EXIT HESI - Comprehensive Exam A
Practice Questions With Full Set
Answers| Updated 2026
A nurse who has recently completed orientation is beginning work in the
labor and delivery unit for the first time. When making assignments, which
client should the charge nurse assign to this new nurse?
A.A primigravida who is 8 cm dilated after 14 hours of labor
B.A client scheduled for a repeat cesarean birth at 38 weeks' gestation
C.A client being induced for fetal demise at 20 weeks' gestation
D.A multiparous client who is dilated 5 cm and 50% effaced - Ans--D
The new nurse should be assigned the least complicated client to gain
experience and confidence, as well as protect client safety. Of the clients
available for assignment, (D) is progressing well and is the least
complicated. (A, B and C) have actual or potential complications and should
be assigned to a more experienced nurse.
A client with human immunodeficiency virus (HIV) infection has white
lesions in the oral cavity that resemble milk curds. Nystatin (Mycostatin)
preparation is prescribed as a swish and swallow. Which information is
most important for the nurse to provide the client?
A.Oral hygiene should be performed before the medication. B.Antifungal
medications are available in tablet, suppository, and liquid forms.
C.Candida albicans is the organism that causes the white lesions in the
mouth.
D.The dietary intake of dairy and spicy foods should be limited. - Ans--A
HIV infection causes depression of cell-mediated immunity that allows an
overgrowth of Candida albicans (oral moniliasis), which appears as white,
cheesy plaque or lesions that resemble milk curds. To ensure effective
contact of the medication with the oral lesions, oral liquids should be
consumed and oral hygiene performed before swishing the liquid
Mycostatin (A). (B and C) provide the client with additional information
,about the pathogenesis and treatment of opportunistic infections, but (A)
allows the client to participate in self-care of the oral infection. Dietary
restriction of spicy foods reduces discomfort associated with stomatitis, but
restriction of dairy products is not indicated (D).
A client who is admitted with emphysema is having difficulty breathing. In
which position should the nurse place the client?
A.High Fowler's position without a pillow behind the head
B.Semi-Fowler's position with a single pillow behind the head
C.Right side-lying position with the head of the bed elevated 45 degrees
D.Sitting upright and forward with both arms supported on an over the bed
table - Ans--D
Adequate lung expansion is dependent on deep breaths that allow the
respiratory muscles to increase the longitudinal and anterior-posterior size
of the thoracic cage. Sitting upright and leaning forward with the arms
supported on an over the bed table (D) allows the thoracic cage to expand in
all four directions and reduces dyspnea. A high Fowler's position does not
allow maximum expansion of the posterior lobes of the lungs (A). A semi-
Fowler's position restricts expansion of the anterior-posterior diameter of
the thoracic cage (B). Positioning a client on the right side with the head of
the bed elevated (C) does not facilitate lung expansion.
A client with chronic renal insufficiency (CRI) is taking 25 mg of
hydrochlorothiazide (HCTZ) PO and 40 mg of furosemide (Lasix) PO daily.
Today, at a routine clinic visit, the client's serum potassium level is 4 mEq/L.
What is the most likely cause of this client's potassium level?
A.The client is noncompliant with his medications.
B.The client recently consumed large quantities of pears or nuts.
C.The client's renal function has affected his potassium level.
D.The client needs to be started on a potassium supplement. - Ans--C
The client has a normalized potassium level despite diuretic use (C). The
kidney automatically secretes 90% of potassium consumed, but in chronic
renal insufficiency (CRI), less potassium is excreted than normal.
Therefore, the two potassium-wasting drugs, a thiazide diuretic and loop
diuretic, are not likely to affect potassium levels. The normal potassium
level is 3.5 to 5 mEq/L, and with a potassium level of 4 mEq/L, there is no
,reason to believe that the client is noncompliant with his treatment (A).
Pears and nuts do not affect the serum potassium level (B). There is no
need for a potassium supplement (D) because the client's potassium level
is within the normal range.
A registered nurse (RN) delivers telehealth services to clients via electronic
communication. Which nursing action creates the greatest risk for
professional liability and has the potential for a malpractice lawsuit?
A.Participating in telephone consultations with clients
B.Identifying oneself by name and title to clients in telehealth
communications
C.Sending medical records to health care providers via the Internet
D.Answering a client-initiated health question via electronic mail - Ans--C
Sending medical records over the Internet, even with the latest security
protection, creates the greatest risk for liability because of the high potential
of breaching client confidentiality and the amount of information being
transferred (C). Client confidentiality is protected by federal wiretapping
laws making telephone consultation (A) a private and protected form of
communication. By stating one's name and credentials in telehealth
communication (B), one is taking responsibility for the encounter. E-mail
initiated by the client (D) poses less risk than sending records via the
Internet.
Which pathophysiologic response supports the contraindication for opioids,
such as morphine, in clients with increased intracranial pressure (ICP)?
A.Sedation produced by opioids is a result of a prolonged half-life when the
ICP is elevated.
B.Higher doses of opioids are required when cerebral blood flow is reduced
by an elevated ICP.
C.Dysphoria from opioids contributes to altered levels of consciousness
with an elevated ICP.
D.Opioids suppress respirations, which increases Pco2 and contributes to
an elevated ICP. - Ans--D
The greatest risk associated with opioids such as morphine (D) is
respiratory depression that causes an increase in Pco2, which increases
ICP and masks the early signs of intracranial bleeding in head injury. (A, B,
, and C) do not support the risks associated with opioid use in a client with
increased ICP.
The charge nurse of a medical surgical unit is alerted to an impending
disaster requiring implementation of the hospital's disaster plan. Specific
facts about the nature of this disaster are not yet known. Which instruction
should the charge nurse give to the other staff members at this time?
A.Prepare to evacuate the unit, starting with the bedridden clients.
B.UAPs should report to the emergency center to handle transports.
C.The licensed staff should begin counting wheelchairs and IV poles on the
unit.
D.Continue with current assignments until more instructions are received. -
Ans--D
When faced with an impending disaster, hospital personnel may be alerted
but should continue with current client care assignments until further
instructions are received (D). Evacuation is typically a response of last
resort that begins with clients who are most able to ambulate (A). (B) is
premature and is likely to increase the chaos if incoming casualties are
anticipated. (C) is poor utilization of personnel.
The nurse assesses a client while the UAP measures the client's vital signs.
The client's vital signs change suddenly, and the nurse determines that the
client's condition is worsening. The nurse is unsure of the client's
resuscitative status and needs to check the client's medical record for any
advanced directives. Which action should the nurse implement?
A.Ask the UAP to check for the advanced directive while the nurse
completes the assessment.
B.Assign the UAP to complete the assessment while the nurse checks for
the advanced directive.
C.Check the medical record for the advanced directive and then complete
the client assessment.
D.Call for the charge nurse to check the advanced directive while
continuing to assess the client. - Ans--D
Because the client's condition is worsening, the nurse should remain with
the client and continue the assessment while calling for help from the
charge nurse to determine the client's resuscitative status (D). (A and B) are
Practice Questions With Full Set
Answers| Updated 2026
A nurse who has recently completed orientation is beginning work in the
labor and delivery unit for the first time. When making assignments, which
client should the charge nurse assign to this new nurse?
A.A primigravida who is 8 cm dilated after 14 hours of labor
B.A client scheduled for a repeat cesarean birth at 38 weeks' gestation
C.A client being induced for fetal demise at 20 weeks' gestation
D.A multiparous client who is dilated 5 cm and 50% effaced - Ans--D
The new nurse should be assigned the least complicated client to gain
experience and confidence, as well as protect client safety. Of the clients
available for assignment, (D) is progressing well and is the least
complicated. (A, B and C) have actual or potential complications and should
be assigned to a more experienced nurse.
A client with human immunodeficiency virus (HIV) infection has white
lesions in the oral cavity that resemble milk curds. Nystatin (Mycostatin)
preparation is prescribed as a swish and swallow. Which information is
most important for the nurse to provide the client?
A.Oral hygiene should be performed before the medication. B.Antifungal
medications are available in tablet, suppository, and liquid forms.
C.Candida albicans is the organism that causes the white lesions in the
mouth.
D.The dietary intake of dairy and spicy foods should be limited. - Ans--A
HIV infection causes depression of cell-mediated immunity that allows an
overgrowth of Candida albicans (oral moniliasis), which appears as white,
cheesy plaque or lesions that resemble milk curds. To ensure effective
contact of the medication with the oral lesions, oral liquids should be
consumed and oral hygiene performed before swishing the liquid
Mycostatin (A). (B and C) provide the client with additional information
,about the pathogenesis and treatment of opportunistic infections, but (A)
allows the client to participate in self-care of the oral infection. Dietary
restriction of spicy foods reduces discomfort associated with stomatitis, but
restriction of dairy products is not indicated (D).
A client who is admitted with emphysema is having difficulty breathing. In
which position should the nurse place the client?
A.High Fowler's position without a pillow behind the head
B.Semi-Fowler's position with a single pillow behind the head
C.Right side-lying position with the head of the bed elevated 45 degrees
D.Sitting upright and forward with both arms supported on an over the bed
table - Ans--D
Adequate lung expansion is dependent on deep breaths that allow the
respiratory muscles to increase the longitudinal and anterior-posterior size
of the thoracic cage. Sitting upright and leaning forward with the arms
supported on an over the bed table (D) allows the thoracic cage to expand in
all four directions and reduces dyspnea. A high Fowler's position does not
allow maximum expansion of the posterior lobes of the lungs (A). A semi-
Fowler's position restricts expansion of the anterior-posterior diameter of
the thoracic cage (B). Positioning a client on the right side with the head of
the bed elevated (C) does not facilitate lung expansion.
A client with chronic renal insufficiency (CRI) is taking 25 mg of
hydrochlorothiazide (HCTZ) PO and 40 mg of furosemide (Lasix) PO daily.
Today, at a routine clinic visit, the client's serum potassium level is 4 mEq/L.
What is the most likely cause of this client's potassium level?
A.The client is noncompliant with his medications.
B.The client recently consumed large quantities of pears or nuts.
C.The client's renal function has affected his potassium level.
D.The client needs to be started on a potassium supplement. - Ans--C
The client has a normalized potassium level despite diuretic use (C). The
kidney automatically secretes 90% of potassium consumed, but in chronic
renal insufficiency (CRI), less potassium is excreted than normal.
Therefore, the two potassium-wasting drugs, a thiazide diuretic and loop
diuretic, are not likely to affect potassium levels. The normal potassium
level is 3.5 to 5 mEq/L, and with a potassium level of 4 mEq/L, there is no
,reason to believe that the client is noncompliant with his treatment (A).
Pears and nuts do not affect the serum potassium level (B). There is no
need for a potassium supplement (D) because the client's potassium level
is within the normal range.
A registered nurse (RN) delivers telehealth services to clients via electronic
communication. Which nursing action creates the greatest risk for
professional liability and has the potential for a malpractice lawsuit?
A.Participating in telephone consultations with clients
B.Identifying oneself by name and title to clients in telehealth
communications
C.Sending medical records to health care providers via the Internet
D.Answering a client-initiated health question via electronic mail - Ans--C
Sending medical records over the Internet, even with the latest security
protection, creates the greatest risk for liability because of the high potential
of breaching client confidentiality and the amount of information being
transferred (C). Client confidentiality is protected by federal wiretapping
laws making telephone consultation (A) a private and protected form of
communication. By stating one's name and credentials in telehealth
communication (B), one is taking responsibility for the encounter. E-mail
initiated by the client (D) poses less risk than sending records via the
Internet.
Which pathophysiologic response supports the contraindication for opioids,
such as morphine, in clients with increased intracranial pressure (ICP)?
A.Sedation produced by opioids is a result of a prolonged half-life when the
ICP is elevated.
B.Higher doses of opioids are required when cerebral blood flow is reduced
by an elevated ICP.
C.Dysphoria from opioids contributes to altered levels of consciousness
with an elevated ICP.
D.Opioids suppress respirations, which increases Pco2 and contributes to
an elevated ICP. - Ans--D
The greatest risk associated with opioids such as morphine (D) is
respiratory depression that causes an increase in Pco2, which increases
ICP and masks the early signs of intracranial bleeding in head injury. (A, B,
, and C) do not support the risks associated with opioid use in a client with
increased ICP.
The charge nurse of a medical surgical unit is alerted to an impending
disaster requiring implementation of the hospital's disaster plan. Specific
facts about the nature of this disaster are not yet known. Which instruction
should the charge nurse give to the other staff members at this time?
A.Prepare to evacuate the unit, starting with the bedridden clients.
B.UAPs should report to the emergency center to handle transports.
C.The licensed staff should begin counting wheelchairs and IV poles on the
unit.
D.Continue with current assignments until more instructions are received. -
Ans--D
When faced with an impending disaster, hospital personnel may be alerted
but should continue with current client care assignments until further
instructions are received (D). Evacuation is typically a response of last
resort that begins with clients who are most able to ambulate (A). (B) is
premature and is likely to increase the chaos if incoming casualties are
anticipated. (C) is poor utilization of personnel.
The nurse assesses a client while the UAP measures the client's vital signs.
The client's vital signs change suddenly, and the nurse determines that the
client's condition is worsening. The nurse is unsure of the client's
resuscitative status and needs to check the client's medical record for any
advanced directives. Which action should the nurse implement?
A.Ask the UAP to check for the advanced directive while the nurse
completes the assessment.
B.Assign the UAP to complete the assessment while the nurse checks for
the advanced directive.
C.Check the medical record for the advanced directive and then complete
the client assessment.
D.Call for the charge nurse to check the advanced directive while
continuing to assess the client. - Ans--D
Because the client's condition is worsening, the nurse should remain with
the client and continue the assessment while calling for help from the
charge nurse to determine the client's resuscitative status (D). (A and B) are
