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HESI EXIT EXAM TEST BANK WITH COMPREHENSIVE ANSWERS

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HESI EXIT EXAM TEST BANK WITH COMPREHENSIVE ANSWERS

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  • February 2, 2023
  • 17
  • 2022/2023
  • Exam (elaborations)
  • Questions & answers
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HESI EXIT



HESI EXIT EXAM TEST BANK WITH COMPREHENSIVE
ANSWERS
A client with asthma receives a prescription for high blood pressure during a clinic visit. Which
prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma? -
(answer)The best antihypertensive agent for clients with asthma is metoprolol (Lopressor) (C), a beta2
blocking agent which is also cardioselective and less likely to cause bronchoconstriction. Pindolol (A) is a
beta2 blocker that can cause bronchoconstriction and increase asthmatic symptoms. Although carteolol
(B) is a beta blocking agent and an effective antihypertensive agent used in managing angina, it can
increase a client's risk for bronchoconstriction due to its nonselective beta blocker action. Propranolol
(D) also blocks the beta2 receptors in the lungs, causing bronchoconstriction, and is not indicated in
clients with asthma and other obstructive pulmonary disorders.

A male client who has been taking propranolol (Inderal) for 18 months tells the nurse that the
healthcare provider discontinued the medication because his blood pressure has been normal for the
past three months. Which instruction should the nurse provide? - (answer)Although the healthcare
provider discontinued the propranolol, measures to prevent rebound cardiac excitation, such as
progressively reducing the dose over one to two weeks (C), should be recommended to prevent
rebound tachycardia, hypertension, and ventricular dysrhythmias. Abrupt cessation (A and B) of the
beta-blocking agent may precipitate tachycardia and rebound hypertension, so gradual weaning should
be recommended. (D) is not indicated.

A client who is taking clonidine (Catapres, Duraclon) reports drowsiness. Which additional assessment
should the nurse make? - (answer)How long has the client been taking the medication?



Drowsiness can occur in the early weeks of treatment with clonidine and with continued use becomes
less intense, so the length of time the client has been on the medication (A) provides information to
direct additional instruction. (B, C, and D) are not relevant.

The nurse is preparing to administer atropine, an anticholinergic, to a client who is scheduled for a
cholecystectomy. The client asks the nurse to explain the reason for the prescribed medication. What
response is best for the nurse to provide? - (answer)Decrease the risk of bradycardia during surgery.

An 80-year-old client is given morphine sulphate for postoperative pain. Which concomitant medication
should the nurse question that poses a potential development of urinary retention in this geriatric
client? - (answer)Drugs with anticholinergic properties, such as tricyclic antidepressants (C), can
exacerbate urinary retention associated with opioids in the older client. Although tricyclic
antidepressants and antihistamines with opioids can exacerbate urinary retention, the concurrent use of
(A and B) with opioids do not. Nonsteroidal antiinflammatory agents (D) can increase the risk for
bleeding, but do not increase urinary retention with opioids (D).

,HESI EXIT


A client with osteoarthritis is given a new prescription for a nonsteroidal antiinflammatory drug (NSAID).
The client asks the nurse, "How is this medication different from the acetaminophen I have been
taking?" Which information about the therapeutic action of NSAIDs should the nurse provide? -
(answer)Provide antiinflammatory response.

A client with cancer has a history of alcohol abuse and is taking acetaminophen (Tylenol) for pain. Which
organ function is most important for the nurse to monitor? - (answer)Acetaminophen and alcohol are
both metabolized in the liver. This places the client at risk for hepatotoxicity, so monitoring liver (A)
function is the most important assessment because the combination of acetaminophen and alcohol,
even in moderate amounts, can cause potentially fatal liver damage. Other non-narcotic analgesics, such
as n onsteroidal anti-inflammatory drugs (NSAIDs), are more likely to promote adverse renal effects (B).
Acetaminophen does not place the client at risk for toxic reactions related to (C or D).

The nurse obtains a heart rate of 92 and a blood pressure of 110/76 prior to administering a scheduled
dose of verapamil (Calan) for a client with atrial flutter. Which action should the nurse implement? -
(answer)Administer the dose as prescribed.



Verapamil slows sinoatrial (SA) nodal automaticity, delays atrioventricular (AV) nodal conduction, which
slows the ventricular rate, and is used to treat atrial flutter, so (A) should be implemented, based on the
client's heart rate and blood pressure. (B and C) are not indicated. (D) delays the administration of the
scheduled dose.

A client is admitted to the hospital with a diagnosis of Type 2 diabetes mellitus and influenza. Which
categories of illness should the nurse develop goals for the client's plan of care? - (answer)One chronic
and one acute illness.

Following an emergency Cesarean delivery, the nurse encourages the new mother to breastfeed her
newborn. The client asks why she should breastfeed now. Which information should the nurse provide?
- (answer)Stimulate contraction of the uterus.

Which intervention should the nurse include in the plan of care for a female client with severe
postpartum depression who is admitted to the inpatient psychiatric unit? - (answer)Supervised and
guided visits with infant.

A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining a fractured
bone. The healthcare provider explains the surgery needed to immobilize the fracture. Which action
should be implemented to obtain a valid informed consent? - (answer)The client is a minor and cannot
legally sign his own consent unless he is an emancipated minor, so the consent should be obtained from
the guardian for this client, which is the custodial parent (B). (A) is not a legal option. A stepparent is not
a legal guardian for a minor unless the child has been adopted by the stepparent (C). The non-custodial
parent does not need to co-sign this form (D).

, HESI EXIT


During a client assessment, the client says, "I can't walk very well." Which action should the nurse
implement first? - (answer)Identify the problem.

The nurse identifies a client's needs and formulates the nursing problem of, "Imbalanced nutrition: less
than body requirements, related to mental impairment and decreased intake, as evidenced by
increasing confusion and weight loss of more than 30 pounds over the last 6 months." Which short-term
goal is best for this client? - (answer)Eat 50% of six small meals each day by the end of one week.

A male client is angry and is leaving the hospital against medical advice (AMA). The client demands to
take his chart with him and states the chart is "his" and he doesn' t want any more contact with the
hospital. How should the nurse respond? - (answer)The chart is the property of the facility, but the client
has a legal right to the information in it, even if he is leaving AMA, so a copy of the record (D) should be
provided. The client does not lose his legal rights to his medical record if he leaves AMA (A). The medical
record is confidential, but the hospital protects the client's privacy by not allowing unauthorized access
to the record, so the hospital may provide the client with a copy (B). The hospital must maintain records
of the care provided and should not release the original record (C).

The nurse manager is assisting a nurse with improving organizational skills and time management.
Which nursing activity is the priority in pre-planning a schedule for selected nursing activities in the daily
assignment? - (answer)In developing organizational skills, medication administration is based on a
prescribed schedule that is time-sensitive in the delivery of nursing care and should be the priority in
scheduling nursing activities in a daily assignment. Although suctioning a client's tracheostomy takes
precedence in providing care, the client's PRN need is less amenable to a preselected schedule. (B and C)
can be scheduled around time-sensitive delivery of care.

What nursing delivery of care provides the nurse to plan and direct care of a group of clients over a 24-
hour period? - (answer)Primary nursing (B) is a model of delivery of care where a nurse is accountable
for planning care for clients around the clock. Functional nursing (D) is a care delivery model that
provides client care by assignment of functions or tasks. Team nursing (A) is a care delivery model where
assignments to a group of clients are provided by a mixed-staff team. Case management (C) 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.

Two unlicensed assistive personnel (UAP) are arguing on the unit about who deserves to take a break
first. What is the most important basic guideline that the nurse should follow in resolving the conflict? -
(answer)Dealing with the issues which are concrete, not personalities (A) which include emotional
reactions, is one of seven important key behaviors in managing conflict. (B, C, and D) do not resolve the
conflict when diverse opinions are expressed emotionally.

The nurse is caring for a client who is unable to void. The plan of care establishes an objective for the
client to ingest at least 1000 mL of fluid between 7:00 am and 3:30 pm. Which client response should
the nurse document that indicates a successful outcome? - (answer)The nurse should evaluate the
client's outcome by observing the client's performance of each expected behavior, so drinking 240 mL of
fluid five or six times during the shift (D) indicates a fluid intake of 1200 to 1440 mL, which meets the

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