HESI EXIT EXAM PRACTICE -
NIGHTINGALE COLLEGE QUESTIONS
AND CORRECT DETAILED ANSWERS
1. A client with heart failure is receiving digoxin and furosemide. Which laboratory result
should the nurse prioritize for reporting to the healthcare provider?
A. Serum sodium level of 136 mEq/L
B. Serum creatinine of 1.1 mg/dL
C. Serum potassium level of 3.1 mEq/L
D. B-type natriuretic peptide (BNP) of 400 pg/mL
Answer: C
Conceptual Explanation: Low potassium levels (hypokalemia) significantly increase the
risk of digoxin toxicity. Since the client is on furosemide, a loop diuretic, they are at risk for
potassium loss.
2. The nurse is triaging clients in the emergency department. Which client requires immediate
intervention?
A. A 10-year-old with a suspected fractured radius reporting 7/10 pain.
B. A 45-year-old with a deep laceration on the leg that is oozing dark red blood.
C. A 62-year-old reporting sudden onset of epigastric pain and diaphoresis.
,D. A 28-year-old with a history of asthma reporting a mild cough and wheezing.
C. A 62-year-old reporting sudden onset of epigastric pain and diaphoresis.
Answer: C
Conceptual Explanation: Epigastric pain and diaphoresis in an older adult can indicate a
myocardial infarction (MI), which is a life-threatening emergency requiring immediate
assessment and intervention.
3. Following a thyroidectomy, a client reports numbness and tingling in the fingers and
around the mouth. Which assessment should the nurse perform first?
A. Evaluate the client’s voice for hoarseness.
B. Monitor the client’s heart rate.
C. Assess the surgical dressing for bleeding.
D. Check for Chvostek’s sign.
Answer: D
Conceptual Explanation: Numbness and tingling are signs of hypocalcemia, which can
occur if the parathyroid glands are accidentally damaged or removed during
thyroidectomy. Chvostek’s sign is a clinical indicator of hypocalcemia.
4. A client is prescribed lithium carbonate for bipolar disorder. Which instruction is most
important for the nurse to include in the teaching plan?
A. Limit sodium intake to prevent fluid retention.
, B. Expect fine hand tremors as a side effect for the first year.
C. Take the medication on an empty stomach.
D. Maintain a consistent fluid and salt intake.
Answer: D
Conceptual Explanation: Lithium is a salt. Maintaining consistent sodium and fluid intake
is crucial because dehydration or low sodium levels can lead to lithium toxicity.
5. Which task can the Registered Nurse (RN) safely delegate to an unlicensed assistive
personnel (UAP)?
A. Assess the pain level of a client who just returned from surgery.
B. Teach a client how to use an incentive spirometer.
C. Measure and record the intake and output of a client with heart failure.
D. Assist a stable client with ambulation for the first time post-op.
Answer: C
Conceptual Explanation: UAPs may perform routine tasks like measuring I&O.
Assessment, teaching, and initial ambulation of post-operative clients require the clinical
judgment of an RN.
NIGHTINGALE COLLEGE QUESTIONS
AND CORRECT DETAILED ANSWERS
1. A client with heart failure is receiving digoxin and furosemide. Which laboratory result
should the nurse prioritize for reporting to the healthcare provider?
A. Serum sodium level of 136 mEq/L
B. Serum creatinine of 1.1 mg/dL
C. Serum potassium level of 3.1 mEq/L
D. B-type natriuretic peptide (BNP) of 400 pg/mL
Answer: C
Conceptual Explanation: Low potassium levels (hypokalemia) significantly increase the
risk of digoxin toxicity. Since the client is on furosemide, a loop diuretic, they are at risk for
potassium loss.
2. The nurse is triaging clients in the emergency department. Which client requires immediate
intervention?
A. A 10-year-old with a suspected fractured radius reporting 7/10 pain.
B. A 45-year-old with a deep laceration on the leg that is oozing dark red blood.
C. A 62-year-old reporting sudden onset of epigastric pain and diaphoresis.
,D. A 28-year-old with a history of asthma reporting a mild cough and wheezing.
C. A 62-year-old reporting sudden onset of epigastric pain and diaphoresis.
Answer: C
Conceptual Explanation: Epigastric pain and diaphoresis in an older adult can indicate a
myocardial infarction (MI), which is a life-threatening emergency requiring immediate
assessment and intervention.
3. Following a thyroidectomy, a client reports numbness and tingling in the fingers and
around the mouth. Which assessment should the nurse perform first?
A. Evaluate the client’s voice for hoarseness.
B. Monitor the client’s heart rate.
C. Assess the surgical dressing for bleeding.
D. Check for Chvostek’s sign.
Answer: D
Conceptual Explanation: Numbness and tingling are signs of hypocalcemia, which can
occur if the parathyroid glands are accidentally damaged or removed during
thyroidectomy. Chvostek’s sign is a clinical indicator of hypocalcemia.
4. A client is prescribed lithium carbonate for bipolar disorder. Which instruction is most
important for the nurse to include in the teaching plan?
A. Limit sodium intake to prevent fluid retention.
, B. Expect fine hand tremors as a side effect for the first year.
C. Take the medication on an empty stomach.
D. Maintain a consistent fluid and salt intake.
Answer: D
Conceptual Explanation: Lithium is a salt. Maintaining consistent sodium and fluid intake
is crucial because dehydration or low sodium levels can lead to lithium toxicity.
5. Which task can the Registered Nurse (RN) safely delegate to an unlicensed assistive
personnel (UAP)?
A. Assess the pain level of a client who just returned from surgery.
B. Teach a client how to use an incentive spirometer.
C. Measure and record the intake and output of a client with heart failure.
D. Assist a stable client with ambulation for the first time post-op.
Answer: C
Conceptual Explanation: UAPs may perform routine tasks like measuring I&O.
Assessment, teaching, and initial ambulation of post-operative clients require the clinical
judgment of an RN.
