HESI RN FUNDAMENTALS EXIT EXAM PREP –
2025/2026 COMPREHENSIVE STUDY GUIDE WITH
VERIFIED Q&A GRADED A+
The nurse is preparing to administer 10 mL of liquid potassium chloride through a feeding
tube, followed by 10 mL of liquid acetaminophen. Which action should the nurse include in
this procedure?
A.
Dilute each of the medications with sterile water prior to administration.
B.
Mix the medications in one syringe before opening the feeding tube.
C.
Administer water between the doses of the two liquid medications.
D.
Withdraw any fluid from the tube before instilling each medication.
C
Rationale: Water should be instilled into the feeding tube between administering the two
medications to maintain the patency of the feeding tube and ensure that the total dose of
medication enters the stomach and does not remain in the tube. These liquid medications
do not need to be diluted when administered via a feeding tube and should be
administered separately, with water instilled between each medication.
The nurse is making an initial daily assessment at 0715 and notes 550 mL of LR running at
75 mL an hour. At what time, in military time, will the nurse hang the next bag of IV fluid?
_____.
1435
60 min × 0.33333 = 19.99 min = 20 min7 hr 20 min + 0715 = 1435
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The nurse is teaching a group of young adults with families about preparing their
underground shelter in the event of a tornado. What instructions will the nurse include in
teaching plan for these families? (Select all that apply.)
A.
Place two electric lights in the shelter.
B.
Plan for 1 gallon of water per family member for at least 3 days.
C.
Don't forget a can opener with the supply of canned food.
D.
Make sure you include a first aid kit in the shelter.
E.
Pack shoes with sturdy soles and they must completely cover the feet.
B, C, D, E
Rationale: The lights need to be battery powered and not rely on electricity. The remaining
items are necessary emergency supplies.
The nurse is using the Glasgow Coma Scale to perform a neurologic assessment. A
comatose client winces and pulls away from a painful stimulus. Which action should the
nurse take next?
A.
Document that the client responds to painful stimulus.
B.
Observe the client's response to verbal stimulation.
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C.
Place the client on seizure precautions for 24 hours.
D.
Report decorticate posturing to the health care provider.
A
Rationale: The client has demonstrated a purposeful response to pain, which should be
documented as such. Response to painful stimulus is assessed after response to verbal
stimulus, not before. There is no indication for placing the client on seizure precautions.
Reporting decorticate posturing to the health care provider is a nonpurposeful movement.
While conducting an intake assessment of an adult client at a community mental health
clinic, the nurse notes that the client's affect is flat, responds to questions with short
answers, and reports problems with sleeping. At the end of the intake assessment, the
client reveals the loss of a life partner 1 month ago. What is the nurse's best action for this
client?
A.
Encourage the client to see the clinic's grief counselor.
B.
Determine if the client has a family history of suicide attempts.
C.
Inquire about whether the life partner was suffering from AIDS.
D.
Consult with the health care provider about the client's need for antidepressant
medications.
A
Rationale: The client is exhibiting normal grieving behaviors, so referral to a grief counselor
is the most important intervention for the nurse to implement. Option B is indicated but is
not a high-priority intervention. Option C is irrelevant at this time but might be important
EDUCATIONAL SUPPORT • ACADEMIC RESOURCES • PROFESSIONAL GUIDANCE
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when determining the client's risk for contracting the illness. An antidepressant may be
indicated, depending on further assessment, but grief counseling is a better action at this
time because grief is an expected reaction to the loss of a loved one.
The nurse who is preparing to give a 14-year-old client a prescribed antipsychotic
medication notes that parental consent has not been obtained. Which action should the
nurse take?
A.
Review the chart for a signed consent for hospitalization.
B.
Get the health care provider's permission to give the medication.
C.
Do not give the medication and document the reason.
D.
Complete an incident report and notify the parents.
C
Rationale: The nurse should not give the medication and should document the reason
because the client is a minor and needs a guardian's permission to receive medications.
Permission to give medications is not granted by a signed hospital consent or a health care
provider's permission, unless conditions are met to justify coerced treatment. Option D is
not necessary unless the medication had previously been administered.
After the nurse tells an older client that an IV line needs to be inserted, the client becomes
very apprehensive, loudly verbalizing a dislike for all health care providers and nurses. How
should the nurse respond?
A.
Ask the client to remain quiet so the procedure can be performed safely.
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