Page 1 of 37
HESI EXIT 4 EXAM AND RATIONALE EXAM
COMPREHENSIVE 2026 QUESTIONS EXAM LATEST
VERSION SOLVED QUESTIONS & ANSWERS VERIFIED
100 %
The nurse is caring for a client with syndrome of inappropriate antidiuretic
hormone (SIADH), which is manifested by which symptoms?
A) Loss of thirst, weight gain.
B) Dependent edema, fever.
C) Polydipsia, polyuria.
D) Hypernatremia, tachypnea.
A
The nurse is planning care for a client with newly diagnosed diabetes mellitus
that requires insulin. Which assessment should the nurse identify before
beginning the teaching session?
A) Present knowledge related to the skill of injection.
B) Intelligence and developmental level
of the client.
C) Willingness of the client to learn the injection sites.
D) Financial resources available for the equipment.
c
The nurse is caring for a client who has taken a large quantity of furosemide
(Lasix) to promote weight loss. The nurse anticipates the finding of which
acid-base imbalance?
A) PO2 of 78 mm Hg
B) HCO3 of 34 mEq/L
C) PCO2 of 56 mm Hg
D) pH of 7.31
b (diuretics cause metabolic acidosis)
, Page 2 of 37
The nurse is preparing a teaching plan for a client who is newly diagnosed
with Type 1 diabetes mellitus. Which signs and symptoms should the nurse
describe when teaching the client about hypoglycemia?
A) Sweating, trembling, tachycardia.
B) Polyuria, polydipsia, polyphagia.
C) Nausea, vomiting, anorexia.
D) Fruity breath, tachypnea, chest pain.
a
Which reaction should the nurse identify in a client who is responding to
stimulation of the sympathetic nervous system?
A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure.
b
Which client should the nurse recognize as most likely to experience sleep
apnea?
A) Middle-aged female who takes a diuretic nightly.
B) Obese older male client with a short, thick neck.
C) Adolescent female with a history of tonsillectomy.
D) School-aged male with a history of hyperactivity disorder.
b
To decrease the risk of acid-base imbalance, what goal must the client with
diabetes mellitus strive for?
A) Checking blood glucose levels once daily
B) Drinking 3 L of fluid per day
C) Eating regularly, every 4 to 8 hours
D) Maintaining blood glucose level within normal limits
d
After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to
draw blood samples to determine peak and trough levels. When are the best
times to draw these samples?
A) 15 minutes before and 15 minutes after the next dose.
B) One hour before and one hour after the next dose.
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C) 5 minutes before and 30 minutes after the next dose.
D) 30 minutes before and 30 minutes after the next dose.
c
The nurse is caring for a client with an oxygen saturation of 88% and
accessory muscle use. The nurse provides oxygen and anticipates which of
these physician orders?
A) Administration of IV sodium bicarbonate
B) Computed tomography (CT) of the chest, stat
C) Intubation and mechanical ventilation
D) Administration of concentrated potassium chloride solution
c
A male client receives a local anesthetic during surgery. During the post-
operative assessment, the nurse notices the client is slurring his speech.
Which action should the nurse take?
A) Determine the client is anxious and allow him to sleep.
B) Evaluate his blood pressure, pulse, and respiratory status.
C) Review the client's pre-operative history for alcohol abuse.
D) Continue to monitor the client for reactivity to anesthesia.
b
When providing discharge teaching for a client with osteoporosis, the nurse
should reinforce which home care activity?
A) A diet low in phosphates.
B) Skin inspection for bruising.
C) Exercise regimen, including swimming.
D) Elimination of hazards to home safety.
d
During lung assessment, the nurse places a stethoscope on a client's chest
and instructs him/her to say "99" each time the chest is touched with the
stethoscope. What should be the correct interpretation if the nurse hears the
spoken words "99" very clearly through the stethoscope?
A) This is a normal auscultatory finding.
B) May indicate pneumothorax.
C) May indicate pneumonia.
D) May indicate severe emphysema.
, Page 4 of 37
c
The nurse is caring for a group of clients with acidosis. The nurse recognizes
that Kussmaul respirations are consistent with which situation?
A) Client receiving mechanical ventilation
B) Use of hydrochlorothiazide
C) Aspirin overdose
D) Administration of sodium bicarbonate
c
During an interview with a client planning elective surgery, the client asks the
nurse, "What is the advantage of having a preferred provider organization
insurance plan?" Which response is best for the nurse to provide?
A) Long-term relationships with healthcare providers are more likely.
B) There are fewer healthcare providers to choose from than in an HMO plan.
C) Insurance coverage of employees is less expensive to employers.
D) An individual can become a member of a PPO without belonging to a group.
c
A client has taken steroids for 12 years to help manage chronic obstructive
pulmonary disease (COPD). When making a home visit, which nursing function
is of greatest importance to this client? Assess the client's
A) pulse rate, both apically and radially.
B) blood pressure, both standing and sitting.
C) temperature.
D) skin color and turgor.
c
The nurse is teaching a female client who uses a contraceptive diaphragm
about reducing the risk for toxic shock syndrome (TSS). Which information
should the nurse include? (Select all that apply.)
A) Remove the diaphragm immediately after intercourse.
B) Wash the diaphragm with an alcohol solution.
C) Use the diaphragm to prevent conception during the menstrual cycle.
D) Do not leave the diaphragm in place longer than 8 hours after intercourse.
E) Contact a healthcare provider a sudden onset of fever grater than 101º F
appears.
F) Replace the old diaphragm every 3 months.
HESI EXIT 4 EXAM AND RATIONALE EXAM
COMPREHENSIVE 2026 QUESTIONS EXAM LATEST
VERSION SOLVED QUESTIONS & ANSWERS VERIFIED
100 %
The nurse is caring for a client with syndrome of inappropriate antidiuretic
hormone (SIADH), which is manifested by which symptoms?
A) Loss of thirst, weight gain.
B) Dependent edema, fever.
C) Polydipsia, polyuria.
D) Hypernatremia, tachypnea.
A
The nurse is planning care for a client with newly diagnosed diabetes mellitus
that requires insulin. Which assessment should the nurse identify before
beginning the teaching session?
A) Present knowledge related to the skill of injection.
B) Intelligence and developmental level
of the client.
C) Willingness of the client to learn the injection sites.
D) Financial resources available for the equipment.
c
The nurse is caring for a client who has taken a large quantity of furosemide
(Lasix) to promote weight loss. The nurse anticipates the finding of which
acid-base imbalance?
A) PO2 of 78 mm Hg
B) HCO3 of 34 mEq/L
C) PCO2 of 56 mm Hg
D) pH of 7.31
b (diuretics cause metabolic acidosis)
, Page 2 of 37
The nurse is preparing a teaching plan for a client who is newly diagnosed
with Type 1 diabetes mellitus. Which signs and symptoms should the nurse
describe when teaching the client about hypoglycemia?
A) Sweating, trembling, tachycardia.
B) Polyuria, polydipsia, polyphagia.
C) Nausea, vomiting, anorexia.
D) Fruity breath, tachypnea, chest pain.
a
Which reaction should the nurse identify in a client who is responding to
stimulation of the sympathetic nervous system?
A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure.
b
Which client should the nurse recognize as most likely to experience sleep
apnea?
A) Middle-aged female who takes a diuretic nightly.
B) Obese older male client with a short, thick neck.
C) Adolescent female with a history of tonsillectomy.
D) School-aged male with a history of hyperactivity disorder.
b
To decrease the risk of acid-base imbalance, what goal must the client with
diabetes mellitus strive for?
A) Checking blood glucose levels once daily
B) Drinking 3 L of fluid per day
C) Eating regularly, every 4 to 8 hours
D) Maintaining blood glucose level within normal limits
d
After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to
draw blood samples to determine peak and trough levels. When are the best
times to draw these samples?
A) 15 minutes before and 15 minutes after the next dose.
B) One hour before and one hour after the next dose.
, Page 3 of 37
C) 5 minutes before and 30 minutes after the next dose.
D) 30 minutes before and 30 minutes after the next dose.
c
The nurse is caring for a client with an oxygen saturation of 88% and
accessory muscle use. The nurse provides oxygen and anticipates which of
these physician orders?
A) Administration of IV sodium bicarbonate
B) Computed tomography (CT) of the chest, stat
C) Intubation and mechanical ventilation
D) Administration of concentrated potassium chloride solution
c
A male client receives a local anesthetic during surgery. During the post-
operative assessment, the nurse notices the client is slurring his speech.
Which action should the nurse take?
A) Determine the client is anxious and allow him to sleep.
B) Evaluate his blood pressure, pulse, and respiratory status.
C) Review the client's pre-operative history for alcohol abuse.
D) Continue to monitor the client for reactivity to anesthesia.
b
When providing discharge teaching for a client with osteoporosis, the nurse
should reinforce which home care activity?
A) A diet low in phosphates.
B) Skin inspection for bruising.
C) Exercise regimen, including swimming.
D) Elimination of hazards to home safety.
d
During lung assessment, the nurse places a stethoscope on a client's chest
and instructs him/her to say "99" each time the chest is touched with the
stethoscope. What should be the correct interpretation if the nurse hears the
spoken words "99" very clearly through the stethoscope?
A) This is a normal auscultatory finding.
B) May indicate pneumothorax.
C) May indicate pneumonia.
D) May indicate severe emphysema.
, Page 4 of 37
c
The nurse is caring for a group of clients with acidosis. The nurse recognizes
that Kussmaul respirations are consistent with which situation?
A) Client receiving mechanical ventilation
B) Use of hydrochlorothiazide
C) Aspirin overdose
D) Administration of sodium bicarbonate
c
During an interview with a client planning elective surgery, the client asks the
nurse, "What is the advantage of having a preferred provider organization
insurance plan?" Which response is best for the nurse to provide?
A) Long-term relationships with healthcare providers are more likely.
B) There are fewer healthcare providers to choose from than in an HMO plan.
C) Insurance coverage of employees is less expensive to employers.
D) An individual can become a member of a PPO without belonging to a group.
c
A client has taken steroids for 12 years to help manage chronic obstructive
pulmonary disease (COPD). When making a home visit, which nursing function
is of greatest importance to this client? Assess the client's
A) pulse rate, both apically and radially.
B) blood pressure, both standing and sitting.
C) temperature.
D) skin color and turgor.
c
The nurse is teaching a female client who uses a contraceptive diaphragm
about reducing the risk for toxic shock syndrome (TSS). Which information
should the nurse include? (Select all that apply.)
A) Remove the diaphragm immediately after intercourse.
B) Wash the diaphragm with an alcohol solution.
C) Use the diaphragm to prevent conception during the menstrual cycle.
D) Do not leave the diaphragm in place longer than 8 hours after intercourse.
E) Contact a healthcare provider a sudden onset of fever grater than 101º F
appears.
F) Replace the old diaphragm every 3 months.
