Exit HESI (Testing, Leadership, |||\\\ |||\\\ |||\\\ |||\\\
Advanced Clinical Concepts, and |||\\\ |||\\\ |||\\\ |||\\\
Medical-Surgical) exam with correct |||\\\ |||\\\ |||\\\ |||\\\
answers
Examples of negative style questions - correct answer✔✔"Which response should the nurse
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
question?"
"Which response indicates the nurse needs to reteach the patient?"
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Note: most questions on the HESI are written in positive style, not negative
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
How to determine priority for answers - correct answer✔✔In addition to ADPIE, ABC, and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
picking the least invasive intervention first, you can use Maslow's hierarchy of needs to set
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
priorities for what should be done first |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
1. Physiological: food, water, warmth, rest
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
2. Safety: safety and security
|||\\\ |||\\\ |||\\\ |||\\\
3. Belonging and love: intimate relationships and friends
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
4. Esteem: prestige, feelings of accomplishment, and self-image
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
5. Self-actualization: utilizing one's full potential, morality, spontaneity, creativity, etc.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Explaining procedures to clients - correct answer✔✔Remember, the nurse cannot explain it
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
first... It needs to be the healthcare provider. The RN's responsibility is that the informed
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
consent form is signed, but not to ensure the patient understands. If the patient has questions
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
about a procedure before signing, the HCP needs to come back to further explain
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,Good Samaritan Act - correct answer✔✔This protects health practitioners against malpractice
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
claims for care provided in emergency situations (i.e. a nurse giving CPR at the site of a car
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
accident)
Use of restraints - correct answer✔✔Restraints of any kind may constitute false imprisonment
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
if used incorrectly. Clients may only be restrained in an emergency, for a limited time, or for the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
purpose of protecting the client from injury or harm
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What types of procedures should be assigned to a professional nurse? - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔Sterile or invasive procedures |||\\\ |||\\\ |||\\\
Note: the test uses the acronym UAP, meaning unlicensed assistive personnel. These would be
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
examples of people who are not professional nurses and could not carry out such procedures
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What actions should a nurse take if he or she questions a health care provider's prescription
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
and believes it to be wrong? - correct answer✔✔Inform the HCP; record that the HCP was
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
informed and what his or her response was to that information; inform nursing supervisor;
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
refuse to carry out prescription |||\\\ |||\\\ |||\\\ |||\\\
UAPs - correct answer✔✔Unlicensed assistive personnel cannot be given tasks that require
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
the use of these parts of the nursing process: assessments (like actual assessing the patient,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
not vital signs), analysis, diagnosis, planning, and evaluation. Delegated activities would fall
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
within the "implementation" phase |||\\\ |||\\\ |||\\\
More on prioritization - correct answer✔✔Which client is the most critically ill?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Which client is most likely to experience a significant change in condition?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Which client requires an assessment by an RN?|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What is ARDS? - correct answer✔✔An unexpected, catastrophic pulmonary complication
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
occurring in a person with no previous pulmonary problems. Client are critically ill and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
managed in intensive care setting. Mortality rate is 50% |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
, Prevent complications of clients on mechanical ventilation with ARDS - correct answer✔✔-
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Elevate HOB ≥ 30º |||\\\ |||\\\ |||\\\
-Assist with sedation vacations |||\\\ |||\\\ |||\\\
-Implement comprehensive oral hygiene |||\\\ |||\\\ |||\\\
-Implement comprehensive mobilization program |||\\\ |||\\\ |||\\\
Frequency of suctioning - correct answer✔✔Suction only when secretions are present (but
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
assess need for suctioning q2h) |||\\\ |||\\\ |||\\\ |||\\\
What test is done before drawing ABGs? - correct answer✔✔Allen's test for collateral
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
circulation and arterial patency |||\\\ |||\\\ |||\\\
Signs of acute respiratory failure in children - correct answer✔✔Restlessness, tachypnea,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
tachycardia, and diaphoresis |||\\\ |||\\\
-A child in severe distress should be on 100% O2
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Respiratory failure lab values - correct answer✔✔PCO2>45 or PO2<60 on 50% O2 signifies
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
respiratory failure |||\\\
Four common causes of respiratory failure in children - correct answer✔✔Congenital heart
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
disease, infection or sepsis, respiratory distress syndrome, aspiration, fluid overload, or
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dehydration
Early signs of shock - correct answer✔✔Agitation and restlessness (resulting from cerebral
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
hypoxia)
Advanced Clinical Concepts, and |||\\\ |||\\\ |||\\\ |||\\\
Medical-Surgical) exam with correct |||\\\ |||\\\ |||\\\ |||\\\
answers
Examples of negative style questions - correct answer✔✔"Which response should the nurse
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
question?"
"Which response indicates the nurse needs to reteach the patient?"
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Note: most questions on the HESI are written in positive style, not negative
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
How to determine priority for answers - correct answer✔✔In addition to ADPIE, ABC, and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
picking the least invasive intervention first, you can use Maslow's hierarchy of needs to set
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
priorities for what should be done first |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
1. Physiological: food, water, warmth, rest
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
2. Safety: safety and security
|||\\\ |||\\\ |||\\\ |||\\\
3. Belonging and love: intimate relationships and friends
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
4. Esteem: prestige, feelings of accomplishment, and self-image
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
5. Self-actualization: utilizing one's full potential, morality, spontaneity, creativity, etc.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Explaining procedures to clients - correct answer✔✔Remember, the nurse cannot explain it
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
first... It needs to be the healthcare provider. The RN's responsibility is that the informed
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
consent form is signed, but not to ensure the patient understands. If the patient has questions
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
about a procedure before signing, the HCP needs to come back to further explain
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,Good Samaritan Act - correct answer✔✔This protects health practitioners against malpractice
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
claims for care provided in emergency situations (i.e. a nurse giving CPR at the site of a car
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
accident)
Use of restraints - correct answer✔✔Restraints of any kind may constitute false imprisonment
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
if used incorrectly. Clients may only be restrained in an emergency, for a limited time, or for the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
purpose of protecting the client from injury or harm
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What types of procedures should be assigned to a professional nurse? - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔Sterile or invasive procedures |||\\\ |||\\\ |||\\\
Note: the test uses the acronym UAP, meaning unlicensed assistive personnel. These would be
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
examples of people who are not professional nurses and could not carry out such procedures
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What actions should a nurse take if he or she questions a health care provider's prescription
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
and believes it to be wrong? - correct answer✔✔Inform the HCP; record that the HCP was
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
informed and what his or her response was to that information; inform nursing supervisor;
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
refuse to carry out prescription |||\\\ |||\\\ |||\\\ |||\\\
UAPs - correct answer✔✔Unlicensed assistive personnel cannot be given tasks that require
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
the use of these parts of the nursing process: assessments (like actual assessing the patient,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
not vital signs), analysis, diagnosis, planning, and evaluation. Delegated activities would fall
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
within the "implementation" phase |||\\\ |||\\\ |||\\\
More on prioritization - correct answer✔✔Which client is the most critically ill?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Which client is most likely to experience a significant change in condition?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Which client requires an assessment by an RN?|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What is ARDS? - correct answer✔✔An unexpected, catastrophic pulmonary complication
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
occurring in a person with no previous pulmonary problems. Client are critically ill and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
managed in intensive care setting. Mortality rate is 50% |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
, Prevent complications of clients on mechanical ventilation with ARDS - correct answer✔✔-
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Elevate HOB ≥ 30º |||\\\ |||\\\ |||\\\
-Assist with sedation vacations |||\\\ |||\\\ |||\\\
-Implement comprehensive oral hygiene |||\\\ |||\\\ |||\\\
-Implement comprehensive mobilization program |||\\\ |||\\\ |||\\\
Frequency of suctioning - correct answer✔✔Suction only when secretions are present (but
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
assess need for suctioning q2h) |||\\\ |||\\\ |||\\\ |||\\\
What test is done before drawing ABGs? - correct answer✔✔Allen's test for collateral
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
circulation and arterial patency |||\\\ |||\\\ |||\\\
Signs of acute respiratory failure in children - correct answer✔✔Restlessness, tachypnea,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
tachycardia, and diaphoresis |||\\\ |||\\\
-A child in severe distress should be on 100% O2
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Respiratory failure lab values - correct answer✔✔PCO2>45 or PO2<60 on 50% O2 signifies
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
respiratory failure |||\\\
Four common causes of respiratory failure in children - correct answer✔✔Congenital heart
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
disease, infection or sepsis, respiratory distress syndrome, aspiration, fluid overload, or
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dehydration
Early signs of shock - correct answer✔✔Agitation and restlessness (resulting from cerebral
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
hypoxia)