ANALYZED EXIT HESI FINAL
EXAM QUESTIONS AND
ANSWERS
A client presents at the ED complaining of a raspy voice, cold intolerance, and fatigue. Lab tests indicate
an elevated TSH and low T3 and T4 levels. After the client is admitted to the telemetry unit, which
intervention is most important for the nurse to implement?
A) Assess for presence of non-pitting edema.
B) Administer the prescribed dose of levothyroxine.
C) Offer additional blankets and a warm drink.
D) Note client's most recent hemoglobin levels. - CORRECT ANSWER -B) Administer the prescribed dose
of levothyroxine.
Rationale: In the negative feedback mechanism of hypothyroidism, a low level of thyroid hormone
stimulates TSH production by the hypothalamus and results in an elevated TSH level, but the thyroid
gland does not respond with wadequate wproduction wof wT3 wand wT4 wto wregulate wbasal wmetabolic
wrate. wThese wserum whormone wlevels windicate wthe wneed wto wadminister wsupplementary wthyroid
whormone was wsoon was wpossible wto wavert wpossible wmyxedema wcoma. wNon-pitting wedema wis
wseen win wchronic whypothyroidism wand wassessment wof wthe wpresence wand wlocation wof wthe
wedema w(A) wis wnot wa wtop wpriority. wProviding wwarmth w(C) wis wbeneficial wbut wof wless wpriority
wthan w(B). wAnemia wis wcommon win whypothyroidism, wbut w(D) wis wof wlower wpriority wthan
winitiating wtreatment wto wprevent wmyxedema wcoma.
The wnurse wsuspects wthat wa wclient wmight wbe whemorrhaging winternally. wWhich wfindings wof wan
worthostatic wtilt wtest ware wa wmost wlikely windication wof wa wmajor wbleed w(> w1000 wml)?
A) A wdecrease win wthe wsystolic wBP wof w10 wmm wHg wwith wa wcorresponding wincrease win wthe wHR wof
w20.
,B) A wdecrease win wthe wsystolic wBP wof w10 wmm wHg wwith wa wcorresponding wdecrease win wthe wHR wof
w20.
C) A wdecrease win wthe wsystolic wBP wof w20 wmm wHg wwith wa wcorresponding wdecrease win wthe wHR wof
w10.
D) A wdecrease win wthe wsystolic wBP wof w20 wmm wHg wwith wa wcorresponding wincrease win wthe wHR
wof w10. w- wCORRECT wANSWER w-Ans: wA) wA wdecrease win wthe wsystolic wBP wof w10 wmm wHg wwith
wa wcorresponding wincrease win wthe wHR wof w20.
Rationale: wThe wloss wof wcirculatory wvolume wresults win wa w10 wmm wHg wdrop win wthe wsystolic
wpressure, wwhile wthe wHR wincreases wby w20 w% wabove wnormal was wa wcompensatory wresponse
wto wthe wlow wpressure.
When wconducting wdiet wteaching wfor wa wclient wwho wis won wa wpostoperative wfull wliquid wdiet,
wwhich wfoods wshould wthe wnurse wencourage wthe wclient wto weat? wSATA.
A) Canned wfruit wcocktail
B) Creamy wpeanut wbutter
C) Vegetable wjuice
D) Vanilla wfrozen wyogurt
E) Clear wbeef wbroth w- wCORRECT wANSWER w-Ans: wC, wD, wE
A wfull wliquid wdiet wincludes wall wliquids wthat ware wnot wclear wsuch was wvegetable wjuice wand
wfrozen wyogurt, was wwell was wclear wliquids. wPieces wof wfruit was wfound win wfruit wcocktail wand
wpeanut wbutter ware wnot wconsidered wliquids.
A wclient wis wreceiving wophthalmic wdrops wpreoperatively wfor wa wcataract wextraction wand wasks wthe
wnurse wwhy whe wis wprescribed wall wthese wmedications? wSATA.
A) One wof wthe wmedications wis wused wto wanesthetize wthe wcorneal wsurface.
B) The wiris wmust wbe wparalyzed wduring wthe wsurgery wto wprevent wit wfrom wreacting wto wlight.
C) Medication wis wused wto winduce wsleep wduring wthe wprocedure.
D) Pupillary wdilation wis wnecessary wto waccess wthe weye wchamber wfor wlens wremoval.
,E) These wmeds wassist win wobstructing wthe wclient's wvision wduring wthe wsurgery. w- wCORRECT
wANSWER w-Ans: wA, wB, wD
Cataract wsurgery wis waccessed wthrough wthe wcornea wusing weyelid wretractors wwhile wthe wclient wis
wawake. wIt wis wnecessary wto wanesthetize wthe wcorneal wsurface w(A), wparalyze wthe wciliary wbody
w(B), wand wprovide wpupil wdilation w(D)(mydriasis) wto wfacilitate waccess wto wthe wlens wwhich wties
wbehind wthe wiris w(posterior wchamber wof wthe wanterior wcavity). wA wsedative wmay wbe wadministered
wto wreduce wanxiety wbut wit wis wnot wused wto winduce wsleep. w(C) wCloudy wvision wmay wbe wa wside
weffect wof wthese wagents, wbut wthe wclient wwill wstill wbe wable wto wsee wduring wthe wsurgery w(E).
When wassessing wan wIV wsite wthat wis wsued wfor wfluid wreplacement wand wmedication wadministration,
wthe wclient wcomplains wof wthe wtenderness wwhen wthe warm wis wtouched wabove wthe wsite. wWhich
wadditional wassessment wwarrants wimmediate wintervention wby wthe wnurse?
A) Sluggish wblood wreturn
B) Client wuses wthe warm wcautiously
C) Spot wof wdried wblood wat wthe winsertion wsite
D) Red wstreak wtracking wthe wvein w- wCORRECT wANSWER w-Ans: wD
A wred wstreak w(D) windicates wvein wirritation wand wnecessitates wdiscontinuing wthe wIV wat wthe
wpresent wsite. wA, wB, wand wC ware windications wfor wrelocating wthe wIV wsite wor wother wimmediate
wintervention.
A wclient wwith wa wliver wabscess wdevelops wseptic wshock. wA wsepsis wresuscitation wbundle wprotocol
wis winitiated wand wthe wclient wreceives wa wbolus wof wIV wfluids. wWhich wparameter wshould wthe
wnurse wmonitor wto wassess weffectiveness wof wthe wfluid wbolus?
A) Blood wcultures.
B) Oxygen wsaturation.
C) White wblood wcount.
D) Mean warterial wpressure w(MAP). w- wCORRECT wANSWER w-D) wMean warterial wpressure w(MAP)
The wcornerstone wof winitial wsepsis wresuscitation wis wfluid wvolume wadministration wto wrestore wand
wthen wmaintain wMAP wof wat wleast w65 wmmHg.
, When wattempting wto westablish wrisk wreduction wstrategies win wa wcommunity, wthe wnurse wnotes wthat
wregional wstudies windicate wa whigh wnumber wof wpersons wwith wgrowth wstunting wand wirreversible
wmental wdeficiencies w(cretinism) wcaused wby whypothyroidism. wThe wnurse wshould wseek wfunding wto
wimplement wwhich wscreening wmeasure?
A) T4 wlevels win wnewborns.
B) TSH wlevels win wwomen wover w45.
C) T3 wlevels win wschool-aged wchildren
D) Iodine wlevels win wall wpersons wover w60. w- wCORRECT wANSWER w-A) wT4 wlevels win wnewborns.
Screening wfor wlow wT4 wlevels win wnewborns wwith wfollow-up wtreatment wcan wreduce wthe wrisk wfor
wirreversible wgrowth wstunting wand wmental wdeficiencies wcaused wby wcongenital whypothyroidism.
For wthe wpast w24 whours, wan wantidiarrheal wagent, wdiphenoxylate, whas wbeen wadministered wto wa
wbedridden, wolder wclient wwith winfectious wgastroenteritis. wWhich wfinding wrequires wthe wnurse wto
wtake wfurther waction?
A) Loss wof wappetite
B) Serum wK+ w4.0 wmEq/L wor wmmol/L w(SI)
C) Loose, wrunny wstools.
D) Tented wskin wturgor. w- wCORRECT wANSWER w-D) wTented wskin wturgor.
Indicates wdehydration, wa wserious wcomplication wfollowing wprolonged wdiarrhea wthat wrequires
wfurther wintervention wby wthe wnurse.
A wmale wclient wwith wulcerative wcolitis wreceived wan wRx wfor wa wcorticosteroid wlast wmonth wbut
wbecause wof wthe wS/E, whe wstopped wtaking wthe wmedications w6 wdays wago. wWhich wfinding
wwarrants wimmediate wintervention wby wthe wnurse?
A) Fluid wretention
EXAM QUESTIONS AND
ANSWERS
A client presents at the ED complaining of a raspy voice, cold intolerance, and fatigue. Lab tests indicate
an elevated TSH and low T3 and T4 levels. After the client is admitted to the telemetry unit, which
intervention is most important for the nurse to implement?
A) Assess for presence of non-pitting edema.
B) Administer the prescribed dose of levothyroxine.
C) Offer additional blankets and a warm drink.
D) Note client's most recent hemoglobin levels. - CORRECT ANSWER -B) Administer the prescribed dose
of levothyroxine.
Rationale: In the negative feedback mechanism of hypothyroidism, a low level of thyroid hormone
stimulates TSH production by the hypothalamus and results in an elevated TSH level, but the thyroid
gland does not respond with wadequate wproduction wof wT3 wand wT4 wto wregulate wbasal wmetabolic
wrate. wThese wserum whormone wlevels windicate wthe wneed wto wadminister wsupplementary wthyroid
whormone was wsoon was wpossible wto wavert wpossible wmyxedema wcoma. wNon-pitting wedema wis
wseen win wchronic whypothyroidism wand wassessment wof wthe wpresence wand wlocation wof wthe
wedema w(A) wis wnot wa wtop wpriority. wProviding wwarmth w(C) wis wbeneficial wbut wof wless wpriority
wthan w(B). wAnemia wis wcommon win whypothyroidism, wbut w(D) wis wof wlower wpriority wthan
winitiating wtreatment wto wprevent wmyxedema wcoma.
The wnurse wsuspects wthat wa wclient wmight wbe whemorrhaging winternally. wWhich wfindings wof wan
worthostatic wtilt wtest ware wa wmost wlikely windication wof wa wmajor wbleed w(> w1000 wml)?
A) A wdecrease win wthe wsystolic wBP wof w10 wmm wHg wwith wa wcorresponding wincrease win wthe wHR wof
w20.
,B) A wdecrease win wthe wsystolic wBP wof w10 wmm wHg wwith wa wcorresponding wdecrease win wthe wHR wof
w20.
C) A wdecrease win wthe wsystolic wBP wof w20 wmm wHg wwith wa wcorresponding wdecrease win wthe wHR wof
w10.
D) A wdecrease win wthe wsystolic wBP wof w20 wmm wHg wwith wa wcorresponding wincrease win wthe wHR
wof w10. w- wCORRECT wANSWER w-Ans: wA) wA wdecrease win wthe wsystolic wBP wof w10 wmm wHg wwith
wa wcorresponding wincrease win wthe wHR wof w20.
Rationale: wThe wloss wof wcirculatory wvolume wresults win wa w10 wmm wHg wdrop win wthe wsystolic
wpressure, wwhile wthe wHR wincreases wby w20 w% wabove wnormal was wa wcompensatory wresponse
wto wthe wlow wpressure.
When wconducting wdiet wteaching wfor wa wclient wwho wis won wa wpostoperative wfull wliquid wdiet,
wwhich wfoods wshould wthe wnurse wencourage wthe wclient wto weat? wSATA.
A) Canned wfruit wcocktail
B) Creamy wpeanut wbutter
C) Vegetable wjuice
D) Vanilla wfrozen wyogurt
E) Clear wbeef wbroth w- wCORRECT wANSWER w-Ans: wC, wD, wE
A wfull wliquid wdiet wincludes wall wliquids wthat ware wnot wclear wsuch was wvegetable wjuice wand
wfrozen wyogurt, was wwell was wclear wliquids. wPieces wof wfruit was wfound win wfruit wcocktail wand
wpeanut wbutter ware wnot wconsidered wliquids.
A wclient wis wreceiving wophthalmic wdrops wpreoperatively wfor wa wcataract wextraction wand wasks wthe
wnurse wwhy whe wis wprescribed wall wthese wmedications? wSATA.
A) One wof wthe wmedications wis wused wto wanesthetize wthe wcorneal wsurface.
B) The wiris wmust wbe wparalyzed wduring wthe wsurgery wto wprevent wit wfrom wreacting wto wlight.
C) Medication wis wused wto winduce wsleep wduring wthe wprocedure.
D) Pupillary wdilation wis wnecessary wto waccess wthe weye wchamber wfor wlens wremoval.
,E) These wmeds wassist win wobstructing wthe wclient's wvision wduring wthe wsurgery. w- wCORRECT
wANSWER w-Ans: wA, wB, wD
Cataract wsurgery wis waccessed wthrough wthe wcornea wusing weyelid wretractors wwhile wthe wclient wis
wawake. wIt wis wnecessary wto wanesthetize wthe wcorneal wsurface w(A), wparalyze wthe wciliary wbody
w(B), wand wprovide wpupil wdilation w(D)(mydriasis) wto wfacilitate waccess wto wthe wlens wwhich wties
wbehind wthe wiris w(posterior wchamber wof wthe wanterior wcavity). wA wsedative wmay wbe wadministered
wto wreduce wanxiety wbut wit wis wnot wused wto winduce wsleep. w(C) wCloudy wvision wmay wbe wa wside
weffect wof wthese wagents, wbut wthe wclient wwill wstill wbe wable wto wsee wduring wthe wsurgery w(E).
When wassessing wan wIV wsite wthat wis wsued wfor wfluid wreplacement wand wmedication wadministration,
wthe wclient wcomplains wof wthe wtenderness wwhen wthe warm wis wtouched wabove wthe wsite. wWhich
wadditional wassessment wwarrants wimmediate wintervention wby wthe wnurse?
A) Sluggish wblood wreturn
B) Client wuses wthe warm wcautiously
C) Spot wof wdried wblood wat wthe winsertion wsite
D) Red wstreak wtracking wthe wvein w- wCORRECT wANSWER w-Ans: wD
A wred wstreak w(D) windicates wvein wirritation wand wnecessitates wdiscontinuing wthe wIV wat wthe
wpresent wsite. wA, wB, wand wC ware windications wfor wrelocating wthe wIV wsite wor wother wimmediate
wintervention.
A wclient wwith wa wliver wabscess wdevelops wseptic wshock. wA wsepsis wresuscitation wbundle wprotocol
wis winitiated wand wthe wclient wreceives wa wbolus wof wIV wfluids. wWhich wparameter wshould wthe
wnurse wmonitor wto wassess weffectiveness wof wthe wfluid wbolus?
A) Blood wcultures.
B) Oxygen wsaturation.
C) White wblood wcount.
D) Mean warterial wpressure w(MAP). w- wCORRECT wANSWER w-D) wMean warterial wpressure w(MAP)
The wcornerstone wof winitial wsepsis wresuscitation wis wfluid wvolume wadministration wto wrestore wand
wthen wmaintain wMAP wof wat wleast w65 wmmHg.
, When wattempting wto westablish wrisk wreduction wstrategies win wa wcommunity, wthe wnurse wnotes wthat
wregional wstudies windicate wa whigh wnumber wof wpersons wwith wgrowth wstunting wand wirreversible
wmental wdeficiencies w(cretinism) wcaused wby whypothyroidism. wThe wnurse wshould wseek wfunding wto
wimplement wwhich wscreening wmeasure?
A) T4 wlevels win wnewborns.
B) TSH wlevels win wwomen wover w45.
C) T3 wlevels win wschool-aged wchildren
D) Iodine wlevels win wall wpersons wover w60. w- wCORRECT wANSWER w-A) wT4 wlevels win wnewborns.
Screening wfor wlow wT4 wlevels win wnewborns wwith wfollow-up wtreatment wcan wreduce wthe wrisk wfor
wirreversible wgrowth wstunting wand wmental wdeficiencies wcaused wby wcongenital whypothyroidism.
For wthe wpast w24 whours, wan wantidiarrheal wagent, wdiphenoxylate, whas wbeen wadministered wto wa
wbedridden, wolder wclient wwith winfectious wgastroenteritis. wWhich wfinding wrequires wthe wnurse wto
wtake wfurther waction?
A) Loss wof wappetite
B) Serum wK+ w4.0 wmEq/L wor wmmol/L w(SI)
C) Loose, wrunny wstools.
D) Tented wskin wturgor. w- wCORRECT wANSWER w-D) wTented wskin wturgor.
Indicates wdehydration, wa wserious wcomplication wfollowing wprolonged wdiarrhea wthat wrequires
wfurther wintervention wby wthe wnurse.
A wmale wclient wwith wulcerative wcolitis wreceived wan wRx wfor wa wcorticosteroid wlast wmonth wbut
wbecause wof wthe wS/E, whe wstopped wtaking wthe wmedications w6 wdays wago. wWhich wfinding
wwarrants wimmediate wintervention wby wthe wnurse?
A) Fluid wretention
