1|Page
HESI Exit Exam Prep Bundle
Updated Questions, NGN Case Studies,
Answers, and Rationales.
While assessing a radial artery catheter, the client complains of numbness and
pain distal to the insertion site. What interventions should the nurse
implement?
ANSWER: Promptly remove the arterial catheter from the radial artery.
A client is admitted with an epidural hematoma that resulted from a
skateboarding accident. To differentiate the vascular source of the
intracranial bleeding, which finding should the nurse monitor?
ANSWER: Rapid onset of decreased level of consciousness.
When preparing a client for discharge from the hospital following a
cystectomy and a urinary diversion to treat bladder cancer, which instruction
is most important for the nurse to include in the client's discharge teaching
plan?
ANSWER: Report any signs of cloudy urine output.
After repositioning an immobile client, the nurse observes an area of
hyperemia. To assess for blanching, what action should the nurse take?
ANSWER: Apply light pressure over the area.
The nurse enters a client's room and observes the client's wrist restraint
secured as seen in the picture. What action should the nurse take?
,2|Page
ANSWER: Reposition the restraint tie onto the bedframe.
A female client with acute respiratory distress syndrome (ARDS) is chemically
paralyzed and sedated while she is on as assist-control ventilator using 50% FIO2.
Which assessment finding warrants immediate intervention by the nurse?
ANSWER: Diminished left lower lobe sounds
Rationale: Diminished lobe sounds indicate collapsed alveoli or tension
pneumothorax, which required immediate chest tube insertion to re-inflate the
lung.
The development of atherosclerosis is a process of sequential events. Arrange
the pathophysiological events in orders of occurrence. (Place the first event on
top and the last on the bottom)
ANSWER: Arterial endothelium injury causes inflammation
Macrophages consume low density lipoprotein (LDL), creating foam cells
Foam cells release growth factors for smooth muscle cells
Smooth muscle grows over fatty streaks creating fibrous plaques
Vessel narrowing results in ischemia
Following a motor vehicle collision, an adult female with a ruptured spleen
and a blood pressure of 70/44, had an emergency splenectomy. Twelve hours
after the surgery, her urine output is 25 ml/hour for the last two hours. What
pathophysiological reason supports the nurse's decision to report this finding
to the healthcare provider?
ANSWER: Oliguria signals tubular necrosis related to hypoperfusion
,3|Page
A nurse-manager is preparing the curricula for a class for charge nurses. A staffing
formula based on what data ensures quality client care and is most cost-effective?
ANSWER: Skills of staff and client acuity
When performing postural drainage on a client with Chronic Obstructive
Pulmonary Disease (COPD), which approach should the nurse use?
ANSWER: Explain that the client may be placed in five positions
A client presents in the emergency room with right-sided facial asymmetry.
The nurse asks the client to perform a series of movements that require use of
the facial muscles. What symptoms suggest that the client has most likely
experience a Bell's palsy rather than a stroke?
ANSWER: Inability to close the affected eye, raise brow, or smile
The nurse is teaching a client how to perform colostomy irrigations. When
observing the client's return demonstration, which action indicated that the
client understood the teaching?
ANSWER: Keeps the irrigating container less than 18 inches above the stoma
The nurse should teach the client to observe which precaution while taking
dronedarone?
ANSWER: Avoid grapefruits and its juice
A client who sustained a head injury following an automobile collision is
admitted to the hospital. The nurse include the client's risk for developing
increased intracranial pressure (ICP) in the plan of care. Which signs indicate
to the nurse that ICP has increased?
, 4|Page
ANSWER: Increased Glasgow coma scale score.
Nuchal rigidity and papilledema.
Confusion and papilledema
Periorbital ecchymosis.
Rationale: papilledema is always an indicator of increased ICP, and confusion is
usually the first sign of increased ICP. Other options do not necessarily reflect
increased ICP.
The nurse is caring for a client receiving continuous IV fluids through a single
lumen central venous catheter (CVC). Based on the CVC care bundle, which
action should be completed daily to reduce the risk for infection?
ANSWER: Confirm the necessity for continued use of the CVC.
During an annual physical examination, an older woman's fasting blood sugar
(FBS) is determined to be 140 mg/dl or 7.8 mmol/L (SI). Which additional
finding obtained during a follow-up visit 2 weeks later is most indicative that
the client has diabetes mellitus (DM)?
ANSWER: Repeated fasting blood sugar (FBS) is 132 mg/dl or 7.4 mmol/L (SI).
A client who was admitted yesterday with severe dehydration is complaining
of pain a 24 gauge IV with normal saline is infusing at a rate of 150 ml/hour.
Which intervention should the nurse implement first?
ANSWER: Stop the normal saline infusion.
An elderly female is admitted because of a change in her level of sensorium.
During the evening shift, the client attempts to get out bed and falls, breaking
her left hip. Buck's skin traction is applied to the left leg while waiting for
HESI Exit Exam Prep Bundle
Updated Questions, NGN Case Studies,
Answers, and Rationales.
While assessing a radial artery catheter, the client complains of numbness and
pain distal to the insertion site. What interventions should the nurse
implement?
ANSWER: Promptly remove the arterial catheter from the radial artery.
A client is admitted with an epidural hematoma that resulted from a
skateboarding accident. To differentiate the vascular source of the
intracranial bleeding, which finding should the nurse monitor?
ANSWER: Rapid onset of decreased level of consciousness.
When preparing a client for discharge from the hospital following a
cystectomy and a urinary diversion to treat bladder cancer, which instruction
is most important for the nurse to include in the client's discharge teaching
plan?
ANSWER: Report any signs of cloudy urine output.
After repositioning an immobile client, the nurse observes an area of
hyperemia. To assess for blanching, what action should the nurse take?
ANSWER: Apply light pressure over the area.
The nurse enters a client's room and observes the client's wrist restraint
secured as seen in the picture. What action should the nurse take?
,2|Page
ANSWER: Reposition the restraint tie onto the bedframe.
A female client with acute respiratory distress syndrome (ARDS) is chemically
paralyzed and sedated while she is on as assist-control ventilator using 50% FIO2.
Which assessment finding warrants immediate intervention by the nurse?
ANSWER: Diminished left lower lobe sounds
Rationale: Diminished lobe sounds indicate collapsed alveoli or tension
pneumothorax, which required immediate chest tube insertion to re-inflate the
lung.
The development of atherosclerosis is a process of sequential events. Arrange
the pathophysiological events in orders of occurrence. (Place the first event on
top and the last on the bottom)
ANSWER: Arterial endothelium injury causes inflammation
Macrophages consume low density lipoprotein (LDL), creating foam cells
Foam cells release growth factors for smooth muscle cells
Smooth muscle grows over fatty streaks creating fibrous plaques
Vessel narrowing results in ischemia
Following a motor vehicle collision, an adult female with a ruptured spleen
and a blood pressure of 70/44, had an emergency splenectomy. Twelve hours
after the surgery, her urine output is 25 ml/hour for the last two hours. What
pathophysiological reason supports the nurse's decision to report this finding
to the healthcare provider?
ANSWER: Oliguria signals tubular necrosis related to hypoperfusion
,3|Page
A nurse-manager is preparing the curricula for a class for charge nurses. A staffing
formula based on what data ensures quality client care and is most cost-effective?
ANSWER: Skills of staff and client acuity
When performing postural drainage on a client with Chronic Obstructive
Pulmonary Disease (COPD), which approach should the nurse use?
ANSWER: Explain that the client may be placed in five positions
A client presents in the emergency room with right-sided facial asymmetry.
The nurse asks the client to perform a series of movements that require use of
the facial muscles. What symptoms suggest that the client has most likely
experience a Bell's palsy rather than a stroke?
ANSWER: Inability to close the affected eye, raise brow, or smile
The nurse is teaching a client how to perform colostomy irrigations. When
observing the client's return demonstration, which action indicated that the
client understood the teaching?
ANSWER: Keeps the irrigating container less than 18 inches above the stoma
The nurse should teach the client to observe which precaution while taking
dronedarone?
ANSWER: Avoid grapefruits and its juice
A client who sustained a head injury following an automobile collision is
admitted to the hospital. The nurse include the client's risk for developing
increased intracranial pressure (ICP) in the plan of care. Which signs indicate
to the nurse that ICP has increased?
, 4|Page
ANSWER: Increased Glasgow coma scale score.
Nuchal rigidity and papilledema.
Confusion and papilledema
Periorbital ecchymosis.
Rationale: papilledema is always an indicator of increased ICP, and confusion is
usually the first sign of increased ICP. Other options do not necessarily reflect
increased ICP.
The nurse is caring for a client receiving continuous IV fluids through a single
lumen central venous catheter (CVC). Based on the CVC care bundle, which
action should be completed daily to reduce the risk for infection?
ANSWER: Confirm the necessity for continued use of the CVC.
During an annual physical examination, an older woman's fasting blood sugar
(FBS) is determined to be 140 mg/dl or 7.8 mmol/L (SI). Which additional
finding obtained during a follow-up visit 2 weeks later is most indicative that
the client has diabetes mellitus (DM)?
ANSWER: Repeated fasting blood sugar (FBS) is 132 mg/dl or 7.4 mmol/L (SI).
A client who was admitted yesterday with severe dehydration is complaining
of pain a 24 gauge IV with normal saline is infusing at a rate of 150 ml/hour.
Which intervention should the nurse implement first?
ANSWER: Stop the normal saline infusion.
An elderly female is admitted because of a change in her level of sensorium.
During the evening shift, the client attempts to get out bed and falls, breaking
her left hip. Buck's skin traction is applied to the left leg while waiting for
