HESI PN EXIT EXAM V3 COMPLETE 300+ QUESTIONS WITH 100% VERIFIED
ANSWERS AND DETAILED RATIONALES
Question 1
The nurse is caring for a client with a new diagnosis of Ménière's disease. Which
finding should the nurse expect during assessment?
A. Sudden hearing loss in both ears with tinnitus
B. Episodic vertigo, tinnitus, and sensorineural hearing loss
C. Constant dizziness without hearing changes
D. Gradual hearing loss with otalgia
CORRECT ANSWER: B
RATIONALE: Ménière's disease is characterized by the triad of episodic vertigo
(lasting minutes to hours), tinnitus (ringing in the ears), and sensorineural hearing
loss. These symptoms are caused by endolymphatic hydrops (increased fluid
pressure in the inner ear).
Question 2
The nurse is reinforcing teaching with a client who has a new prescription for
brimonidine (Alphagan) eye drops for glaucoma. The nurse should instruct the
client to report which finding as a possible adverse effect?
A. Temporary blurred vision after instillation
B. Dry mouth and fatigue
C. Stinging upon instillation
D. Increased tear production
CORRECT ANSWER: B
,RATIONALE: Brimonidine is an alpha-2 adrenergic agonist that can cause systemic
side effects including dry mouth, fatigue, drowsiness, and hypotension. The client
should report these if they become bothersome. Temporary blurred vision and
stinging are common local effects.
Question 3
A client with a diagnosis of hyperemesis gravidarum is admitted for severe nausea
and vomiting during pregnancy. The nurse should monitor the client for which
complication?
A. Hyperkalemia
B. Metabolic alkalosis
C. Respiratory acidosis
D. Hypoglycemia
CORRECT ANSWER: B
RATIONALE: Hyperemesis gravidarum causes loss of gastric acid (hydrochloric acid)
through vomiting, leading to metabolic alkalosis. Hypokalemia (not hyperkalemia),
hypochloremia, and dehydration are also common. The client may have ketosis
from starvation.
Question 4
The nurse is caring for a client with a new diagnosis of amyotrophic lateral
sclerosis (ALS). The nurse should prioritize which assessment?
A. Respiratory status and vital capacity
B. Bowel sounds and nutritional intake
C. Skin integrity and pressure points
D. Urinary output and renal function
CORRECT ANSWER: A
,RATIONALE: ALS causes progressive muscle weakness, including the diaphragm
and intercostal muscles, leading to respiratory failure. Respiratory status, vital
capacity, and oxygen saturation are the priority assessments. Respiratory failure is
the most common cause of death in ALS.
Question 5
The nurse is reinforcing teaching with a client who has a new prescription for
timolol (Timoptic) eye drops for glaucoma. The nurse should instruct the client to
perform which action to reduce systemic absorption?
A. Blink rapidly after instilling the drop
B. Close the eye and apply pressure to the inner canthus for 1-2 minutes
C. Tilt the head back and look upward
D. Use two drops at a time to ensure effectiveness
CORRECT ANSWER: B
RATIONALE: Nasolacrimal occlusion (applying pressure to the inner canthus for 1-2
minutes after instillation) reduces systemic absorption of eye drops, especially
beta-blockers like timolol, which can cause bradycardia and hypotension. The
client should close the eye gently, not blink rapidly.
Question 6
A client with a history of chronic kidney disease (CKD) is admitted with
pericarditis. The nurse understands that pericarditis in CKD is most likely caused
by which condition?
A. Bacterial infection
B. Uremic toxins
C. Viral infection
D. Autoimmune reaction
CORRECT ANSWER: B
, RATIONALE: Uremic pericarditis occurs in clients with advanced CKD due to
accumulation of uremic toxins. It typically resolves with dialysis. Infectious
pericarditis is less common. The nurse should assess for chest pain that improves
with leaning forward and a pericardial friction rub.
Question 7
The nurse is caring for a client with a new diagnosis of herpes zoster ophthalmicus
(shingles involving the eye). Which finding should the nurse report to the
healthcare provider immediately?
A. Vesicles on the tip of the nose
B. Pain along the forehead
C. Blurred vision in one eye
D. Redness of the conjunctiva
CORRECT ANSWER: A
RATIONALE: Vesicles on the tip of the nose (Hutchinson sign) indicates
involvement of the nasociliary branch of the trigeminal nerve, which has a high
risk of ocular involvement (keratitis, uveitis, glaucoma). This finding requires
immediate ophthalmologic referral to prevent vision loss.
Question 8
The nurse is reinforcing teaching with a client who has a new prescription for a
low-tyramine diet while taking a monoamine oxidase inhibitor (MAOI). The nurse
should instruct the client to avoid which food?
A. Fresh mozzarella cheese
B. Soy sauce
C. Cream cheese
D. Cottage cheese
CORRECT ANSWER: B
ANSWERS AND DETAILED RATIONALES
Question 1
The nurse is caring for a client with a new diagnosis of Ménière's disease. Which
finding should the nurse expect during assessment?
A. Sudden hearing loss in both ears with tinnitus
B. Episodic vertigo, tinnitus, and sensorineural hearing loss
C. Constant dizziness without hearing changes
D. Gradual hearing loss with otalgia
CORRECT ANSWER: B
RATIONALE: Ménière's disease is characterized by the triad of episodic vertigo
(lasting minutes to hours), tinnitus (ringing in the ears), and sensorineural hearing
loss. These symptoms are caused by endolymphatic hydrops (increased fluid
pressure in the inner ear).
Question 2
The nurse is reinforcing teaching with a client who has a new prescription for
brimonidine (Alphagan) eye drops for glaucoma. The nurse should instruct the
client to report which finding as a possible adverse effect?
A. Temporary blurred vision after instillation
B. Dry mouth and fatigue
C. Stinging upon instillation
D. Increased tear production
CORRECT ANSWER: B
,RATIONALE: Brimonidine is an alpha-2 adrenergic agonist that can cause systemic
side effects including dry mouth, fatigue, drowsiness, and hypotension. The client
should report these if they become bothersome. Temporary blurred vision and
stinging are common local effects.
Question 3
A client with a diagnosis of hyperemesis gravidarum is admitted for severe nausea
and vomiting during pregnancy. The nurse should monitor the client for which
complication?
A. Hyperkalemia
B. Metabolic alkalosis
C. Respiratory acidosis
D. Hypoglycemia
CORRECT ANSWER: B
RATIONALE: Hyperemesis gravidarum causes loss of gastric acid (hydrochloric acid)
through vomiting, leading to metabolic alkalosis. Hypokalemia (not hyperkalemia),
hypochloremia, and dehydration are also common. The client may have ketosis
from starvation.
Question 4
The nurse is caring for a client with a new diagnosis of amyotrophic lateral
sclerosis (ALS). The nurse should prioritize which assessment?
A. Respiratory status and vital capacity
B. Bowel sounds and nutritional intake
C. Skin integrity and pressure points
D. Urinary output and renal function
CORRECT ANSWER: A
,RATIONALE: ALS causes progressive muscle weakness, including the diaphragm
and intercostal muscles, leading to respiratory failure. Respiratory status, vital
capacity, and oxygen saturation are the priority assessments. Respiratory failure is
the most common cause of death in ALS.
Question 5
The nurse is reinforcing teaching with a client who has a new prescription for
timolol (Timoptic) eye drops for glaucoma. The nurse should instruct the client to
perform which action to reduce systemic absorption?
A. Blink rapidly after instilling the drop
B. Close the eye and apply pressure to the inner canthus for 1-2 minutes
C. Tilt the head back and look upward
D. Use two drops at a time to ensure effectiveness
CORRECT ANSWER: B
RATIONALE: Nasolacrimal occlusion (applying pressure to the inner canthus for 1-2
minutes after instillation) reduces systemic absorption of eye drops, especially
beta-blockers like timolol, which can cause bradycardia and hypotension. The
client should close the eye gently, not blink rapidly.
Question 6
A client with a history of chronic kidney disease (CKD) is admitted with
pericarditis. The nurse understands that pericarditis in CKD is most likely caused
by which condition?
A. Bacterial infection
B. Uremic toxins
C. Viral infection
D. Autoimmune reaction
CORRECT ANSWER: B
, RATIONALE: Uremic pericarditis occurs in clients with advanced CKD due to
accumulation of uremic toxins. It typically resolves with dialysis. Infectious
pericarditis is less common. The nurse should assess for chest pain that improves
with leaning forward and a pericardial friction rub.
Question 7
The nurse is caring for a client with a new diagnosis of herpes zoster ophthalmicus
(shingles involving the eye). Which finding should the nurse report to the
healthcare provider immediately?
A. Vesicles on the tip of the nose
B. Pain along the forehead
C. Blurred vision in one eye
D. Redness of the conjunctiva
CORRECT ANSWER: A
RATIONALE: Vesicles on the tip of the nose (Hutchinson sign) indicates
involvement of the nasociliary branch of the trigeminal nerve, which has a high
risk of ocular involvement (keratitis, uveitis, glaucoma). This finding requires
immediate ophthalmologic referral to prevent vision loss.
Question 8
The nurse is reinforcing teaching with a client who has a new prescription for a
low-tyramine diet while taking a monoamine oxidase inhibitor (MAOI). The nurse
should instruct the client to avoid which food?
A. Fresh mozzarella cheese
B. Soy sauce
C. Cream cheese
D. Cottage cheese
CORRECT ANSWER: B
