HESI PN EXIT EXAM V4 COMPLETE 300+ QUESTIONS WITH 100% VERIFIED
ANSWERS AND DETAILED RATIONALES
Question 1
The nurse is reinforcing teaching with a client who has a new diagnosis of Raynaud
phenomenon. Which instruction should the nurse include to prevent vasospastic
attacks?
A. Apply warm compresses to the hands when they feel cold
B. Wear gloves when removing food from the freezer
C. Soak hands in hot water several times daily
D. Avoid all physical activity during cold weather
CORRECT ANSWER: B
RATIONALE: Raynaud phenomenon causes vasospasm of digital arteries in
response to cold or stress. Wearing gloves when handling cold objects (freezer
items, cold drinks) helps prevent attacks. Warm compresses can be used after an
attack but do not prevent it. Hot water can cause burns from decreased sensation.
Question 2
The nurse is caring for a client with a new diagnosis of acute lymphocytic leukemia
(ALL) receiving induction chemotherapy. The client's temperature is 101.5°F
(38.6°C). What is the nurse's priority action?
A. Administer acetaminophen (Tylenol) as prescribed
B. Obtain blood cultures and notify the healthcare provider
C. Apply a cooling blanket to reduce fever
D. Encourage increased oral fluid intake
CORRECT ANSWER: B
,RATIONALE: Clients receiving induction chemotherapy for ALL are severely
neutropenic (low white blood cell count). Fever is a medical emergency indicating
possible sepsis. The nurse should obtain blood cultures and notify the healthcare
provider immediately for empirical antibiotics.
Question 3
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
monitor for which systemic side effect?
A. Bradycardia and hypotension
B. Tachycardia and hypertension
C. Diarrhea and abdominal cramping
D. Polyuria and polydipsia
CORRECT ANSWER: A
RATIONALE: Timolol is a beta-blocker that can be systemically absorbed through
the nasolacrimal duct, causing bradycardia, hypotension, and dizziness. Clients
should be instructed to apply pressure to the inner canthus (nasolacrimal
occlusion) to reduce systemic absorption.
Question 4
A client with a diagnosis of chronic kidney disease (CKD) is prescribed sevelamer
(Renagel). The nurse should instruct the client to take this medication at which
time?
A. One hour before meals
B. With meals
C. Two hours after meals
D. At bedtime only
CORRECT ANSWER: B
,RATIONALE: Sevelamer is a phosphate binder that must be taken with meals to
bind dietary phosphate in the gastrointestinal tract. Taking it on an empty
stomach is ineffective. The number of capsules depends on the phosphate content
of the meal.
Question 5
The nurse is caring for a client with a new diagnosis of pyelonephritis. Which
finding should the nurse expect during assessment?
A. Suprapubic pain and dysuria only
B. Fever, chills, and costovertebral angle tenderness
C. Painless hematuria
D. Nausea and vomiting without urinary symptoms
CORRECT ANSWER: B
RATIONALE: Pyelonephritis (kidney infection) presents with fever, chills, flank pain,
costovertebral angle tenderness, nausea, vomiting, and often dysuria. Suprapubic
pain alone suggests cystitis. Painless hematuria suggests a renal tumor or
glomerular disease.
Question 6
The nurse is reinforcing teaching with a client who has a new prescription for a
low-tyramine diet while taking phenelzine (Nardil). The nurse should instruct the
client to avoid which food?
A. Fresh mozzarella cheese
B. Yogurt
C. Soy sauce
D. Cream cheese
CORRECT ANSWER: C
, RATIONALE: Soy sauce is high in tyramine and can cause hypertensive crisis when
taken with MAOIs like phenelzine. Fresh mozzarella, yogurt, and cream cheese are
lower in tyramine. Other foods to avoid include aged cheeses, aged meats,
fermented foods, beer, wine, and fava beans.
Question 7
The nurse is caring for a client with a new diagnosis of thrombocytopenia
secondary to chemotherapy. Which finding requires immediate intervention?
A. Platelet count of 40,000/mm³
B. Petechiae on the lower extremities
C. The client reports a severe headache
D. Bruising on the arms from minor trauma
CORRECT ANSWER: C
RATIONALE: A severe headache in a client with thrombocytopenia may indicate
intracranial hemorrhage, a life-threatening emergency. This finding requires
immediate notification of the healthcare provider. A platelet count of 40,000,
petechiae, and bruising are concerning but not immediately life-threatening.
Question 8
The nurse is reinforcing teaching with a client who has a new prescription for a
wig after chemotherapy-induced alopecia. The nurse should instruct the client to
purchase the wig at which time?
A. Before chemotherapy begins
B. After the first cycle of chemotherapy
C. When hair loss is complete
D. After chemotherapy ends
CORRECT ANSWER: A
ANSWERS AND DETAILED RATIONALES
Question 1
The nurse is reinforcing teaching with a client who has a new diagnosis of Raynaud
phenomenon. Which instruction should the nurse include to prevent vasospastic
attacks?
A. Apply warm compresses to the hands when they feel cold
B. Wear gloves when removing food from the freezer
C. Soak hands in hot water several times daily
D. Avoid all physical activity during cold weather
CORRECT ANSWER: B
RATIONALE: Raynaud phenomenon causes vasospasm of digital arteries in
response to cold or stress. Wearing gloves when handling cold objects (freezer
items, cold drinks) helps prevent attacks. Warm compresses can be used after an
attack but do not prevent it. Hot water can cause burns from decreased sensation.
Question 2
The nurse is caring for a client with a new diagnosis of acute lymphocytic leukemia
(ALL) receiving induction chemotherapy. The client's temperature is 101.5°F
(38.6°C). What is the nurse's priority action?
A. Administer acetaminophen (Tylenol) as prescribed
B. Obtain blood cultures and notify the healthcare provider
C. Apply a cooling blanket to reduce fever
D. Encourage increased oral fluid intake
CORRECT ANSWER: B
,RATIONALE: Clients receiving induction chemotherapy for ALL are severely
neutropenic (low white blood cell count). Fever is a medical emergency indicating
possible sepsis. The nurse should obtain blood cultures and notify the healthcare
provider immediately for empirical antibiotics.
Question 3
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
monitor for which systemic side effect?
A. Bradycardia and hypotension
B. Tachycardia and hypertension
C. Diarrhea and abdominal cramping
D. Polyuria and polydipsia
CORRECT ANSWER: A
RATIONALE: Timolol is a beta-blocker that can be systemically absorbed through
the nasolacrimal duct, causing bradycardia, hypotension, and dizziness. Clients
should be instructed to apply pressure to the inner canthus (nasolacrimal
occlusion) to reduce systemic absorption.
Question 4
A client with a diagnosis of chronic kidney disease (CKD) is prescribed sevelamer
(Renagel). The nurse should instruct the client to take this medication at which
time?
A. One hour before meals
B. With meals
C. Two hours after meals
D. At bedtime only
CORRECT ANSWER: B
,RATIONALE: Sevelamer is a phosphate binder that must be taken with meals to
bind dietary phosphate in the gastrointestinal tract. Taking it on an empty
stomach is ineffective. The number of capsules depends on the phosphate content
of the meal.
Question 5
The nurse is caring for a client with a new diagnosis of pyelonephritis. Which
finding should the nurse expect during assessment?
A. Suprapubic pain and dysuria only
B. Fever, chills, and costovertebral angle tenderness
C. Painless hematuria
D. Nausea and vomiting without urinary symptoms
CORRECT ANSWER: B
RATIONALE: Pyelonephritis (kidney infection) presents with fever, chills, flank pain,
costovertebral angle tenderness, nausea, vomiting, and often dysuria. Suprapubic
pain alone suggests cystitis. Painless hematuria suggests a renal tumor or
glomerular disease.
Question 6
The nurse is reinforcing teaching with a client who has a new prescription for a
low-tyramine diet while taking phenelzine (Nardil). The nurse should instruct the
client to avoid which food?
A. Fresh mozzarella cheese
B. Yogurt
C. Soy sauce
D. Cream cheese
CORRECT ANSWER: C
, RATIONALE: Soy sauce is high in tyramine and can cause hypertensive crisis when
taken with MAOIs like phenelzine. Fresh mozzarella, yogurt, and cream cheese are
lower in tyramine. Other foods to avoid include aged cheeses, aged meats,
fermented foods, beer, wine, and fava beans.
Question 7
The nurse is caring for a client with a new diagnosis of thrombocytopenia
secondary to chemotherapy. Which finding requires immediate intervention?
A. Platelet count of 40,000/mm³
B. Petechiae on the lower extremities
C. The client reports a severe headache
D. Bruising on the arms from minor trauma
CORRECT ANSWER: C
RATIONALE: A severe headache in a client with thrombocytopenia may indicate
intracranial hemorrhage, a life-threatening emergency. This finding requires
immediate notification of the healthcare provider. A platelet count of 40,000,
petechiae, and bruising are concerning but not immediately life-threatening.
Question 8
The nurse is reinforcing teaching with a client who has a new prescription for a
wig after chemotherapy-induced alopecia. The nurse should instruct the client to
purchase the wig at which time?
A. Before chemotherapy begins
B. After the first cycle of chemotherapy
C. When hair loss is complete
D. After chemotherapy ends
CORRECT ANSWER: A
