HESI Comprehensive Exit Exam 1 – Complete Exam
Questions and Answers with Rationales | Latest Update
2026/2027- Already Graded A+
Question 1
The nurse is monitoring neurological vital signs for a male client who lost consciousness
after falling and hitting his head. Which assessment finding is the earliest and most
sensitive indication of altered cerebral function?
A. Unequal pupils
B. Loss of central reflexes
C. Inability to open the eyes
D. Change in level of consciousness
Correct Answer: D
Explanation: Neurological vital signs include serial assessments of TPR, blood
pressure, and components of the Glasgow Coma Scale (GCS), which includes verbal,
musculoskeletal, and pupillary responses. A change in the client's level of consciousness,
as indicated by responses to commands during the GCS, is the first and the most
sensitive sign of change in cerebral function. The other assessment data choices are late
signs of altered cerebral function.
Question 2
A client who has active tuberculosis (TB) is admitted to the medical unit. What action is
most important for the nurse to implement?
A. Place an isolation cart in the hallway
B. Fit the client with a respirator mask
C. Don a clean gown for client care
D. Assign the client to a negative air-flow room
Correct Answer: D
Explanation: Active tuberculosis requires implementation of airborne precautions, so
the client should be assigned to a negative pressure air-flow room. Although isolation
gowns and isolation carts should be implemented for clients in isolation with contact
precautions, it is most important that air flow from the room is minimized when the
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,client has TB. The respirator mask should be implemented when the client leaves the
isolation environment.
Question 3
The nurse is planning to conduct nutritional assessments and diet teaching to clients at
a family health clinic. Which individual has the greatest nutritional and energy
demands?
A. A pregnant woman
B. A teenager beginning puberty
C. A 3-month-old infant
D. A school-aged child
Correct Answer: A
Explanation: A pregnant woman's metabolic demands are 20 to 24% more than the
basic metabolic rate. The other clients require only 15 to 20% more than the basic
metabolic rate.
Question 4
What nursing delivery of care provides the nurse to plan and direct care of a group of
clients over a 24-hour period?
A. Team nursing
B. Primary nursing
C. Case management
D. Functional nursing
Correct Answer: B
Explanation: Primary nursing is a model of delivery of care where a nurse is
accountable for planning care for clients around the clock. Functional nursing is a care
delivery model that provides client care by assignment of functions or tasks. Team
nursing is a care delivery model where assignments to a group of clients are provided by
a mixed-staff team. Case management is the delivery of care that uses a collaborative
process of assessment, planning, facilitation, and advocacy for options and services to
meet an individual's health needs and promote quality cost-effective outcomes.
Question 5
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,Which approach should the nurse use when preparing a toddler for a procedure?
A. Demonstrate the procedure using a doll
B. Avoid asking the child to make choices
C. Plan a teaching session to last about 20 minutes
D. Show equipment but prevent child from handling it
Correct Answer: A
Explanation: Imitation is one of the most distinguishing characteristics of toddler
play, so demonstration of a procedure on a doll enables a non-threatening, dramatic
experience that can help prepare the toddler for the actual procedure. The primary
developmental task in toddlerhood is acquiring a sense of autonomy, so giving choices
whenever possible to a toddler is recommended, not avoiding asking the toddler to make
a choice. Since the toddler's attention span is short, teaching sessions should be brief
and can be repeated for reinforcement. Showing the equipment before its use helps
relieve anxiety, but the child should be allowed to handle some of the equipment to
prevent frustration and alleviate fear.
Question 6
The nurse is caring for a client who is the daughter of a local politician. When the nurse
approaches a man who is reading the names on the hall doors, he identifies himself as a
reporter for the local newspaper and requests information about the client's status.
Which standard of nursing practice should the nurse use to respond?
A. Caring
B. Veracity
C. Advocacy
D. Confidentiality
Correct Answer: D
Explanation: Confidentiality is the nurse's primary responsibility and is supported by
HIPAA, which mandates that personal information is not disclosed and access to
sensitive client information is limited. Caring involves the nurse's concern about how
the client experiences the world. Veracity is the nurse's duty to tell the truth and not
deceive others. Advocacy is support of the client's best interests.
Question 7
A male client diagnosed with antisocial personality disorder is morbidly obese and is
placed on a low fat, low calorie diet. At dinner the nurse notes that he is trying to get
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, other clients on the unit to give him part of their meals. What intervention should the
nurse implement?
A. Remove the client from the table and have him sit alone
B. Send the client back to his room and do not allow him to eat
C. Report the behavior to the on-call psychologist immediately
D. Confront the client about the consequences of the behavior
Correct Answer: D
Explanation: The nurse should provide a reality check by helping the client realize
that there are consequences to his behavior. Removing the client from the room or table
does not help the client realize that his behavior is manipulative and harmful to himself
as well as others. This behavior needs to be documented, but does not need to be
reported immediately.
Question 8
The nurse is assessing a client who complains of weight loss, racing heart rate, and
difficulty sleeping. The nurse determines the client has moist skin with fine hair,
prominent eyes, lid retraction, and a staring expression. These findings are consistent
with which disorder?
A. Grave's disease
B. Cushing syndrome
C. Multiple sclerosis
D. Addison's disease
Correct Answer: A
Explanation: This client is exhibiting symptoms associated with hyperthyroidism or
Grave's disease, which is an autoimmune condition affecting the thyroid. Cushing
syndrome, multiple sclerosis, or Addison's disease are not associated with these
symptoms.
Question 9
Which information should the nurse give a client with chronic kidney disease (CKD)?
A. Restrict calcium-rich foods
B. Obtain monthly B12 injections
C. Avoid salt substitutes
D. Increase daily intake of fiber
pg. 4
Questions and Answers with Rationales | Latest Update
2026/2027- Already Graded A+
Question 1
The nurse is monitoring neurological vital signs for a male client who lost consciousness
after falling and hitting his head. Which assessment finding is the earliest and most
sensitive indication of altered cerebral function?
A. Unequal pupils
B. Loss of central reflexes
C. Inability to open the eyes
D. Change in level of consciousness
Correct Answer: D
Explanation: Neurological vital signs include serial assessments of TPR, blood
pressure, and components of the Glasgow Coma Scale (GCS), which includes verbal,
musculoskeletal, and pupillary responses. A change in the client's level of consciousness,
as indicated by responses to commands during the GCS, is the first and the most
sensitive sign of change in cerebral function. The other assessment data choices are late
signs of altered cerebral function.
Question 2
A client who has active tuberculosis (TB) is admitted to the medical unit. What action is
most important for the nurse to implement?
A. Place an isolation cart in the hallway
B. Fit the client with a respirator mask
C. Don a clean gown for client care
D. Assign the client to a negative air-flow room
Correct Answer: D
Explanation: Active tuberculosis requires implementation of airborne precautions, so
the client should be assigned to a negative pressure air-flow room. Although isolation
gowns and isolation carts should be implemented for clients in isolation with contact
precautions, it is most important that air flow from the room is minimized when the
pg. 1
,client has TB. The respirator mask should be implemented when the client leaves the
isolation environment.
Question 3
The nurse is planning to conduct nutritional assessments and diet teaching to clients at
a family health clinic. Which individual has the greatest nutritional and energy
demands?
A. A pregnant woman
B. A teenager beginning puberty
C. A 3-month-old infant
D. A school-aged child
Correct Answer: A
Explanation: A pregnant woman's metabolic demands are 20 to 24% more than the
basic metabolic rate. The other clients require only 15 to 20% more than the basic
metabolic rate.
Question 4
What nursing delivery of care provides the nurse to plan and direct care of a group of
clients over a 24-hour period?
A. Team nursing
B. Primary nursing
C. Case management
D. Functional nursing
Correct Answer: B
Explanation: Primary nursing is a model of delivery of care where a nurse is
accountable for planning care for clients around the clock. Functional nursing is a care
delivery model that provides client care by assignment of functions or tasks. Team
nursing is a care delivery model where assignments to a group of clients are provided by
a mixed-staff team. Case management is the delivery of care that uses a collaborative
process of assessment, planning, facilitation, and advocacy for options and services to
meet an individual's health needs and promote quality cost-effective outcomes.
Question 5
pg. 2
,Which approach should the nurse use when preparing a toddler for a procedure?
A. Demonstrate the procedure using a doll
B. Avoid asking the child to make choices
C. Plan a teaching session to last about 20 minutes
D. Show equipment but prevent child from handling it
Correct Answer: A
Explanation: Imitation is one of the most distinguishing characteristics of toddler
play, so demonstration of a procedure on a doll enables a non-threatening, dramatic
experience that can help prepare the toddler for the actual procedure. The primary
developmental task in toddlerhood is acquiring a sense of autonomy, so giving choices
whenever possible to a toddler is recommended, not avoiding asking the toddler to make
a choice. Since the toddler's attention span is short, teaching sessions should be brief
and can be repeated for reinforcement. Showing the equipment before its use helps
relieve anxiety, but the child should be allowed to handle some of the equipment to
prevent frustration and alleviate fear.
Question 6
The nurse is caring for a client who is the daughter of a local politician. When the nurse
approaches a man who is reading the names on the hall doors, he identifies himself as a
reporter for the local newspaper and requests information about the client's status.
Which standard of nursing practice should the nurse use to respond?
A. Caring
B. Veracity
C. Advocacy
D. Confidentiality
Correct Answer: D
Explanation: Confidentiality is the nurse's primary responsibility and is supported by
HIPAA, which mandates that personal information is not disclosed and access to
sensitive client information is limited. Caring involves the nurse's concern about how
the client experiences the world. Veracity is the nurse's duty to tell the truth and not
deceive others. Advocacy is support of the client's best interests.
Question 7
A male client diagnosed with antisocial personality disorder is morbidly obese and is
placed on a low fat, low calorie diet. At dinner the nurse notes that he is trying to get
pg. 3
, other clients on the unit to give him part of their meals. What intervention should the
nurse implement?
A. Remove the client from the table and have him sit alone
B. Send the client back to his room and do not allow him to eat
C. Report the behavior to the on-call psychologist immediately
D. Confront the client about the consequences of the behavior
Correct Answer: D
Explanation: The nurse should provide a reality check by helping the client realize
that there are consequences to his behavior. Removing the client from the room or table
does not help the client realize that his behavior is manipulative and harmful to himself
as well as others. This behavior needs to be documented, but does not need to be
reported immediately.
Question 8
The nurse is assessing a client who complains of weight loss, racing heart rate, and
difficulty sleeping. The nurse determines the client has moist skin with fine hair,
prominent eyes, lid retraction, and a staring expression. These findings are consistent
with which disorder?
A. Grave's disease
B. Cushing syndrome
C. Multiple sclerosis
D. Addison's disease
Correct Answer: A
Explanation: This client is exhibiting symptoms associated with hyperthyroidism or
Grave's disease, which is an autoimmune condition affecting the thyroid. Cushing
syndrome, multiple sclerosis, or Addison's disease are not associated with these
symptoms.
Question 9
Which information should the nurse give a client with chronic kidney disease (CKD)?
A. Restrict calcium-rich foods
B. Obtain monthly B12 injections
C. Avoid salt substitutes
D. Increase daily intake of fiber
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