HESI EXIT saunders questions and answers
2026\2027 A+ Grade
ENDOCRINE
- correct answer
A client is brought to the emergency department in an unresponsive state, and a diagnosis of
hyperosmolar hyperglycemic syndrome is made. The nurse would immediately prepare to initiate which
anticipated health care provider's prescription?
1. Endotracheal intubation
2. 100 units of NPH insulin
3. Intravenous infusion of normal saline
4. Intravenous infusion of sodium bicarbonate
- correct answer 3
treatment in hyperosmolar hyperglycemic syndrome (HHS) is to rehydrate the client to restore fluid
volume and to correct electrolyte deficiency.
The use of sodium bicarbonate to correct acidosis is avoided because it can precipitate a further drop in
serum potassium level
An external insulin pump is prescribed for a client with diabetes mellitus. When the client asks the nurse
about the functioning of the pump, the nurse bases the response on which information about the
pump?
1. It is timed to release programmed doses of either short-duration or NPH insulin into the bloodstream
at specific intervals.
2. It continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring
blood glucose levels.
3. It is surgically attached to the pancreas and infuses regular insulin into the pancreas. This releases
insulin into the bloodstream.
,4. It administers a small continuous dose of short-duration insulin subcutaneously. The client can self-
administer an additional bolus dose from the pump before each meal.
- correct answer 4
A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department.
Which findings support this diagnosis? Select all that apply.
1. Increase in pH
2. Comatose state
3. Deep, rapid breathing
4. Decreased urine output
5. Elevated blood glucose level
- correct answer 2,3,5
The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and
ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose
should be taken if which symptom or symptoms develop? Select all that apply.
1. Polyuria
2. Shakiness
3. Palpitations
4. Blurred vision
5. Lightheadedness
6. Fruity breath odor
- correct answer 2,3,5
A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the
treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety?
1. Administer a sedative.
2. Convey empathy, trust, and respect toward the client.
3. Ignore the signs and symptoms of anxiety, anticipating that they will soon disappear.
4. Make sure that the client is familiar with the correct medical terms to promote understanding of what
is happening.
- correct answer 2
,The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse
recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client makes
which statement?
1. "I will stop taking my insulin if I'm too sick to eat."
2. "I will decrease my insulin dose during times of illness."
3. "I will adjust my insulin dose according to the level of glucose in my urine."
4. "I will notify my health care provider (HCP) if my blood glucose level is higher than 250 mg/dL (14.2
mmol/L)."
- correct answer 4
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose
level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is
initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240
mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?
1. An ampule of 50% dextrose
2. NPH insulin subcutaneously
3. IV fluids containing dextrose
4. Phenytoin for the prevention of seizures
- correct answer 3
when the blood glucose level falls to 250 to 300 mg/dL (14.2 to 17.1 mmol/L), the IV infusion rate is
reduced and a dextrose solution is added to maintain a blood glucose level of about 250 mg/dL
The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications.
Which sign or symptom, if exhibited in the client, indicates that the client is at risk for chronic
complications of diabetes if the blood glucose is not adequately managed?
1. Polyuria
2. Diaphoresis
3. Pedal edema
4. Decreased respiratory rate
- correct answer 1
Classic symptoms of hyperglycemia include polydipsia, polyuria, and polyphagia.
, The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The
nurse places priority on which client problem?
1. Lack of knowledge
2. Inadequate fluid volume
3. Compromised family coping
4. Inadequate consumption of nutrients
- correct answer 2
The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client relates a
history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24
hours. Which additional statement by the client indicates a need for further teaching?
1. "I need to stop my insulin."
2. "I need to increase my fluid intake."
3. "I need to monitor my blood glucose every 3 to 4 hours."
4. "I need to call the health care provider (HCP) because of these symptoms."
- correct answer 1
The nurse is caring for a client after hypophysectomy and notes clear nasal drainage from the client's
nostril. The nurse should take which initial action?
1. Lower the head of the bed.
2. Test the drainage for glucose.
3. Obtain a culture of the drainage.
4. Continue to observe the drainage.
- correct answer 2
hypophysectomy is the surgical removal of the pituitary gland
client should be monitored for rhinorrhea, which could indicate a cerebrospinal fluid leak. If this occurs,
the drainage should be collected and tested for the presence of cerebrospinal fluid. Cerebrospinal fluid
contains glucose, and if positive, this would indicate that the drainage is cerebrospinal fluid.
The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone
secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which health care provider
prescriptions should the nurse anticipate receiving? Select all that apply.
2026\2027 A+ Grade
ENDOCRINE
- correct answer
A client is brought to the emergency department in an unresponsive state, and a diagnosis of
hyperosmolar hyperglycemic syndrome is made. The nurse would immediately prepare to initiate which
anticipated health care provider's prescription?
1. Endotracheal intubation
2. 100 units of NPH insulin
3. Intravenous infusion of normal saline
4. Intravenous infusion of sodium bicarbonate
- correct answer 3
treatment in hyperosmolar hyperglycemic syndrome (HHS) is to rehydrate the client to restore fluid
volume and to correct electrolyte deficiency.
The use of sodium bicarbonate to correct acidosis is avoided because it can precipitate a further drop in
serum potassium level
An external insulin pump is prescribed for a client with diabetes mellitus. When the client asks the nurse
about the functioning of the pump, the nurse bases the response on which information about the
pump?
1. It is timed to release programmed doses of either short-duration or NPH insulin into the bloodstream
at specific intervals.
2. It continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring
blood glucose levels.
3. It is surgically attached to the pancreas and infuses regular insulin into the pancreas. This releases
insulin into the bloodstream.
,4. It administers a small continuous dose of short-duration insulin subcutaneously. The client can self-
administer an additional bolus dose from the pump before each meal.
- correct answer 4
A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department.
Which findings support this diagnosis? Select all that apply.
1. Increase in pH
2. Comatose state
3. Deep, rapid breathing
4. Decreased urine output
5. Elevated blood glucose level
- correct answer 2,3,5
The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and
ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose
should be taken if which symptom or symptoms develop? Select all that apply.
1. Polyuria
2. Shakiness
3. Palpitations
4. Blurred vision
5. Lightheadedness
6. Fruity breath odor
- correct answer 2,3,5
A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the
treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety?
1. Administer a sedative.
2. Convey empathy, trust, and respect toward the client.
3. Ignore the signs and symptoms of anxiety, anticipating that they will soon disappear.
4. Make sure that the client is familiar with the correct medical terms to promote understanding of what
is happening.
- correct answer 2
,The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse
recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client makes
which statement?
1. "I will stop taking my insulin if I'm too sick to eat."
2. "I will decrease my insulin dose during times of illness."
3. "I will adjust my insulin dose according to the level of glucose in my urine."
4. "I will notify my health care provider (HCP) if my blood glucose level is higher than 250 mg/dL (14.2
mmol/L)."
- correct answer 4
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose
level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is
initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240
mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?
1. An ampule of 50% dextrose
2. NPH insulin subcutaneously
3. IV fluids containing dextrose
4. Phenytoin for the prevention of seizures
- correct answer 3
when the blood glucose level falls to 250 to 300 mg/dL (14.2 to 17.1 mmol/L), the IV infusion rate is
reduced and a dextrose solution is added to maintain a blood glucose level of about 250 mg/dL
The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications.
Which sign or symptom, if exhibited in the client, indicates that the client is at risk for chronic
complications of diabetes if the blood glucose is not adequately managed?
1. Polyuria
2. Diaphoresis
3. Pedal edema
4. Decreased respiratory rate
- correct answer 1
Classic symptoms of hyperglycemia include polydipsia, polyuria, and polyphagia.
, The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The
nurse places priority on which client problem?
1. Lack of knowledge
2. Inadequate fluid volume
3. Compromised family coping
4. Inadequate consumption of nutrients
- correct answer 2
The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client relates a
history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24
hours. Which additional statement by the client indicates a need for further teaching?
1. "I need to stop my insulin."
2. "I need to increase my fluid intake."
3. "I need to monitor my blood glucose every 3 to 4 hours."
4. "I need to call the health care provider (HCP) because of these symptoms."
- correct answer 1
The nurse is caring for a client after hypophysectomy and notes clear nasal drainage from the client's
nostril. The nurse should take which initial action?
1. Lower the head of the bed.
2. Test the drainage for glucose.
3. Obtain a culture of the drainage.
4. Continue to observe the drainage.
- correct answer 2
hypophysectomy is the surgical removal of the pituitary gland
client should be monitored for rhinorrhea, which could indicate a cerebrospinal fluid leak. If this occurs,
the drainage should be collected and tested for the presence of cerebrospinal fluid. Cerebrospinal fluid
contains glucose, and if positive, this would indicate that the drainage is cerebrospinal fluid.
The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone
secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which health care provider
prescriptions should the nurse anticipate receiving? Select all that apply.
