HESI EXIT EXAM COMPREHENSIVE
REVIEW QUESTIONS AND CORRECT
DETAILED ANSWERS
1. A nurse is caring for a client with a history of congestive heart failure. The client suddenly
develops dyspnea, orthopnea, and crackles throughout the lungs. Which action should the
nurse take first?
A. Place the client in high-Fowler’s position
B. Administer a dose of morphine sulfate IV
C. Start oxygen at 2L/min via nasal cannula
D. Notify the healthcare provider
Answer: A
Conceptual Explanation: Positioning the client in high-Fowler’s is the priority
intervention to improve gas exchange and decrease venous return to the heart, addressing
the immediate respiratory distress before medication administration or notification.
2. A client is prescribed Digoxin 0.25 mg daily. The nurse notes the client’s potassium level is
3.2 mEq/L. Which action is most appropriate?
A. Administer the dose as prescribed
B. Hold the dose and notify the provider
,C. Encourage the client to eat a banana
D. Recheck the potassium level in 4 hours
Answer: B
Conceptual Explanation: Hypokalemia increases the risk of digoxin toxicity. A potassium
level of 3.2 is low (normal 3.5-5.0). The nurse must hold the dose and notify the provider to
prevent toxicity.
3. The nurse is assessing a client with pre-eclampsia who is receiving Magnesium Sulfate. The
nurse notes a respiratory rate of 10 breaths/min and absent deep tendon reflexes. What is
the priority action?
A. Stop the Magnesium Sulfate infusion
B. Check the client’s blood pressure
C. Administer Calcium Gluconate IV push
D. Increase the maintenance IV fluid rate
Answer: A
Conceptual Explanation: The signs indicate magnesium toxicity. The first priority is to
stop the infusion to prevent further toxicity before administering the antidote, Calcium
Gluconate.
, 4. Which assessment finding should the nurse expect in a client diagnosed with Cushing’s
Syndrome?
A. Hyperkalemia and hypotension
B. Weight loss and hyperpigmentation
C. Central obesity and buffalo hump
D. Hypoglycemia and tachycardia
Answer: C
Conceptual Explanation: Cushing’s Syndrome involves excessive cortisol, leading to
characteristic physical changes like central obesity, buffalo hump, and moon face.
5. A client with a head injury develops a urinary output of 600 mL/hr. The nurse suspects
Diabetes Insipidus. Which laboratory value supports this suspicion?
A. Serum sodium 130 mEq/L
B. Urine specific gravity 1.002
C. Urine osmolality 1200 mOsm/kg
D. Serum glucose 250 mg/dL
Answer: B
Conceptual Explanation: Diabetes Insipidus (DI) is characterized by low ADH, resulting in
massive dilute urine output. A low urine specific gravity (normal 1.005-1.030) is a hallmark
sign.
REVIEW QUESTIONS AND CORRECT
DETAILED ANSWERS
1. A nurse is caring for a client with a history of congestive heart failure. The client suddenly
develops dyspnea, orthopnea, and crackles throughout the lungs. Which action should the
nurse take first?
A. Place the client in high-Fowler’s position
B. Administer a dose of morphine sulfate IV
C. Start oxygen at 2L/min via nasal cannula
D. Notify the healthcare provider
Answer: A
Conceptual Explanation: Positioning the client in high-Fowler’s is the priority
intervention to improve gas exchange and decrease venous return to the heart, addressing
the immediate respiratory distress before medication administration or notification.
2. A client is prescribed Digoxin 0.25 mg daily. The nurse notes the client’s potassium level is
3.2 mEq/L. Which action is most appropriate?
A. Administer the dose as prescribed
B. Hold the dose and notify the provider
,C. Encourage the client to eat a banana
D. Recheck the potassium level in 4 hours
Answer: B
Conceptual Explanation: Hypokalemia increases the risk of digoxin toxicity. A potassium
level of 3.2 is low (normal 3.5-5.0). The nurse must hold the dose and notify the provider to
prevent toxicity.
3. The nurse is assessing a client with pre-eclampsia who is receiving Magnesium Sulfate. The
nurse notes a respiratory rate of 10 breaths/min and absent deep tendon reflexes. What is
the priority action?
A. Stop the Magnesium Sulfate infusion
B. Check the client’s blood pressure
C. Administer Calcium Gluconate IV push
D. Increase the maintenance IV fluid rate
Answer: A
Conceptual Explanation: The signs indicate magnesium toxicity. The first priority is to
stop the infusion to prevent further toxicity before administering the antidote, Calcium
Gluconate.
, 4. Which assessment finding should the nurse expect in a client diagnosed with Cushing’s
Syndrome?
A. Hyperkalemia and hypotension
B. Weight loss and hyperpigmentation
C. Central obesity and buffalo hump
D. Hypoglycemia and tachycardia
Answer: C
Conceptual Explanation: Cushing’s Syndrome involves excessive cortisol, leading to
characteristic physical changes like central obesity, buffalo hump, and moon face.
5. A client with a head injury develops a urinary output of 600 mL/hr. The nurse suspects
Diabetes Insipidus. Which laboratory value supports this suspicion?
A. Serum sodium 130 mEq/L
B. Urine specific gravity 1.002
C. Urine osmolality 1200 mOsm/kg
D. Serum glucose 250 mg/dL
Answer: B
Conceptual Explanation: Diabetes Insipidus (DI) is characterized by low ADH, resulting in
massive dilute urine output. A low urine specific gravity (normal 1.005-1.030) is a hallmark
sign.
