HESI RN Exit Exam Questions and Verified
Answers Latest Updated
Question 1
Which information is more important for the nurse to obtain when determining a
client's risk for Obstructive Sleep Apnea Syndrome (OSAS)?
a- Body mass index
b- Level of consciousness
c- Self-description of pain
d- Breath sounds
Correct Answer
a. Body mass index
Question 2
The fire alarm goes off while the charge nurse is receiving the shift report. What
action should the charge nurse implement first?
a. Instruct the client's family member to stay in the visitor waiting area until further
notice
b. Tell the staff to keep all clients and visitors in the client rooms with the doors
closed.
c. Direct the nursing staff to evacuate the clients using the stairs in a calm and orderly
manner.
d. Call the hospital operator to determine if the is indeed a real emergency or a fire
drill.
Correct Answer
Tell the staff to keep all clients and visitors in the client rooms with the doors closed
Rationale: The charge nurse should treat the alarm as an actual fire emergency and
instruct all clients and visitors to stay in the clients' room with doors closed until
otherwise notified. A should be anxiety producing. Visitors should remain in the
rooms with the clients. C is only necessary if the location and severity of the fire
make the unit unsafe for inhabitants and would only be implemented after other
measures to control de fire had failed. D should not be done until after measures
are taken to protect clients and visitors.
Page 1 of 374
,Question 3
The nurse is caring for a 4-year-old male child who becomes unresponsive as his
heart rate decreases to 40 beats/minute. His blood pressure is 88/70 mmHg, and his
oxygen saturation is 70% while receiving 100% oxygen by non-rebreather face mask.
In what sequence, from first to last, should the nurse implement these actions? (Place
the first action on top and last action on the bottom.)
1. Start chest compressions with assisted manual ventilations
2. Administer epinephrine 0.01 mg/kg intraosseous (IO)
3. Apply pads and prepare for transthoracic pacing
4. Review the possible underlying causes for bradycardia.
Correct Answer
1. Start chest compressions with assisted manual ventilations
2. Administer epinephrine 0.01 mg/kg intraosseous (IO)
3. Apply pads and prepare for transthoracic pacing
4. Review the possible underlying causes for bradycardia
Rationale: The American Heart Association guidelines recommend that the basic life
support (BLS) algorithm should be initiated immediately in pediatric clients who are
unresponsive or have a heart rate below 60 beats/minutes*** and exhibit signs of
poor perfusion. This child is manifesting poor perfusion as evidenced by a low
blood pressure and poor oxygenation, so chest compression and assisted manual
ventilation should be provided first, followed by administration of drug therapy for
persistent bradycardia. Preparation with pad placement for transthoracic pacing
should be implemented next, followed by treatment indicated for the underlying
cause of the child's bradycardia.
Page 2 of 374
,Question 4
While assisting a client who recently had a hip replacement into a bed pan, the nurse
notices that there is a small amount of bloody drainage on the surgical dressing, the
client's skin is warm to the touch, and there is a strong odor from the urine. Which
action should the nurse take?
a. Obtain a urine sample from the bed pan
b. Remove dressing and assess surgical site
c. Insert an indwelling urinary catheter
d. Measure the client's oral temperature
Correct Answer
Measure the client's oral temperature
Rationale: The strong odor from the urine and skin that is warm to the touch may
indicate that the client has a urinary tract infection. Assessing the client's
temperature provides objective information regarding infection that can be
reported to the healthcare provider. Urine should be obtained via a clean catch, not
the bed pan where it has been contaminated. The drainage on the dressing is
normal and does not require direct conservation currently. An indwelling catheter
should be avoided if possible because it increases the risk of infection.
Page 3 of 374
, Question 5
A client who received multiple antihypertensive medications experiences syncope due
to a drop in blood pressure to 70/40. What is the rationale for the nurse's decision to
hold the client's scheduled antihypertensive medication?
a. Increased urinary clearance of the multiple medications has produced diuresis and
lowered the blood pressure
b. The antagonistic interaction among the various blood pressure medications has
reduced their effectiveness
c. The additive effect of multiple medications has caused the blood pressure to drop
too low.
d. The synergistic effect of the multiple medications has resulted in drug toxicity and
resulting hypotension.
Correct Answer
The additive effect of multiple medications has caused the blood pressure to drop
too low
Rationale: When medication with a similar action are administered, an additive
effect occurs that is the sum of the effects of each of the medication. In this case,
several medications that all lower the blood pressure, when administer together,
resulted in hypotension.
Page 4 of 374
Answers Latest Updated
Question 1
Which information is more important for the nurse to obtain when determining a
client's risk for Obstructive Sleep Apnea Syndrome (OSAS)?
a- Body mass index
b- Level of consciousness
c- Self-description of pain
d- Breath sounds
Correct Answer
a. Body mass index
Question 2
The fire alarm goes off while the charge nurse is receiving the shift report. What
action should the charge nurse implement first?
a. Instruct the client's family member to stay in the visitor waiting area until further
notice
b. Tell the staff to keep all clients and visitors in the client rooms with the doors
closed.
c. Direct the nursing staff to evacuate the clients using the stairs in a calm and orderly
manner.
d. Call the hospital operator to determine if the is indeed a real emergency or a fire
drill.
Correct Answer
Tell the staff to keep all clients and visitors in the client rooms with the doors closed
Rationale: The charge nurse should treat the alarm as an actual fire emergency and
instruct all clients and visitors to stay in the clients' room with doors closed until
otherwise notified. A should be anxiety producing. Visitors should remain in the
rooms with the clients. C is only necessary if the location and severity of the fire
make the unit unsafe for inhabitants and would only be implemented after other
measures to control de fire had failed. D should not be done until after measures
are taken to protect clients and visitors.
Page 1 of 374
,Question 3
The nurse is caring for a 4-year-old male child who becomes unresponsive as his
heart rate decreases to 40 beats/minute. His blood pressure is 88/70 mmHg, and his
oxygen saturation is 70% while receiving 100% oxygen by non-rebreather face mask.
In what sequence, from first to last, should the nurse implement these actions? (Place
the first action on top and last action on the bottom.)
1. Start chest compressions with assisted manual ventilations
2. Administer epinephrine 0.01 mg/kg intraosseous (IO)
3. Apply pads and prepare for transthoracic pacing
4. Review the possible underlying causes for bradycardia.
Correct Answer
1. Start chest compressions with assisted manual ventilations
2. Administer epinephrine 0.01 mg/kg intraosseous (IO)
3. Apply pads and prepare for transthoracic pacing
4. Review the possible underlying causes for bradycardia
Rationale: The American Heart Association guidelines recommend that the basic life
support (BLS) algorithm should be initiated immediately in pediatric clients who are
unresponsive or have a heart rate below 60 beats/minutes*** and exhibit signs of
poor perfusion. This child is manifesting poor perfusion as evidenced by a low
blood pressure and poor oxygenation, so chest compression and assisted manual
ventilation should be provided first, followed by administration of drug therapy for
persistent bradycardia. Preparation with pad placement for transthoracic pacing
should be implemented next, followed by treatment indicated for the underlying
cause of the child's bradycardia.
Page 2 of 374
,Question 4
While assisting a client who recently had a hip replacement into a bed pan, the nurse
notices that there is a small amount of bloody drainage on the surgical dressing, the
client's skin is warm to the touch, and there is a strong odor from the urine. Which
action should the nurse take?
a. Obtain a urine sample from the bed pan
b. Remove dressing and assess surgical site
c. Insert an indwelling urinary catheter
d. Measure the client's oral temperature
Correct Answer
Measure the client's oral temperature
Rationale: The strong odor from the urine and skin that is warm to the touch may
indicate that the client has a urinary tract infection. Assessing the client's
temperature provides objective information regarding infection that can be
reported to the healthcare provider. Urine should be obtained via a clean catch, not
the bed pan where it has been contaminated. The drainage on the dressing is
normal and does not require direct conservation currently. An indwelling catheter
should be avoided if possible because it increases the risk of infection.
Page 3 of 374
, Question 5
A client who received multiple antihypertensive medications experiences syncope due
to a drop in blood pressure to 70/40. What is the rationale for the nurse's decision to
hold the client's scheduled antihypertensive medication?
a. Increased urinary clearance of the multiple medications has produced diuresis and
lowered the blood pressure
b. The antagonistic interaction among the various blood pressure medications has
reduced their effectiveness
c. The additive effect of multiple medications has caused the blood pressure to drop
too low.
d. The synergistic effect of the multiple medications has resulted in drug toxicity and
resulting hypotension.
Correct Answer
The additive effect of multiple medications has caused the blood pressure to drop
too low
Rationale: When medication with a similar action are administered, an additive
effect occurs that is the sum of the effects of each of the medication. In this case,
several medications that all lower the blood pressure, when administer together,
resulted in hypotension.
Page 4 of 374
