HESI RN EXIT EXAM 800 QUESTIONS AND
ANSWERS WITH RATIONALE
Following discharge teaching, a male client with duodenal ulcer tells the nurse
the he will drink plenty of dairy products, such as milk, to help coat and protect
his ulcer. What is the best follow-up action by the nurse?
a. Remind the client that it is also important to switch to decaffeinated coffee
and tea.
b. Suggest that the client also plan to eat frequent small meals to reduce
discomfort
c. Review with the client the need to avoid foods that are rich in milk and
cream.
d. Reinforce this teaching by asking the client to list a dairy food that he might
select.
Review with the client the need to avoid foods that are rich in milk and cream
Rationale: Diets rich in milk and cream stimulate gastric acid secretion and should
be avoided.
A low-risk primigravida at 28-weeks gestation arrives for her regular antepartal
clinic visit. Which assessment finding should the nurse consider within normal
limits for this client?
a. Pulse increase of 10 beats/minute
b. Proteinuria
c. Glucosuria
d. Fundal height 0f 22 centimeters
,Pulse increase of 10 beats/minute
Rationale: Blood volume increases 25 to 40 % in pregnancy which increases
cardiac output and increases heart rate by approx. 10 to 20 beats/ mints.
Proteinuria is for preeclampsia, Glucosuria is for gestational diabetes. A fundal
height for 28 weeks should be at 28 cm not 22
A client who is admitted to the intensive care unit with a right chest tube
attached to a THORA-SEAL chest drainage unit becomes increasingly anxious
and complain of difficulty breathing. The nurse determine the client is
tachypneic with absent breath sounds in the client's right lungs fields. Which
additional finding indicates that the client has developed a tension
pneumothorax?
a. Continuous bubbling in the water seal chamber
b. Decrease bright red blood drainage
c. Tachypnea and difficulty breathing
d. Tracheal deviation toward the left lung.
Tracheal deviation toward the left lung.
Rationale: Tracheal deviation toward the unaffected left lung with absent breath
sounds over the affected right lung are classic late signs of a tension
pneumothorax.
A client with chronic alcoholism is admitted with a decreased serum magnesium
level. Which snack option should the nurse recommend to this client?
a. Cheddar cheese and crackers.
b. Carrot and celery sticks.
c. Beef bologna sausage slices.
d. Dry roasted almonds.
Dry roasted almonds.
Rational: alcoholism promotes inadequate food intake and gastrointestinal loss of
,magnesium include green leafy vegetables and nuts and seeds. Other snacks
listed provide much lower amounts of magnesium per serving.
The nurse discovers that an elderly client with no history of cardiac or renal
disease has an elevated serum magnesium level. To further investigate the
cause of this electrolyte imbalance, what information is most important for the
nurse to obtain from the client's medical history?
a. Genetically inherited disorders of family members
b. Length and frequency of the client's tobacco use.
c. Ingestion of selfish or fish oil capsules daily.
d. Frequency of laxative use for chronic constipation
Frequency of laxative use for chronic constipation
Rationale: Elderly clients are at risk of developing hypermagnesemia as a result of
chronic laxative abuse.
Which action should the nurse implement with auscultating anterior breath
sounds? (Place the first action on top and last action on the bottom)
Correct order: PADD
1. Place stethoscope in suprasternal area to auscultate for bronchial sounds
2. Auscultate bronchovesicular sounds from side to side the first and second
intercostal spaces
3. Displace female breast tissue and apply stethoscope directly on chest wall to
hear vesicular sounds
4. Document normal breath sounds and location of adventitious breath sounds
Correct order: (PADD)
The nurse is preparing a teaching plan for an older female client diagnosed with
osteoporosis. What expected outcome has the highest priority for this client?
a. Identifies 2 treatments for constipation due to immobility.
b. Names 3 home safety hazards to be resolve immediately.
, c. State 4 risk factors for the development of osteoporosis.
d. Lists 5 calcium-rich foods to be added to her daily diet.
Names 3 home safety hazards to be resolve immediately
Rational: a major teaching goal for an elderly client with osteoporosis is
maintenance of safety to prevent falls. Injury due to a fall, usually resulting in a
hip fracture, can result in reduced mobility and associated complications. Other
goals are also important when teaching clients who have osteoporosis, but they
do not have the priority of preventing falls, which relates to safety.
The nurse is teaching a male adolescent recently diagnosed with type 1 diabetes
mellitus (DM) about self-injecting insulin. Which approach is best for the nurse
to use to evaluate the effectiveness of the teaching?
a. Ask the adolescent to describe his level of comfort with injecting himself with
insulin.
b. Observe him as he demonstrates self-injection technique in another diabetic
adolescent
c. Have the adolescent list the procedural steps for safe insulin administration.
d. Review his glycosylated hemoglobin level 3 months after the teaching
session.
c. Have the adolescent list the procedural steps for safe insulin administration.
A mother runs into the emergency department with s toddler in her arms and
tells the nurse that her child got into some cleaning products. The child smells of
chemicals on hands, face, and on the front of the child's clothes. After ensuring
the airway is patent, what action should the nurse implement first?
a. Call poison control emergency number.
b. Determine type of chemical exposure.
c. Obtain equipment for gastric lavage.
d. Assess child for altered sensorium.
Determine type of chemical exposure.
Rational: once the type of chemical is determined, poison control should be called
ANSWERS WITH RATIONALE
Following discharge teaching, a male client with duodenal ulcer tells the nurse
the he will drink plenty of dairy products, such as milk, to help coat and protect
his ulcer. What is the best follow-up action by the nurse?
a. Remind the client that it is also important to switch to decaffeinated coffee
and tea.
b. Suggest that the client also plan to eat frequent small meals to reduce
discomfort
c. Review with the client the need to avoid foods that are rich in milk and
cream.
d. Reinforce this teaching by asking the client to list a dairy food that he might
select.
Review with the client the need to avoid foods that are rich in milk and cream
Rationale: Diets rich in milk and cream stimulate gastric acid secretion and should
be avoided.
A low-risk primigravida at 28-weeks gestation arrives for her regular antepartal
clinic visit. Which assessment finding should the nurse consider within normal
limits for this client?
a. Pulse increase of 10 beats/minute
b. Proteinuria
c. Glucosuria
d. Fundal height 0f 22 centimeters
,Pulse increase of 10 beats/minute
Rationale: Blood volume increases 25 to 40 % in pregnancy which increases
cardiac output and increases heart rate by approx. 10 to 20 beats/ mints.
Proteinuria is for preeclampsia, Glucosuria is for gestational diabetes. A fundal
height for 28 weeks should be at 28 cm not 22
A client who is admitted to the intensive care unit with a right chest tube
attached to a THORA-SEAL chest drainage unit becomes increasingly anxious
and complain of difficulty breathing. The nurse determine the client is
tachypneic with absent breath sounds in the client's right lungs fields. Which
additional finding indicates that the client has developed a tension
pneumothorax?
a. Continuous bubbling in the water seal chamber
b. Decrease bright red blood drainage
c. Tachypnea and difficulty breathing
d. Tracheal deviation toward the left lung.
Tracheal deviation toward the left lung.
Rationale: Tracheal deviation toward the unaffected left lung with absent breath
sounds over the affected right lung are classic late signs of a tension
pneumothorax.
A client with chronic alcoholism is admitted with a decreased serum magnesium
level. Which snack option should the nurse recommend to this client?
a. Cheddar cheese and crackers.
b. Carrot and celery sticks.
c. Beef bologna sausage slices.
d. Dry roasted almonds.
Dry roasted almonds.
Rational: alcoholism promotes inadequate food intake and gastrointestinal loss of
,magnesium include green leafy vegetables and nuts and seeds. Other snacks
listed provide much lower amounts of magnesium per serving.
The nurse discovers that an elderly client with no history of cardiac or renal
disease has an elevated serum magnesium level. To further investigate the
cause of this electrolyte imbalance, what information is most important for the
nurse to obtain from the client's medical history?
a. Genetically inherited disorders of family members
b. Length and frequency of the client's tobacco use.
c. Ingestion of selfish or fish oil capsules daily.
d. Frequency of laxative use for chronic constipation
Frequency of laxative use for chronic constipation
Rationale: Elderly clients are at risk of developing hypermagnesemia as a result of
chronic laxative abuse.
Which action should the nurse implement with auscultating anterior breath
sounds? (Place the first action on top and last action on the bottom)
Correct order: PADD
1. Place stethoscope in suprasternal area to auscultate for bronchial sounds
2. Auscultate bronchovesicular sounds from side to side the first and second
intercostal spaces
3. Displace female breast tissue and apply stethoscope directly on chest wall to
hear vesicular sounds
4. Document normal breath sounds and location of adventitious breath sounds
Correct order: (PADD)
The nurse is preparing a teaching plan for an older female client diagnosed with
osteoporosis. What expected outcome has the highest priority for this client?
a. Identifies 2 treatments for constipation due to immobility.
b. Names 3 home safety hazards to be resolve immediately.
, c. State 4 risk factors for the development of osteoporosis.
d. Lists 5 calcium-rich foods to be added to her daily diet.
Names 3 home safety hazards to be resolve immediately
Rational: a major teaching goal for an elderly client with osteoporosis is
maintenance of safety to prevent falls. Injury due to a fall, usually resulting in a
hip fracture, can result in reduced mobility and associated complications. Other
goals are also important when teaching clients who have osteoporosis, but they
do not have the priority of preventing falls, which relates to safety.
The nurse is teaching a male adolescent recently diagnosed with type 1 diabetes
mellitus (DM) about self-injecting insulin. Which approach is best for the nurse
to use to evaluate the effectiveness of the teaching?
a. Ask the adolescent to describe his level of comfort with injecting himself with
insulin.
b. Observe him as he demonstrates self-injection technique in another diabetic
adolescent
c. Have the adolescent list the procedural steps for safe insulin administration.
d. Review his glycosylated hemoglobin level 3 months after the teaching
session.
c. Have the adolescent list the procedural steps for safe insulin administration.
A mother runs into the emergency department with s toddler in her arms and
tells the nurse that her child got into some cleaning products. The child smells of
chemicals on hands, face, and on the front of the child's clothes. After ensuring
the airway is patent, what action should the nurse implement first?
a. Call poison control emergency number.
b. Determine type of chemical exposure.
c. Obtain equipment for gastric lavage.
d. Assess child for altered sensorium.
Determine type of chemical exposure.
Rational: once the type of chemical is determined, poison control should be called
