HESI MANAGEMENT PRACTICE TEST,
COMPREHENSIVE EXAM 3 FINAL QUESTIONS
The charge nurse working the 3 to 11 shift of a 24-bed medical unit in a large acute care
hospital is making assignments. Currently, there are 20 clients on the unit and 4
admissions are scheduled to arrive during the shift. Besides the charge nurse, the staff
consists of two experienced practical nurses (PN) and one unlicensed assistive
personnel (UAP) who has worked on the unit for 10 years. Taking into consideration the
acuity of each client, which distribution of clients is the best assignment for the nurse to
make?
A. 10 clients and 2 admissions to each of the PNs. Have the UAP take all vital signs and
collect all I&Os.
B. 10 clients to each of the PNs. Have the UAP take vital signs. The charge nurse takes
the 4 new admissions.
C. 8 clients to each of the PNs, 4 clients to the charge nurse, and the 4 admissions to
the UAP.
D. 8 clients to each of the PNs, 4 admissions to the charge nurse, and 4 low-acuity clien
- Answer -B
During report, the charge nurse informs a nurse that she must work on another unit. The
nurse begins to sign deeply and tosses about her belongings as she is preparing to
leave, making it known that she is very unhappy about having to "float." What is the best
immediate action for the charge nurse to take?
A. Continue with report, and talk to the nurse about the incident at a later time.
B. Ask the nurse to call the supervisor to see if she can be reassigned.
C. Stop report and remind the nurse that all the staff must "float" at some time.
D. In the presence of other staff members, inform the nurse that her behavior is
inappropriate. - Answer -A
The nurse is giving change-of-shift report for four clients in the emergency center and
reports the client with the terminal disease has a living will and a "Do not resuscitate"
(DNR) order on file. Which client fits the criteria for a terminal illness?
A. 2-year-old child with esophageal burns from drinking drain cleaner who now has a
gastrostomy tube.
B. 76-year-old female client with Alzheimer's disease who is pacing the halls and trying
to "go home".
C. 52-year-old male client who had a partial lobectomy and on a ventilator on the 2
postoperative day.
D. 43-year-old male with amyotrophic lateral sclerosis who is refusing artificial nutrition
or hydration. - Answer -D
The charge nurse assigns the care of a client with diabetes who has hyperglycemia to a
practical nurse (PN). In supervising the PN, what is the charge nurse's most important
action?
,A. Decide which sliding scale insulin dose should be administered.
B. Obtain the blood sugar results via skin puncture and glucometer.
C. Notify the healthcare provider of the daily serum glucose results.
D. Confer with the PN about any manifestations the client is exhibiting. - Answer -D
The charge nurse working on a surgical unit must discharge as many clients as possible
to prepare for emergency admissions. Which client is stable enough to be discharged
from the unit?
A. An elderly client with end-stage cirrhosis who had a liver biopsy 4 hours ago.
B. A client scheduled for a femoro-popliteal bypass surgery tomorrow.
C. A middle-aged client with acute pancreatitis and lower left quadrant pain.
D. A female client with angina and ectopy noted on the telemetry monitor - Answer -B
An emergency room anticipates an influx of injured clients from a large motor vehicle
collision on a major freeway. Which client should the triage nurse send to the trauma
staff for immediate intervention?
A. A young adult male with a suspected closed head injury who has no respirations
despite having his airway repositioned by the emergency medical team.
B. An adult with a suspected intraabdominal bleed who was not breathing on arrival, but
is currently responding since repositioning the airway.
C. A teenager with a suspected fractured left leg whose respirations are 26 breaths/min,
capillary refill <2 seconds, and who can follow simple commands.
D. A young adult with a facial laceration that is controlled by pressure and whose
respiratory rate, capillary refill, and ability to follow commands are all WNL. - Answer -B
The nurse receives report in the emergency center for four clients. Which client should
the nurse assess first?
A. A screaming child with a compound fracture of the wrist.
B. A diabetic client with a laceration on the sole of the foot.
C. A client experiencing shortness of breath and dyspnea.
D. A geriatric client with many new and old bruises noted. - Answer -C
The nurse witnesses a male client's signature for surgical consent for a Billroth II
procedure after the surgeon discusses the procedure and its implication with the client.
After signing the consent, the client questions the importance of a change in his diet
postoperatively. What action should the nurse implement?
A. Review information about dumping syndrome.
B. Have the client sign another consent.
C. Notify the surgeon about the client's comment.
D. Explain the surgical procedure. - Answer -A
The nurse is designing a program to control nosocomial infections on a geriatric unit of
an acute care hospital. What strategy should be included in this plan?
A. Do not allow those with influenza to be admitted to the unit.
B. Require that all clients receive a pneumonia vaccine prior to admission.
C. Ensure that sterile technique is followed when changing surgical dressings.
, D. Encourage clients to drink water to prevent urinary tract infections. - Answer -C
The registered nurse (RN) and unlicensed assisted personnel (UAP) are working
together to provide care for a bedfast client needing total care, medication, and Foley
catheter irrigation. How should the RN assign the client's care?
A. UAP: Personal care, catheter, irrigation, I&O. RN: Medications.
B. UAP: Personal care. RN: Medications, catheter irrigation, I&O.
C. UAP: Catheter irrigation, I&O. RN: Medications. Both provide personal care.
D. UAP: Personal care, I&O. RN: Catheter irrigation, medications. - Answer -D
The charge nurse, along with two registered nurses (RN), one practical nurse (PN), and
one unlicensed assistive personnel (UAP), is working in an emergency department.
What activity should be assigned to the UAP? - Answer -Transport a client diagnosed
with septicemia to the medical unit.
The charge nurse is assigning a room for a newly-admitted client, diagnosed with acute
Pneumocystis carinii pneumonia, secondary to acquired immunodeficiency syndrome
(AIDS). Which room would be best to assign to this client? - Answer -A semi-private
room without a roommate (D) is the best assignment because the room can be easily
blocked to create a private room should the client require isolation measures due to the
pneumonia (the AIDS diagnosis alone does not affect the type of room assignment). A
client with pneumonia should not be exposed to an outside air ventilation system (A).
The client should not be assigned to a room with a client who is at risk for pneumonia
The charge nurse working in a long-term care facility is informed by the LPN that a
client's son is unhappy with the care his mother is receiving. What action should the
nurse take first? - Answer -The nurse should first obtain information about the nature of
the complaint and ask the LPN to describe what he/she knows of the situation.
During coronary artery bypass graft (CABG) surgery, a male client with a history of
chronic tobacco abuse experiences a dramatic decrease in his oxygen saturation.
Subsequently, the client remains on a ventilator two days longer than anticipated. Which
factor should the nurse consider when evaluating the client's progress? - Answer -
Variance- A variance is any event that may alter a pt's progress through the clinical
pathway, such as remaining on a ventilator for an additional two days
A female client is receiving an enteral feeding via NG tube. The daughter reports to the
charge nurse that her mother is coughing vigorously and sounds congested. Which staff
member should the charge nurse ask to check on the client? - Answer -The RN who is
entering nursing notes (D) is working on a task that has less priority than (A).
The nurse educator is teaching the nursing staff about a new computerized
documentation system that is recently implemented. What information is the best
indication that the education is effective? - Answer -Less time for nursing staff to
complete the daily charting
COMPREHENSIVE EXAM 3 FINAL QUESTIONS
The charge nurse working the 3 to 11 shift of a 24-bed medical unit in a large acute care
hospital is making assignments. Currently, there are 20 clients on the unit and 4
admissions are scheduled to arrive during the shift. Besides the charge nurse, the staff
consists of two experienced practical nurses (PN) and one unlicensed assistive
personnel (UAP) who has worked on the unit for 10 years. Taking into consideration the
acuity of each client, which distribution of clients is the best assignment for the nurse to
make?
A. 10 clients and 2 admissions to each of the PNs. Have the UAP take all vital signs and
collect all I&Os.
B. 10 clients to each of the PNs. Have the UAP take vital signs. The charge nurse takes
the 4 new admissions.
C. 8 clients to each of the PNs, 4 clients to the charge nurse, and the 4 admissions to
the UAP.
D. 8 clients to each of the PNs, 4 admissions to the charge nurse, and 4 low-acuity clien
- Answer -B
During report, the charge nurse informs a nurse that she must work on another unit. The
nurse begins to sign deeply and tosses about her belongings as she is preparing to
leave, making it known that she is very unhappy about having to "float." What is the best
immediate action for the charge nurse to take?
A. Continue with report, and talk to the nurse about the incident at a later time.
B. Ask the nurse to call the supervisor to see if she can be reassigned.
C. Stop report and remind the nurse that all the staff must "float" at some time.
D. In the presence of other staff members, inform the nurse that her behavior is
inappropriate. - Answer -A
The nurse is giving change-of-shift report for four clients in the emergency center and
reports the client with the terminal disease has a living will and a "Do not resuscitate"
(DNR) order on file. Which client fits the criteria for a terminal illness?
A. 2-year-old child with esophageal burns from drinking drain cleaner who now has a
gastrostomy tube.
B. 76-year-old female client with Alzheimer's disease who is pacing the halls and trying
to "go home".
C. 52-year-old male client who had a partial lobectomy and on a ventilator on the 2
postoperative day.
D. 43-year-old male with amyotrophic lateral sclerosis who is refusing artificial nutrition
or hydration. - Answer -D
The charge nurse assigns the care of a client with diabetes who has hyperglycemia to a
practical nurse (PN). In supervising the PN, what is the charge nurse's most important
action?
,A. Decide which sliding scale insulin dose should be administered.
B. Obtain the blood sugar results via skin puncture and glucometer.
C. Notify the healthcare provider of the daily serum glucose results.
D. Confer with the PN about any manifestations the client is exhibiting. - Answer -D
The charge nurse working on a surgical unit must discharge as many clients as possible
to prepare for emergency admissions. Which client is stable enough to be discharged
from the unit?
A. An elderly client with end-stage cirrhosis who had a liver biopsy 4 hours ago.
B. A client scheduled for a femoro-popliteal bypass surgery tomorrow.
C. A middle-aged client with acute pancreatitis and lower left quadrant pain.
D. A female client with angina and ectopy noted on the telemetry monitor - Answer -B
An emergency room anticipates an influx of injured clients from a large motor vehicle
collision on a major freeway. Which client should the triage nurse send to the trauma
staff for immediate intervention?
A. A young adult male with a suspected closed head injury who has no respirations
despite having his airway repositioned by the emergency medical team.
B. An adult with a suspected intraabdominal bleed who was not breathing on arrival, but
is currently responding since repositioning the airway.
C. A teenager with a suspected fractured left leg whose respirations are 26 breaths/min,
capillary refill <2 seconds, and who can follow simple commands.
D. A young adult with a facial laceration that is controlled by pressure and whose
respiratory rate, capillary refill, and ability to follow commands are all WNL. - Answer -B
The nurse receives report in the emergency center for four clients. Which client should
the nurse assess first?
A. A screaming child with a compound fracture of the wrist.
B. A diabetic client with a laceration on the sole of the foot.
C. A client experiencing shortness of breath and dyspnea.
D. A geriatric client with many new and old bruises noted. - Answer -C
The nurse witnesses a male client's signature for surgical consent for a Billroth II
procedure after the surgeon discusses the procedure and its implication with the client.
After signing the consent, the client questions the importance of a change in his diet
postoperatively. What action should the nurse implement?
A. Review information about dumping syndrome.
B. Have the client sign another consent.
C. Notify the surgeon about the client's comment.
D. Explain the surgical procedure. - Answer -A
The nurse is designing a program to control nosocomial infections on a geriatric unit of
an acute care hospital. What strategy should be included in this plan?
A. Do not allow those with influenza to be admitted to the unit.
B. Require that all clients receive a pneumonia vaccine prior to admission.
C. Ensure that sterile technique is followed when changing surgical dressings.
, D. Encourage clients to drink water to prevent urinary tract infections. - Answer -C
The registered nurse (RN) and unlicensed assisted personnel (UAP) are working
together to provide care for a bedfast client needing total care, medication, and Foley
catheter irrigation. How should the RN assign the client's care?
A. UAP: Personal care, catheter, irrigation, I&O. RN: Medications.
B. UAP: Personal care. RN: Medications, catheter irrigation, I&O.
C. UAP: Catheter irrigation, I&O. RN: Medications. Both provide personal care.
D. UAP: Personal care, I&O. RN: Catheter irrigation, medications. - Answer -D
The charge nurse, along with two registered nurses (RN), one practical nurse (PN), and
one unlicensed assistive personnel (UAP), is working in an emergency department.
What activity should be assigned to the UAP? - Answer -Transport a client diagnosed
with septicemia to the medical unit.
The charge nurse is assigning a room for a newly-admitted client, diagnosed with acute
Pneumocystis carinii pneumonia, secondary to acquired immunodeficiency syndrome
(AIDS). Which room would be best to assign to this client? - Answer -A semi-private
room without a roommate (D) is the best assignment because the room can be easily
blocked to create a private room should the client require isolation measures due to the
pneumonia (the AIDS diagnosis alone does not affect the type of room assignment). A
client with pneumonia should not be exposed to an outside air ventilation system (A).
The client should not be assigned to a room with a client who is at risk for pneumonia
The charge nurse working in a long-term care facility is informed by the LPN that a
client's son is unhappy with the care his mother is receiving. What action should the
nurse take first? - Answer -The nurse should first obtain information about the nature of
the complaint and ask the LPN to describe what he/she knows of the situation.
During coronary artery bypass graft (CABG) surgery, a male client with a history of
chronic tobacco abuse experiences a dramatic decrease in his oxygen saturation.
Subsequently, the client remains on a ventilator two days longer than anticipated. Which
factor should the nurse consider when evaluating the client's progress? - Answer -
Variance- A variance is any event that may alter a pt's progress through the clinical
pathway, such as remaining on a ventilator for an additional two days
A female client is receiving an enteral feeding via NG tube. The daughter reports to the
charge nurse that her mother is coughing vigorously and sounds congested. Which staff
member should the charge nurse ask to check on the client? - Answer -The RN who is
entering nursing notes (D) is working on a task that has less priority than (A).
The nurse educator is teaching the nursing staff about a new computerized
documentation system that is recently implemented. What information is the best
indication that the education is effective? - Answer -Less time for nursing staff to
complete the daily charting
