HESI RN COMPREHENSIVE EXIT EXAM VERSION II- 75+ QUESTIONS AND
ANSWERS|WELL STUCTURED|A+ GRADED|
QUESTIONS ANSWERS
The nurse knows which statement by the mother indicates that the
mother understands safety precautions with her four month-old
infant and her 4year-old child?
A) "I strap the infant car seat on the front seat to face backwards."
B) "I place my infant in the middle of the living room floor on a
blanket to play with my 4 year old while I make supper in the
The correct answer is D: "I have the four year-old hold and help
kitchen."
feed the four month-old a bottle in the kitchen
C) "My sleeping baby lies so cute in the crib with the little but-
tocksstuck up in the air
while the four year old naps on the sofa."
D) "I have the 4 year-old hold and help feed the four month-old
bottle in the kitchen
while I make supper."
Upon completing the admission documents, the nurse learns that
the 87 year-old client does not have an advance directive. What
action should the nurse take?
The correct answer is B: Give information about advance direc-
A) Record the information on the chart
B) Give information about advance directives tives
C) Assume that this client wishes a full code
D) Refer this issue to the unit secretary;
A nurse administers the influenza vaccine to a client in a clinic.
Within 15 minutes after the immunization was given, the client
complains of itchy and watery eyes, increased anxiety, and dif-
ficulty breathing. The nurse expects that the first action in the
sequence of The correct answer is B: Administer epinephrine 1:1000 as or-
care for this client will be to dered .
A) Maintain the airway
B) Administer epinephrine 1:1000 as ordered
C) Monitor for hypotension with shock
D) Administer diphenhydramine as ordered
Which of these children at the site of a disaster at a child day care
center would thea triage nurse put in the "treat last" category?
A) An infant with intermittent bulging anterior fontanel between
crying episodes The correct answer is B: A toddler with severe deep abrasions over
B) A toddler with severe deep abrasions over 98% of the body 98% of the body .
C) A preschooler with 1 lower leg fracture and the other leg with
an upper leg fracture
D) A school-age child with singed eyebrows and hair on the arms
When admitting a client to an acute care facility, an identification
bracelet is sent up with the admission form. In the event these do
not match, the nurse's best action is to
A) Change whichever item is incorrect to the correct information The correct answer is C: notify the admissions office and wait to
B) Use the bracelet and admission form until a replacement is apply the bracelet
supplied
C) Notify the admissions office and wait to apply the bracelet
D) Make a corrected identification bracelet for the client
The nurse is having difficulty reading the health care provider's
writtenorder that was
written right before the shift change. What action should be taken?
A) Leave the order for the oncoming staff to follow-up The correct answer is D: Call the provider for clarification
B) Contact the charge nurse for an interpretation
C) Ask the pharmacy for assistance in the interpretation
D) Call the provider for clarification
An adult client is found to be unresponsive on morning rounds.
After Checking for responsiveness and calling for help, the next
action that should be taken by the nurse is to:
A) check the carotid pulse The correct answer is D: open the client''s airway
B) deliver 5 abdominal thrusts
C) give 2 rescue breaths
D) open the client's airway
, HESI RN COMPREHENSIVE EXIT EXAM VERSION II- 75+ QUESTIONS AND
ANSWERS|WELL STUCTURED|A+ GRADED|
QUESTIONS ANSWERS
A client has an order for 1000 ml of D5W over an 8 hour period.
The nurse discovers that 800 ml has been infused after 4 hours.
What is the priority nursing action?
A) Ask the client if there are any breathing problems The correct answer is D: Auscultate the lungs
B) Have the client void as much as possible
C) Check the vital signs
D) Auscultate the lungs
Following change-of-shift report on an orthopedic unit, which
client should the nurse
see first?
A) 16 year-old who had an open reduction of a fractured wrist 10
hours ago
The correct answer is C: 72 year-old recovering from surgery after
B) 20 year-old in skeletal traction for 2 weeks since a motorcycle
hip replacement 2 hours ago
accident
C) 72 year-old recovering from surgery after a hip replacement 2
hours ago
D) 75 year-old who is in skin traction prior to planned hip pinning
surgery.
A nurse observes a family member administer a rectal suppository
by having the client lie on the left side for the administration. The
family member pushed the suppository until the finger went up to
the second knuckle. After 10 minutes the client
was told by the family member to turn to the right side and the
client did this. What is the The correct answer is B: That was done correctly. Did you have
appropriate comment for the nurse to make? any problems with the insertion?
A) Why don't we now have the client turn back to the left side.
B) That was done correctly. Did you have any problems with the
insertion?
C) Let's check to see if the suppository is far enough.
D) Did you feel any stool in the intestinal tract?
A client with a diagnosis of Methicillin resistant Staphylococcus
aureus(MRSA) has
died. Which type of precautions is the appropriate type to use
when performing post mortem care?
A) airborne precautions The correct answer is C: contact precautions
B) droplet precautions
C) contact precautions
D) compromised host precautions
The nurse is reviewing with a client how to collect a clean catch
urine specimen. Which sequence is appropriate teaching?
A) Void a little, clean the meatus, then collect specimen
B) clean the meatus, begin voiding, then catch urine stream B) clean the meatus, begin voiding, then catch urine stream
C) Clean the meatus, then urinate into container
D) Void continuously and catch some of the urine
The provider orders Lanoxin (digoxin) 0.125 mg PO and
furosemide 40mg every day. Which of these foods would the nurse
reinforce for the client to eat at least daily?
A) spaghetti B) watermelon
B) watermelon
C) chicken
D) tomatoes
A nurse is stuck in the hand by an exposed needle. What imme-
diate action should the
Nurse take?
A) Look up the policy on needle sticks C) Immediately wash the hands with vigor
B) Contact employee health services
C) Immediately wash the hands with vigor
D) Notify the supervisor and risk management
As the nurse observes the student nurse during the administration
of narcotic analgesic IM injection, the nurse notes that the student
, HESI RN COMPREHENSIVE EXIT EXAM VERSION II- 75+ QUESTIONS AND
ANSWERS|WELL STUCTURED|A+ GRADED|
QUESTIONS ANSWERS
begins to give the medication without first aspirating. What should
the nurse do?
A) Ask the student: "What did you forget to do?"
D) Walk up and whisper in the student's ear "Stop. Aspirate.
B) Stop. Tell me why aspiration is needed.
Theninject."
C) Loudly state: "You forgot to aspirate."
D) Walk up and whisper in the student's ear "Stop. Aspirate.
Theninject."
A client with Guillain Barre is in a non responsive state, yet vital
signs are stable and
breathing is independent. What should the nurse document to
most accurately describe
the client's condition? B) Glascow Coma Scale 8, respirations regular
A) Comatose, breathing unlabored
B) Glascow Coma Scale 8, respirations regular
C) Appears to be sleeping, vital signs stable
D) Glascow Coma Scale 13, no ventilator required
17. A client enters the emergency department unconscious via
ambulance from the
client's workplace. What document should be given priority to
guide the direction of care
for this client?
A) The statement of client rights and the client self determination The correct answer is C: A notarized original of advance directives
act brought in by the partner
B) Orders written by the health care provider
C) A notarized original of advance directives brought in by the
partner
D) The clinical pathway protocol of the agency and the emergency
department
18. The charge nurse has a health care team that consists of 1
PN, 1unlicensed assistive
personnel (UAP) and 1 PN nursing student. Which assignment
should be questioned by
the nurse manager?
A) An admission at the change of shifts with atrial fibrillation and The correct answer is A: An admission at the change of shifts with
heart failure - PN atrial fibrillation and heart failure - PN
B) Client who had a major stroke 6 days ago - PN nursing student
C) A child with burns who has packed cells and albumin IV running
-charge nurse
D) An elderly client who had a myocardial infarction a week ago -
UAP
19. A mother brings her 3 month-old into the clinic, complaining
that the child seems to
be spitting up all the time and have a lot of gas. The nurse expects
to find which of the following on the initial history and physical
The correct answer is B: Restlessness and increased mucus
assessment?
A) Increased temperature and lethargy production
B) Restlessness and increased mucus production
C) Increased sleeping and listlessness
D) Diarrhea and poor skin turgor
20. As the nurse takes a history of a 3 year-old with neuroblas-
toma, what comments by
the parents require follow-up and are consistent with the diagno-
sis? The correct answer is C: "Clothes are becoming tight across her
A) "The child has been listless and has lost weight." abdomen."
B) "The urine is dark yellow and small in amounts."
C) "Clothes are becoming tighter across her abdomen."
D) "We notice muscle weakness and some unsteadiness."
21. A 16 year-old enters the emergency department. The triage
nurse identifies
that this
ANSWERS|WELL STUCTURED|A+ GRADED|
QUESTIONS ANSWERS
The nurse knows which statement by the mother indicates that the
mother understands safety precautions with her four month-old
infant and her 4year-old child?
A) "I strap the infant car seat on the front seat to face backwards."
B) "I place my infant in the middle of the living room floor on a
blanket to play with my 4 year old while I make supper in the
The correct answer is D: "I have the four year-old hold and help
kitchen."
feed the four month-old a bottle in the kitchen
C) "My sleeping baby lies so cute in the crib with the little but-
tocksstuck up in the air
while the four year old naps on the sofa."
D) "I have the 4 year-old hold and help feed the four month-old
bottle in the kitchen
while I make supper."
Upon completing the admission documents, the nurse learns that
the 87 year-old client does not have an advance directive. What
action should the nurse take?
The correct answer is B: Give information about advance direc-
A) Record the information on the chart
B) Give information about advance directives tives
C) Assume that this client wishes a full code
D) Refer this issue to the unit secretary;
A nurse administers the influenza vaccine to a client in a clinic.
Within 15 minutes after the immunization was given, the client
complains of itchy and watery eyes, increased anxiety, and dif-
ficulty breathing. The nurse expects that the first action in the
sequence of The correct answer is B: Administer epinephrine 1:1000 as or-
care for this client will be to dered .
A) Maintain the airway
B) Administer epinephrine 1:1000 as ordered
C) Monitor for hypotension with shock
D) Administer diphenhydramine as ordered
Which of these children at the site of a disaster at a child day care
center would thea triage nurse put in the "treat last" category?
A) An infant with intermittent bulging anterior fontanel between
crying episodes The correct answer is B: A toddler with severe deep abrasions over
B) A toddler with severe deep abrasions over 98% of the body 98% of the body .
C) A preschooler with 1 lower leg fracture and the other leg with
an upper leg fracture
D) A school-age child with singed eyebrows and hair on the arms
When admitting a client to an acute care facility, an identification
bracelet is sent up with the admission form. In the event these do
not match, the nurse's best action is to
A) Change whichever item is incorrect to the correct information The correct answer is C: notify the admissions office and wait to
B) Use the bracelet and admission form until a replacement is apply the bracelet
supplied
C) Notify the admissions office and wait to apply the bracelet
D) Make a corrected identification bracelet for the client
The nurse is having difficulty reading the health care provider's
writtenorder that was
written right before the shift change. What action should be taken?
A) Leave the order for the oncoming staff to follow-up The correct answer is D: Call the provider for clarification
B) Contact the charge nurse for an interpretation
C) Ask the pharmacy for assistance in the interpretation
D) Call the provider for clarification
An adult client is found to be unresponsive on morning rounds.
After Checking for responsiveness and calling for help, the next
action that should be taken by the nurse is to:
A) check the carotid pulse The correct answer is D: open the client''s airway
B) deliver 5 abdominal thrusts
C) give 2 rescue breaths
D) open the client's airway
, HESI RN COMPREHENSIVE EXIT EXAM VERSION II- 75+ QUESTIONS AND
ANSWERS|WELL STUCTURED|A+ GRADED|
QUESTIONS ANSWERS
A client has an order for 1000 ml of D5W over an 8 hour period.
The nurse discovers that 800 ml has been infused after 4 hours.
What is the priority nursing action?
A) Ask the client if there are any breathing problems The correct answer is D: Auscultate the lungs
B) Have the client void as much as possible
C) Check the vital signs
D) Auscultate the lungs
Following change-of-shift report on an orthopedic unit, which
client should the nurse
see first?
A) 16 year-old who had an open reduction of a fractured wrist 10
hours ago
The correct answer is C: 72 year-old recovering from surgery after
B) 20 year-old in skeletal traction for 2 weeks since a motorcycle
hip replacement 2 hours ago
accident
C) 72 year-old recovering from surgery after a hip replacement 2
hours ago
D) 75 year-old who is in skin traction prior to planned hip pinning
surgery.
A nurse observes a family member administer a rectal suppository
by having the client lie on the left side for the administration. The
family member pushed the suppository until the finger went up to
the second knuckle. After 10 minutes the client
was told by the family member to turn to the right side and the
client did this. What is the The correct answer is B: That was done correctly. Did you have
appropriate comment for the nurse to make? any problems with the insertion?
A) Why don't we now have the client turn back to the left side.
B) That was done correctly. Did you have any problems with the
insertion?
C) Let's check to see if the suppository is far enough.
D) Did you feel any stool in the intestinal tract?
A client with a diagnosis of Methicillin resistant Staphylococcus
aureus(MRSA) has
died. Which type of precautions is the appropriate type to use
when performing post mortem care?
A) airborne precautions The correct answer is C: contact precautions
B) droplet precautions
C) contact precautions
D) compromised host precautions
The nurse is reviewing with a client how to collect a clean catch
urine specimen. Which sequence is appropriate teaching?
A) Void a little, clean the meatus, then collect specimen
B) clean the meatus, begin voiding, then catch urine stream B) clean the meatus, begin voiding, then catch urine stream
C) Clean the meatus, then urinate into container
D) Void continuously and catch some of the urine
The provider orders Lanoxin (digoxin) 0.125 mg PO and
furosemide 40mg every day. Which of these foods would the nurse
reinforce for the client to eat at least daily?
A) spaghetti B) watermelon
B) watermelon
C) chicken
D) tomatoes
A nurse is stuck in the hand by an exposed needle. What imme-
diate action should the
Nurse take?
A) Look up the policy on needle sticks C) Immediately wash the hands with vigor
B) Contact employee health services
C) Immediately wash the hands with vigor
D) Notify the supervisor and risk management
As the nurse observes the student nurse during the administration
of narcotic analgesic IM injection, the nurse notes that the student
, HESI RN COMPREHENSIVE EXIT EXAM VERSION II- 75+ QUESTIONS AND
ANSWERS|WELL STUCTURED|A+ GRADED|
QUESTIONS ANSWERS
begins to give the medication without first aspirating. What should
the nurse do?
A) Ask the student: "What did you forget to do?"
D) Walk up and whisper in the student's ear "Stop. Aspirate.
B) Stop. Tell me why aspiration is needed.
Theninject."
C) Loudly state: "You forgot to aspirate."
D) Walk up and whisper in the student's ear "Stop. Aspirate.
Theninject."
A client with Guillain Barre is in a non responsive state, yet vital
signs are stable and
breathing is independent. What should the nurse document to
most accurately describe
the client's condition? B) Glascow Coma Scale 8, respirations regular
A) Comatose, breathing unlabored
B) Glascow Coma Scale 8, respirations regular
C) Appears to be sleeping, vital signs stable
D) Glascow Coma Scale 13, no ventilator required
17. A client enters the emergency department unconscious via
ambulance from the
client's workplace. What document should be given priority to
guide the direction of care
for this client?
A) The statement of client rights and the client self determination The correct answer is C: A notarized original of advance directives
act brought in by the partner
B) Orders written by the health care provider
C) A notarized original of advance directives brought in by the
partner
D) The clinical pathway protocol of the agency and the emergency
department
18. The charge nurse has a health care team that consists of 1
PN, 1unlicensed assistive
personnel (UAP) and 1 PN nursing student. Which assignment
should be questioned by
the nurse manager?
A) An admission at the change of shifts with atrial fibrillation and The correct answer is A: An admission at the change of shifts with
heart failure - PN atrial fibrillation and heart failure - PN
B) Client who had a major stroke 6 days ago - PN nursing student
C) A child with burns who has packed cells and albumin IV running
-charge nurse
D) An elderly client who had a myocardial infarction a week ago -
UAP
19. A mother brings her 3 month-old into the clinic, complaining
that the child seems to
be spitting up all the time and have a lot of gas. The nurse expects
to find which of the following on the initial history and physical
The correct answer is B: Restlessness and increased mucus
assessment?
A) Increased temperature and lethargy production
B) Restlessness and increased mucus production
C) Increased sleeping and listlessness
D) Diarrhea and poor skin turgor
20. As the nurse takes a history of a 3 year-old with neuroblas-
toma, what comments by
the parents require follow-up and are consistent with the diagno-
sis? The correct answer is C: "Clothes are becoming tight across her
A) "The child has been listless and has lost weight." abdomen."
B) "The urine is dark yellow and small in amounts."
C) "Clothes are becoming tighter across her abdomen."
D) "We notice muscle weakness and some unsteadiness."
21. A 16 year-old enters the emergency department. The triage
nurse identifies
that this
