HESI EXIT NGN ACTUAL EXAM TEST
Success-Focused Exam Bundle | Sample Papers, Answer Tips, and Key Takeaway
Summaries
A pt presses the call bell and requests pain medication for a severe headache. To assess the
quality of the pt. Pain, which approach should the nurse use? - Ask the patient to describe the
pain
The nurse is wearing personal protective equipment while caring for a pt. When exiting the
room, which PPE should be removed first? - Gloves
An older pt is brought to the ED with a sudden onset of confusion that occurred after
experiencing a fall at home. The daughter, who has power of attorney, has brought the client's
prescriptions. Which information should the nurse provide first when reporting to the
healthcare provider using SBAR communication? - Increasing confusion of the pt.
A pt tells the nurse about working out with a personal trainer and swimming three times a week
in an effort to lose weight and sleep better. The pt states that it still is taking hours to fall asleep
at night. Which action should the nurse implement? - Ask the pt for a description of the exercise
schedule that is being followed
2 days prior to discharge from the rehab facility, the nurse is teaching a pt who is recovering
from Guillain-Barre syndrome about home. Which actions should the nurse include when
providing discharge teaching to the pt and spouse? SATA - -review safe transfer strategies
-develop a nutritional plan
-help identify community support
The nurse implements a tertiary prevention program for type 2 diabetes in a rural health clinic.
Which outcome indicates that the program was effective? - pt who develop disease
complications promptly received rehabilitation
,The nurse has received funding to design a health promotion project for African American
women who are at risk for developing breast cancer. Which resource is most important in
designing this program? - participation of community leaders in planning the program
A pt with multiple injuries is being treated in the burn trauma unit just hours after the injuries
occurred. The healthcare provider instructs the nurse to avoid auto contamination when
performing dressing changes. Which intervention is most important for the nurse to
implement? - use gown, mask, and gloves with dressing changes
A pt is recovering in the critical care unit following a cardiac cath. IV nitro and heparin are
infusing. The pt is sedated but responds to instructions. After changing positions, the pt
complains of pain at the right groin insertion site. What action should the nurse implement? -
Stimulate the pt to take deep breaths
Prior to obtaining a trapeze bar for a pt with limited mobility, which pt assessment is most
important for the nurse to obtain? - upper body muscle strength
While the nurse is assessing an older pt fall risk, the pt reports living at home alone and never
falling. Which action should the nurse take? - Continue to obtain pt data needed to complete
the fall risk survey
The nurse is feeding an older adult who was admitted with aspiration pneumonia. The pt is
weak and begins coughing while attempting to drink through a straw. Which intervention should
the nurse implement? - Teach coughing and deep breathing exercises
The nurse is teaching the pt about home care after surgery for an ileal conduit placement.
When reviewing the information, which statement should the nurse recognize as needing
additional education? - Empty the pouch when it is half full.
A 12 week gestation is admitted to the antepartum unit with a dx of hyperemesis gravidarum.
Which action is most important for the nurse to implement? - initiate prescribed IV fluids
,A pt with dyspnea is being admitted to the medical unit. To best prepare for the pt arrival, the
nurse should ensure that the pt bed is in which position? - Picture with the bed sitting up
A pt who is scheduled for a bronchoscopy in the morning is anxious and asking the nurse
numerous questions about the procedure. In preparing the pt for the procedure, which
intervention has the highest priority? - Instruct pt to write down questions
While caring for a pt post operative dressing, the nurse observes purulent drainage at the
wound. Before reporting this finding to the provider, the nurse should review which of the pt
lab values? - culture for sensitive organisms
A pt with a lower respiratory tract infection receives a prescription for ciprofloxacin 500mg PO
every 12hrs. When the client requests an afternoon snack, which dietary choice should the
nurse provide? - Cinnamon apple sauce
An older male reporting abd pain is admitted from a facility. It has been 7 days since his last BM
and his abd is distended, and he just vomited 150ml of dark brown emesis. In what order should
the nurse implement these interventions? - Send emesis to lab
Elevate HOB
complete focused assessment
offers PRN pain meds
A patient who recently received a prescription for ramelteon to treat sleep deprivation reports
experiencing several side effects since taking the med. Which side effect should the nurse report
to the healthcare provider? - Somnambulism
A pt is scheduled for a spiral CT scan with contrast to evaluate for pulmonary embolism. Which
information in the client's history requires follow up by the nurse? - take metformin for type 2
diabetes
, The nurse should withhold which medication if the client's serum potassium level is 6.2 mEq/? -
Spironolactone
A nurse receives a report on a pt who is four hours post-total abdominal hysterectomy. The
previous nurse reports that it was necessary to change the client's perineal pad hourly and that
it is again saturated. The previous nurse also reports that the client's urinary output has
decreased. Which action should the nurse implement first? - Assess for weakness or dizziness
A pt who is admitted for primary hypothyroidism has early signs of myxedema coma. In
assessing the pt, in which sequence should the nurse complete these actions? - -Observe
breathing patterns
-assess blood pressure
-measure body temp
-palpate for pedal edema
The nurse is taking the blood pressure measurement of a client with Parkinson's disease. Which
information in the admission assessment is relevant to the nurse's plan for taking the blood
pressure reading? SATA - Blurred Vision
Flat Affect
frequent syncope
After administering a proton pump inhibitor, which action should the nurse take to evaluate the
effectiveness of the medication? - Ask the pt about gastrointestinal pain
A pt is receiving enoxaparin 30 mg subcutaneously twice a day. In assessing for adverse effects
of the medication, which serum laboratory value most important for the nurse to monitor -
platelet count
Success-Focused Exam Bundle | Sample Papers, Answer Tips, and Key Takeaway
Summaries
A pt presses the call bell and requests pain medication for a severe headache. To assess the
quality of the pt. Pain, which approach should the nurse use? - Ask the patient to describe the
pain
The nurse is wearing personal protective equipment while caring for a pt. When exiting the
room, which PPE should be removed first? - Gloves
An older pt is brought to the ED with a sudden onset of confusion that occurred after
experiencing a fall at home. The daughter, who has power of attorney, has brought the client's
prescriptions. Which information should the nurse provide first when reporting to the
healthcare provider using SBAR communication? - Increasing confusion of the pt.
A pt tells the nurse about working out with a personal trainer and swimming three times a week
in an effort to lose weight and sleep better. The pt states that it still is taking hours to fall asleep
at night. Which action should the nurse implement? - Ask the pt for a description of the exercise
schedule that is being followed
2 days prior to discharge from the rehab facility, the nurse is teaching a pt who is recovering
from Guillain-Barre syndrome about home. Which actions should the nurse include when
providing discharge teaching to the pt and spouse? SATA - -review safe transfer strategies
-develop a nutritional plan
-help identify community support
The nurse implements a tertiary prevention program for type 2 diabetes in a rural health clinic.
Which outcome indicates that the program was effective? - pt who develop disease
complications promptly received rehabilitation
,The nurse has received funding to design a health promotion project for African American
women who are at risk for developing breast cancer. Which resource is most important in
designing this program? - participation of community leaders in planning the program
A pt with multiple injuries is being treated in the burn trauma unit just hours after the injuries
occurred. The healthcare provider instructs the nurse to avoid auto contamination when
performing dressing changes. Which intervention is most important for the nurse to
implement? - use gown, mask, and gloves with dressing changes
A pt is recovering in the critical care unit following a cardiac cath. IV nitro and heparin are
infusing. The pt is sedated but responds to instructions. After changing positions, the pt
complains of pain at the right groin insertion site. What action should the nurse implement? -
Stimulate the pt to take deep breaths
Prior to obtaining a trapeze bar for a pt with limited mobility, which pt assessment is most
important for the nurse to obtain? - upper body muscle strength
While the nurse is assessing an older pt fall risk, the pt reports living at home alone and never
falling. Which action should the nurse take? - Continue to obtain pt data needed to complete
the fall risk survey
The nurse is feeding an older adult who was admitted with aspiration pneumonia. The pt is
weak and begins coughing while attempting to drink through a straw. Which intervention should
the nurse implement? - Teach coughing and deep breathing exercises
The nurse is teaching the pt about home care after surgery for an ileal conduit placement.
When reviewing the information, which statement should the nurse recognize as needing
additional education? - Empty the pouch when it is half full.
A 12 week gestation is admitted to the antepartum unit with a dx of hyperemesis gravidarum.
Which action is most important for the nurse to implement? - initiate prescribed IV fluids
,A pt with dyspnea is being admitted to the medical unit. To best prepare for the pt arrival, the
nurse should ensure that the pt bed is in which position? - Picture with the bed sitting up
A pt who is scheduled for a bronchoscopy in the morning is anxious and asking the nurse
numerous questions about the procedure. In preparing the pt for the procedure, which
intervention has the highest priority? - Instruct pt to write down questions
While caring for a pt post operative dressing, the nurse observes purulent drainage at the
wound. Before reporting this finding to the provider, the nurse should review which of the pt
lab values? - culture for sensitive organisms
A pt with a lower respiratory tract infection receives a prescription for ciprofloxacin 500mg PO
every 12hrs. When the client requests an afternoon snack, which dietary choice should the
nurse provide? - Cinnamon apple sauce
An older male reporting abd pain is admitted from a facility. It has been 7 days since his last BM
and his abd is distended, and he just vomited 150ml of dark brown emesis. In what order should
the nurse implement these interventions? - Send emesis to lab
Elevate HOB
complete focused assessment
offers PRN pain meds
A patient who recently received a prescription for ramelteon to treat sleep deprivation reports
experiencing several side effects since taking the med. Which side effect should the nurse report
to the healthcare provider? - Somnambulism
A pt is scheduled for a spiral CT scan with contrast to evaluate for pulmonary embolism. Which
information in the client's history requires follow up by the nurse? - take metformin for type 2
diabetes
, The nurse should withhold which medication if the client's serum potassium level is 6.2 mEq/? -
Spironolactone
A nurse receives a report on a pt who is four hours post-total abdominal hysterectomy. The
previous nurse reports that it was necessary to change the client's perineal pad hourly and that
it is again saturated. The previous nurse also reports that the client's urinary output has
decreased. Which action should the nurse implement first? - Assess for weakness or dizziness
A pt who is admitted for primary hypothyroidism has early signs of myxedema coma. In
assessing the pt, in which sequence should the nurse complete these actions? - -Observe
breathing patterns
-assess blood pressure
-measure body temp
-palpate for pedal edema
The nurse is taking the blood pressure measurement of a client with Parkinson's disease. Which
information in the admission assessment is relevant to the nurse's plan for taking the blood
pressure reading? SATA - Blurred Vision
Flat Affect
frequent syncope
After administering a proton pump inhibitor, which action should the nurse take to evaluate the
effectiveness of the medication? - Ask the pt about gastrointestinal pain
A pt is receiving enoxaparin 30 mg subcutaneously twice a day. In assessing for adverse effects
of the medication, which serum laboratory value most important for the nurse to monitor -
platelet count
