HESI RN EXIT EXAM WITH NGN LATEST VERSION B /HESI EXIT RN NEXT GENERATION EXAM ALL 160 QUESTIONS AND CORRECT DETAILED ANSWERS

HESI RN EXIT EXAM WITH NGN LATEST VERSION B /HESI EXIT RN NEXT GENERATION EXAM ALL 160 QUESTIONS AND CORRECT DETAILED ANSWERS A 3-year-old boy was successfully toilet trained prior to his admission to the hospital for injuries sustained from a fall. His parents are very concerned that the child has regressed in his toileting behaviors. Which information should the nurse provide to the parents? A. A retraining program will need to be initiated when the child returns home. B. Diapering will be provided since hospitalization is stressful to preschoolers C. A potty chair should be brought from home so he can maintain his toileting skills D. Children usually resume their toileting behaviors when they leave the hospital - ANSWER-D. Children usually resume their toileting behaviors when they leave the hospital .A 7-year old is admitted to the hospital with persistent vomiting, and a nasogastric tube attached to low intermittent suction is applied. Which finding is most important for the nurse to report to the healthcare provider? A. Shift intake of 640mL IV fluids plus 30mL PO ice chips B. Serum pH of 7.45 C. Gastric output of 100 mL in the last 8 hours D. Serum potassium of 3.0 mg/dL - ANSWER-D. Serum potassium of 3.0 mg/dL .A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the hospital. Which information is most important for the nurse to provide the parents prior to discharge? A. Instructions about how much fluid the child should drink daily. B. Signs of addiction to opioid pain medications C. Information about non-pharmaceutical pain relief measures D. Referral for social services for the child and family - ANSWER-A. Instructions about how much fluid the child should drink daily .A client asks the nurse for information about how to reduce risk factors for benign prostatic hyperplasia (BPH). Which information should the nurse provide? A. Consume a high protein diet B. Increase physical activity C. Take vitamin supplements D. Obtain a prostate-specific antigen blood level test - ANSWER-B. Increase physical activity .A client at 12 weeks gestation is admitted to the antepartum unit with a diagnosis of hyperemesis gravidarum. Which action is most important for the nurse to implement? A. Obtain the client's 24-hour dietary recall B. Document mucosal membrane status C. Schedule a consult with a nutritionist D. Initiate prescribed intravenous fluids - ANSWER-D. Initiate prescribed intravenous fluids .A client diagnosed with calcium kidney stones has a history of gout. A new prescription for aluminum hydroxide is scheduled to begin at 0730. Which client medication should the nurse bring to the healthcare provider's attention? A. Esinapril B. Allopurinol C. Furosemide D. Aspirin, low dose - ANSWER-B. Allopurinol .A client fell in the bathroom when left unattended by the unlicensed assistive personnel (UAP). Which information should the nurse include in the client's health record? A. The UAP left the client to assist another client B. The last time client was assisted to the bathroom C. The unit was understaffed when the client fell D. The client fell sustaining a fracture to the left hip - ANSWER-D. The client fell sustaining a fracture to the left hip .A client in the emergency center demonstrates rapid speech, flight of ideas, and reports sleeping only three hours during the past 48 hours. Based on these findings, it is most important for the nurse to review the laboratory value for which medication? A. Lorazepam B. Fluoxetine C. Divalproex D. Olanzapine - ANSWER-C. Divalproex .A client in the third trimester of pregnancy reports that she fells some "lumpy places" in her breasts and that her nipples sometimes leak a yellowish fluid. She has an appointment with her healthcare provider in two weeks. What action should the nurse take? A. Tell the client to begin nipple stimulation to prepare for breast feeding. B. Reschedule the client's prenatal appointment for the following day C. Explain that this normal secretion can be assessed at the next visit D. Recommend that the client start wearing a supportive brassiere - ANSWER-C. Explain that this normal secretion can be assessed at the next visit .A client is admitted with a diagnosis of urolithiasis. Which finding is most important for the nurse to report to the healthcare provider? A. Volume of each voiding is more than 300mL B. Serum potassium that is elevated C. Relief of flank pain that radiated into the groin D. Hematuria that is beginning to turn pink - ANSWER-D. Hematuria that is beginning to turn pink .A client is diagnosed with Meniere's disease. Which problem should the nurse identify as most important in the plan of care? A. Risk for ineffective self-health management related to deficient knowledge B. Ineffective coping related to personal vulnerability C. Risk for injury related to vertigo D. Anxiety related to disruption of lifestyle - ANSWER-C. Risk for injury related to vertigo. .A client is receiving enoxaparin 30mg subcutaneously twice a day. In assessing for adverse effects of the medication, which serum laboratory value is most important for the nurse to monitor? A. Glucose B. Calcium C. Platelet count D. White blood cell count - ANSWER-C. Platelet count .A client is recovering in the critical care unit following a cardiac catheterization. IV nitroglycerin and heparin are infusing. The client is sedated but responds to verbal instructions. After changing positions, the client complains of pain at the right groin insertion site. What action should the nurse implement? A. Check femoral site for hematoma formation B. Stimulate the client to take deep breaths C. Evaluate the integrity of the IV insertion site D. Assess distal lower extremity capillary refill - ANSWER-B. Stimulate the client to take deep breaths .A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow-up by the nurse? A. CT scan that was performed 6 months earlier B. Metal hip prosthesis was placed 20 years ago C. Report of client's sobriety for the last 5 years D. Takes metformin for type 2 diabetes mellitus - ANSWER-D. Takes metformin for type 2 diabetes mellitus .A client presents to the emergency department with muscle aches, headache, fever, and describes a recent loss of taste and smell. The nurse obtains a nasal swab for COVID-19 testing. Which action is most important for the nurse to take? A. Place the nasal swab specimen for COVID-19 directly into a biohazard bag B. Move the client to a private room, keep the door closed, and initiate droplet precautions. C. Teach the client to wear a mask, hand wash, and social distance to prevent spreading the virus D. Explain to the client to inform others that they may have been potentially exposed in the last 14 days. - ANSWER-A. Place the nasal swab specimen for COVID-19 directly into a biohazard bag .A client presents to the labor and delivery unit with a report of leaking fluid that is greenish-brown vaginal discharge. Which action should the nurse take first? A. Start an intravenous infusion B. Administer oxygen via facemask C. Perform a vaginal exam D. Begin continuous fetal monitoring - ANSWER-D. Begin continuous fetal monitoring .A client presses the call bell and requests pain medication for a severe headache. To assess the quality of the client's pain, which approach should the nurse use? A. Ask the client to describe the pain B. Observe body language and movement C. Identify effective pain relief measures D. Provide a numeric pain scale - ANSWER-A. Ask the client to describe the pain .A client taking clopidogrel reports the onset of diarrhea. Which nursing action should the nurse implement first? A. Observe the appearance of the stool B. Assess the elasticity of the client's skin C. Review the client's laboratory values D. Auscultate the client's bowel sounds - ANSWER-A. Observe the appearance of the stool .A client tells the nurse about working out with a personal trainer and swimming three times a week in an effort to lose weight and sleep better. The client states that it still is taking hours to fall asleep at night. Which action should the nurse implement? A. Advise the client that lifestyle changes often take several weeks to be effective B. Encourage the client to exercise everyday to eliminate bedtime wakefulness C. Ask the client for a description of the exercise schedule that is being followed D. Determine the amount of weight the client has lost since increasing activity - ANSWER-C. Ask the client for a description of the exercise schedule that is being followed .A client who experienced a cerebrovascular accident (CVA) is aphasic and has left sided paralysis. Which nurse should be responsible for coordinating the progression of this client's care? A. Nurse case manager B. Adult nurse practitioner C. Neurology unit supervisor D. Risk management nurse - ANSWER-B. Adult nurse practitioner .A client who gave birth 48 hours ago has decided to bottle feed the infant. During the assessment, the nurse observes that both breasts are swollen, warm, and tender on palpation. Which instruction should the nurse provide? A. Apply ice to the breasts for comfort B. Wear a loose-fitting bra during the day to prevent nipple irritation C. Run warm water over breasts D. Express small amounts of milk from the breasts to relieve pressure - ANSWER-A. Apply ice to the breasts for comfort .A client who is admitted for primary hypothyroidism has early signs of myxedema coma. In assessing the client, in which sequence should the nurse complete these actions? (descending order) - ANSWER-1. Observe breathing patterns 2. Assess blood pressure 3. Measure body temperature 4. Palpate for pedal edema .A client who is admitted with complications related to hypopituitarism is diaphoretic and hypotensive. Which assessment finding warrants immediate intervention by the nurse? - ANSWER-Lethargy .A client who is scheduled for a bronchoscopy in the morning is anxious and asking the nurse numerous questions about the procedure. In preparing the client for the procedure, which intervention has the highest priority? A. Allow client to gargle with warm salt water B. Administer a sedative to alleviate anxiety C. Instruct client to write down the questions D. Deny client's request for a midnight snack - ANSWER-C. Instruct client to write down the questions .A client who recently received a prescription for ramelteon to treat sleep deprivation reports experiencing several side effects since taking the drug. Which side effect should the nurse report to the healthcare provider? A. A change in the sleep-wake cycle B. Mild sedation C. Dizziness reported after initial dose D. Somnambulism - ANSWER-D. Somnambulism .A client with a lower respiratory tract infection receives a prescription for ciprofloxacin 500mg PO every 12 hours. When the client requests an afternoon snack, which dietary choice should the nurse provide? A. Cinnamon applesauce B. Vanilla-flavored yogurt C. Calcium-fortified juice D. Low-fat chocolate milk - ANSWER-A. Cinnamon applesauce .A client with a prescription for "do not resuscitate" (DNR) begins to manifest signs of impending death. After notifying the family of the client's status, what priority action should the nurse implement? A. The impending signs of death should be documented B. The client's status should be conveyed to the chaplain C. The client's need for pain medication should be determined D. The nurse manager should be updated on the client's status - ANSWER-C. The client's need for pain medication should be determined .A client with acute pancreatitis is admitted with severe, piercing abdominal pain and an elevated serum amylase. Which additional information is the client most likely to report to the nurse? A. Abdominal pain decreases when lying supine B. Pain lasts an hour and leaves the abdomen tender C. Right upper quadrant pain refers to right scapula D. Drinks alcohol until intoxicated at least twice weekly. - ANSWER-A. Abdominal pain decreases when lying supine .A client with bacterial meningitis is receiving phenytoin. Which assessment finding indicates to the nurse that the client is experiencing a therapeutic response? - ANSWER-B. Normal electroencephalogram after drug administration .A client with chronic kidney disease has an arteriovenous fistula in the left forearm. Which observation by the nurse indicates that the fistula is patent? A. Assessment of a bruit on the left forearm B. Auscultation of a thrill on the left forearm C. The left radial pulse is 2+ bounding. - ANSWER-B. Auscultation of a thrill on the left forearm .A client with dyspnea is being admitted to the medical unit. To best prepare for the client's arrival, the nurse should ensure that the client's bed is in which position? A. Supine B. supine; feet elevated higher than head C. supine; head elevated higher than feet D. Fowlers - ANSWER-Fowlers .A client with hyperthyroidism is admitted to the postoperative unit after a subtotal thyroidectomy. Which of the client's serum laboratory values requires intervention by the nurse? A. T3- uptake at 50% B. Glucose 150 mg/dL C. Total calcium 5.0 mg/dL D. Thyroxine 12 mcg/dL - ANSWER-C. Total calcium 5.0 mg/dL .A client with multiple burn injuries is being treated in the burn trauma unit just hours after the injuries occurred. The healthcare provider instructs the nurse to avoid auto contamination when performing dressing changes. Which intervention is most important for the nurse to implement? A. Dress each wound separately B. Assign equipment to this one client C. Utilize reverse isolation protocol D. Use gown, mask, and gloves with dressing changes - ANSWER-D. Use gown, mask, and gloves with dressing changes .A client with postpartum depression, who is admitted to the behavioral health unit, refuses to leave her room or eat meals. In addition to maintaining physical safety, which short-term goal should the nurse include in the plan of care? A. Sleeps at least 6 hours per night B. Consumes 3 meals and 1500 mL of fluid per day C. Engages in one client to client interaction daily D. Attends one group activity per day - ANSWER-D. Attends one group activity per day .A client with rheumatoid arthritis (RA) starts a new prescription for etanercept subcutaneously once weekly. The nurse should emphasize the importance of reporting which problem to the healthcare provider? A. Joint stiffness B. Persistent fever C. Headache D. Increased hunger and thirst - ANSWER-A. Joint stiffness .A client with Type 1 diabetes mellitus and a large draining ulcer of the right foot is admitted with a suspected Staphylococcus aureus infection. Which interventions should the nurse implement? (Select all that apply) A. Monitor the client's white blood cell count B. Explain the purpose of a low bacteria diet C. Send wound drainage for culture and sensitivity D. Institute contact precautions for staff and visitors E. Use standard precautions and wear a mask - ANSWER-A. Monitor the client's white blood cell count C. Send wound drainage for culture and sensitivity D. Institute contact precautions for staff and visitors .A client with type 2 diabetes mellitus arrives to the clinic reporting episodes of weakness and palpitations. Which finding should the nurse identify may indicate an emerging situation? A. Potassium 3.5 mEq/L B. Fingertips feel numb C. Sodium 135 mEq/L D. Cervical spine stiffness - ANSWER-B. Fingertips feel numb .A client with type 2 diabetes mellitus is admitted for frequent hyperglycemic episodes and a glycosylated hemoglobin (A1C) of 10%. Insulin glargine 10 units subcutaneously once a day at bedtime and a sliding scale of insulin aspart every 6h are prescribed. What actions should the nurse include in this client's plan of care? (Select all that apply) A. Do not contaminate the insulin aspart so that it is available for IV use B. Review with the client proper foot care and prevention of injury C. Teach subcutaneous injection technique, site rotation, and insulin management D. Coordinate carbohydrate controlled meals at consistent times and intervals. E. Mix bedtime dose of insulin glargine with insulin aspart sliding scale dose F. Fingerstick glucose assessments every 6h with meals - ANSWER-B. Review with client proper foot care and prevention of injury C. Teach subcutaneous injection technique, site rotation, and insulin management D. Coordinate carbohydrate controlled meals at consistent times and intervals F. Fingerstick glucose assessments every 6h with meals .A client with urge incontinence was treated with onabotuilinumtoxinA injections and is now experiencing urinary retention. Which action should the nurse include in the client's plan of care? A. Provide a bedside commode for immediate use in the client's room B. Teach the client techniques for performing intermittent catheterization C. Explain the need to limit intake of oral fluids to reduce client discomfort D. Remind the client to practice pelvic floor (Kegel) exercises regularly - ANSWER-D. Remind the client to practice pelvic floor (Kegel) exercises regularly .A client's morning assessment includes bounding peripheral pulses, weight gain of 2 pounds (0.91 kg), pitting ankle edema, and moist crackles bilaterally. Which intervention is most important for the nurse to include in this client's plan of care? A. Maintain accurate intake and output B. Administer prescribed diuretic C. Weigh client every morning D. Restrict daily fluid intake to 1500mL - ANSWER-B. Administer prescribed diuretic .A combination multi-drug cocktail is being considered for an asymptomatic HIV-infected client with a CD4 cell count of 500. Which nursing assessment of the client is most crucial in determining whether therapy should be initiated? A. Willing to comply with complex drug schedules B. Maintains an adequate social support system C. Qualifies for a prescription assistance program