HESI 799 RN Exit Exam - Comprehensive Practice Questions
Question 1
A male client with duodenal ulcer tells the nurse 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.
Answer: C. 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. While dairy products were once thought to "coat" the stomach, they
actually increase acid production, which can worsen ulcer symptoms.
Question 2
A male client with hypertension returns to the clinic two weeks later to evaluate his
blood pressure. 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
Answer: C. Stroke secondary to hemorrhage
Rationale: Stroke related to cerebral hemorrhage is a major risk for uncontrolled
hypertension. Uncontrolled hypertension damages cerebral blood vessels,
increasing the risk of hemorrhagic stroke .
Question 3
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.
Answer: B. 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
blankets 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 padding the side
rails to the UAP .
Question 4
,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
Answer: A. Describes life without purpose
Rationale: Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor
(SNRI) that is known to increase the risk of suicidal thinking in adolescents and
young adults with major depressive disorder. Statements suggesting life has no
purpose indicate suicidal ideation requiring immediate intervention .
Question 5
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 Papanicolaou (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 months
D. One additional negative Pap smear in six months is needed
Answer: A. Further evaluation involving surgery may be needed
Rationale: An abdominal mass in a client with a family history of ovarian cancer
should be evaluated carefully. A Pap smear is a screening test for cervical cancer,
not ovarian cancer, and does not rule out ovarian pathology .
, Question 6
A client who recently underwent a tracheostomy is being prepared for discharge to
home. Which instruction 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 the tracheostomy site.
Answer: B. Teach tracheal suctioning techniques.
Rationale: Suctioning helps to clear secretions and maintain a patent airway,
which is critical. Airway patency is the priority concern for clients with a
tracheostomy .
Question 7
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
Answer: D. Document the assessment data
Rationale: The reservoir bag should not deflate completely during inspiration, and
the client's respiratory rate of 14 breaths/minute is within normal limits (12-20).
These findings indicate the oxygen delivery system is functioning correctly,
requiring only documentation .
Question 1
A male client with duodenal ulcer tells the nurse 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.
Answer: C. 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. While dairy products were once thought to "coat" the stomach, they
actually increase acid production, which can worsen ulcer symptoms.
Question 2
A male client with hypertension returns to the clinic two weeks later to evaluate his
blood pressure. 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
Answer: C. Stroke secondary to hemorrhage
Rationale: Stroke related to cerebral hemorrhage is a major risk for uncontrolled
hypertension. Uncontrolled hypertension damages cerebral blood vessels,
increasing the risk of hemorrhagic stroke .
Question 3
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.
Answer: B. 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
blankets 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 padding the side
rails to the UAP .
Question 4
,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
Answer: A. Describes life without purpose
Rationale: Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor
(SNRI) that is known to increase the risk of suicidal thinking in adolescents and
young adults with major depressive disorder. Statements suggesting life has no
purpose indicate suicidal ideation requiring immediate intervention .
Question 5
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 Papanicolaou (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 months
D. One additional negative Pap smear in six months is needed
Answer: A. Further evaluation involving surgery may be needed
Rationale: An abdominal mass in a client with a family history of ovarian cancer
should be evaluated carefully. A Pap smear is a screening test for cervical cancer,
not ovarian cancer, and does not rule out ovarian pathology .
, Question 6
A client who recently underwent a tracheostomy is being prepared for discharge to
home. Which instruction 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 the tracheostomy site.
Answer: B. Teach tracheal suctioning techniques.
Rationale: Suctioning helps to clear secretions and maintain a patent airway,
which is critical. Airway patency is the priority concern for clients with a
tracheostomy .
Question 7
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
Answer: D. Document the assessment data
Rationale: The reservoir bag should not deflate completely during inspiration, and
the client's respiratory rate of 14 breaths/minute is within normal limits (12-20).
These findings indicate the oxygen delivery system is functioning correctly,
requiring only documentation .
