicensed assistive personnel (UAP) is assigned to provide personal care for a patient whose
prescribed activity is bedrest with bedside commode use. The UAP reports to the practicing
nurse that the patient is so obese that the UAP feels unable to safely assist the patient in
transferring from the bedto the bedside commode. How should the practicing nurse respond?
a. Determine the patient’s level of mobility and need for assistance.
b. Instruct the UAP that all patients deserve equal care.
c. Advice the patient to maintain bedrest so that safety can be ensured.
d. Assign another UAP to care for the patient.
12. A practicing nurse determines that more than 25% of the students at a middle school are
overweight. Thepracticing nurse presents the information at the parent-teacher meeting.
What action is most important for the practicing nurse to include in the meeting?
a. Provide information on ways to increase activity for the family.
b. Have several teachers talk about health risks associated with obesity.
c. Distribute a shopping list of suggested healthy snack items.
d. Determine the parents’ degree of concern about their children’s weight.
VERIFIED ANSWERS SCORED A+
1. A male patient with stomach cancer returns to the unit following a total gastrectomy. He has
a nasogastric tube to suction and is receiving Lactated Ringer’s solution at 75 mL/hour IV.
One hour after admission to the unit, the practicing nurse notes 300 mL of blood in the
suction canister, thepatient’s heart rate is 155 beats/minute, and his blood pressure is 78/48
mmHg. In addition toreporting the finding to the surgeon. Which action should the practicing
nurse implement first?
a. Measure and document the patient’s urinary output.
b. Request the patient’s reserved unit if packed red blood cells.
c. Prepare the placement of a central venous catheter.
d. Increase the infusion rate of Lactated Ringer’s solution.
2. an adult male who fell 20 feet from the roof of this home has multiple injuries, including a right
pneumothorax. Chest tubes were inserted in the emergency department prior to his transfer to
the intensive care unit (ICU). the practicing nurse notes that the suction control chamber is
bubbling at the
- 10 cm H2O mark, with fluctuation in the water seal, and over the past hour 75 ml of bright red
blood is measured in the collection chamber. Which intervention should the practicing nurse
implement?
a. Add sterile water to the suction control chamber.
b. Give blood from the collection chamber as autotransfusion
c. Manipulate blood in tubing to drain into chamber.
d. Increase wall suction to eliminate fluctuation in water seal.
3. A patient who received hemodialysis yesterday is experiencing a blood pressure of 200/100
mmHg, heart rate 110 beats/minute, and respiratory rate 36 breaths/minute. The patient is
manifesting shortness of breath, bilateral 2+ pedal edema, and an oxygen saturation on room air
of 89%. Which action should the practicing nurse take first?
a. Elevate the foot of the bed.
b. Restrict the patient’s
fluid. c. Begin
supplemental oxygen.
d. Prepare the patient for hemodialysis.
,4. A patient with Addison’s crisis is admitted for treatment with adrenal cortical supplementation.
Based on the patient’s admitting diagnosis, which findings require immediate action by the
practicing nurse?
(Select all that apply)
a. Headache and tremors
b. Irregular heart rate
c. Skin hyperpigmentation
d. Postural hypotension
e. Pallor and diaphoresis
5. An older patient is admitted with fluid volume deficit and dehydration. Which assessment
findingis the best indicator of hydration that the practicing nurse should report to the
healthcare provider?
a. Urine specific gravity is 1.040
b. Systolic blood pressure decreases 10 points when standing.
c. The patient denies being thirsty.
d. Skin tenting occurs when the patient’s forearm is pinched.
6. After an inservice about electronic health record (EHR) security and safeguarding
patientinformation, the practicing nurse observes a colleague going home with printed
copies of patient information in a uniform pocket. Which action should the practicing
nurse take?
a. File a detailed incident report with the specific hiring facility.
b. Warn the colleague that their actions are unprofessional.
c. Comment anonymously about the action of a staff discussion board.
d. Communicate the colleague’s actions to the unit charge practicing nurse.
,7. The practicing nurse is evaluating a tertiary prevention program for patients with
cardiovascular diseaseimplemented in a rural health clinic. Which outcome indicate the
program is effective?
a. At-risk patients received an increased number of routine health screenings.
b. Patients reported having new confidence in making healthy food choices.
c. Patients who incurred disease complications promptly received rehabilitation.
d. Patient relapse rate of 30% in a 5-year community-wide anti-smoking campaign.
8. The practicing nurse is caring for a patient with chronic obstructive pulmonary disease
(COPD) who usesoxygen at 2 L/minute per nasal cannula continuously. The practicing nurse
observes that the patient is having increased shortness of breath with respirations at 23
breaths/minute. Which action should the practicing nurse implement first?
a. Determine if the patient is experiencing any anxiety.
b. Auscultate the patient’s bilateral lung sounds and oxygen saturation.
c. Notify the healthcare provider about the patient’s distress.
d. Assess the delivery mechanism of the oxygen tank, tubing, and cannula.
9. Which statement by a patient who is 24 hours post-subtotal thyroidectomy requires
animmediate investigation by the practicing nurse?
a. “When I get out of bed quickly, I feel a little dizzy.”
b. “The dressing over my incision feels like it is too tight.”
c. “I’m most comfortable when the head of the bed is raised.”
d. “This IV infusion makes me urinate more often than usual.”
, 10. An older adult male who is in his early 70’s is admitted to the emergency department because of
a COPD exacerbation. This patient is struggling to breathe and the healthcare team is preparing
for endotracheal intubation. The spouse’s wife, who is 30 years younger than the patient, asks
thepracticing nurse to stop the procedure and provide the practicing nurse a copy of the
patient’s living will. Which action should the practicing nurse take?
a. Facilitate a family meeting with the palliative care team.
b. Notify the healthcare provider of the patient’s wishes.
c. Place a certified copy of the living will in the patient’s record.
d. Alert the nursing staff of the patient’s don’t resuscitate status.
11. An unlicensed assistive personnel (UAP) is assigned to provide personal care for a patient whose
prescribed activity is bedrest with bedside commode use. The UAP reports to the practicing
nurse that the patient is so obese that the UAP feels unable to safely assist the patient in
transferring from the bedto the bedside commode. How should the practicing nurse respond?
a. Determine the patient’s level of mobility and need for assistance.
b. Instruct the UAP that all patients deserve equal care.
c. Advice the patient to maintain bedrest so that safety can be ensured.
d. Assign another UAP to care for the patient.
12. A practicing nurse determines that more than 25% of the students at a middle school are
overweight. Thepracticing nurse presents the information at the parent-teacher meeting.
What action is most important for the practicing nurse to include in the meeting?
a. Provide information on ways to increase activity for the family.
b. Have several teachers talk about health risks associated with obesity.
c. Distribute a shopping list of suggested healthy snack items.
d. Determine the parents’ degree of concern about their children’s weight.
