HESI 400 RN EXIT EXAM
COMPREHENSIVE
STUDY GUIDE
SECTION 1: MEDICATION CALCULATIONS
QUESTION 1
Potassium chloride 25 mEq in 500 mL D5W to infuse over 6 hours. Available: 10 mEq/5mL.
How many mL to add?
ANSWER
12.5 mL
RATIONALE / EXPLANATION
Using formula D/H × Q: 25 mEq ÷ 10 mEq × 5 mL = 12.5 mL
QUESTION 2
Morphine Sulfate Oral Solution 38 mg PO q4h PRN. Available: 100 mg/5 mL (20 mg/mL).
How many mL?
ANSWER
1.9 mL
RATIONALE / EXPLANATION
38 mg ÷ 20 mg/mL = 1.9 mL
QUESTION 3
Promethazine 0.5 mg/kg IM for 42 lb child. Available: 25 mg/mL. How many mL?
ANSWER
0.4 mL
RATIONALE / EXPLANATION
42 lbs ÷ 2.2 = 19.09 kg. 0.5 mg × 19.09 kg = 9.545 mg. 9.545 mg ÷ 25 mg/mL = 0.38 → 0.4 mL
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,QUESTION 4
Heparin protocol 18 units/kg/hr for 144 lb client. Available: 25,000 units/250 mL D5W. mL/hr?
ANSWER
12 mL/hr
RATIONALE / EXPLANATION
144 lbs ÷ 2.2 = 65 kg. 65 kg × 18 units/kg/hr = 1170 units/hr. 25000 units/250 mL = 100 units/mL.
1170 ÷ 100 = 11.7 → 12 mL/hr
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, SECTION 2: GASTROINTESTINAL
QUESTION 5
Older client with chronic constipation on furosemide and laxatives. Suggestions? (Select all)
ANSWER
Include oatmeal with stewed prunes for breakfast
Increase fluid intake by keeping water glass next to recliner
Recommend seeking help with regular shopping and meal preparation
RATIONALE / EXPLANATION
Older adults at higher risk for constipation due to decreased GI muscle tone. Oatmeal/prunes
increase fiber; fluids decrease constipation; meal prep assistance improves diet quality.
QUESTION 6
Client post-cholecystectomy 2 weeks ago with nausea, abdominal distention, pain. First
assessment?
ANSWER
Auscultate all quadrants of the abdomen
RATIONALE / EXPLANATION
Assess bowel sounds first to evaluate GI function before other assessments.
QUESTION 7
Which task can nurse delegate to UAP for client with NG tube?
ANSWER
Disconnect the NG suction so the client can ambulate in the hallway
RATIONALE / EXPLANATION
UAP can disconnect/reconnect NG suction for ambulation. Cannot replace, secure if displaced,
or manipulate tube placement.
QUESTION 8
Page 3 of 31
, Sucralfate (Carafate) scheduled for 0900 after breakfast. Action?
ANSWER
Hold until later - give before next meal
RATIONALE / EXPLANATION
Carafate coats mucosal lining and should be given BEFORE meals, not after.
Page 4 of 31
COMPREHENSIVE
STUDY GUIDE
SECTION 1: MEDICATION CALCULATIONS
QUESTION 1
Potassium chloride 25 mEq in 500 mL D5W to infuse over 6 hours. Available: 10 mEq/5mL.
How many mL to add?
ANSWER
12.5 mL
RATIONALE / EXPLANATION
Using formula D/H × Q: 25 mEq ÷ 10 mEq × 5 mL = 12.5 mL
QUESTION 2
Morphine Sulfate Oral Solution 38 mg PO q4h PRN. Available: 100 mg/5 mL (20 mg/mL).
How many mL?
ANSWER
1.9 mL
RATIONALE / EXPLANATION
38 mg ÷ 20 mg/mL = 1.9 mL
QUESTION 3
Promethazine 0.5 mg/kg IM for 42 lb child. Available: 25 mg/mL. How many mL?
ANSWER
0.4 mL
RATIONALE / EXPLANATION
42 lbs ÷ 2.2 = 19.09 kg. 0.5 mg × 19.09 kg = 9.545 mg. 9.545 mg ÷ 25 mg/mL = 0.38 → 0.4 mL
Page 1 of 31
,QUESTION 4
Heparin protocol 18 units/kg/hr for 144 lb client. Available: 25,000 units/250 mL D5W. mL/hr?
ANSWER
12 mL/hr
RATIONALE / EXPLANATION
144 lbs ÷ 2.2 = 65 kg. 65 kg × 18 units/kg/hr = 1170 units/hr. 25000 units/250 mL = 100 units/mL.
1170 ÷ 100 = 11.7 → 12 mL/hr
Page 2 of 31
, SECTION 2: GASTROINTESTINAL
QUESTION 5
Older client with chronic constipation on furosemide and laxatives. Suggestions? (Select all)
ANSWER
Include oatmeal with stewed prunes for breakfast
Increase fluid intake by keeping water glass next to recliner
Recommend seeking help with regular shopping and meal preparation
RATIONALE / EXPLANATION
Older adults at higher risk for constipation due to decreased GI muscle tone. Oatmeal/prunes
increase fiber; fluids decrease constipation; meal prep assistance improves diet quality.
QUESTION 6
Client post-cholecystectomy 2 weeks ago with nausea, abdominal distention, pain. First
assessment?
ANSWER
Auscultate all quadrants of the abdomen
RATIONALE / EXPLANATION
Assess bowel sounds first to evaluate GI function before other assessments.
QUESTION 7
Which task can nurse delegate to UAP for client with NG tube?
ANSWER
Disconnect the NG suction so the client can ambulate in the hallway
RATIONALE / EXPLANATION
UAP can disconnect/reconnect NG suction for ambulation. Cannot replace, secure if displaced,
or manipulate tube placement.
QUESTION 8
Page 3 of 31
, Sucralfate (Carafate) scheduled for 0900 after breakfast. Action?
ANSWER
Hold until later - give before next meal
RATIONALE / EXPLANATION
Carafate coats mucosal lining and should be given BEFORE meals, not after.
Page 4 of 31
