HESI EXIT COMPREHENSIVE EXAM 2023-2024 260+
ACTUAL QUESTIONS AND DETAILED ANSWERS WITH
RATIONALES
A nurse is reviewing the record of a client scheduled for electroconvulsive
therapy (ECT). Which of the following diagnoses, if noted on the client's record,
would indicate a need to contact the physician who is scheduled to perform the
ECT?
A. Recent stroke
B. Hypothyroidism
C. History of glaucoma
D. Peripheral vascular disease - Answer A. Recent stroke
A client scheduled for suprapubic prostatectomy has listened to the surgeon's
explanation of the surgery. The client later asks the nurse to explain again how
the prostate is going to be removed. The nurse tells the client that the prostate
will be removed through:
A. A lower abdominal incision
B. An upper abdominal incision
C. An incision made in the perineal area
D. The urethra, with the use of a cutting wire - Answer A. A lower abdominal incision
A nurse is preparing a poster for a health fair booth promoting primary
prevention of skin cancer. Which of the following recommendations does the
nurse include on the poster? Select all that apply.
A. Seek medical advice if you find a skin lesion.
B. Use sunscreen with a low sun protection factor (SPF).
C. Avoid sun exposure before 10 a.m. and after 4 p.m.
,D. Wear a hat, opaque clothing, and sunglasses when out in the sun.
E. Examine the body every 6 months for possibly cancerous or precancerous lesions. -
Answer A. Seek medical advice if you find a skin lesion.
D. Wear a hat, opaque clothing, and sunglasses when out in the sun.
-Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which
assessment does the nurse perform as a priority before administering the
medication?
A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24 hours - Answer A.
Checking the client's blood pressure
Checking the client's blood pressure
Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension. One
common side effect is postural hypotension. Therefore the nurse would check the client's blood pressure
immediately before administering each dose. Checking the client's peripheral pulses, the results of the
most recent potassium level, and the intake and output for the previous 24 hours are not specifically
associated with this mediation.
A client is scheduled to undergo an upper gastrointestinal (GI) series, and the
nurse provides instructions to the client about the test. Which statement by the
client indicates a need for further instruction?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before the test."
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet
enema on the morning of the test."
D. "I need to take a laxative after the test is completed, because the liquid that I'll have
to drink for the test can be constipating." - Answer C. "I need to drink citrate of
,magnesia the night before the test and give myself a Fleet enema on the morning of the
test."
An upper GI series involves visualization of the esophagus, duodenum, and upper
jejunum by means of the use of a contrast medium. It involves swallowing a contrast
medium (usually barium), which is administered in a flavored milkshake. Films are taken
at intervals during the test, which takes about 30 minutes. No special preparation is
necessary before a GI series, except that NPO status must be maintained for 8 hours
before the test. After an upper GI series, the client is prescribed a laxative to hasten
elimination of the barium. Barium that remains in the colon may become hard and
difficult to expel, leading to fecal impaction.
A nurse on the evening shift checks a physician's prescriptions and notes that
the dose of a prescribed medication is higher than the normal dose. The nurse
calls the physician's answering service and is told that the physician is off for the
night and will be available in the morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call physician
C. Withhold the medication until the physician can be reached in the morning
D. Administer the medication but consult the physician when he becomes available -
Answer B. Ask the answering service to contact the on-call physician
An emergency department (ED) nurse is monitoring a client with suspected acute
myocardial infarction (MI) who is awaiting transfer to the coronary intensive care
unit. The nurse notes the sudden onset of premature ventricular contractions
(PVCs) on the monitor, checks the client's carotid pulse, and determines that the
PVCs are not resulting in perfusion. The appropriate action by the nurse is:
A. Documenting the findings
B. Asking the ED physician to check the client
C. Continuing to monitor the client's cardiac status
, D. Informing the client that PVCs are expected after an MI - Answer B. Asking the ED
physician to check the client
.NPO status is imposed 8 hours before the procedure on a client scheduled to
undergo electroconvulsive therapy (ECT) at 1 p.m. On the morning of the
procedure, the nurse checks the client's record and notes that the client routinely
takes an oral antihypertensive medication each morning. The nurse should:
A. Administer the antihypertensive with a small sip of water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
D. Hold the antihypertensive and resume its administration on the day after the ECT -
Answer A. Administer the antihypertensive with a small sip of water
A client who recently underwent coronary artery bypass graft surgery comes to
the physician's office for a follow-up visit. On assessment, the client tells the
nurse that he is feeling depressed. Which response by the nurse is therapeutic?
A. "Tell me more about what you're feeling."
B. "That's a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over this depression."
D. "Every client who has this surgery feels the same way for about a month." - Answer
A. "Tell me more about what you're feeling."
A client in labor experiences spontaneous rupture of the membranes. The nurse
immediately counts the fetal heart rate (FHR) for 1 full minute and then checks the
amniotic fluid. The nurse notes that the fluid is yellow and has a strong odor.
Which of the following actions should be the nurse's priority?
A. Contacting the physician
B. Documenting the findings
C. Checking the fluid for protein
ACTUAL QUESTIONS AND DETAILED ANSWERS WITH
RATIONALES
A nurse is reviewing the record of a client scheduled for electroconvulsive
therapy (ECT). Which of the following diagnoses, if noted on the client's record,
would indicate a need to contact the physician who is scheduled to perform the
ECT?
A. Recent stroke
B. Hypothyroidism
C. History of glaucoma
D. Peripheral vascular disease - Answer A. Recent stroke
A client scheduled for suprapubic prostatectomy has listened to the surgeon's
explanation of the surgery. The client later asks the nurse to explain again how
the prostate is going to be removed. The nurse tells the client that the prostate
will be removed through:
A. A lower abdominal incision
B. An upper abdominal incision
C. An incision made in the perineal area
D. The urethra, with the use of a cutting wire - Answer A. A lower abdominal incision
A nurse is preparing a poster for a health fair booth promoting primary
prevention of skin cancer. Which of the following recommendations does the
nurse include on the poster? Select all that apply.
A. Seek medical advice if you find a skin lesion.
B. Use sunscreen with a low sun protection factor (SPF).
C. Avoid sun exposure before 10 a.m. and after 4 p.m.
,D. Wear a hat, opaque clothing, and sunglasses when out in the sun.
E. Examine the body every 6 months for possibly cancerous or precancerous lesions. -
Answer A. Seek medical advice if you find a skin lesion.
D. Wear a hat, opaque clothing, and sunglasses when out in the sun.
-Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which
assessment does the nurse perform as a priority before administering the
medication?
A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24 hours - Answer A.
Checking the client's blood pressure
Checking the client's blood pressure
Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension. One
common side effect is postural hypotension. Therefore the nurse would check the client's blood pressure
immediately before administering each dose. Checking the client's peripheral pulses, the results of the
most recent potassium level, and the intake and output for the previous 24 hours are not specifically
associated with this mediation.
A client is scheduled to undergo an upper gastrointestinal (GI) series, and the
nurse provides instructions to the client about the test. Which statement by the
client indicates a need for further instruction?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before the test."
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet
enema on the morning of the test."
D. "I need to take a laxative after the test is completed, because the liquid that I'll have
to drink for the test can be constipating." - Answer C. "I need to drink citrate of
,magnesia the night before the test and give myself a Fleet enema on the morning of the
test."
An upper GI series involves visualization of the esophagus, duodenum, and upper
jejunum by means of the use of a contrast medium. It involves swallowing a contrast
medium (usually barium), which is administered in a flavored milkshake. Films are taken
at intervals during the test, which takes about 30 minutes. No special preparation is
necessary before a GI series, except that NPO status must be maintained for 8 hours
before the test. After an upper GI series, the client is prescribed a laxative to hasten
elimination of the barium. Barium that remains in the colon may become hard and
difficult to expel, leading to fecal impaction.
A nurse on the evening shift checks a physician's prescriptions and notes that
the dose of a prescribed medication is higher than the normal dose. The nurse
calls the physician's answering service and is told that the physician is off for the
night and will be available in the morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call physician
C. Withhold the medication until the physician can be reached in the morning
D. Administer the medication but consult the physician when he becomes available -
Answer B. Ask the answering service to contact the on-call physician
An emergency department (ED) nurse is monitoring a client with suspected acute
myocardial infarction (MI) who is awaiting transfer to the coronary intensive care
unit. The nurse notes the sudden onset of premature ventricular contractions
(PVCs) on the monitor, checks the client's carotid pulse, and determines that the
PVCs are not resulting in perfusion. The appropriate action by the nurse is:
A. Documenting the findings
B. Asking the ED physician to check the client
C. Continuing to monitor the client's cardiac status
, D. Informing the client that PVCs are expected after an MI - Answer B. Asking the ED
physician to check the client
.NPO status is imposed 8 hours before the procedure on a client scheduled to
undergo electroconvulsive therapy (ECT) at 1 p.m. On the morning of the
procedure, the nurse checks the client's record and notes that the client routinely
takes an oral antihypertensive medication each morning. The nurse should:
A. Administer the antihypertensive with a small sip of water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
D. Hold the antihypertensive and resume its administration on the day after the ECT -
Answer A. Administer the antihypertensive with a small sip of water
A client who recently underwent coronary artery bypass graft surgery comes to
the physician's office for a follow-up visit. On assessment, the client tells the
nurse that he is feeling depressed. Which response by the nurse is therapeutic?
A. "Tell me more about what you're feeling."
B. "That's a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over this depression."
D. "Every client who has this surgery feels the same way for about a month." - Answer
A. "Tell me more about what you're feeling."
A client in labor experiences spontaneous rupture of the membranes. The nurse
immediately counts the fetal heart rate (FHR) for 1 full minute and then checks the
amniotic fluid. The nurse notes that the fluid is yellow and has a strong odor.
Which of the following actions should be the nurse's priority?
A. Contacting the physician
B. Documenting the findings
C. Checking the fluid for protein
