HESI 799 RN Exit Exam questions with
Rationale Answers Graded A+
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. |- |Ans-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 |male |client |with |hypertension, |who |received |new |antihypertensive |prescriptions |at |his |last |visit
| returns |to |the |clinic |two |weeks |later |to |evaluate |his |blood |pressure |(BP). |His |BP |is |158/106 |and |he
|admits |that |he |has |not |been |taking |the |prescribed |medication |because |the |drugs |make |him |"feel
|bad". |In |explaining |the |need |for |hypertension |control, |the |nurse |should |stress |that |an |elevated |BP
|places |the |client |at |risk |for |which |pathophysiological |condition?
a. Blindness |secondary |to |cataracts
b. Acute |kidney |injury |due |to |glomerular |damage
c. Stroke |secondary |to |hemorrhage
d. Heart |block |due |to |myocardial |damage |- |Ans-Stroke |secondary |to |hemorrhage
Rationale: |Stroke |related |to |cerebral |hemorrhage |is |major |risk |for |uncontrolled |hypertension.
The |nurse |observes |an |unlicensed |assistive |personnel |(UAP) |positioning |a |newly |admitted |client |who
|has |a |seizure |disorder. |The |client |is |supine |and |the |UAP |is |placing |soft |pillows |along |the |side |rails.
|What |action |should |the |nurse |implement?
,a. Ensure |that |the |UAP |has |placed |the |pillows |effectively |to |protect |the |client.
b. Instruct |the |UAP |to |obtain |soft |blankets |to |secure |to |the |side |rails |instead |of |pillows.
c. Assume |responsibility |for |placing |the |pillows |while |the |UAP |completes |another |task.
d. Ask |the |UAP |to |use |some |of |the |pillows |to |prop |the |client |in |a |side |lying |position. |- |Ans-Instruct
|the |UAP |to |obtain |soft |blankets |to |secure |to |the |side |rails |instead |of |pillows
Rationale: |The |nurse |should |instruct |the |UAP |to |pad |the |side |rails |with |soft |blankest |because |the
|use |of |pillows |could |result |in |suffocation |and |would |need |to |be |removed |at |the |onset |of |the |seizure.
|The |nurse |can |delegate |paddling |the |side |rails |to |the |UAP
An |adolescent |with |major |depressive |disorder |has |been |taking |duloxetine |(Cymbalta) |for |the |past |12
|days. |Which |assessment |finding |requires |immediate |follow-up
a. Describes |life |without |purpose
b. Complains |of |nausea |and |loss |of |appetite
c. States |is |often |fatigued |and |drowsy
d. Exhibits |an |increase |in |sweating. |- |Ans-Describes |life |without |purpose
Rationale: |Cymbalta |is |a |selective |serotonin |and |norepinephrine |reuptake |inhibitor |that |is |known |to
|increase |the |risk |of |suicidal |thinking |in |adolescents |and |young |adults |with |major |depressive |disorder.
|B, |C |and |D |are |side |effects
A |60-year-old |female |client |with |a |positive |family |history |of |ovarian |cancer |has |developed |an
|abdominal |mass |and |is |being |evaluated |for |possible |ovarian |cancer. |Her |Papanicolau |(Pap) |smear
|results |are |negative. |What |information |should |the |nurse |include |in |the |client's |teaching |plan
a. Further |evaluation |involving |surgery |may |be |needed
b. A |pelvic |exam |is |also |needed |before |cancer |is |ruled |out
c. Pap |smear |evaluation |should |be |continued |every |six |month
,d. One |additional |negative |pap |smear |in |six |months |is |needed. |- |Ans-Further |evaluation |involving
|surgery |may |be |needed
Rationale: |An |abdominal |mass |in |a |client |with |a |family |history |for |ovarian |cancer |should |be |evaluated
|carefully
A |client |who |recently |underwent |a |tracheostomy |is |being |prepared |for |discharge |to |home. |Which
|instructions |is |most |important |for |the |nurse |to |include |in |the |discharge |plan?
a. Explain |how |to |use |communication |tools.
b. Teach |tracheal |suctioning |techniques
c. Encourage |self-care |and |independence.
d. Demonstrate |how |to |clean |tracheostomy |site. |- |Ans-Teach |tracheal |suctioning |techniques
Rationale: |Suctioning |helps |to |clear |secretions |and |maintain |an |open |airway, |which |is |critical.
In |assessing |an |adult |client |with |a |partial |rebreather |mask, |the |nurse |notes |that |the |oxygen |reservoir
|bag |does |not |deflate |completely |during |inspiration |and |the |client's |respiratory |rate |is |14 |breaths |/
|minute.
What |action |should |the |nurse |implement
a. Encourage |the |client |to |take |deep |breaths
b. Remove |the |mask |to |deflate |the |bag
c. Increase |the |liter |flow |of |oxygen
d. Document |the |assessment |data |- |Ans-Document |the |assessment |data
Rational: |reservoir |bag |should |not |deflate |completely |during |inspiration |and |the |client's |respiratory
|rate |is |within |normal |limits.
During |shift |report, |the |central |electrocardiogram |(EKG) |monitoring |system |alarms. |Which |client |alarm
|should |the |nurse |investigate |first?
, a. Respiratory |apnea |of |30 |seconds
b. Oxygen |saturation |rate |of |88%
c. Eight |premature |ventricular |beats |every |minute
d. Disconnected |monitor |signal |for |the |last |6 |minutes. |- |Ans-Respiratory |apnea |of |30 |seconds
Rationale: |The |priority |is |the |client |whose |alarm |indicating |respiratory |apnea |that |should |be |assessed
|first.
During |a |home |visit, |the |nurse |observed |an |elderly |client |with |diabetes |slip |and |fall. |What |action
|should |the |nurse |take |first?
a. Give |the |client |4 |ounces |of |orange |juice
b. Call |911 |to |summon |emergency |assistance
c. Check |the |client |for |lacerations |or |fractures
d. Asses |clients |blood |sugar |level |- |Ans-Check |the |client |for |lacerations |or |fractures
Rationale: |After |the |client |falls, |the |nurse |should |immediately |assess |for |the |possibility |of |injuries |and
|provide |first |aid |as |needed
At |0600 |while |admitting |a |woman |for |a |schedule |repeat |cesarean |section |(C-Section), |the |client |tells
|the |nurse |that |she |drank |a |cup |a |coffee |at |0400 |because |she |wanted |to |avoid |getting |a |headache.
|Which |action |should |the |nurse |take |first?
a. Ensure |preoperative |lab |results |are |available
b. Start |prescribed |IV |with |lactated |Ringer's
c. Inform |the |anesthesia |care |provider
d. Contact |the |client's |obstetrician. |- |Ans-Inform |the |anesthesia |care |provider
Rationale: |Surgical |preoperative |instruction |includes |NPO |after |midnight |the |day |of |surgery |to
|decrease |the |risk |of |aspiration |should |vomiting |occur |during |anesthesia. |While |it |is |possible |the |C-
section |will |be |done |on |schedule |or |rescheduled |for |later |in |the |day, |the |anesthesia |provider |should
|be |notified |first.
Rationale Answers Graded A+
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. |- |Ans-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 |male |client |with |hypertension, |who |received |new |antihypertensive |prescriptions |at |his |last |visit
| returns |to |the |clinic |two |weeks |later |to |evaluate |his |blood |pressure |(BP). |His |BP |is |158/106 |and |he
|admits |that |he |has |not |been |taking |the |prescribed |medication |because |the |drugs |make |him |"feel
|bad". |In |explaining |the |need |for |hypertension |control, |the |nurse |should |stress |that |an |elevated |BP
|places |the |client |at |risk |for |which |pathophysiological |condition?
a. Blindness |secondary |to |cataracts
b. Acute |kidney |injury |due |to |glomerular |damage
c. Stroke |secondary |to |hemorrhage
d. Heart |block |due |to |myocardial |damage |- |Ans-Stroke |secondary |to |hemorrhage
Rationale: |Stroke |related |to |cerebral |hemorrhage |is |major |risk |for |uncontrolled |hypertension.
The |nurse |observes |an |unlicensed |assistive |personnel |(UAP) |positioning |a |newly |admitted |client |who
|has |a |seizure |disorder. |The |client |is |supine |and |the |UAP |is |placing |soft |pillows |along |the |side |rails.
|What |action |should |the |nurse |implement?
,a. Ensure |that |the |UAP |has |placed |the |pillows |effectively |to |protect |the |client.
b. Instruct |the |UAP |to |obtain |soft |blankets |to |secure |to |the |side |rails |instead |of |pillows.
c. Assume |responsibility |for |placing |the |pillows |while |the |UAP |completes |another |task.
d. Ask |the |UAP |to |use |some |of |the |pillows |to |prop |the |client |in |a |side |lying |position. |- |Ans-Instruct
|the |UAP |to |obtain |soft |blankets |to |secure |to |the |side |rails |instead |of |pillows
Rationale: |The |nurse |should |instruct |the |UAP |to |pad |the |side |rails |with |soft |blankest |because |the
|use |of |pillows |could |result |in |suffocation |and |would |need |to |be |removed |at |the |onset |of |the |seizure.
|The |nurse |can |delegate |paddling |the |side |rails |to |the |UAP
An |adolescent |with |major |depressive |disorder |has |been |taking |duloxetine |(Cymbalta) |for |the |past |12
|days. |Which |assessment |finding |requires |immediate |follow-up
a. Describes |life |without |purpose
b. Complains |of |nausea |and |loss |of |appetite
c. States |is |often |fatigued |and |drowsy
d. Exhibits |an |increase |in |sweating. |- |Ans-Describes |life |without |purpose
Rationale: |Cymbalta |is |a |selective |serotonin |and |norepinephrine |reuptake |inhibitor |that |is |known |to
|increase |the |risk |of |suicidal |thinking |in |adolescents |and |young |adults |with |major |depressive |disorder.
|B, |C |and |D |are |side |effects
A |60-year-old |female |client |with |a |positive |family |history |of |ovarian |cancer |has |developed |an
|abdominal |mass |and |is |being |evaluated |for |possible |ovarian |cancer. |Her |Papanicolau |(Pap) |smear
|results |are |negative. |What |information |should |the |nurse |include |in |the |client's |teaching |plan
a. Further |evaluation |involving |surgery |may |be |needed
b. A |pelvic |exam |is |also |needed |before |cancer |is |ruled |out
c. Pap |smear |evaluation |should |be |continued |every |six |month
,d. One |additional |negative |pap |smear |in |six |months |is |needed. |- |Ans-Further |evaluation |involving
|surgery |may |be |needed
Rationale: |An |abdominal |mass |in |a |client |with |a |family |history |for |ovarian |cancer |should |be |evaluated
|carefully
A |client |who |recently |underwent |a |tracheostomy |is |being |prepared |for |discharge |to |home. |Which
|instructions |is |most |important |for |the |nurse |to |include |in |the |discharge |plan?
a. Explain |how |to |use |communication |tools.
b. Teach |tracheal |suctioning |techniques
c. Encourage |self-care |and |independence.
d. Demonstrate |how |to |clean |tracheostomy |site. |- |Ans-Teach |tracheal |suctioning |techniques
Rationale: |Suctioning |helps |to |clear |secretions |and |maintain |an |open |airway, |which |is |critical.
In |assessing |an |adult |client |with |a |partial |rebreather |mask, |the |nurse |notes |that |the |oxygen |reservoir
|bag |does |not |deflate |completely |during |inspiration |and |the |client's |respiratory |rate |is |14 |breaths |/
|minute.
What |action |should |the |nurse |implement
a. Encourage |the |client |to |take |deep |breaths
b. Remove |the |mask |to |deflate |the |bag
c. Increase |the |liter |flow |of |oxygen
d. Document |the |assessment |data |- |Ans-Document |the |assessment |data
Rational: |reservoir |bag |should |not |deflate |completely |during |inspiration |and |the |client's |respiratory
|rate |is |within |normal |limits.
During |shift |report, |the |central |electrocardiogram |(EKG) |monitoring |system |alarms. |Which |client |alarm
|should |the |nurse |investigate |first?
, a. Respiratory |apnea |of |30 |seconds
b. Oxygen |saturation |rate |of |88%
c. Eight |premature |ventricular |beats |every |minute
d. Disconnected |monitor |signal |for |the |last |6 |minutes. |- |Ans-Respiratory |apnea |of |30 |seconds
Rationale: |The |priority |is |the |client |whose |alarm |indicating |respiratory |apnea |that |should |be |assessed
|first.
During |a |home |visit, |the |nurse |observed |an |elderly |client |with |diabetes |slip |and |fall. |What |action
|should |the |nurse |take |first?
a. Give |the |client |4 |ounces |of |orange |juice
b. Call |911 |to |summon |emergency |assistance
c. Check |the |client |for |lacerations |or |fractures
d. Asses |clients |blood |sugar |level |- |Ans-Check |the |client |for |lacerations |or |fractures
Rationale: |After |the |client |falls, |the |nurse |should |immediately |assess |for |the |possibility |of |injuries |and
|provide |first |aid |as |needed
At |0600 |while |admitting |a |woman |for |a |schedule |repeat |cesarean |section |(C-Section), |the |client |tells
|the |nurse |that |she |drank |a |cup |a |coffee |at |0400 |because |she |wanted |to |avoid |getting |a |headache.
|Which |action |should |the |nurse |take |first?
a. Ensure |preoperative |lab |results |are |available
b. Start |prescribed |IV |with |lactated |Ringer's
c. Inform |the |anesthesia |care |provider
d. Contact |the |client's |obstetrician. |- |Ans-Inform |the |anesthesia |care |provider
Rationale: |Surgical |preoperative |instruction |includes |NPO |after |midnight |the |day |of |surgery |to
|decrease |the |risk |of |aspiration |should |vomiting |occur |during |anesthesia. |While |it |is |possible |the |C-
section |will |be |done |on |schedule |or |rescheduled |for |later |in |the |day, |the |anesthesia |provider |should
|be |notified |first.
