EXIT HESI EXAM 2022/2023
A nurse is reviewing the laboratory results of a client who has rheumatoid arthritis.
Which of the following findings should the nurse report to the provider?
a. WBC count 8,000
b. platelets 150,000
c. aspartate aminotransferase 10 units
d. erythrocyte sedimentation rate 75mm - ANSWER d
A nurse is caring for a client who has generalized petechiae and ecchymoses. The
nurse should expect a prescription for which of the following laboratory tests?
a. platelet count
b. potassium level
c. creatine clearance
d. prealbumin - ANSWER a
A nurse is caring for a client following application of a cast. Which of the following
actions should the nurse take first?
a. place an ice pack over the cast
b. palpate the pulse distal to the cast
c. teach the client to keep the cast clean and dry
d. position the casted extremity on a pillow - ANSWER b
A nurse is caring for a client who has vision loss. Which of the following actions should
the nurse take? SATA
a. keep objects in the clients room in the same place.
b. ensure there is high-wattage lighting in the clients room.
c. approach the client from the side
d. allow extra time for the client to perform tasks
e. touch the client gently to announce presence - ANSWER a, b, d
A nurse is caring for a client who is newly diagnosed with pancreatic cancer and has
questions about the disease. To research the nurse should identify that which of the
following electronic database has the most comprehensive collection nursing articles?
a. medline
b. C inahl
c. ProQuest
d. health source - ANSWER b
A nurse in the emergency department is assessing newly admitted client who is
experiencing drooling and hoarseness following a brain injury. Which of the following
actions should the nurse take first?
a. obtain a baseline EKG
b. Obtain a blood specimen for ABG analysis
c. insert an 18 gauge IV catheter
d. Administer 100% humidified oxygen - ANSWER d
,EXIT HESI EXAM 2022/2023
A nurse is planning care for a client who has unilateral paralysis and dysphagia
following a right hemispheric stroke. Which of the following interventions should the
nurse include in the plan?
a. Place food on the left side of the client's mouth when he is ready to eat.
b. Provide total care in performing the client's ADLs.
c. Maintain the client on bed rest.
d. Place the client's left arm on a pillow while he is sitting. - ANSWER d
A nurse is caring for a client who is in a seclusion room following violent behavior. The
client continues to display aggressive behavior. Which of the following actions should
the nurse take?
a. Confront the client about this behavior.
b. Express sympathy for the client's situation.
c. Speak assertively to the client.
d. Stand within 30 cm (1 ft) of the client when speaking with them. - ANSWER a
A nurse is caring for a client who is receiving brachytherapy for treatment of prostate
cancer. Which of the following actions should the nurse take?
a. Cleanse equipment before removal from the client's room.
b. Limit the client's visitors to 30 min per day.
c. Discard the client's linens in a double bag.
d. Discard the radioactive source in a biohazard bag - ANSWER b
A nurse is caring for a client who has severe preeclampsia and is receiving magnesium
sulfate intravenously. The nurse discontinues the magnesium sulfate after the client
displaces toxicity. Which of the following actions should the nurse take?
a. Position the client supine
b. Prepare an IV bolus of dextrose 5% in water
c. Administer methylergonovine IM
d. Administer calcium gluconate IV - ANSWER d
A charge nurse is teaching new staff members about factors that increase a client's risk
to become violent. Which of the following risk factors should the nurse include as the
best predictor of future violence?
a. Experiencing delusions
b. Male gender
c. Pervious violent behavior
d. A history of being in prison - ANSWER c
A nurse is preparing to perform a sterile dressing change. Which of the following actions
should the nurse take when setting up the sterile field?
a. Place the cap from the solution sterile side up on clean surface
b. Open the outermost flap of the sterile kit toward the body→ flap AWAY from the
body's first
c. Place the sterile dressing within 1.25 cm (0.5in) of the edge of the sterile field → 2.5
cm (1-inch) border around any sterile drape or wrap that is considered contaminated.
,EXIT HESI EXAM 2022/2023
d. Set up the sterile field 5 cm (2 in) below waist level→ it says BELOW waist level;
should be ABOVE waist level - ANSWER a
A nurse is providing teaching to an older adult client about methods to promote
nighttime sleep. Which of the following instructions should the nurse include?
a. Eat a light snack before bedtime
c. Stay in bed at least 1 hr if unable to fall asleep
d. Take a 1 hr nap during the day
e. Perform exercises prior to bedtime - ANSWER a
A home health nurse is preparing for an initial visit with an older adult client who lives
alone. Which of the following actions should the nurse take first?
a. Educate the client about current medical diagnosis
b. Refer the client to a meal delivery program
c. Identify environmental hazards in the home
d. Arrange for client transportation to follow-up appointments Rationale Priority: Assess
first. - ANSWER c
A nurse is assessing the remote memory of an older adult client who has mild dementia.
Which of the following questions should the nurse ask the client?
a. "Can you tell me who visited you today?"
b. "What high school did you graduate from
c. "Can you list your current medications?"
d. "What did you have for breakfast yesterday?" - ANSWER b
A nurse is providing teaching to an adolescent who has type 1 diabetes mellitus. Which
of the following goals should the nurse include in the teaching
a. HbA1c level greater than 8%- 6.5 - 8 is the target reference. >
b. Blood glucose level greater than 200 mg/dL at bedtime
c. Blood glucose level less than 60 mg/dL before breakfast- < 70 = HYPOGLYCEMIC
d. HbA1c level less than 7% - ANSWER d
A nurse is caring for a client who is receiving phenytoin for management of grand mal
seizures and has a new prescription for isoniazid and rifampin. Which of the following
should the nurse conclude if the client develops ataxia and incoordination?
a. The client is experiencing an adverse reaction to rifampin
b. The client's seizure disorder is no longer under control
c. The client is showing evidence of phenytoin toxicity
d. The client is having adverse effects due to combination antimicrobial therapy -
ANSWER c
A nurse is caring for a client who is 1 hr postoperative following rhinoplasty. Which of
the following manifestations requires immediate action by the nurse?
a. Increase in frequency of swallowing→ may indicate bleeding
b. Moderate sanguineous drainage on the drip pad
c. Bruising to the face→ side effect
, EXIT HESI EXAM 2022/2023
d. Absent gag reflex→ possibly due to anesthesia given. (1 hour postoperative) -
ANSWER a
Rationale "Requires immediate action" choose the worst possibility that could lead to.
ABC
A nurse is planning care for a preschool-age child who is in the acute phase Kawasaki
disease. Which of the following interventions should the nurse include in the plan of
care?
a. Give scheduled doses of acetaminophen every 6 hr
b. Monitor the child's cardiac status
c. Administer antibiotics via intermittent IV bolus for 24 hr
d. Provide stimulation with children of the same age in the playroom - ANSWER b
A nurse is planning an educational program for high school students about cigarette
smoking. Which of the following potential consequences of smoking is most likely to
discourage adolescents from using tobacco?
a. Use of tobacco might lead to alcohol and drug abuse
b. Smoking in adolescence increases the risk of developing lung cancer later in life
c. Use of tobacco decreases the level of athletic ability
d. Smoking in adolescence increases the risk of lifelong addiction - ANSWER c
A nurse is assessing a client who is prescribed spironolactone. Which of the following
laboratory values should the nurse monitor for this client?
a. Total bilirubin
b. Urine ketones
c. Serum potassium- diuretic that retains potassium= hyperkalemic risk
d. Platelet count - ANSWER c
A nurse has agreed to serve as an interpreter for an older adult client who is assigned to
another nurse. Which of the following statements by the nurse indicates an
understanding of this role?
a. "I will let the client know that I am available as the interpreter."
b. "I will receive a small fee for interpreting for this client."
c. "I am glad I'm available today, but when I'm not, you can use a family member."
d. "I will let the client know that an interpreter is unavailable during the night shift." -
ANSWER a
A nurse in a pediatric unit is preparing to insert an IV catheter for 7-year- old. Which of
the following actions should the nurse take?
a. Tell the child they will feel discomfort during the catheter insertion.
b. Use a mummy restraint to hold the child during the catheter insertion.
c. Require the parents to leave the room during the procedure. - ANSWER a
A nurse is caring for a client who has arteriovenous fistula which of the following
findings should the nurse report?
a. Thrill upon palpation.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Drcynthia. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £13.49. You're not tied to anything after your purchase.
