INET HESI RN EXIT EXAM QUESTIONS COMPLETE WITH 100% VERIFIED ANSWERS

INET HESI RN EXIT EXAM QUESTIONS COMPLETE WITH 100% VERIFIED ANSWERS 1. A client with major depressive disorder is started on phenelzine (Nardil). Which food item on the hospital tray should the nurse remove? A. Grilled chicken breast B. Aged cheddar cheese C. White rice D. Steamed carrots Correct Answer: B Explanation: Phenelzine is a monoamine oxidase inhibitor (MAOI). Aged cheeses are high in tyramine, which can cause a hypertensive crisis when combined with MAOIs. The nurse must remove any tyramine-rich foods. ________________________________________ 2. A nurse is assessing a client with suspected appendicitis. Which finding is the earliest sign of this condition? A. Rebound tenderness at McBurney’s point B. Periumbilical pain that migrates to the right lower quadrant C. Fever and chills D. Vomiting before the onset of pain Correct Answer: B Explanation: The classic early sign of appendicitis is vague periumbilical pain that later localizes to the right lower quadrant (RLQ). Rebound tenderness and fever occur later. Vomiting typically follows pain. ________________________________________ 3. A client with chronic kidney disease has a potassium level of 6.8 mEq/L. Which emergency intervention should the nurse anticipate first? A. Oral sodium polystyrene sulfonate (Kayexalate) B. IV calcium gluconate C. IV furosemide D. Hemodialysis Correct Answer: B Explanation: Hyperkalemia (K+ 6.5) can cause cardiac arrhythmias. IV calcium gluconate stabilizes the cardiac membrane as a first-line emergency measure. Kayexalate and dialysis remove potassium but act more slowly. Furosemide may be used but not first. ________________________________________ 4. A postpartum nurse is caring for a client 2 hours after vaginal delivery. Which assessment finding requires immediate action? A. Fundus firm at umbilicus B. Moderate lochia rubra C. Saturation of one perineal pad every 15 minutes D. Blood pressure 110/70 mm Hg Correct Answer: C Explanation: Saturating one pad every 15 minutes indicates hemorrhage (excessive bleeding). Normal postpartum bleeding is one pad per hour. The fundus should be firm; a boggy uterus would also be concerning, but here the pad saturation is the red flag. ________________________________________ 5. A nurse is teaching a client with asthma about using a peak expiratory flow meter. Which statement indicates correct understanding? A. “I will use the meter only when I feel short of breath.” B. “I will record my personal best from readings taken when I feel well.” C. “I should take my rescue inhaler before each reading.” D. “A reading in the yellow zone means my asthma is well controlled.” Correct Answer: B Explanation: The personal best is established during asymptomatic periods to create a baseline. Green zone = well-controlled (80-100% of personal best); yellow = caution (50-80%); red = medical alert (50%). Using the meter only when symptomatic defeats its preventive purpose. ________________________________________ 6. A client receiving a blood transfusion develops chills, fever, and lower back pain 30 minutes after the start. What is the nurse’s priority action? A. Slow the infusion rate B. Stop the transfusion immediately C. Administer acetaminophen as ordered D. Notify the healthcare provider Correct Answer: B Explanation: Chills, fever, and back pain suggest an acute hemolytic reaction (ABO incompatibility). The first action is to stop the transfusion to prevent further harm, then maintain IV line with new tubing and saline, notify the provider, and send blood bag to lab. ________________________________________ 7. A nurse is preparing to administer digoxin to a client with heart failure. Which assessment finding requires withholding the medication? A. Heart rate 68 bpm B. Apical pulse 52 bpm C. Blood pressure 130/80 mm Hg D. Respiratory rate 18/min Correct Answer: B Explanation: Digoxin is withheld if the apical pulse is below 60 bpm in adults (or below 70 in children/elderly) because bradycardia increases the risk of digoxin toxicity. Other vital signs are within normal limits. ________________________________________ 8. A client with type 1 diabetes reports feeling shaky and sweaty. A blood glucose check shows 55 mg/dL. What should the nurse administer first? A. Insulin lispro 5 units subcutaneously B. 15 grams of fast-acting carbohydrate (e.g., 4 oz orange juice) C. Glucagon 1 mg intramuscularly D. 1 tablespoon of honey Correct Answer: B Explanation: The client is conscious with hypoglycemia (55 mg/dL). The rule of 15: give 15g fast-acting carbs, recheck in 15 minutes. Glucagon is for unconscious clients or severe hypoglycemia. Honey is okay but not first-line in conscious patients; juice is standard. ________________________________________ 9. A nurse is assessing a client with cirrhosis for signs of hepatic encephalopathy. Which finding is an early indicator? A. Asterixis (liver flap) B. Subtle personality changes and forgetfulness C. Fetor hepaticus (musty breath) D. Coma Correct Answer: B Explanation: Early hepatic encephalopathy presents with mild confusion, sleep disturbances, and personality changes. Asterixis and fetor hepaticus appear as condition progresses. Coma is late stage. ________________________________________ 10. A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which laboratory value indicates therapeutic effect? A. Platelet count 250,000/mm³ B. INR 2.5 C. aPTT 60 seconds D. PT 12 seconds