HESI 799 RN Exit Exam questions with
complete and correct answers
A client on a long-term mental health unit repeatedly takes own pulse
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regardless of the circumstance. What action should the nurse implement?
|| || || || || || || || || ||
a. Overlook the client's behavior.
|| || || ||
b. Distract client to interfere with the ritual.
|| || || || || || ||
c. Ask why the client checks the pulse.
|| || || || || || ||
d. Hold client's hand to stop the behavior. - CORRECT ANSWERS ✔✔Overlook
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the client's behavior.
|| || ||
A client is discharged with automated peritoneal dialysis (PD) to be used
|| || || || || || || || || || ||
nightly...which instructions should the nurse include?
|| || || || || ||
a. Wash hands before cleaning exit site
|| || || || || ||
b. Keep the head of the bed flat at night
|| || || || || || || || ||
c. Feel for a thrill and a distal pulse nightly
|| || || || || || || || ||
d. Do not get up if fluid is left in the abdomen - CORRECT ANSWERS ✔✔Wash
|| || || || || || || || || || || || || || ||
hands before cleaning exit site
|| || || || ||
Rationale: meticulous hand hygiene is essential when performing care for a
|| || || || || || || || || ||
peritoneal dialysis, infections is a common complication of peritoneal
|| || || || || || || || ||
dialysis.
||
,The charge nurse observes the practical nurse (PN) apply sterile gloves in
|| || || || || || || || || || ||
preparation for performing a sterile dressing change. Which action by the PN
|| || || || || || || || || || || ||
requires correction by the charge nurse?
|| || || || || ||
a- Opening the package
|| || ||
b- Picking up the second glove
|| || || || ||
c- Picking up the first glove
|| || || || ||
d- Positioning of the table - CORRECT ANSWERS ✔✔Picking up the second
|| || || || || || || || || || ||
glove
||
A 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.
|| || || || || || || || ||
b. Cushing reflex and cerebral edema after 24 hours
|| || || || || || || ||
c. Fever, nuchal rigidity and opisthotonos within hours
|| || || || || || ||
d. Headache and pupillary changes 48 hours after a head injury - CORRECT
|| || || || || || || || || || || ||
ANSWERS ✔✔Altered consciousness within the first 24 hours after injury.
|| || || || || || || || || ||
A male client reports to the clinic nurse that he has been feeling well and is
|| || || || || || || || || || || || || || ||
often "dizzy" his blood pressure is elevated. Based on this findings, this client
|| || || || || || || || || || || || ||
is at a greatest risk for which pathophysiological condition?
|| || || || || || || || ||
,a. Pulmonary hypertension
|| ||
b. Left ventricular hypertrophy
|| || ||
c. Renal failure
|| ||
d. Stroke - CORRECT ANSWERS ✔✔Stroke
|| || || || ||
The nurse ask the parent to stay during the examination of a male toddler's
|| || || || || || || || || || || || ||
genital area. Which intervention should the nurse implement?
|| || || || || || || ||
a. Examine the genitalia as the last part of the total exam.
|| || || || || || || || || || ||
b. Use soothing statements to facilitate cooperation
|| || || || || ||
c. Allow the child to keep underpants on to examine genitalia
|| || || || || || || || || ||
d. Work slowly and methodically so not to stress the child - CORRECT
|| || || || || || || || || || || ||
ANSWERS ✔✔Examine the genitalia as the last part of the total exam.
|| || || || || || || || || || || ||
Rationale: Examination of a child's genitalia is particularly stressful to
|| || || || || || || || ||
toddles, so this assessment is best left as the last part of the examination. B
|| || || || || || || || || || || || || || ||
are best done by a parent, not the nurse. The genitals must be completely
|| || || || || || || || || || || || || ||
visualized and sometimes palpates underwear for a brief period of.
|| || || || || || || || || ||
The nurse is changing a client's IV tubing and closes the roller clamp on the
|| || || || || || || || || || || || || ||
new tubing setup when the bag of solution is _____. Which action should the
|| || || || || || || || || || || || || ||
nurse take to ensure adequate filling of the drip chamber?
|| || || || || || || || || ||
a. Lower the IV bag to a flat surface
|| || || || || || || ||
b. Compress the drip chamber
|| || || ||
c. Open the roller clamp
|| || || ||
, d. Squeeze the bag of IV solution - CORRECT ANSWERS ✔✔Compress the drip
|| || || || || || || || || || || ||
chamber
||
During an Insulin infusion for a client with diabetes mellitus who is
|| || || || || || || || || || ||
experiencing hyperglycemic hyperosmolar syndrome in addition to the
|| || || || || || || ||
client's glucose, which laboratory value is most important for the nurse to
|| || || || || || || || || || || ||
monitor?
||
a. Urine ketones
|| ||
b. Urine albumin
|| ||
c. Serum protein
|| ||
d. Serum potassium - CORRECT ANSWERS ✔✔d. Serum potassium
|| || || || || || || ||
Rationale: Electrolyte shifts are common during correction of hyperosmolar
|| || || || || || || ||
and hyperglycemic states. Monitor electrolyte levels at least every 4 hours, or
|| || || || || || || || || || || ||
every 2 hours if needed. Monitor serum sodium and potassium levels closely.
|| || || || || || || || || || || ||
If needed, use isotonic and hypotonic saline solutions to adjust the patient's
|| || || || || || || || || || || ||
sodium level. Despite major potassium loss during diuresis in early HHS
|| || || || || || || || || || ||
stages, many patients initially present in a hyperkalemic state due to
|| || || || || || || || || || ||
dehydration. When fluid and insulin therapy begin, the serum potassium
|| || || || || || || || || ||
level may drop dramatically.
|| || || ||
In planning strategies to reduce a client's risk for complications following
|| || || || || || || || || ||
orthopedic surgery, the nurse recognizes which pathology as the underlying
|| || || || || || || || || ||
cause of osteomyelitis?
|| || ||
a. Infectious process
|| ||
b. Metastatic process
|| ||
complete and correct answers
A client on a long-term mental health unit repeatedly takes own pulse
|| || || || || || || || || || ||
regardless of the circumstance. What action should the nurse implement?
|| || || || || || || || || ||
a. Overlook the client's behavior.
|| || || ||
b. Distract client to interfere with the ritual.
|| || || || || || ||
c. Ask why the client checks the pulse.
|| || || || || || ||
d. Hold client's hand to stop the behavior. - CORRECT ANSWERS ✔✔Overlook
|| || || || || || || || || || ||
the client's behavior.
|| || ||
A client is discharged with automated peritoneal dialysis (PD) to be used
|| || || || || || || || || || ||
nightly...which instructions should the nurse include?
|| || || || || ||
a. Wash hands before cleaning exit site
|| || || || || ||
b. Keep the head of the bed flat at night
|| || || || || || || || ||
c. Feel for a thrill and a distal pulse nightly
|| || || || || || || || ||
d. Do not get up if fluid is left in the abdomen - CORRECT ANSWERS ✔✔Wash
|| || || || || || || || || || || || || || ||
hands before cleaning exit site
|| || || || ||
Rationale: meticulous hand hygiene is essential when performing care for a
|| || || || || || || || || ||
peritoneal dialysis, infections is a common complication of peritoneal
|| || || || || || || || ||
dialysis.
||
,The charge nurse observes the practical nurse (PN) apply sterile gloves in
|| || || || || || || || || || ||
preparation for performing a sterile dressing change. Which action by the PN
|| || || || || || || || || || || ||
requires correction by the charge nurse?
|| || || || || ||
a- Opening the package
|| || ||
b- Picking up the second glove
|| || || || ||
c- Picking up the first glove
|| || || || ||
d- Positioning of the table - CORRECT ANSWERS ✔✔Picking up the second
|| || || || || || || || || || ||
glove
||
A 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.
|| || || || || || || || ||
b. Cushing reflex and cerebral edema after 24 hours
|| || || || || || || ||
c. Fever, nuchal rigidity and opisthotonos within hours
|| || || || || || ||
d. Headache and pupillary changes 48 hours after a head injury - CORRECT
|| || || || || || || || || || || ||
ANSWERS ✔✔Altered consciousness within the first 24 hours after injury.
|| || || || || || || || || ||
A male client reports to the clinic nurse that he has been feeling well and is
|| || || || || || || || || || || || || || ||
often "dizzy" his blood pressure is elevated. Based on this findings, this client
|| || || || || || || || || || || || ||
is at a greatest risk for which pathophysiological condition?
|| || || || || || || || ||
,a. Pulmonary hypertension
|| ||
b. Left ventricular hypertrophy
|| || ||
c. Renal failure
|| ||
d. Stroke - CORRECT ANSWERS ✔✔Stroke
|| || || || ||
The nurse ask the parent to stay during the examination of a male toddler's
|| || || || || || || || || || || || ||
genital area. Which intervention should the nurse implement?
|| || || || || || || ||
a. Examine the genitalia as the last part of the total exam.
|| || || || || || || || || || ||
b. Use soothing statements to facilitate cooperation
|| || || || || ||
c. Allow the child to keep underpants on to examine genitalia
|| || || || || || || || || ||
d. Work slowly and methodically so not to stress the child - CORRECT
|| || || || || || || || || || || ||
ANSWERS ✔✔Examine the genitalia as the last part of the total exam.
|| || || || || || || || || || || ||
Rationale: Examination of a child's genitalia is particularly stressful to
|| || || || || || || || ||
toddles, so this assessment is best left as the last part of the examination. B
|| || || || || || || || || || || || || || ||
are best done by a parent, not the nurse. The genitals must be completely
|| || || || || || || || || || || || || ||
visualized and sometimes palpates underwear for a brief period of.
|| || || || || || || || || ||
The nurse is changing a client's IV tubing and closes the roller clamp on the
|| || || || || || || || || || || || || ||
new tubing setup when the bag of solution is _____. Which action should the
|| || || || || || || || || || || || || ||
nurse take to ensure adequate filling of the drip chamber?
|| || || || || || || || || ||
a. Lower the IV bag to a flat surface
|| || || || || || || ||
b. Compress the drip chamber
|| || || ||
c. Open the roller clamp
|| || || ||
, d. Squeeze the bag of IV solution - CORRECT ANSWERS ✔✔Compress the drip
|| || || || || || || || || || || ||
chamber
||
During an Insulin infusion for a client with diabetes mellitus who is
|| || || || || || || || || || ||
experiencing hyperglycemic hyperosmolar syndrome in addition to the
|| || || || || || || ||
client's glucose, which laboratory value is most important for the nurse to
|| || || || || || || || || || || ||
monitor?
||
a. Urine ketones
|| ||
b. Urine albumin
|| ||
c. Serum protein
|| ||
d. Serum potassium - CORRECT ANSWERS ✔✔d. Serum potassium
|| || || || || || || ||
Rationale: Electrolyte shifts are common during correction of hyperosmolar
|| || || || || || || ||
and hyperglycemic states. Monitor electrolyte levels at least every 4 hours, or
|| || || || || || || || || || || ||
every 2 hours if needed. Monitor serum sodium and potassium levels closely.
|| || || || || || || || || || || ||
If needed, use isotonic and hypotonic saline solutions to adjust the patient's
|| || || || || || || || || || || ||
sodium level. Despite major potassium loss during diuresis in early HHS
|| || || || || || || || || || ||
stages, many patients initially present in a hyperkalemic state due to
|| || || || || || || || || || ||
dehydration. When fluid and insulin therapy begin, the serum potassium
|| || || || || || || || || ||
level may drop dramatically.
|| || || ||
In planning strategies to reduce a client's risk for complications following
|| || || || || || || || || ||
orthopedic surgery, the nurse recognizes which pathology as the underlying
|| || || || || || || || || ||
cause of osteomyelitis?
|| || ||
a. Infectious process
|| ||
b. Metastatic process
|| ||
