HESI EXIT FINAL EXAM PREP
(NIGHTINGALE COLLEGE) QUESTIONS
AND CORRECT DETAILED ANSWERS
1. A client with a history of heart failure is prescribed Digoxin 0.25 mg daily. Which of the
following assessment findings would most likely indicate digoxin toxicity?
A. Hyperkalemia and bradycardia
B. Visual disturbances such as yellow halos and nausea
C. Increased urinary output and weight loss
D. Tachycardia and hypertension
Answer: B
Conceptual Explanation: Early signs of Digoxin toxicity include gastrointestinal
symptoms like nausea and vomiting, followed by neurological symptoms and visual
changes such as yellow-green halos around lights.
2. A nurse is reviewing arterial blood gas (ABG) results for a client with COPD. The results are:
pH 7.31, PaCO2 52 mmHg, HCO3 28 mEq/L. How should the nurse interpret these findings?
A. Partially compensated respiratory acidosis
B. Uncompensated respiratory alkalosis
C. Compensated metabolic acidosis
,D. Fully compensated respiratory acidosis
Answer: A
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated (indicating the kidneys are trying to compensate), but since the
pH is not back to normal, it is partially compensated.
3. Which priority action should the nurse take for a client who just returned to the unit
following a total hip arthroplasty?
A. Perform range-of-motion exercises on the affected hip
B. Instruct the client to cross their legs for comfort
C. Maintain the affected leg in an abducted position using a pillow
D. Keep the client in a high Fowler position
Answer: C
Conceptual Explanation: Following a total hip arthroplasty, it is vital to keep the hip in
abduction to prevent dislocation of the prosthesis. Crossing legs or extreme flexion (high
Fowler’s) increases the risk of dislocation.
4. A client is diagnosed with Cushing’s Syndrome. Which electrolyte imbalance is the nurse
most likely to observe?
A. Hyponatremia and hyperkalemia
B. Hyperkalemia and hypercalcemia
, C. Hypocalcemia and hypermagnesemia
D. Hypernatremia and hypokalemia
Answer: D
Conceptual Explanation: Cushing’s syndrome involves excessive cortisol, which has
mineralocorticoid effects leading to sodium retention (hypernatremia) and potassium
excretion (hypokalemia).
5. A nurse is caring for a client receiving Total Parenteral Nutrition (TPN) through a central
line. The TPN bag is empty, and the next bag is not yet available from the pharmacy. Which
solution should the nurse hang in the meantime?
A. 10 percent Dextrose in water (D10W)
B. Lactated Ringer’s
C. 0.9 percent Normal Saline
D. 5 percent Dextrose in 0.45 percent Saline
Answer: A
Conceptual Explanation: Abruptly stopping TPN can lead to rebound hypoglycemia.
D10W is used to maintain blood glucose levels until the next TPN bag arrives.
6. A client presents to the emergency department with suspected cardiac tamponade. Which
of the following findings, known as Beck’s Triad, should the nurse expect?
A. Hypertension, bradycardia, and irregular respirations
(NIGHTINGALE COLLEGE) QUESTIONS
AND CORRECT DETAILED ANSWERS
1. A client with a history of heart failure is prescribed Digoxin 0.25 mg daily. Which of the
following assessment findings would most likely indicate digoxin toxicity?
A. Hyperkalemia and bradycardia
B. Visual disturbances such as yellow halos and nausea
C. Increased urinary output and weight loss
D. Tachycardia and hypertension
Answer: B
Conceptual Explanation: Early signs of Digoxin toxicity include gastrointestinal
symptoms like nausea and vomiting, followed by neurological symptoms and visual
changes such as yellow-green halos around lights.
2. A nurse is reviewing arterial blood gas (ABG) results for a client with COPD. The results are:
pH 7.31, PaCO2 52 mmHg, HCO3 28 mEq/L. How should the nurse interpret these findings?
A. Partially compensated respiratory acidosis
B. Uncompensated respiratory alkalosis
C. Compensated metabolic acidosis
,D. Fully compensated respiratory acidosis
Answer: A
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated (indicating the kidneys are trying to compensate), but since the
pH is not back to normal, it is partially compensated.
3. Which priority action should the nurse take for a client who just returned to the unit
following a total hip arthroplasty?
A. Perform range-of-motion exercises on the affected hip
B. Instruct the client to cross their legs for comfort
C. Maintain the affected leg in an abducted position using a pillow
D. Keep the client in a high Fowler position
Answer: C
Conceptual Explanation: Following a total hip arthroplasty, it is vital to keep the hip in
abduction to prevent dislocation of the prosthesis. Crossing legs or extreme flexion (high
Fowler’s) increases the risk of dislocation.
4. A client is diagnosed with Cushing’s Syndrome. Which electrolyte imbalance is the nurse
most likely to observe?
A. Hyponatremia and hyperkalemia
B. Hyperkalemia and hypercalcemia
, C. Hypocalcemia and hypermagnesemia
D. Hypernatremia and hypokalemia
Answer: D
Conceptual Explanation: Cushing’s syndrome involves excessive cortisol, which has
mineralocorticoid effects leading to sodium retention (hypernatremia) and potassium
excretion (hypokalemia).
5. A nurse is caring for a client receiving Total Parenteral Nutrition (TPN) through a central
line. The TPN bag is empty, and the next bag is not yet available from the pharmacy. Which
solution should the nurse hang in the meantime?
A. 10 percent Dextrose in water (D10W)
B. Lactated Ringer’s
C. 0.9 percent Normal Saline
D. 5 percent Dextrose in 0.45 percent Saline
Answer: A
Conceptual Explanation: Abruptly stopping TPN can lead to rebound hypoglycemia.
D10W is used to maintain blood glucose levels until the next TPN bag arrives.
6. A client presents to the emergency department with suspected cardiac tamponade. Which
of the following findings, known as Beck’s Triad, should the nurse expect?
A. Hypertension, bradycardia, and irregular respirations
