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HESI COMPREHENSIVE EXAM A- Q&A
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HESI COMPREHENSIVE EXAM A- Q&A
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HESI COMPREHENSIVE EXAM A- Q&A1. Enalapril maleate is prescribed for a hospitalized client. Which assessment does the
nurse perform as a priority before administering the medication?
A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24 hours - Answer-A.
Checking the client's blood pressure
2. A client is scheduled to undergo an upper gastrointestinal (GI) series, and the nurse
provides instructions to the client about the test. Which statement by the client indicates
a need for further instruction?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before test."
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet
enema on the morning of the test."
D. "I need to take a laxative after the test is completed, because the liquid that I'll have
to drink for the test can be constipating." - Answer-C. "I need to drink citrate of
magnesia the night before the test and give myself a Fleet enema on the morning of the
test."
3. A nurse on the evening shift checks a health care provider's prescriptions and notes
that the dose of a prescribed medication is higher than the normal dose. The nurse calls
the health care provider's answering service and is told that the health care provider is
off for the night and will be available in the morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call health care provider
C. Withhold the medication until the health care provider can be reached in the morning
D. Administer the medication but consult the health care provider when he becomes
available - Answer-B. Ask the answering service to contact the on-call health care
provider
4. An emergency department (ED) nurse is monitoring a client with suspected acute
myocardial infarction (MI) who is awaiting transfer to the coronary intensive care unit.
The nurse notes the sudden onset of premature ventricular contractions (PVCs) on the
monitor, checks the client's carotid pulse, and determines that the PVCs are not
resulting in perfusion. The appropriate action by the nurse is:
A. Documenting the findings
B. Asking the ED health care provider to check the client
C. Continuing to monitor the client's cardiac status
D. Informing the client that PVCs are expected after an MI - Answer-B. Asking the ED
health care provider to check the client
,5. NPO status is imposed 8 hours before the procedure on a client scheduled to
undergo electroconvulsive therapy (ECT) at 1 p.m. On the morning of the procedure,
the nurse checks the client's record and notes that the client routinely takes an oral
antihypertensive medication each morning. The nurse should:
A. Administer the antihypertensive with a small sip of water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
D. Hold the antihypertensive and resume its administration on the day after the ECT -
Answer-A. Administer the antihypertensive with a small sip of water
6. A client who recently underwent coronary artery bypass graft surgery comes to the
health care provider's office for a follow-up visit. On assessment, the client tells the
nurse that he is feeling depressed. Which response by the nurse is therapeutic?
A. "Tell me more about what you're feeling."
B. "That's a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over this depression."
D. "Every client who has this surgery feels the same way for about a month." - Answer-
A. "Tell me more about what you're feeling."
7. A client in labor experiences spontaneous rupture of the membranes. The nurse
immediately counts the fetal heart rate (FHR) for 1 full minute and then checks the
amniotic fluid. The nurse notes that the fluid is yellow and has a strong odor. Which
action should be the nurse's priority?
A. Contacting the health care provider
B. Documenting the findings
C. Checking the fluid for protein
D. Continuing to monitor the client and the FHR - Answer-A. Contacting the health care
provider
8. A nurse has assisted a health care provider in inserting a central venous access
device into a client with a diagnosis of severe malnutrition who will be receiving
parenteral nutrition (PN). After insertion of the catheter, the nurse immediately plans to:
A. Call the radiography department to obtain a chest x-ray
B. Check the client's blood glucose level to serve as a baseline measurement
C. Hang the prescribed bag of PN and start the infusion at the prescribed rate
D. Infuse normal saline solution through the catheter at a rate of 100 mL/hr to maintain
patency - Answer-A. Call the radiography department to obtain a chest x-ray
9. A rape victim being treated in the emergency department says to the nurse, "I'm
really worried that I've got HIV now." What is the appropriate response by the nurse?
A. "HIV is rarely an issue in rape victims."
B. "Every rape victim is concerned about HIV."
C. "You're more likely to get pregnant than to contract HIV."
D. "Let's talk about the information that you need to determine your risk of contracting
HIV." - Answer-D. "Let's talk about the information that you need to determine your risk
of contracting HIV."
,10. A client is taking prescribed ibuprofen , 300 mg orally four times daily, to relieve joint
pain resulting from rheumatoid arthritis. The client tells the nurse that the medication is
causing nausea and indigestion. The nurse should tell the client to:
A. Contact the health care provider
B. Stop taking the medication
C. Take the medication with food
D. Take the medication twice a day instead of four times - Answer-C. Take the
medication with food
11. A client's oral intake of liquids includes 120 mL on the night shift, 800 mL on the day
shift, and 650 mL on the evening shift. The client is receiving an intravenous (IV)
antibiotic every 12 hours, diluted in 50 mL of normal saline solution. The nurse empties
700 mL of urine from the client's Foley catheter at the end of the day shift. Thereafter,
500 mL of urine is emptied at the end of the evening shift and 325 mL at the end of the
night shift. Nasogastric tube drainage totals 155 mL for the 24-hour period, and the total
drainage from the Jackson-Pratt device is 175 mL. What is the client's total intake
during the 24-hour period? Type your answer in the space provided. ________mL -
Answer-1670 mL
Rationale: The client's 24-hour total oral intake is 1570 mL, and the IV intake totals 100
mL (50 mL of normal saline solution every 12 hours). Therefore the 24-hour intake total
is 1670 mL.
12. Lorazepam 1 mg by way of intravenous (IV) injection (IV push) is prescribed for a
client for the management of anxiety. The nurse prepares the medication as prescribed
and administers the medication over a period of:
A. 3 minutes
B. 10 seconds
C. 15 seconds
D. 30 minutes - Answer-A. 3 minutes
13. A nurse, conducting an assessment of a client being seen in the clinic for symptoms
of a sinus infection, asks the client about medications that he is taking. The client tells
the nurse that he is taking nefazodone hydrochloride . On the basis of this information,
the nurse determines that the client most likely has a history of:
A. Depression
B. Diabetes mellitus
C. Hyperthyroidism
D. Coronary artery disease - Answer-A. Depression
14. Phenelzine sulfate is prescribed for a client with depression. The nurse provides
information to the client about the adverse effects of the medication and tells the client
to contact the health care provider immediately if she experiences:
A. Dry mouth
B. Restlessness
C. Feelings of depression
, D. Neck stiffness or soreness - Answer-D. Neck stiffness or soreness
15. Risperidone is prescribed for a client hospitalized in the mental health unit for the
treatment of a psychotic disorder. Which finding in the client's medical record would
prompt the nurse to contact the prescribing health care provider before administering
the medication?
A. The client has a history of cataracts.
B. The client has a history of hypothyroidism.
C. The client takes a prescribed antihypertensive.
D. The client is allergic to acetylsalicylic acid (aspirin). - Answer-C. The client takes a
prescribed antihypertensive.
16. A client who has been undergoing long-term therapy with an antipsychotic
medication is admitted to the inpatient mental health unit. Which finding does the nurse,
knowing that long-term use of an antipsychotic medication can cause tardive
dyskinesia, monitor in the client?
A. Fever
B. Diarrhea
C. Hypertension
D. Tongue protrusion - Answer-D. Tongue protrusion
17. A nurse is reviewing the record of a client scheduled for electroconvulsive therapy
(ECT). Which diagnosis, if noted on the client's record, would indicate a need to contact
the health care provider who is scheduled to perform the ECT?
A. Recent stroke
B. Hypothyroidism
C. History of glaucoma
D. Peripheral vascular disease - Answer-A. Recent stroke
18. A client scheduled for suprapubic prostatectomy has listened to the surgeon's
explanation of the surgery. The client later asks the nurse to explain again how the
prostate is going to be removed. The nurse tells the client that the prostate will be
removed through:
A. A lower abdominal incision
B. An upper abdominal incision
C. An incision made in the perineal area
D. The urethra, with the use of a cutting wire - Answer-A. A lower abdominal incision
19. A nurse is preparing a poster for a health fair booth promoting primary prevention of
skin cancer. Which recommendations does the nurse include on the poster? Select all
that apply.
A. Seek medical advice if you find a skin lesion.
B. Use sunscreen with a low sun protection factor (SPF).
C. Avoid sun exposure before 10 a.m. and after 4 p.m.
D. Wear a hat, opaque clothing, and sunglasses when out in the sun.
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