HESI PN EXIT EXAM V2 COMPLETE 300+ QUESTIONS WITH 100% VERIFIED
ANSWERS AND DETAILED RATIONALES
Question 1
The nurse is assessing a client who is 1 day post-operative following a left
pneumonectomy. The client is positioned on the left side. What is the rationale for
this positioning?
A. To prevent aspiration of secretions from the right lung
B. To allow the remaining lung to expand more fully
C. To promote drainage of blood from the surgical site
D. To reduce tension on the chest tube insertion site
CORRECT ANSWER: B
RATIONALE: After a pneumonectomy, positioning the client on the operative side
(left side) allows the remaining lung to expand more fully and improves
ventilation-perfusion matching. This also prevents mediastinal shift.
Question 2
A client with cirrhosis of the liver develops ascites. The nurse should monitor the
client for which complication related to ascites?
A. Constipation
B. Respiratory distress
C. Hypothermia
D. Bradycardia
CORRECT ANSWER: B
RATIONALE: Severe ascites can cause respiratory distress due to increased intra-
abdominal pressure pushing upward on the diaphragm, reducing lung expansion.
The nurse should monitor for shortness of breath and tachypnea.
,Question 3
The nurse is reinforcing teaching with a client who has a new prescription for
donepezil (Aricept) for Alzheimer disease. Which statement by the client indicates
correct understanding?
A. "This medication will cure my Alzheimer disease over time."
B. "I should take this medication at bedtime to reduce side effects."
C. "This medication will improve my memory and cognitive function."
D. "I can stop taking this medication when my symptoms improve."
CORRECT ANSWER: C
RATIONALE: Donepezil is a cholinesterase inhibitor that may improve cognitive
function and memory in clients with Alzheimer disease. It does not cure the
disease. It is usually taken at bedtime to reduce GI side effects, but option C is the
best answer about its purpose.
Question 4
A client with chronic kidney disease (CKD) is receiving hemodialysis. The nurse
notes that the client's arteriovenous (AV) fistula has a palpable thrill and audible
bruit. What is the nurse's best action?
A. Notify the healthcare provider immediately
B. Document the findings as normal
C. Apply a warm compress to the fistula
D. Elevate the arm to reduce swelling
CORRECT ANSWER: B
RATIONALE: A palpable thrill and audible bruit indicate that the AV fistula is patent
and functioning normally. The nurse should document these normal findings.
Absence of thrill and bruit would indicate thrombosis and require immediate
notification.
,Question 5
The nurse is caring for a client who has just returned from a cardiac
catheterization via the right femoral artery. The nurse should report which finding
to the healthcare provider immediately?
A. The client reports mild groin discomfort
B. The right foot is warm and pink with a palpable pulse
C. The pressure dressing has a small amount of serous drainage
D. The client reports numbness and tingling in the right foot
CORRECT ANSWER: D
RATIONALE: Numbness and tingling in the right foot may indicate arterial
insufficiency or nerve compression from a hematoma. This finding should be
reported immediately. Mild groin discomfort, warm pink foot with pulses, and
small serous drainage are expected findings.
Question 6
A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). The
client's international normalized ratio (INR) is 1.1. What is the nurse's priority
action?
A. Administer the next dose of warfarin as prescribed
B. Hold the warfarin and notify the healthcare provider
C. Administer vitamin K as prescribed
D. Increase the warfarin dose without an order
CORRECT ANSWER: A
RATIONALE: The therapeutic INR range for atrial fibrillation is typically 2.0-3.0. An
INR of 1.1 is subtherapeutic, but the nurse should administer the next dose as
prescribed and notify the healthcare provider for a possible dose increase.
Holding the medication would worsen the subtherapeutic level.
, Question 7
The nurse is reinforcing teaching with a client who has a new prescription for a
metered-dose inhaler (MDI) containing ipratropium bromide (Atrovent). The nurse
should instruct the client to use this medication for which purpose?
A. To relieve acute asthma attacks
B. As a daily maintenance bronchodilator for COPD
C. To reduce airway inflammation
D. To prevent exercise-induced bronchospasm
CORRECT ANSWER: B
RATIONALE: Ipratropium is an anticholinergic bronchodilator used as a
maintenance medication for COPD. It is not a rescue medication for acute attacks
(albuterol is used for that). It does not reduce inflammation (corticosteroids do
that).
Question 8
A client who delivered a full-term infant 12 hours ago reports a heavy gush of
vaginal bleeding. The nurse assesses the fundus and finds it is boggy and located 2
cm above the umbilicus. What is the nurse's priority action?
A. Notify the healthcare provider immediately
B. Administer oxytocin (Pitocin) as prescribed
C. Massage the fundus until it becomes firm
D. Increase the intravenous fluid rate
CORRECT ANSWER: C
RATIONALE: A boggy fundus above the umbilicus with heavy bleeding indicates
uterine atony, the most common cause of postpartum hemorrhage. The priority is
to massage the fundus until it becomes firm. After massaging, oxytocin may be
ANSWERS AND DETAILED RATIONALES
Question 1
The nurse is assessing a client who is 1 day post-operative following a left
pneumonectomy. The client is positioned on the left side. What is the rationale for
this positioning?
A. To prevent aspiration of secretions from the right lung
B. To allow the remaining lung to expand more fully
C. To promote drainage of blood from the surgical site
D. To reduce tension on the chest tube insertion site
CORRECT ANSWER: B
RATIONALE: After a pneumonectomy, positioning the client on the operative side
(left side) allows the remaining lung to expand more fully and improves
ventilation-perfusion matching. This also prevents mediastinal shift.
Question 2
A client with cirrhosis of the liver develops ascites. The nurse should monitor the
client for which complication related to ascites?
A. Constipation
B. Respiratory distress
C. Hypothermia
D. Bradycardia
CORRECT ANSWER: B
RATIONALE: Severe ascites can cause respiratory distress due to increased intra-
abdominal pressure pushing upward on the diaphragm, reducing lung expansion.
The nurse should monitor for shortness of breath and tachypnea.
,Question 3
The nurse is reinforcing teaching with a client who has a new prescription for
donepezil (Aricept) for Alzheimer disease. Which statement by the client indicates
correct understanding?
A. "This medication will cure my Alzheimer disease over time."
B. "I should take this medication at bedtime to reduce side effects."
C. "This medication will improve my memory and cognitive function."
D. "I can stop taking this medication when my symptoms improve."
CORRECT ANSWER: C
RATIONALE: Donepezil is a cholinesterase inhibitor that may improve cognitive
function and memory in clients with Alzheimer disease. It does not cure the
disease. It is usually taken at bedtime to reduce GI side effects, but option C is the
best answer about its purpose.
Question 4
A client with chronic kidney disease (CKD) is receiving hemodialysis. The nurse
notes that the client's arteriovenous (AV) fistula has a palpable thrill and audible
bruit. What is the nurse's best action?
A. Notify the healthcare provider immediately
B. Document the findings as normal
C. Apply a warm compress to the fistula
D. Elevate the arm to reduce swelling
CORRECT ANSWER: B
RATIONALE: A palpable thrill and audible bruit indicate that the AV fistula is patent
and functioning normally. The nurse should document these normal findings.
Absence of thrill and bruit would indicate thrombosis and require immediate
notification.
,Question 5
The nurse is caring for a client who has just returned from a cardiac
catheterization via the right femoral artery. The nurse should report which finding
to the healthcare provider immediately?
A. The client reports mild groin discomfort
B. The right foot is warm and pink with a palpable pulse
C. The pressure dressing has a small amount of serous drainage
D. The client reports numbness and tingling in the right foot
CORRECT ANSWER: D
RATIONALE: Numbness and tingling in the right foot may indicate arterial
insufficiency or nerve compression from a hematoma. This finding should be
reported immediately. Mild groin discomfort, warm pink foot with pulses, and
small serous drainage are expected findings.
Question 6
A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). The
client's international normalized ratio (INR) is 1.1. What is the nurse's priority
action?
A. Administer the next dose of warfarin as prescribed
B. Hold the warfarin and notify the healthcare provider
C. Administer vitamin K as prescribed
D. Increase the warfarin dose without an order
CORRECT ANSWER: A
RATIONALE: The therapeutic INR range for atrial fibrillation is typically 2.0-3.0. An
INR of 1.1 is subtherapeutic, but the nurse should administer the next dose as
prescribed and notify the healthcare provider for a possible dose increase.
Holding the medication would worsen the subtherapeutic level.
, Question 7
The nurse is reinforcing teaching with a client who has a new prescription for a
metered-dose inhaler (MDI) containing ipratropium bromide (Atrovent). The nurse
should instruct the client to use this medication for which purpose?
A. To relieve acute asthma attacks
B. As a daily maintenance bronchodilator for COPD
C. To reduce airway inflammation
D. To prevent exercise-induced bronchospasm
CORRECT ANSWER: B
RATIONALE: Ipratropium is an anticholinergic bronchodilator used as a
maintenance medication for COPD. It is not a rescue medication for acute attacks
(albuterol is used for that). It does not reduce inflammation (corticosteroids do
that).
Question 8
A client who delivered a full-term infant 12 hours ago reports a heavy gush of
vaginal bleeding. The nurse assesses the fundus and finds it is boggy and located 2
cm above the umbilicus. What is the nurse's priority action?
A. Notify the healthcare provider immediately
B. Administer oxytocin (Pitocin) as prescribed
C. Massage the fundus until it becomes firm
D. Increase the intravenous fluid rate
CORRECT ANSWER: C
RATIONALE: A boggy fundus above the umbilicus with heavy bleeding indicates
uterine atony, the most common cause of postpartum hemorrhage. The priority is
to massage the fundus until it becomes firm. After massaging, oxytocin may be
