Exit HESI Practice questions fully updated (100% solved)
A 12 year-old boy who had an appendectomy two days ago is receiving 0.9% normal saline at 50
ml/hr. His urine specific gravity is 1.035. What action should the nurse implement?
A) Evaluate postural blood pressure measurements.
B) Obtain a specimen for urinalysis.
C) Encourage popsicles and fluids of choice.
D) Assess bowel sounds in all quadrants. - ✔✔✔-C) Encourage popsicles and fluids of choice.
Specific gravity of urine is a measurement of hydration status (NR 1.010 to 1.025) which is
indicative of fluid volume deficit); when Sp Gr increases as urine become more concentrated.
The nurse should continue the prescribed IV fluids and increase PO intake.
A 30-year-old male client tells the nurse that about half of his diet comes from eating meat and
eggs. What instruction should the nurse provide?
A) Maintain protein intake and increase intake of fruits and vegetables.
B) Increase protein intake with the additional intake of dairy products.
C) Decrease protein intake and eat more whole grains and vegetables.
D) Maintain protein intake but substitute fish and nuts for meat and eggs. - ✔✔✔-C) Decrease
protein intake and eat more whole grains and vegetables.
Proteins should comprise less than 50% of daily dietary intake.
A 6 week old infant diagnosed with pyloric stenosis has recently developed projectile vomiting.
Which assessment finding indicates to the nurse that the infant is becoming dehydrated?
A) Palpable mass in the right upper quadrant.
B) Bulging fontanel.
C) Visible peristaltic waves
,Exit HESI Practice questions fully updated (100% solved)
D) Weak cry without any tears - ✔✔✔-D) Weak cry without any tears
A 62 year old male client who has been diagnosed with emphysema asks the nurse to tell him
about the symptoms of his disease. Which statement should be included in the nurse's
description of emphysema to this client?
A) Breathing through pursed lips causes lung expansion and decreased physical exertion.
B) Tolerance for oxygen deprivation results in an increased ability to carry out daily activities.
C) A barrel chest results because of using a hyperventilating breathing pattern.
D) Oxygen requirements decrease because of the over-expansion of alveoli. - ✔✔✔-C) A barrel
chest results because of using a hyperventilating breathing pattern.
Emphysema clients avoid hypoxia by breathing faster (hyperventilating) which eventually causes
a barrel chest. Emphysema clients do breathe through pursed lips which helps to expand the
resistant alveoli but does not decrease physical exertion. Emphysema clients have the same
oxygen requirements as any other person, but work harder to meet these requirements (B and
D). They also become increasingly debilitated and require frequent rest periods to carry out
daily activities.
A client at 30 weeks gestation is admitted due to preterm labor. A prescription of terbutaline
sulfate 0.25 mg is given SQ. Based on which finding should the nurse withhold the next dose of
this drug?
A) Maternal blood pressure of 90/60
B) FHR of 170 bpm for 15 minutes
C) Maternal pulse rate of 162 bpm
D) Serum potassium of 2.8 - ✔✔✔-C) Maternal pulse rate of 162 bpm
The nurse should check the maternal pulse prior to administering the beta sympathomimetic
drug terbutaline and notify the HCP before administration of the drug if the pulse is over 140
,Exit HESI Practice questions fully updated (100% solved)
bpm. (A) is within normal limits because peripheral vasodilation accompanies pregnancy and
causes the BP to decrease. (B) is a normal response to the fetus to maternal use of terbutaline,
but should be reported if above 180. (D) is not an abnormal finding due to the shift of
potassium to intracellular spaces that can occur with this medication.
A client diagnosed with a seizure disorder is receiving phenytoin (Dilantin). Which instruction
should the nurse provide this client?
A) Take the medication on an empty stomach.
B) Contact your HCP before trying to get pregnant.
C) Stop taking the medication if hirsutism occurs.
D) Decrease fluid intake when taking this medication. - ✔✔✔-B) Contact your HCP before trying
to get pregnant.
This medication is teratogenic (crosses the placenta and can cause congenital defects)(B).
Dilantin should be taken with food to minimize side effects (A). (C) is not a side effect, and this
medication should never be stopped abruptly. Adequate hydration should be maintained (D)
when taking Dilantin.
A client exposed to TB is scheduled to begin prophylactic treatment with isoniazid. Which
information is most important for the nurse to note before administering the initial dose?
A) Conversion of the client's PPD test from negative to positive.
B) Length of time of the exposure to TB
C) Current diagnosis of Hep B
D) History of IV drug use. - ✔✔✔-C) Current diagnosis of Hep B
Prophylactic treatment of TB with isoniazid is contraindicated for persons with liver disease
because it may cause liver damage. The nurse should hold the prescribed dose and contact the
HCP.
, Exit HESI Practice questions fully updated (100% solved)
A client has an IV fluid infusing in the right forearm. To determine the client's distal pulse rate
most accurately, which action should the nurse implement?
A) Elevate the client's upper extremity before counting the pulse rate.
B) Auscultate directly below the IV site with a Doppler stethoscope.
C) Turn off the IV fluids that are infusing while counting the pulse.
D) Palpate at the radial pulse site with the pads of 2-3 fingers. - ✔✔✔-D) Palpate at the radial
pulse site with the pads of 2-3 fingers.
The rapid pulse site (D) is easily accessible and palpable unless an IV is placed at the client's
wrist. (A) may make the pulse more difficult to palpate. (B) places the stethoscope over a vein
rather than an artery and is unlikely to provide an accurate pulse rate. The pulse rate can be
accurately counted without implementing C.
A client in the ED has baseline ABGs of ph 7.25 PCO2 60 mmHg, HCO3 35, and PO2 60 mmHg.
Which interpretation should the nurse conclude when analyzing these findings?
A) Acute respiratory acidosis.
B) Compensated respiratory acidosis with hypoxia.
C) Normal acid base balance.
D) Compensated respiratory alkalosis with normal oxygenation. - ✔✔✔-B) Compensated
respiratory acidosis with hypoxia.
A client is admitted to labor with possible preeclampsia. The admission data include blood
pressure 144/96, facial edema, and 3+ pitting edema in lower extremities. Which further
assessment has the highest priority?
A) Temperature, pulse, respirations
A 12 year-old boy who had an appendectomy two days ago is receiving 0.9% normal saline at 50
ml/hr. His urine specific gravity is 1.035. What action should the nurse implement?
A) Evaluate postural blood pressure measurements.
B) Obtain a specimen for urinalysis.
C) Encourage popsicles and fluids of choice.
D) Assess bowel sounds in all quadrants. - ✔✔✔-C) Encourage popsicles and fluids of choice.
Specific gravity of urine is a measurement of hydration status (NR 1.010 to 1.025) which is
indicative of fluid volume deficit); when Sp Gr increases as urine become more concentrated.
The nurse should continue the prescribed IV fluids and increase PO intake.
A 30-year-old male client tells the nurse that about half of his diet comes from eating meat and
eggs. What instruction should the nurse provide?
A) Maintain protein intake and increase intake of fruits and vegetables.
B) Increase protein intake with the additional intake of dairy products.
C) Decrease protein intake and eat more whole grains and vegetables.
D) Maintain protein intake but substitute fish and nuts for meat and eggs. - ✔✔✔-C) Decrease
protein intake and eat more whole grains and vegetables.
Proteins should comprise less than 50% of daily dietary intake.
A 6 week old infant diagnosed with pyloric stenosis has recently developed projectile vomiting.
Which assessment finding indicates to the nurse that the infant is becoming dehydrated?
A) Palpable mass in the right upper quadrant.
B) Bulging fontanel.
C) Visible peristaltic waves
,Exit HESI Practice questions fully updated (100% solved)
D) Weak cry without any tears - ✔✔✔-D) Weak cry without any tears
A 62 year old male client who has been diagnosed with emphysema asks the nurse to tell him
about the symptoms of his disease. Which statement should be included in the nurse's
description of emphysema to this client?
A) Breathing through pursed lips causes lung expansion and decreased physical exertion.
B) Tolerance for oxygen deprivation results in an increased ability to carry out daily activities.
C) A barrel chest results because of using a hyperventilating breathing pattern.
D) Oxygen requirements decrease because of the over-expansion of alveoli. - ✔✔✔-C) A barrel
chest results because of using a hyperventilating breathing pattern.
Emphysema clients avoid hypoxia by breathing faster (hyperventilating) which eventually causes
a barrel chest. Emphysema clients do breathe through pursed lips which helps to expand the
resistant alveoli but does not decrease physical exertion. Emphysema clients have the same
oxygen requirements as any other person, but work harder to meet these requirements (B and
D). They also become increasingly debilitated and require frequent rest periods to carry out
daily activities.
A client at 30 weeks gestation is admitted due to preterm labor. A prescription of terbutaline
sulfate 0.25 mg is given SQ. Based on which finding should the nurse withhold the next dose of
this drug?
A) Maternal blood pressure of 90/60
B) FHR of 170 bpm for 15 minutes
C) Maternal pulse rate of 162 bpm
D) Serum potassium of 2.8 - ✔✔✔-C) Maternal pulse rate of 162 bpm
The nurse should check the maternal pulse prior to administering the beta sympathomimetic
drug terbutaline and notify the HCP before administration of the drug if the pulse is over 140
,Exit HESI Practice questions fully updated (100% solved)
bpm. (A) is within normal limits because peripheral vasodilation accompanies pregnancy and
causes the BP to decrease. (B) is a normal response to the fetus to maternal use of terbutaline,
but should be reported if above 180. (D) is not an abnormal finding due to the shift of
potassium to intracellular spaces that can occur with this medication.
A client diagnosed with a seizure disorder is receiving phenytoin (Dilantin). Which instruction
should the nurse provide this client?
A) Take the medication on an empty stomach.
B) Contact your HCP before trying to get pregnant.
C) Stop taking the medication if hirsutism occurs.
D) Decrease fluid intake when taking this medication. - ✔✔✔-B) Contact your HCP before trying
to get pregnant.
This medication is teratogenic (crosses the placenta and can cause congenital defects)(B).
Dilantin should be taken with food to minimize side effects (A). (C) is not a side effect, and this
medication should never be stopped abruptly. Adequate hydration should be maintained (D)
when taking Dilantin.
A client exposed to TB is scheduled to begin prophylactic treatment with isoniazid. Which
information is most important for the nurse to note before administering the initial dose?
A) Conversion of the client's PPD test from negative to positive.
B) Length of time of the exposure to TB
C) Current diagnosis of Hep B
D) History of IV drug use. - ✔✔✔-C) Current diagnosis of Hep B
Prophylactic treatment of TB with isoniazid is contraindicated for persons with liver disease
because it may cause liver damage. The nurse should hold the prescribed dose and contact the
HCP.
, Exit HESI Practice questions fully updated (100% solved)
A client has an IV fluid infusing in the right forearm. To determine the client's distal pulse rate
most accurately, which action should the nurse implement?
A) Elevate the client's upper extremity before counting the pulse rate.
B) Auscultate directly below the IV site with a Doppler stethoscope.
C) Turn off the IV fluids that are infusing while counting the pulse.
D) Palpate at the radial pulse site with the pads of 2-3 fingers. - ✔✔✔-D) Palpate at the radial
pulse site with the pads of 2-3 fingers.
The rapid pulse site (D) is easily accessible and palpable unless an IV is placed at the client's
wrist. (A) may make the pulse more difficult to palpate. (B) places the stethoscope over a vein
rather than an artery and is unlikely to provide an accurate pulse rate. The pulse rate can be
accurately counted without implementing C.
A client in the ED has baseline ABGs of ph 7.25 PCO2 60 mmHg, HCO3 35, and PO2 60 mmHg.
Which interpretation should the nurse conclude when analyzing these findings?
A) Acute respiratory acidosis.
B) Compensated respiratory acidosis with hypoxia.
C) Normal acid base balance.
D) Compensated respiratory alkalosis with normal oxygenation. - ✔✔✔-B) Compensated
respiratory acidosis with hypoxia.
A client is admitted to labor with possible preeclampsia. The admission data include blood
pressure 144/96, facial edema, and 3+ pitting edema in lower extremities. Which further
assessment has the highest priority?
A) Temperature, pulse, respirations
