PN HESI EXIT FINAL TEST PAPER 2026
COMPLETE QUESTIONS AND CORRECT
ANSWERS ALREADY PASSED
●● 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..
Answer: 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.
Answer: 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..
Answer: 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.
Answer: 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..
Answer: D
COMPLETE QUESTIONS AND CORRECT
ANSWERS ALREADY PASSED
●● 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..
Answer: 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.
Answer: 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..
Answer: 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.
Answer: 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..
Answer: D
