HESI RN LEADERSHIP / MANAGEMENT
EXIT Exam Advanced Practice
2026|2027 Questions and Answers with
Complete A+ Solutions 100% Correct!!!
A client with a 10-year history of methadone use for chronic leg pain is being treated with
azithromycin for pneumonia. On the third hospital day, both medications are discontinued as
the QT interval on EKG has lengthened, increasing arrhythmia risk. The client wants to be
discharged against medical advice to return home and take the client's own medications to
prevent going into withdrawal without the methadone. Which is the most appropriate nursing
response?
1. "I will ask the HCP to come talk with us so that we can develop a plan to prevent withdrawal
while reducing your risk of heart problems."
2. "I will talk with the HCP about your concerns, but in the meantime it's important that you
stay here."
3. "It's important that you stay in the hospital so that we can treat you quickly if you have
problems."
4. "You have the right to make your own decisions, but you are at high risk of having heart
problems if you go h - Correct Answer -1
When clients are hospitalized, they lose control of many things, including their medication
management. This loss of control can be frightening for the client, especially one who has had
control of medications for many years.
This client, who has a decade of experience taking methadone for chronic pain, is afraid that
suddenly stopping this medication may precipitate withdrawal. The client is trying to regain
,control and avoid this problem by leaving the hospital against medical advice. However, the
client remains at risk of life-threatening arrhythmias. Therefore, the nurse should promote
negotiation between the client and HCP to develop a plan of care that will address the concerns
of each. The plan should advocate for the client to ensure that the concerns are addressed.
Care planning should be a collaborative, shared process informed by the knowledge and
preferences of the client and evidence-based recommendations by the HCP that are appropriate
to the situation.
(Option 2) This response is based on the idea of the nurse and HCP being in control, but it fails
to include the client in the decision-making team.
(Option 3) This statement provides a rationale for the client to remain in the hospital, but it
does not address the client's concerns about going into withdrawal.
(Option 4) This response is based on the idea of client autonomy, but it does not propose a
solution to the problem.
Educational objective: A plan of care should be developed collaboratively, informed by the
client's knowledge, beliefs, and preferences, and the expertise and evidence-based
recommendations of HCPs.
There has been a major community disaster. Stable clients need to be discharged to make more
beds available for the victims. Which clients could be discharged safely? Select all that apply.
1. Diagnosed with endocarditis on antibiotics with a peripherally inserted central catheter (PICC)
line
2. History of multiple sclerosis with ataxia and diplopia
3. One day postoperative from a hemicolectomy
,4. Reporting abdominal pain with coffee ground emesis
5. Taking warfarin with prothrombin time/International Normalized Ratio of 2x control value -
Correct Answer -1, 2, 5
Ataxia and diplopia are expected signs/symptoms of multiple sclerosis. Two times the control
value demonstrates that warfarin has reached a therapeutic level. The long-term antibiotic
course (and follow-up lab work) can continue at home through the PICC line (Options 1, 2, and
5).
(Option 3) Large intestine peristalsis does not return for up to 3-5 days. The client cannot be
discharged until able to tolerate oral intake with normal elimination. The client has to at least be
passing flatus.
(Option 4) Coffee ground emesis indicates upper gastrointestinal bleeding. The etiology and
treatment need to be determined before the client is discharged.
Educational objective: Those who are stable for discharge include the client with multiple
sclerosis with ataxia and diplopia, the client on warfarin (Coumadin) that has reached the
therapeutic effect, and the client with a PICC line for a long-term antibiotic course.
The health care provider gives the preoperative nurse a signed consent form and walks away
rapidly. The client turns to the nurse and states, "I don't know what is going on. Why do I need
surgery?" What is the most appropriate action?
1. Call the nursing supervisor
2. Call the operating room scheduler and cancel the surgery
3. Page the health care provider and request clarification on behalf of the client
4. Report the incident to hospital administration - Correct Answer -3
, Informed consent requires that the health care provider performing the procedure explain
everything to the client's satisfaction (within reason). Signed consent may be witnessed by the
nurse. If the client does not fully understand informed consent, the nurse must notify the health
care provider or refer up the chain of nursing command. The nurse is not responsible for
verifying that the client understands the procedure and its respective risks.
(Option 1) This would be appropriate if the health care provider refuses to talk to the client.
(Option 2) This is not the nurse's responsibility; this request would have to be relayed up the
chain of nursing command.
(Option 4) This is premature; the incident is isolated and not all facts are known.
Educational objective: Clients may not consent to an invasive procedure without being informed
of the clinical reasoning, consequences, and possible complications.
A charge nurse suspects that the unlicensed assistive personnel (UAP) is falsifying the
documentation of clients' capillary glucose results rather than performing the test. What is the
best action by the charge nurse to handle this situation?
1. Ask a client if the UAP has performed the test
2. Discuss the importance of task completion and accurate documentation in a staff meeting
3. Give the UAP a verbal warning not to falsify data
4. Take a client's capillary glucose personally and compare it to the recorded result - Correct
Answer -4
EXIT Exam Advanced Practice
2026|2027 Questions and Answers with
Complete A+ Solutions 100% Correct!!!
A client with a 10-year history of methadone use for chronic leg pain is being treated with
azithromycin for pneumonia. On the third hospital day, both medications are discontinued as
the QT interval on EKG has lengthened, increasing arrhythmia risk. The client wants to be
discharged against medical advice to return home and take the client's own medications to
prevent going into withdrawal without the methadone. Which is the most appropriate nursing
response?
1. "I will ask the HCP to come talk with us so that we can develop a plan to prevent withdrawal
while reducing your risk of heart problems."
2. "I will talk with the HCP about your concerns, but in the meantime it's important that you
stay here."
3. "It's important that you stay in the hospital so that we can treat you quickly if you have
problems."
4. "You have the right to make your own decisions, but you are at high risk of having heart
problems if you go h - Correct Answer -1
When clients are hospitalized, they lose control of many things, including their medication
management. This loss of control can be frightening for the client, especially one who has had
control of medications for many years.
This client, who has a decade of experience taking methadone for chronic pain, is afraid that
suddenly stopping this medication may precipitate withdrawal. The client is trying to regain
,control and avoid this problem by leaving the hospital against medical advice. However, the
client remains at risk of life-threatening arrhythmias. Therefore, the nurse should promote
negotiation between the client and HCP to develop a plan of care that will address the concerns
of each. The plan should advocate for the client to ensure that the concerns are addressed.
Care planning should be a collaborative, shared process informed by the knowledge and
preferences of the client and evidence-based recommendations by the HCP that are appropriate
to the situation.
(Option 2) This response is based on the idea of the nurse and HCP being in control, but it fails
to include the client in the decision-making team.
(Option 3) This statement provides a rationale for the client to remain in the hospital, but it
does not address the client's concerns about going into withdrawal.
(Option 4) This response is based on the idea of client autonomy, but it does not propose a
solution to the problem.
Educational objective: A plan of care should be developed collaboratively, informed by the
client's knowledge, beliefs, and preferences, and the expertise and evidence-based
recommendations of HCPs.
There has been a major community disaster. Stable clients need to be discharged to make more
beds available for the victims. Which clients could be discharged safely? Select all that apply.
1. Diagnosed with endocarditis on antibiotics with a peripherally inserted central catheter (PICC)
line
2. History of multiple sclerosis with ataxia and diplopia
3. One day postoperative from a hemicolectomy
,4. Reporting abdominal pain with coffee ground emesis
5. Taking warfarin with prothrombin time/International Normalized Ratio of 2x control value -
Correct Answer -1, 2, 5
Ataxia and diplopia are expected signs/symptoms of multiple sclerosis. Two times the control
value demonstrates that warfarin has reached a therapeutic level. The long-term antibiotic
course (and follow-up lab work) can continue at home through the PICC line (Options 1, 2, and
5).
(Option 3) Large intestine peristalsis does not return for up to 3-5 days. The client cannot be
discharged until able to tolerate oral intake with normal elimination. The client has to at least be
passing flatus.
(Option 4) Coffee ground emesis indicates upper gastrointestinal bleeding. The etiology and
treatment need to be determined before the client is discharged.
Educational objective: Those who are stable for discharge include the client with multiple
sclerosis with ataxia and diplopia, the client on warfarin (Coumadin) that has reached the
therapeutic effect, and the client with a PICC line for a long-term antibiotic course.
The health care provider gives the preoperative nurse a signed consent form and walks away
rapidly. The client turns to the nurse and states, "I don't know what is going on. Why do I need
surgery?" What is the most appropriate action?
1. Call the nursing supervisor
2. Call the operating room scheduler and cancel the surgery
3. Page the health care provider and request clarification on behalf of the client
4. Report the incident to hospital administration - Correct Answer -3
, Informed consent requires that the health care provider performing the procedure explain
everything to the client's satisfaction (within reason). Signed consent may be witnessed by the
nurse. If the client does not fully understand informed consent, the nurse must notify the health
care provider or refer up the chain of nursing command. The nurse is not responsible for
verifying that the client understands the procedure and its respective risks.
(Option 1) This would be appropriate if the health care provider refuses to talk to the client.
(Option 2) This is not the nurse's responsibility; this request would have to be relayed up the
chain of nursing command.
(Option 4) This is premature; the incident is isolated and not all facts are known.
Educational objective: Clients may not consent to an invasive procedure without being informed
of the clinical reasoning, consequences, and possible complications.
A charge nurse suspects that the unlicensed assistive personnel (UAP) is falsifying the
documentation of clients' capillary glucose results rather than performing the test. What is the
best action by the charge nurse to handle this situation?
1. Ask a client if the UAP has performed the test
2. Discuss the importance of task completion and accurate documentation in a staff meeting
3. Give the UAP a verbal warning not to falsify data
4. Take a client's capillary glucose personally and compare it to the recorded result - Correct
Answer -4
