HESI PN EXIT EXAM V4 – Practical Nursing Comprehensive
Exit Exam | Advanced Practice Questions with Detailed
Rationales | Graded A+
1. A client with heart failure is prescribed carvedilol. Which assessment finding indicates the
medication is effective?
A. Decreased blood pressure and heart rate
B. Increased blood pressure and heart rate
C. Decreased urine output
D. Increased dyspnea on exertion
☑ Correct Answer: A
☑ Explanation: Carvedilol is a beta-blocker that reduces blood pressure and heart rate,
decreasing the workload on the heart in heart failure. Increased blood pressure (B) indicates
ineffectiveness. Decreased urine output (C) and increased dyspnea (D) indicate worsening heart
failure.
,2. A client is admitted with a diagnosis of deep vein thrombosis (DVT) and is started on
heparin therapy. Which laboratory value should the nurse monitor to assess therapeutic
effectiveness?
A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
☑ Correct Answer: C
☑ Explanation: Heparin therapy is monitored using aPTT. PT and INR (A and B) are used
for warfarin monitoring. Platelet count (D) is monitored for heparin-induced thrombocytopenia
but not therapeutic effectiveness.
3. A client with chronic kidney disease is prescribed erythropoietin. The nurse understands
the purpose of this medication is to:
A. Decrease blood pressure
B. Increase red blood cell production
,C. Reduce serum potassium levels
D. Increase urine output
☑ Correct Answer: B
☑ Explanation: Erythropoietin stimulates red blood cell production in clients with chronic
kidney disease who have anemia. It does not decrease blood pressure (A), reduce potassium (C),
or increase urine output (D).
4. A client is 2 hours post-appendectomy. Which finding should the nurse report to the
healthcare provider immediately?
A. Pain rated 4 on a 0-10 scale
B. Temperature of 99.6°F (37.6°C)
C. Rigid, board-like abdomen
D. Serosanguineous drainage on the dressing
☑ Correct Answer: C
☑ Explanation: A rigid, board-like abdomen indicates possible peritonitis, a serious
postoperative complication requiring immediate intervention. Pain (A) is expected. A
, temperature of 99.6°F (B) is slightly elevated but not urgent. Serosanguineous drainage (D) is
expected postoperatively.
5. A client with asthma is prescribed fluticasone/salmeterol (Advair). Which statement by the
client indicates understanding of the medication?
A. "I will use this medication for acute asthma attacks."
B. "I will rinse my mouth after using this medication."
C. "I will stop using this medication if I feel better."
D. "I will use this medication as needed for wheezing."
☑ Correct Answer: B
☑ Explanation: Rinsing the mouth after using inhaled corticosteroids (fluticasone) helps
prevent oral thrush. This medication is for maintenance, not acute attacks (A and D are
incorrect). It should not be stopped abruptly (C is incorrect).
6. A client with a history of atrial fibrillation is prescribed warfarin. Which dietary instruction
should the nurse provide?
Exit Exam | Advanced Practice Questions with Detailed
Rationales | Graded A+
1. A client with heart failure is prescribed carvedilol. Which assessment finding indicates the
medication is effective?
A. Decreased blood pressure and heart rate
B. Increased blood pressure and heart rate
C. Decreased urine output
D. Increased dyspnea on exertion
☑ Correct Answer: A
☑ Explanation: Carvedilol is a beta-blocker that reduces blood pressure and heart rate,
decreasing the workload on the heart in heart failure. Increased blood pressure (B) indicates
ineffectiveness. Decreased urine output (C) and increased dyspnea (D) indicate worsening heart
failure.
,2. A client is admitted with a diagnosis of deep vein thrombosis (DVT) and is started on
heparin therapy. Which laboratory value should the nurse monitor to assess therapeutic
effectiveness?
A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
☑ Correct Answer: C
☑ Explanation: Heparin therapy is monitored using aPTT. PT and INR (A and B) are used
for warfarin monitoring. Platelet count (D) is monitored for heparin-induced thrombocytopenia
but not therapeutic effectiveness.
3. A client with chronic kidney disease is prescribed erythropoietin. The nurse understands
the purpose of this medication is to:
A. Decrease blood pressure
B. Increase red blood cell production
,C. Reduce serum potassium levels
D. Increase urine output
☑ Correct Answer: B
☑ Explanation: Erythropoietin stimulates red blood cell production in clients with chronic
kidney disease who have anemia. It does not decrease blood pressure (A), reduce potassium (C),
or increase urine output (D).
4. A client is 2 hours post-appendectomy. Which finding should the nurse report to the
healthcare provider immediately?
A. Pain rated 4 on a 0-10 scale
B. Temperature of 99.6°F (37.6°C)
C. Rigid, board-like abdomen
D. Serosanguineous drainage on the dressing
☑ Correct Answer: C
☑ Explanation: A rigid, board-like abdomen indicates possible peritonitis, a serious
postoperative complication requiring immediate intervention. Pain (A) is expected. A
, temperature of 99.6°F (B) is slightly elevated but not urgent. Serosanguineous drainage (D) is
expected postoperatively.
5. A client with asthma is prescribed fluticasone/salmeterol (Advair). Which statement by the
client indicates understanding of the medication?
A. "I will use this medication for acute asthma attacks."
B. "I will rinse my mouth after using this medication."
C. "I will stop using this medication if I feel better."
D. "I will use this medication as needed for wheezing."
☑ Correct Answer: B
☑ Explanation: Rinsing the mouth after using inhaled corticosteroids (fluticasone) helps
prevent oral thrush. This medication is for maintenance, not acute attacks (A and D are
incorrect). It should not be stopped abruptly (C is incorrect).
6. A client with a history of atrial fibrillation is prescribed warfarin. Which dietary instruction
should the nurse provide?
