HESI RN Exit Practice Test 1
Remediation questions and
answers
Clients taking sedating medications are at increased fall risk. Nursing care should focus on
providing a safe and injury free environment. Education should be provided to ensure that the
client is aware of their limitations and follows safety protocols. In the situation described in the
question, the client followed the correct process by signaling the nurse with the call light for
assistance with ambulating to the bathroom. When no assistance was provided in a timely
manner, the client got up and attempted to walk to the bathroom by themselves. This behavior
does not constitute the need for a vest or wrist restraints, but demonstrates inadequate care
on the part of the nursing staff, both in providing timely care to the client and by applying
restraints without a medical indication. The nurse manager should reprimand the staff nurse for
violating this client's rights and review that restraints can only be ap
A client who is 12 weeks' pregnant is admitted for hyperemesis gravidarum. What nursing
intervention is appropriate at this time? (Select all that apply)
A. Place on nothing-by-mouth status
B. Initiate IV fluids and electrolytes
C. Start small frequent meals with non-fatty, bland foods
D. Involve client in selection of foods
E. Provide vitamin B6 supplement - Ans Hyperemesis gravidarum is a severe type of morning
sickness with persistent nausea and vomiting that is associated with dehydration, electrolyte
abnormalities, ketosis and weight loss (> 5% of the pre- pregnancy weight). Initial treatment
consists of placing the client on nothing-by-mouth status until all vomiting has stopped for at
least 48 hours (Choice A) and intravenous fluids and electrolyte replacement (Choice B). Clients
can also be prescribed vitamin B6 (pyridoxine, Choice E) and antiemetic drugs to suppress the
nausea and vomiting.
,Choices C and D are not appropriate in the initial management of a client with hyperemesis
gravidarum as they are likely to result in increased nausea and vomiting. After vomiting has
been subsided for at least 48 hours, the client can slowly be introduced to non-fatty bland
foods. At this time, a nutritionist should work together with the client to develop a nutritional
plan
The nurse is caring for a client who is placed on telemetry for cardiac monitoring. Where would
the nurse place the 5 electrodes? - Ans The picture that correctly displays the electrode lead
placement is A. The nurse should place the white electrode in the 2nd intercostal space (ICS)
right midclavicular line; the green lead on the right lower ribcage (8th ICS right midclavicular
line); the brown lead in the 4th ICS on the right sternal border; the black lead in the 2nd ICS left
midclavicular line; and the red lead on the lower left ribcage (8th ICS left midclavicular line). The
other configurations are incorrect. Note that choice B is the proper configuration for ECG
electrode placement.
A pregnant woman with hyperemesis gravidarum has been vomiting excessively and lab results
reveal hypokalemia (serum potassium 3.0 mEq/L). What other abnormalities should the nurse
expect to find?
A. Peaked T waves and QRS prolongation on EKG
B. Decreased PCO2
C. Increased serum bicarbonate
D. Decreased serum chloride
E. Increased urinary potassium - Ans : C, D
,Excessive vomiting results in the loss of potassium, chloride, and (stomach) acid. This results in
the development of hypokalemic, hypochloremic metabolic alkalosis. Therefore, lab results will
show a rise in bicarbonate levels (Choice C) and low chloride levels (Choice D).
Choice A is incorrect because the nurse would expect to see U wave and ST depression on the
EKG due to hypokalemia. Peaked T waves and QRS prolongation are signs of hyperkalemia.
Choice B is incorrect because the PCO2 will be increased (i.e. the client will be hypoventilating)
to compensate for the rise in bicarbonate. Choice E is incorrect because this client is
hypokalemic as a result of excess vomiting and not as a result of renal potassium loss. the
kidneys will minimize potassium excretion in an attempt to raise serum potassium levels.
A clear liquid diet is ordered for a client scheduled for a colonoscopy. Which food selection
indicates that teaching has been effective? (Select all that apply)
A. Gelatin
B. Orange juice with pulp
C. Cappuccino
D. Tea with honey
E. Broth - Ans : A, D, E
Clients on clear liquid diet can- as the name implies- only consume clear liquids. No solids are
included in this diet. Option A (gelatin), D (tea with honey), and E (broth) are proper choices for
a client on a clear liquid diet.
Choice B is incorrect because pulp cannot be consumed while on a liquid diet. The client is
permitted to drink clear juices such as apple juice or grape juice without pulp. Choice C is
incorrect because a cappuccino contains milk, which is not permitted on a clear liquid diet. The
client is permitted to drink a cup of dark coffee without milk
, The nurse is instruction a new graduate on the use of a pleur evac drainage system for a client
with a pleural effusion. In what location should the nurse instruct the new graduate to look if an
air leak is suspected?
A. Location A
B. Location B
C. Location C
D. Location D - Ans : C
The nurse should instruct the graduate nurse to assess location C to see if an air leak is present.
Location C is the air leak meter; bubbling in this location indicates an air leak. In contrast,
fluctuation of the fluid in the air leak chamber and water seal (tube connecting B and C) is
normal as a result of pressure changes during respiration.
Choice A is incorrect because location A is the collection chamber. In this chamber, the drainage
from the chest is collected. It has calibration marks and make it easier to read and document
the amount of drainage. There will be no bubbling in this chamber.
Choice B is incorrect because location B is the high negativity float valve and high negativity
relief chamber. The negativity float valve and negativity relief chamber are safety measures
that maintain the water seal in the event of high negative pressures (which can be caused by
coughing, crying, and s
A client with a 40 pack year history of smoking is scheduled for a pulmonary function test. What
should the nurse explain regarding this diagnostic test?
A. "This test is used to assess your risk for lung cancer"
B. "This test is used to determine the percentage of oxygen that is in your lungs with every
breath"
Remediation questions and
answers
Clients taking sedating medications are at increased fall risk. Nursing care should focus on
providing a safe and injury free environment. Education should be provided to ensure that the
client is aware of their limitations and follows safety protocols. In the situation described in the
question, the client followed the correct process by signaling the nurse with the call light for
assistance with ambulating to the bathroom. When no assistance was provided in a timely
manner, the client got up and attempted to walk to the bathroom by themselves. This behavior
does not constitute the need for a vest or wrist restraints, but demonstrates inadequate care
on the part of the nursing staff, both in providing timely care to the client and by applying
restraints without a medical indication. The nurse manager should reprimand the staff nurse for
violating this client's rights and review that restraints can only be ap
A client who is 12 weeks' pregnant is admitted for hyperemesis gravidarum. What nursing
intervention is appropriate at this time? (Select all that apply)
A. Place on nothing-by-mouth status
B. Initiate IV fluids and electrolytes
C. Start small frequent meals with non-fatty, bland foods
D. Involve client in selection of foods
E. Provide vitamin B6 supplement - Ans Hyperemesis gravidarum is a severe type of morning
sickness with persistent nausea and vomiting that is associated with dehydration, electrolyte
abnormalities, ketosis and weight loss (> 5% of the pre- pregnancy weight). Initial treatment
consists of placing the client on nothing-by-mouth status until all vomiting has stopped for at
least 48 hours (Choice A) and intravenous fluids and electrolyte replacement (Choice B). Clients
can also be prescribed vitamin B6 (pyridoxine, Choice E) and antiemetic drugs to suppress the
nausea and vomiting.
,Choices C and D are not appropriate in the initial management of a client with hyperemesis
gravidarum as they are likely to result in increased nausea and vomiting. After vomiting has
been subsided for at least 48 hours, the client can slowly be introduced to non-fatty bland
foods. At this time, a nutritionist should work together with the client to develop a nutritional
plan
The nurse is caring for a client who is placed on telemetry for cardiac monitoring. Where would
the nurse place the 5 electrodes? - Ans The picture that correctly displays the electrode lead
placement is A. The nurse should place the white electrode in the 2nd intercostal space (ICS)
right midclavicular line; the green lead on the right lower ribcage (8th ICS right midclavicular
line); the brown lead in the 4th ICS on the right sternal border; the black lead in the 2nd ICS left
midclavicular line; and the red lead on the lower left ribcage (8th ICS left midclavicular line). The
other configurations are incorrect. Note that choice B is the proper configuration for ECG
electrode placement.
A pregnant woman with hyperemesis gravidarum has been vomiting excessively and lab results
reveal hypokalemia (serum potassium 3.0 mEq/L). What other abnormalities should the nurse
expect to find?
A. Peaked T waves and QRS prolongation on EKG
B. Decreased PCO2
C. Increased serum bicarbonate
D. Decreased serum chloride
E. Increased urinary potassium - Ans : C, D
,Excessive vomiting results in the loss of potassium, chloride, and (stomach) acid. This results in
the development of hypokalemic, hypochloremic metabolic alkalosis. Therefore, lab results will
show a rise in bicarbonate levels (Choice C) and low chloride levels (Choice D).
Choice A is incorrect because the nurse would expect to see U wave and ST depression on the
EKG due to hypokalemia. Peaked T waves and QRS prolongation are signs of hyperkalemia.
Choice B is incorrect because the PCO2 will be increased (i.e. the client will be hypoventilating)
to compensate for the rise in bicarbonate. Choice E is incorrect because this client is
hypokalemic as a result of excess vomiting and not as a result of renal potassium loss. the
kidneys will minimize potassium excretion in an attempt to raise serum potassium levels.
A clear liquid diet is ordered for a client scheduled for a colonoscopy. Which food selection
indicates that teaching has been effective? (Select all that apply)
A. Gelatin
B. Orange juice with pulp
C. Cappuccino
D. Tea with honey
E. Broth - Ans : A, D, E
Clients on clear liquid diet can- as the name implies- only consume clear liquids. No solids are
included in this diet. Option A (gelatin), D (tea with honey), and E (broth) are proper choices for
a client on a clear liquid diet.
Choice B is incorrect because pulp cannot be consumed while on a liquid diet. The client is
permitted to drink clear juices such as apple juice or grape juice without pulp. Choice C is
incorrect because a cappuccino contains milk, which is not permitted on a clear liquid diet. The
client is permitted to drink a cup of dark coffee without milk
, The nurse is instruction a new graduate on the use of a pleur evac drainage system for a client
with a pleural effusion. In what location should the nurse instruct the new graduate to look if an
air leak is suspected?
A. Location A
B. Location B
C. Location C
D. Location D - Ans : C
The nurse should instruct the graduate nurse to assess location C to see if an air leak is present.
Location C is the air leak meter; bubbling in this location indicates an air leak. In contrast,
fluctuation of the fluid in the air leak chamber and water seal (tube connecting B and C) is
normal as a result of pressure changes during respiration.
Choice A is incorrect because location A is the collection chamber. In this chamber, the drainage
from the chest is collected. It has calibration marks and make it easier to read and document
the amount of drainage. There will be no bubbling in this chamber.
Choice B is incorrect because location B is the high negativity float valve and high negativity
relief chamber. The negativity float valve and negativity relief chamber are safety measures
that maintain the water seal in the event of high negative pressures (which can be caused by
coughing, crying, and s
A client with a 40 pack year history of smoking is scheduled for a pulmonary function test. What
should the nurse explain regarding this diagnostic test?
A. "This test is used to assess your risk for lung cancer"
B. "This test is used to determine the percentage of oxygen that is in your lungs with every
breath"
