HESI RN EXIT EXAM
COMPREHENSIVE
STUDY GUIDE
SECTION 1: GASTROINTESTINAL & NUTRITION
QUESTION 1
Client with duodenal ulcer says he will drink plenty of dairy products to coat and protect his
ulcer. Best follow-up action?
ANSWER
Review with the client the need to avoid foods rich in milk and cream
RATIONALE / EXPLANATION
Milk and cream stimulate gastric acid secretion and should be avoided. Also avoid caffeine.
QUESTION 2
Client taking tetracycline complains of GI upset. What snack to take with the medication?
ANSWER
Toasted wheat bread and jelly
RATIONALE / EXPLANATION
Dairy products decrease tetracycline effectiveness. Toast with no dairy may decrease GI
symptoms.
QUESTION 3
Antibiotic cephradine prescribed for postoperative wound infection. Which food to
encourage?
ANSWER
D. Cinnamon applesauce
RATIONALE / EXPLANATION
Page 1 of 30
,Dairy products and calcium-fortified foods decrease absorption of ciprofloxacin. Applesauce has
no calcium.
QUESTION 4
Client on warfarin (Coumadin). What dietary instruction?
ANSWER
Eat approximately the same amount of leafy green vegetables daily so vitamin
K consumed is consistent
RATIONALE / EXPLANATION
Coumadin dose is adjusted based on normal vitamin K consumption. Keep intake consistent,
don't eliminate or increase.
QUESTION 5
Pregnant client complaining of heartburn. Best instruction?
ANSWER
Eat small meals throughout the day to avoid a full stomach
RATIONALE / EXPLANATION
Small frequent meals decrease stomach fullness and heartburn. Avoid antacids in pregnancy
unless prescribed.
QUESTION 6
Client with small bowel resection has diarrhea. No BM for 3 days but now frequent small
liquid stools. Action?
ANSWER
Digitally check the client for a fecal impaction
RATIONALE / EXPLANATION
Liquid stool around impaction is classic sign of fecal impaction - seepage of liquid around the
solid mass.
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, SECTION 2: CARDIOVASCULAR & HEMODYNAMICS
QUESTION 7
Client with hypertension not taking meds because they make him 'feel bad.' What risk to
stress?
ANSWER
Stroke secondary to hemorrhage
RATIONALE / EXPLANATION
Stroke from cerebral hemorrhage is the major risk of uncontrolled hypertension.
QUESTION 8
After placing stethoscope for S1 and S2, what action to determine if S3 is present?
ANSWER
Listen with the bell at the same location
RATIONALE / EXPLANATION
The bell auscultates low-pitched sounds like S3 and S4. Listen at same site with bell before
moving to next location.
QUESTION 9
Client with heart failure has nausea, vomiting, yellow vision, palpitations. Most important
assessment?
ANSWER
Obtain a list of medications taken for cardiac history
RATIONALE / EXPLANATION
These are signs of digitalis toxicity. Medication list will likely include digoxin (Lanoxin) - confirm
with serum level >2 mg/ml.
QUESTION 10
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COMPREHENSIVE
STUDY GUIDE
SECTION 1: GASTROINTESTINAL & NUTRITION
QUESTION 1
Client with duodenal ulcer says he will drink plenty of dairy products to coat and protect his
ulcer. Best follow-up action?
ANSWER
Review with the client the need to avoid foods rich in milk and cream
RATIONALE / EXPLANATION
Milk and cream stimulate gastric acid secretion and should be avoided. Also avoid caffeine.
QUESTION 2
Client taking tetracycline complains of GI upset. What snack to take with the medication?
ANSWER
Toasted wheat bread and jelly
RATIONALE / EXPLANATION
Dairy products decrease tetracycline effectiveness. Toast with no dairy may decrease GI
symptoms.
QUESTION 3
Antibiotic cephradine prescribed for postoperative wound infection. Which food to
encourage?
ANSWER
D. Cinnamon applesauce
RATIONALE / EXPLANATION
Page 1 of 30
,Dairy products and calcium-fortified foods decrease absorption of ciprofloxacin. Applesauce has
no calcium.
QUESTION 4
Client on warfarin (Coumadin). What dietary instruction?
ANSWER
Eat approximately the same amount of leafy green vegetables daily so vitamin
K consumed is consistent
RATIONALE / EXPLANATION
Coumadin dose is adjusted based on normal vitamin K consumption. Keep intake consistent,
don't eliminate or increase.
QUESTION 5
Pregnant client complaining of heartburn. Best instruction?
ANSWER
Eat small meals throughout the day to avoid a full stomach
RATIONALE / EXPLANATION
Small frequent meals decrease stomach fullness and heartburn. Avoid antacids in pregnancy
unless prescribed.
QUESTION 6
Client with small bowel resection has diarrhea. No BM for 3 days but now frequent small
liquid stools. Action?
ANSWER
Digitally check the client for a fecal impaction
RATIONALE / EXPLANATION
Liquid stool around impaction is classic sign of fecal impaction - seepage of liquid around the
solid mass.
Page 2 of 30
, SECTION 2: CARDIOVASCULAR & HEMODYNAMICS
QUESTION 7
Client with hypertension not taking meds because they make him 'feel bad.' What risk to
stress?
ANSWER
Stroke secondary to hemorrhage
RATIONALE / EXPLANATION
Stroke from cerebral hemorrhage is the major risk of uncontrolled hypertension.
QUESTION 8
After placing stethoscope for S1 and S2, what action to determine if S3 is present?
ANSWER
Listen with the bell at the same location
RATIONALE / EXPLANATION
The bell auscultates low-pitched sounds like S3 and S4. Listen at same site with bell before
moving to next location.
QUESTION 9
Client with heart failure has nausea, vomiting, yellow vision, palpitations. Most important
assessment?
ANSWER
Obtain a list of medications taken for cardiac history
RATIONALE / EXPLANATION
These are signs of digitalis toxicity. Medication list will likely include digoxin (Lanoxin) - confirm
with serum level >2 mg/ml.
QUESTION 10
Page 3 of 30
