HESI 799 RN Exit Exam actual questions
with correct answers with rationales
Following discharge teaching, a male client with duodenal ulcer tells the nurse the he will
|| || || || || || || || || || || || || ||
drink plenty of dairy products, such as milk, to help coat and protect his ulcer. What is
|| || || || || || || || || || || || || || || || ||
the best follow-up action by the nurse?
|| || || || || || ||
a. Remind the client that it is also important to switch to decaffeinated coffee and tea.
|| || || || || || || || || || || || || || ||
b. Suggest that the client also plan to eat frequent small meals to reduce discomfort
|| || || || || || || || || || || || || ||
c. Review with the client the need to avoid foods that are rich in milk and cream.
|| || || || || || || || || || || || || || || ||
d. Reinforce this teaching by asking the client to list a dairy food that he might select. -
|| || || || || || || || || || || || || || || || ||
CORRECT ANSWERS ✔✔Review with the client the need to avoid foods that are rich in
|| || || || || || || || || || || || || || ||
milk and cream
|| || ||
Rationale: Diets rich in milk and cream stimulate gastric acid secretion and should be
|| || || || || || || || || || || || ||
avoided.
||
A male client with hypertension, who received new antihypertensive prescriptions at his
|| || || || || || || || || || ||
last visit returns to the clinic two weeks later to evaluate his blood pressure (BP). His BP
|| || || || || || || || || || || || || || || || ||
is 158/106 and he admits that he has not been taking the prescribed medication because
|| || || || || || || || || || || || || || ||
the drugs make him "feel bad". In explaining the need for hypertension control, the nurse
|| || || || || || || || || || || || || || ||
should stress that an elevated BP places the client at risk for which pathophysiological
|| || || || || || || || || || || || || ||
condition?
||
a. Blindness secondary to cataracts
|| || || ||
b. Acute kidney injury due to glomerular damage
|| || || || || || ||
c. Stroke secondary to hemorrhage
|| || || ||
d. Heart block due to myocardial damage - CORRECT ANSWERS ✔✔Stroke secondary to
|| || || || || || || || || || || ||
hemorrhage
||
,Rationale: Stroke related to cerebral hemorrhage is major risk for uncontrolled
|| || || || || || || || || ||
hypertension.
||
The nurse observes an unlicensed assistive personnel (UAP) positioning a newly
|| || || || || || || || || ||
admitted client who has a seizure disorder. The client is supine and the UAP is placing
|| || || || || || || || || || || || || || || ||
soft pillows along the side rails. What action should the nurse implement?
|| || || || || || || || || || || ||
a. Ensure that the UAP has placed the pillows effectively to protect the client.
|| || || || || || || || || || || || ||
b. Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows.
|| || || || || || || || || || || || || || || ||
c. Assume responsibility for placing the pillows while the UAP completes another task.
|| || || || || || || || || || || ||
d. Ask the UAP to use some of the pillows to prop the client in a side lying position. -
|| || || || || || || || || || || || || || || || || || ||
CORRECT ANSWERS ✔✔Instruct the UAP to obtain soft blankets to secure to the side
|| || || || || || || || || || || || || ||
rails instead of pillows
|| || || ||
Rationale: The nurse should instruct the UAP to pad the side rails with soft blankest
|| || || || || || || || || || || || || ||
because the use of pillows could result in suffocation and would need to be removed at
|| || || || || || || || || || || || || || || ||
the onset of the seizure. The nurse can delegate paddling the side rails to the UAP
|| || || || || || || || || || || || || || || ||
An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for
|| || || || || || || || || || ||
the past 12 days. Which assessment finding requires immediate follow-up
|| || || || || || || || || ||
a. Describes life without purpose
|| || || ||
b. Complains of nausea and loss of appetite
|| || || || || || ||
c. States is often fatigued and drowsy
|| || || || || ||
d. Exhibits an increase in sweating. - CORRECT ANSWERS ✔✔Describes life without
|| || || || || || || || || || ||
purpose
||
,Rationale: Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor that is
|| || || || || || || || || || ||
known to increase the risk of suicidal thinking in adolescents and young adults with
|| || || || || || || || || || || || || ||
major depressive disorder. B, C and D are side effects
|| || || || || || || || || ||
A 60-year-old female client with a positive family history of ovarian cancer has developed
|| || || || || || || || || || || || ||
an abdominal mass and is being evaluated for possible ovarian cancer. Her Papanicolau
|| || || || || || || || || || || || ||
(Pap) smear results are negative. What information should the nurse include in the
|| || || || || || || || || || || || ||
client's teaching plan
|| || ||
a. Further evaluation involving surgery may be needed
|| || || || || || ||
b. A pelvic exam is also needed before cancer is ruled out
|| || || || || || || || || || ||
c. Pap smear evaluation should be continued every six month
|| || || || || || || || ||
d. One additional negative pap smear in six months is needed. - CORRECT ANSWERS
|| || || || || || || || || || || || ||
✔✔Further evaluation involving surgery may be needed
|| || || || || || ||
Rationale: An abdominal mass in a client with a family history for ovarian cancer should
|| || || || || || || || || || || || || ||
be evaluated carefully
|| || ||
A client who recently underwent a tracheostomy is being prepared for discharge to
|| || || || || || || || || || || ||
home. Which instructions is most important for the nurse to include in the discharge
|| || || || || || || || || || || || || ||
plan?
||
a. Explain how to use communication tools.
|| || || || || ||
b. Teach tracheal suctioning techniques
|| || || ||
c. Encourage self-care and independence.
|| || || ||
d. Demonstrate how to clean tracheostomy site. - CORRECT ANSWERS ✔✔Teach tracheal
|| || || || || || || || || || ||
suctioning techniques
|| ||
Rationale: Suctioning helps to clear secretions and maintain an open airway, which is
|| || || || || || || || || || || ||
critical.
||
, In assessing an adult client with a partial rebreather mask, the nurse notes that the
|| || || || || || || || || || || || || ||
oxygen reservoir bag does not deflate completely during inspiration and the client's
|| || || || || || || || || || || ||
respiratory rate is 14 breaths / minute. What action should the nurse implement
|| || || || || || || || || || || || ||
a. Encourage the client to take deep breaths
|| || || || || || ||
b. Remove the mask to deflate the bag
|| || || || || || ||
c. Increase the liter flow of oxygen
|| || || || || ||
d. Document the assessment data - CORRECT ANSWERS ✔✔Document the assessment
|| || || || || || || || || ||
data
|| ||
Rational: reservoir bag should not deflate completely during inspiration and the client's
|| || || || || || || || || || ||
respiratory rate is within normal limits.
|| || || || || ||
During shift report, the central electrocardiogram (EKG) monitoring system alarms.
|| || || || || || || || ||
Which client alarm should the nurse investigate first?
|| || || || || || || ||
a. Respiratory apnea of 30 seconds
|| || || || ||
b. Oxygen saturation rate of 88%
|| || || || ||
c. Eight premature ventricular beats every minute
|| || || || || ||
d. Disconnected monitor signal for the last 6 minutes. - CORRECT ANSWERS
|| || || || || || || || || || ||
✔✔Respiratory apnea of 30 seconds
|| || || || ||
Rationale: The priority is the client whose alarm indicating respiratory apnea that should
|| || || || || || || || || || || ||
be assessed first.
|| || ||
During a home visit, the nurse observed an elderly client with diabetes slip and fall. What
|| || || || || || || || || || || || || || ||
action should the nurse take first?
|| || || || || ||
a. Give the client 4 ounces of orange juice
|| || || || || || || ||
b. Call 911 to summon emergency assistance
|| || || || || ||
with correct answers with rationales
Following discharge teaching, a male client with duodenal ulcer tells the nurse the he will
|| || || || || || || || || || || || || ||
drink plenty of dairy products, such as milk, to help coat and protect his ulcer. What is
|| || || || || || || || || || || || || || || || ||
the best follow-up action by the nurse?
|| || || || || || ||
a. Remind the client that it is also important to switch to decaffeinated coffee and tea.
|| || || || || || || || || || || || || || ||
b. Suggest that the client also plan to eat frequent small meals to reduce discomfort
|| || || || || || || || || || || || || ||
c. Review with the client the need to avoid foods that are rich in milk and cream.
|| || || || || || || || || || || || || || || ||
d. Reinforce this teaching by asking the client to list a dairy food that he might select. -
|| || || || || || || || || || || || || || || || ||
CORRECT ANSWERS ✔✔Review with the client the need to avoid foods that are rich in
|| || || || || || || || || || || || || || ||
milk and cream
|| || ||
Rationale: Diets rich in milk and cream stimulate gastric acid secretion and should be
|| || || || || || || || || || || || ||
avoided.
||
A male client with hypertension, who received new antihypertensive prescriptions at his
|| || || || || || || || || || ||
last visit returns to the clinic two weeks later to evaluate his blood pressure (BP). His BP
|| || || || || || || || || || || || || || || || ||
is 158/106 and he admits that he has not been taking the prescribed medication because
|| || || || || || || || || || || || || || ||
the drugs make him "feel bad". In explaining the need for hypertension control, the nurse
|| || || || || || || || || || || || || || ||
should stress that an elevated BP places the client at risk for which pathophysiological
|| || || || || || || || || || || || || ||
condition?
||
a. Blindness secondary to cataracts
|| || || ||
b. Acute kidney injury due to glomerular damage
|| || || || || || ||
c. Stroke secondary to hemorrhage
|| || || ||
d. Heart block due to myocardial damage - CORRECT ANSWERS ✔✔Stroke secondary to
|| || || || || || || || || || || ||
hemorrhage
||
,Rationale: Stroke related to cerebral hemorrhage is major risk for uncontrolled
|| || || || || || || || || ||
hypertension.
||
The nurse observes an unlicensed assistive personnel (UAP) positioning a newly
|| || || || || || || || || ||
admitted client who has a seizure disorder. The client is supine and the UAP is placing
|| || || || || || || || || || || || || || || ||
soft pillows along the side rails. What action should the nurse implement?
|| || || || || || || || || || || ||
a. Ensure that the UAP has placed the pillows effectively to protect the client.
|| || || || || || || || || || || || ||
b. Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows.
|| || || || || || || || || || || || || || || ||
c. Assume responsibility for placing the pillows while the UAP completes another task.
|| || || || || || || || || || || ||
d. Ask the UAP to use some of the pillows to prop the client in a side lying position. -
|| || || || || || || || || || || || || || || || || || ||
CORRECT ANSWERS ✔✔Instruct the UAP to obtain soft blankets to secure to the side
|| || || || || || || || || || || || || ||
rails instead of pillows
|| || || ||
Rationale: The nurse should instruct the UAP to pad the side rails with soft blankest
|| || || || || || || || || || || || || ||
because the use of pillows could result in suffocation and would need to be removed at
|| || || || || || || || || || || || || || || ||
the onset of the seizure. The nurse can delegate paddling the side rails to the UAP
|| || || || || || || || || || || || || || || ||
An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for
|| || || || || || || || || || ||
the past 12 days. Which assessment finding requires immediate follow-up
|| || || || || || || || || ||
a. Describes life without purpose
|| || || ||
b. Complains of nausea and loss of appetite
|| || || || || || ||
c. States is often fatigued and drowsy
|| || || || || ||
d. Exhibits an increase in sweating. - CORRECT ANSWERS ✔✔Describes life without
|| || || || || || || || || || ||
purpose
||
,Rationale: Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor that is
|| || || || || || || || || || ||
known to increase the risk of suicidal thinking in adolescents and young adults with
|| || || || || || || || || || || || || ||
major depressive disorder. B, C and D are side effects
|| || || || || || || || || ||
A 60-year-old female client with a positive family history of ovarian cancer has developed
|| || || || || || || || || || || || ||
an abdominal mass and is being evaluated for possible ovarian cancer. Her Papanicolau
|| || || || || || || || || || || || ||
(Pap) smear results are negative. What information should the nurse include in the
|| || || || || || || || || || || || ||
client's teaching plan
|| || ||
a. Further evaluation involving surgery may be needed
|| || || || || || ||
b. A pelvic exam is also needed before cancer is ruled out
|| || || || || || || || || || ||
c. Pap smear evaluation should be continued every six month
|| || || || || || || || ||
d. One additional negative pap smear in six months is needed. - CORRECT ANSWERS
|| || || || || || || || || || || || ||
✔✔Further evaluation involving surgery may be needed
|| || || || || || ||
Rationale: An abdominal mass in a client with a family history for ovarian cancer should
|| || || || || || || || || || || || || ||
be evaluated carefully
|| || ||
A client who recently underwent a tracheostomy is being prepared for discharge to
|| || || || || || || || || || || ||
home. Which instructions is most important for the nurse to include in the discharge
|| || || || || || || || || || || || || ||
plan?
||
a. Explain how to use communication tools.
|| || || || || ||
b. Teach tracheal suctioning techniques
|| || || ||
c. Encourage self-care and independence.
|| || || ||
d. Demonstrate how to clean tracheostomy site. - CORRECT ANSWERS ✔✔Teach tracheal
|| || || || || || || || || || ||
suctioning techniques
|| ||
Rationale: Suctioning helps to clear secretions and maintain an open airway, which is
|| || || || || || || || || || || ||
critical.
||
, In assessing an adult client with a partial rebreather mask, the nurse notes that the
|| || || || || || || || || || || || || ||
oxygen reservoir bag does not deflate completely during inspiration and the client's
|| || || || || || || || || || || ||
respiratory rate is 14 breaths / minute. What action should the nurse implement
|| || || || || || || || || || || || ||
a. Encourage the client to take deep breaths
|| || || || || || ||
b. Remove the mask to deflate the bag
|| || || || || || ||
c. Increase the liter flow of oxygen
|| || || || || ||
d. Document the assessment data - CORRECT ANSWERS ✔✔Document the assessment
|| || || || || || || || || ||
data
|| ||
Rational: reservoir bag should not deflate completely during inspiration and the client's
|| || || || || || || || || || ||
respiratory rate is within normal limits.
|| || || || || ||
During shift report, the central electrocardiogram (EKG) monitoring system alarms.
|| || || || || || || || ||
Which client alarm should the nurse investigate first?
|| || || || || || || ||
a. Respiratory apnea of 30 seconds
|| || || || ||
b. Oxygen saturation rate of 88%
|| || || || ||
c. Eight premature ventricular beats every minute
|| || || || || ||
d. Disconnected monitor signal for the last 6 minutes. - CORRECT ANSWERS
|| || || || || || || || || || ||
✔✔Respiratory apnea of 30 seconds
|| || || || ||
Rationale: The priority is the client whose alarm indicating respiratory apnea that should
|| || || || || || || || || || || ||
be assessed first.
|| || ||
During a home visit, the nurse observed an elderly client with diabetes slip and fall. What
|| || || || || || || || || || || || || || ||
action should the nurse take first?
|| || || || || ||
a. Give the client 4 ounces of orange juice
|| || || || || || || ||
b. Call 911 to summon emergency assistance
|| || || || || ||
