HESI 799 RN EXIT EXAM 2026 PRACTICE TEST
PAPER PATIENT CARE MANAGEMENT REVIEW
SHEET FULL SOLUTIONS
◉ Before leaving the room of a confused client, the nurse notes that
a half bow knot was used to attach the client's wrist restraints to the
movable portion of the client's bed frame. What action should the
nurse take before leaving the room?
a. Ensure that the knot can be quickly released.
b. Tie the knot with a double turn or square knot.
c. Move the ties so the restraints are secured to the side rails.
d. Ensure that the restraints are snug against the client's wrist.
Answer: Ensure that the knot can be quickly released.
◉ While assessing a client's chest tube (CT), the nurse discovers
bubbling in the water seal chamber of the chest tube collection
device. The client's vital signs are: blood pressure of 80/40 mmHg,
heart rate 120 beats/minutes, respiratory rate 32 breaths/minutes,
oxygen saturation 88%. Which interventions should the nurse
implement?
a. Provide supplemental oxygen
,b. Auscultate bilateral lung fields
c. Administer a nebulizer treatment
d. Reinforce occlusive CT dressing
e. Give PRN dose of pain medication Answer: a. Provide
supplemental oxygen
b. Auscultate bilateral lung fields
d. Reinforce occlusive CT dressing
Rationale: The air bubbles indicate an air leak from the lungs, the
chest tube site, or the chest tube collection system. Providing oxygen
improves the oxygen saturation until the leak has been resolved.
Auscultating the lung fields helps to identify absent or decrease lung
sound due to collapsing lung.
◉ Oral antibiotics are prescribed for an 18-month-old toddler with
severe otitis media. An antipyrine and benzocaine-otic also
prescribed for pain and inflammation. What instruction should the
nurse emphasize concerning the installation of the antipyrine/
benzocaine otic solution?
a. Place the dropper on the upper outer ear canal and instill the
medication slowly.
b. Warm the medication in the microwave for 10 seconds before
instilling.
c. Keep the medication refrigerated between administrations.
,d. Have the child lie with the ear up for one to two minutes after
installation. Answer: d. Have the child lie with the ear up for one to
two minutes after installation.
◉ An older adult male is admitted with complications related to
chronic obstructive pulmonary disease (COPD). He reports
progressive dyspnea that worsens on exertion and his weakness has
increased over the past month. The nurse notes that he has
dependent edema in both lower legs. Based on these assessment
findings, which dietary instruction should the nurse provide?
a. Limit the intake of high calorie foods.
b. Eat meals at the same time daily.
c. Maintain a low protein diet.
d. Restrict daily fluid intake. Answer: Restrict daily fluid intake.
Rationale: the client is exhibiting signs of Cor pulmonale, a
complication of COPD that causes the right side of the heart to fail.
Restricting fluid intake to 1000 to 2000 ml/day, eating a high-calorie
diet at small frequent meals with foods that are high in protein and
low in sodium can help relieve the edema and decrease workload on
the right-side of the heart.
◉ The nurse inserts an indwelling urinary catheter as seen in the
video what action should the nurse take next?
, a. Remove the catheter and insert into urethral opening
b. Observe for urine flow and then inflate the balloon.
c. Insert the catheter further and observe for discomfort.
d. Leave the catheter in place and obtain a sterile catheter. Answer:
Leave the catheter in place and obtain a sterile catheter.
◉ A client with coronary artery disease who is experiencing
syncopal episodes is admitted for an electrophysiology study (EPS)
and possible cardiac ablation therapy. Which intervention should the
nurse delegate to the unlicensed assistive personnel (UAP)?
a. Prepare the skin for procedure.
b. Identify client's pulse points
c. Witness consent for procedure
d. Check telemetry monitoring Answer: Prepare the skin for
procedure.
◉ Following an outbreak of measles involving 5 students in an
elementary school, which action is most important for the school
nurse to take?
a. Review the immunization records of all children in the elementary
school
PAPER PATIENT CARE MANAGEMENT REVIEW
SHEET FULL SOLUTIONS
◉ Before leaving the room of a confused client, the nurse notes that
a half bow knot was used to attach the client's wrist restraints to the
movable portion of the client's bed frame. What action should the
nurse take before leaving the room?
a. Ensure that the knot can be quickly released.
b. Tie the knot with a double turn or square knot.
c. Move the ties so the restraints are secured to the side rails.
d. Ensure that the restraints are snug against the client's wrist.
Answer: Ensure that the knot can be quickly released.
◉ While assessing a client's chest tube (CT), the nurse discovers
bubbling in the water seal chamber of the chest tube collection
device. The client's vital signs are: blood pressure of 80/40 mmHg,
heart rate 120 beats/minutes, respiratory rate 32 breaths/minutes,
oxygen saturation 88%. Which interventions should the nurse
implement?
a. Provide supplemental oxygen
,b. Auscultate bilateral lung fields
c. Administer a nebulizer treatment
d. Reinforce occlusive CT dressing
e. Give PRN dose of pain medication Answer: a. Provide
supplemental oxygen
b. Auscultate bilateral lung fields
d. Reinforce occlusive CT dressing
Rationale: The air bubbles indicate an air leak from the lungs, the
chest tube site, or the chest tube collection system. Providing oxygen
improves the oxygen saturation until the leak has been resolved.
Auscultating the lung fields helps to identify absent or decrease lung
sound due to collapsing lung.
◉ Oral antibiotics are prescribed for an 18-month-old toddler with
severe otitis media. An antipyrine and benzocaine-otic also
prescribed for pain and inflammation. What instruction should the
nurse emphasize concerning the installation of the antipyrine/
benzocaine otic solution?
a. Place the dropper on the upper outer ear canal and instill the
medication slowly.
b. Warm the medication in the microwave for 10 seconds before
instilling.
c. Keep the medication refrigerated between administrations.
,d. Have the child lie with the ear up for one to two minutes after
installation. Answer: d. Have the child lie with the ear up for one to
two minutes after installation.
◉ An older adult male is admitted with complications related to
chronic obstructive pulmonary disease (COPD). He reports
progressive dyspnea that worsens on exertion and his weakness has
increased over the past month. The nurse notes that he has
dependent edema in both lower legs. Based on these assessment
findings, which dietary instruction should the nurse provide?
a. Limit the intake of high calorie foods.
b. Eat meals at the same time daily.
c. Maintain a low protein diet.
d. Restrict daily fluid intake. Answer: Restrict daily fluid intake.
Rationale: the client is exhibiting signs of Cor pulmonale, a
complication of COPD that causes the right side of the heart to fail.
Restricting fluid intake to 1000 to 2000 ml/day, eating a high-calorie
diet at small frequent meals with foods that are high in protein and
low in sodium can help relieve the edema and decrease workload on
the right-side of the heart.
◉ The nurse inserts an indwelling urinary catheter as seen in the
video what action should the nurse take next?
, a. Remove the catheter and insert into urethral opening
b. Observe for urine flow and then inflate the balloon.
c. Insert the catheter further and observe for discomfort.
d. Leave the catheter in place and obtain a sterile catheter. Answer:
Leave the catheter in place and obtain a sterile catheter.
◉ A client with coronary artery disease who is experiencing
syncopal episodes is admitted for an electrophysiology study (EPS)
and possible cardiac ablation therapy. Which intervention should the
nurse delegate to the unlicensed assistive personnel (UAP)?
a. Prepare the skin for procedure.
b. Identify client's pulse points
c. Witness consent for procedure
d. Check telemetry monitoring Answer: Prepare the skin for
procedure.
◉ Following an outbreak of measles involving 5 students in an
elementary school, which action is most important for the school
nurse to take?
a. Review the immunization records of all children in the elementary
school
