HESI Exit PN | HESI Exit PN Exam Version 5
Comprehensive Review | Questions with Correct
Answers and Expert Explanation for Each Question
| Nursing Exit Assessment
1. A nurse is preparing to administer digoxin to a client with heart failure. Which
assessment finding should the nurse identify as a priority before administration?
A. Blood pressure 110/70 mmHg
B. Respiratory rate of 18 breaths per minute
C. Apical pulse rate of 52 beats per minute
D. Temperature of 37.2 degrees Celsius
Correct Answer: C
Expert Explanation: The nurse must assess the apical pulse for one full minute
prior to administering digoxin. Digoxin is a cardiac glycoside that slows the heart
rate while increasing contractility. A pulse rate below 60 beats per minute in an
adult or below 90 in an infant usually warrants withholding the medication. Toxicity
often manifests as bradycardia, nausea, or visual disturbances. If the pulse is low,
the nurse must notify the healthcare provider immediately for further instructions.
2. A client is prescribed furosemide 40 mg PO daily. Which electrolyte imbalance
should the nurse monitor for most closely?
A. Hypokalemia
,B. Hypocalcemia
C. Hyperkalemia
D. Hypermagnesemia
Correct Answer: A
Expert Explanation: Furosemide is a loop diuretic that promotes the excretion of
water, sodium, and potassium. Hypokalemia is a frequent and potentially life-
threatening side effect of this medication class. The nurse should encourage the
client to consume potassium-rich foods such as bananas or spinach. Clinical signs of
low potassium include muscle weakness, cardiac dysrhythmias, and leg cramps.
Regular monitoring of serum electrolyte levels is essential for patients on long-term
loop diuretic therapy.
3. The nurse is educating a client starting warfarin therapy. Which of the following
statements by the client indicates a need for further teaching?
A. I will use an electric razor for shaving.
B. I should avoid activities that could cause injury.
C. I will increase my intake of green leafy vegetables to help the medicine work.
D. I need to have my blood tested regularly.
Correct Answer: C
,Expert Explanation: Warfarin is an anticoagulant that works by interfering with
Vitamin K-dependent clotting factors. Green leafy vegetables are high in Vitamin K,
which can counteract the effects of warfarin and decrease its efficacy. The client
should maintain a consistent intake of Vitamin K rather than increasing or
decreasing it abruptly. Regular monitoring of the Prothrombin Time and
International Normalized Ratio is required to ensure therapeutic dosing. Using an
electric razor and avoiding trauma are safety measures to prevent bleeding
complications.
4. A client requires 0.5 mg of a medication, and the supply is available as 250 mcg
tablets. How many tablets should the nurse administer?
A. 2 tablets
B. 1 tablet
C. 0.5 tablet
D. 4 tablets
Correct Answer: A
Expert Explanation: To solve this dosage calculation, the nurse must first convert
milligrams to micrograms. Since 1 mg equals 1,000 mcg, 0.5 mg is equal to 500 mcg.
The formula for administration is the desired dose divided by the dose on hand.
, Therefore, 500 mcg divided by 250 mcg equals 2 tablets. Accuracy in unit
conversion is vital to prevent medication errors and ensure patient safety.
5. Which medication should the nurse have available as an antidote for a client
receiving heparin?
A. Vitamin K
B. Naloxone
C. Protamine sulfate
D. Calcium gluconate
Correct Answer: C
Expert Explanation: Protamine sulfate is the specific pharmacological antagonist
used to reverse the effects of heparin. Heparin is a fast-acting anticoagulant that
increases the risk of hemorrhage if levels become too high. The nurse monitors the
activated Partial Thromboplastin Time to assess the therapeutic level of heparin. In
the event of severe bleeding or overdose, protamine sulfate binds to heparin to
neutralize its activity. Vitamin K is the antidote for warfarin, not heparin.
6. A nurse is caring for a client with a new prescription for lisinopril. The nurse should
instruct the client to report which common adverse effect?
A. Persistent dry cough
B. Increased appetite
Comprehensive Review | Questions with Correct
Answers and Expert Explanation for Each Question
| Nursing Exit Assessment
1. A nurse is preparing to administer digoxin to a client with heart failure. Which
assessment finding should the nurse identify as a priority before administration?
A. Blood pressure 110/70 mmHg
B. Respiratory rate of 18 breaths per minute
C. Apical pulse rate of 52 beats per minute
D. Temperature of 37.2 degrees Celsius
Correct Answer: C
Expert Explanation: The nurse must assess the apical pulse for one full minute
prior to administering digoxin. Digoxin is a cardiac glycoside that slows the heart
rate while increasing contractility. A pulse rate below 60 beats per minute in an
adult or below 90 in an infant usually warrants withholding the medication. Toxicity
often manifests as bradycardia, nausea, or visual disturbances. If the pulse is low,
the nurse must notify the healthcare provider immediately for further instructions.
2. A client is prescribed furosemide 40 mg PO daily. Which electrolyte imbalance
should the nurse monitor for most closely?
A. Hypokalemia
,B. Hypocalcemia
C. Hyperkalemia
D. Hypermagnesemia
Correct Answer: A
Expert Explanation: Furosemide is a loop diuretic that promotes the excretion of
water, sodium, and potassium. Hypokalemia is a frequent and potentially life-
threatening side effect of this medication class. The nurse should encourage the
client to consume potassium-rich foods such as bananas or spinach. Clinical signs of
low potassium include muscle weakness, cardiac dysrhythmias, and leg cramps.
Regular monitoring of serum electrolyte levels is essential for patients on long-term
loop diuretic therapy.
3. The nurse is educating a client starting warfarin therapy. Which of the following
statements by the client indicates a need for further teaching?
A. I will use an electric razor for shaving.
B. I should avoid activities that could cause injury.
C. I will increase my intake of green leafy vegetables to help the medicine work.
D. I need to have my blood tested regularly.
Correct Answer: C
,Expert Explanation: Warfarin is an anticoagulant that works by interfering with
Vitamin K-dependent clotting factors. Green leafy vegetables are high in Vitamin K,
which can counteract the effects of warfarin and decrease its efficacy. The client
should maintain a consistent intake of Vitamin K rather than increasing or
decreasing it abruptly. Regular monitoring of the Prothrombin Time and
International Normalized Ratio is required to ensure therapeutic dosing. Using an
electric razor and avoiding trauma are safety measures to prevent bleeding
complications.
4. A client requires 0.5 mg of a medication, and the supply is available as 250 mcg
tablets. How many tablets should the nurse administer?
A. 2 tablets
B. 1 tablet
C. 0.5 tablet
D. 4 tablets
Correct Answer: A
Expert Explanation: To solve this dosage calculation, the nurse must first convert
milligrams to micrograms. Since 1 mg equals 1,000 mcg, 0.5 mg is equal to 500 mcg.
The formula for administration is the desired dose divided by the dose on hand.
, Therefore, 500 mcg divided by 250 mcg equals 2 tablets. Accuracy in unit
conversion is vital to prevent medication errors and ensure patient safety.
5. Which medication should the nurse have available as an antidote for a client
receiving heparin?
A. Vitamin K
B. Naloxone
C. Protamine sulfate
D. Calcium gluconate
Correct Answer: C
Expert Explanation: Protamine sulfate is the specific pharmacological antagonist
used to reverse the effects of heparin. Heparin is a fast-acting anticoagulant that
increases the risk of hemorrhage if levels become too high. The nurse monitors the
activated Partial Thromboplastin Time to assess the therapeutic level of heparin. In
the event of severe bleeding or overdose, protamine sulfate binds to heparin to
neutralize its activity. Vitamin K is the antidote for warfarin, not heparin.
6. A nurse is caring for a client with a new prescription for lisinopril. The nurse should
instruct the client to report which common adverse effect?
A. Persistent dry cough
B. Increased appetite
