HESI EXIT EXAM STUDY | COMPLETE QUESTIONS AND DETAILED VERIFIED ANSWERS AND A+ GRADE

EXIT HESI -PN Exam A PRACTICE
Questions and Answers with complete solution


1. A nurse who has recently completed orientation is beginning work in the labor and delivery uni
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t for the first time.When making assignments, which client should the charge nurse assign to this ne
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w nurse? l




A.A primigravida who is 8 cm dilated after 14 hours of labor
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B.A client scheduled for a repeat cesarean birth at 38 weeks' gestation
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C.A client being induced for fetal demise at 20 weeks' gestation
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D.A multiparous client who is dilated 5 cm and 50% effaced (ANSWER) D
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The new nurse should be assigned the least complicated client to gain experience and confidence,
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as well as protect client safety.Of the clients available for assign-
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ment, (D)is progressing well and is the least complicated.(A, B and C) have actual or potential compli
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cations and should be assigned to a more experienced nurse. l l l l l l l l l




2. A client with human immunodeficiency virus (HIV) infection has white lesions in the oral cavity that
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resemble milk curds. Nystatin (Mycostatin) preparationis prescribed as a swish and swallow.Whic
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h information is most important for the nurse to provide the client?
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A. Oral hygieneshouldbeperformedbeforethemedication.B.Antifungalmed-l l l l l l l l l


ications are available in tablet, suppository, and liquid forms.
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C. Candida albicans is the organism that causes the white lesions in the mouth. l l l l l l l l l l l l


D. The dietary intake of dairy and spicy foods should be limited. (ANSWER) A
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HIV infection causes depression of cell-mediated immunity that allows an over-
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growthofCandidaalbicans(oralmoniliasis),whichappearsaswhite,cheesyplaque or lesions that re
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semble milk curds.To ensure effective contact of the medication with the oral lesions, oral liquids sho
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uld be consumed and oral hygiene performed beforeswishingtheliquidMycostatin(A).(BandC)pr
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ovidetheclientwithadditional informationaboutthepathogenesisandtreatmentofopportunisticinf
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ections,but(A) allows the client to participate in self- l l l l l l l l l


care of the oral infection.Dietary restriction of spicy foods reduces discomfort associated with stom
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atitis, but restriction of dairy products is not indicated (D).
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3. A client who is admitted with emphysema is having difficulty breathing.In which position should t
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he nurse place the client?
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,A.High Fowler's position without a pillow behind the head B.Semi-
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Fowler's position with a single pillow behind the head
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C.Right side-
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lying position with the head of the bed elevated 45 degrees D.Sitting upright and forward with bot
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arms supported on an over the bed table (ANSWER) D
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,Adequate lung expansion is dependent on deep breaths that allow the respiratory musclestoincrea l l l l l l l l l l l l l l


ethelongitudinalandanterior-
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posteriorsizeofthethoraciccage. Sittinguprightandleaningforwardwiththearmssupportedonan
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erthebedtable l l l


(D)allowsthethoraciccage toexpandinall fourdirections andreduces dyspnea.A high Fowler's pos
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ition does not allow maximum expansion of the posterior lobes of the lungs (A).A semi-
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Fowler's position restricts expansion of the anterior- l l l l l l


posterior diameterofthethoraciccage (B).Positioning aclient onthe rightsidewiththe head of the be
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d elevated (C) does not facilitate lung expansion.
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4. A client with chronic renal insufficiency (CRI) is taking 25 mg of hy-
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drochlorothiazide(HCTZ)POand40mgoffurosemide(Lasix)POdaily.Today, at a routine clinic visit
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,the client's serum potassium level is 4 mEq/L.What is the most likely cause of this client's potassium le
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vel?

A. The client is noncompliant with his medications. l l l l l l


B. The client recently consumed large quantities of pears or nuts.
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C. The client's renal function has affected his potassium level.l l l l l l l l


D. The client needs to be started on a potassium supplement. (ANSWER) C
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Theclienthasanormalizedpotassiumleveldespitediureticuse(C).Thekidneyau-
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tomatically secretes 90% ofpotassium consumed, butin chronic renal insufficiency (CRI),lesspotassiu
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misexcretedthannormal.Therefore,thetwopotassium-
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wasting drugs, a thiazide diuretic and loop diuretic, are not likely to affect potassium levels. Thenorm
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alpotassiumlevelis3.5to5mEq/L,andwithapotassiumlevelof4mEq/L, there is no reason to believe t
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at the client is noncompliant with his treatment (A). Pears and nuts do not affect the serum potassium le
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el (B).There is no need for a potassium supplement (D)because the client's potassiumlevel iswithinthe
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ormal range. l




5. Aregisterednurse(RN)deliverstelehealthservicestoclientsviaelectronic communication.Which
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nursingactioncreatesthegreatestriskforprofession- l l l l l l l


al liability and has the potential for a malpractice lawsuit?
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A. Participating in telephone consultations with clients l l l l l


B. Identifying oneself by name and title to clients in telehealth communica- tions l l l l l l l l l l l


C. Sending medical records to health care providers via the Internet D.Answering a clie l l l l l l l l l l l l


nt-initiated health questionvia electronicmail (ANSWER) C l l l l l l ll


Sending medical records over the Internet, even with the latest security protection, createsthe grea
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test riskforliabilitybecauseofthe highpotentialofbreachingclient confidentiality and the amount o
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f information being transferred (C).Client confiden-
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tiality is protected by federal wiretapping laws making telephone consultation (A) a
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, privateandprotected formofcommunication.By statingone'sname andcredentials intelehealthcom
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munication(B),oneistakingresponsibilityfortheencounter.E- l l l l l l l l l


mail initiated by the client (D) poses less risk than sending records via the Internet.
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6. Which pathophysiologic response supports the contraindication for opi-
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oids,such as morphine,in clients with increased intracranial pressure (ICP)?
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A. Sedation produced by opioids is a result of a prolonged half-life when the ICP is elevated. l l l l l l l l l l l l l l l


B.Higher doses of opioids are required when cerebral blood flow is reduced by an elevated ICP.
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C. Dysphoriafromopioidscontributestoalteredlevelsofconsciousnesswith an elevated ICP. l l l l l l l l l l l l


D. Opioidssuppressrespirations,whichincreasesPco2andcontributestoan elevated ICP. (ANSWEl l l l l l l l l l l l


R) D ll


The greatest risk associated with opioids such as morphine (D) is respiratory depression that causes
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increase in Pco2, which increases ICP and masks the early signs of intracranial bleeding in head injur
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(A, B, and C) do not support the risks associated with opioid use in a client with increased ICP.
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7. The charge nurse of a medical surgical unit is alerted to an impending disaster requiring imple
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mentation of the hospital's disaster plan. Specific facts about the nature of this disaster are not ye
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t known.Which instruction should the charge nurse give to the other staff members at this time?
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A. Prepare to evacuate the unit, starting with the bedridden clients. B.UAPs should report l l l l l l l l l l l l l


to the emergency center to handle transports.
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C. The licensed staff should begin counting wheelchairs and IV poles on the unit.
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D. Continuewithcurrentassignmentsuntilmoreinstructionsarereceived. (ANSWER) D When faced l l l l l l l l l ll l l


with an impending disaster, hospital personnel may be alerted but should continue with current clie
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nt care assignments until further instructions are received(D).Evacuationistypicallyaresponseoflas
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tresortthatbeginswithclients who are most able to ambulate (A). (B) is premature and is likely to incr
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ease the chaos if incoming casualties are anticipated. (C) is poor utilization of personnel.
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8. The nurse assesses a client while the UAP measures the client's vital signs.The client's vital signs
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change suddenly, and the nurse determines that the client's condition is worsening.The nurse is un
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sure of the client's resuscitative status and needs to check the client's medical record for any adva
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nced directives.Which action should the nurse implement?
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