Exit HESI Exam Multiple Choice Questions and Answers
A client is admitted to the intensive care unit with diabetes insipidus due to a pituitary gland tumor.
Which potential complication should the nurse monitor closely?
A. Hypokalemia
B. Ketonuria.
C. Peripheral edema
D. Elevated blood pressure - (Answer)A. Hypokalemia
Pituitary tumors that suppress antidiuretic hormone (ADH) result in diabetes insipidus, which causes
massive polyuria and serum electrolyte imbalances, including hypokalemia, which can lead to lethal
arrhythmias.
A 3-year-old boy was successfully toilet trained prior to his admission to the hospital for injuries
sustained from a fall. His parents are very concerned about this regression in toileting. Which
information should the nurse provide the parents?
A. A retraining program will need to be initiated when the child returns home.
B. Diapering will be provided since hospitalization is stressful to preschoolers.
C. Children usually resume their toileting behaviors when they leave the hospital.
D. A potty chair will be brought from home so he can maintain his toileting skills. - (Answer)C. Children
usually resume their toileting behaviors when they leave the hospital.
The parents should be reassured that once the child is back in his familiar environment, he is likely to
resume using the toileting behaviors (C). Retraining (A) is unlikely to be needed and such information
might be distressing to the parents. (B) does not address the parents' concern. Bringing a potty chair
from home (B) is likely to increase the child's stress because he is being encouraged to perform toileting
skills while he remains in unfamiliar surroundings.
The family of an older woman reports that they are no longer capable of caring for her at home. While
performing the admission assessment at a long-term care facility, the nurse determines that the client is
in continent of urine, has dry mucous membranes, and has a large bruise on the coccyx. What
interventions should the nurse include in the plan of care? (Select all that apply.)
A. Thicken liquids and provide pureed foods.
B. Apply a barrier cream to perianal areas.
C. Report suspicion of elder abuse.
, D. Implement toilet training program.
E. Offer beverages at frequent intervals. - (Answer)B. Apply a barrier cream to perianal areas.
D. Implement toilet training program.
E. Offer beverages at frequent intervals.
The plan of care should include measures to prevent skin breakdown due to the incontinence using a
barrier cream (B) and a toileting program (D) to help reduce the incidence of incontinence. Dry mucous
membranes indicate the need for increased fluids (E). Further assessment is needed before the other
interventions are indicated.
Sleep apnea - obesity - (Answer)Obesity is a risk factor for OSAS, and calculation of BMI provides data
related to obesity. A BMI of 30.00 and above is considered obese.
pyloric stenosis- preop - (Answer)Hydrating an infant prior to surgery with prescribed IV fluids is the
highest priority bc vomiting associated with pyloric stenosis often contributes to dehydration.
diabetes insipidus - (Answer)Pituitary tumors that suppress ADH result in DI, which can cause massive
polyuria and serum electrolytes imbalances, including hypokalemia which can lead to lethal arrythmias.
acute pancreatitis - care - (Answer)The pathophysiologic processes in AP result form oral fluid and food
ingestion that causes secretion of pancreatic enzymes, which destroy ductal tissue and pancreatic cells,
resulting in autodigestion and fibrosis of the pancreas. The main focus of nursing care is reducing pain
caused by pancreatic destruction through interventions that decrease GI activity such as keeping the pt
NPO.
Sex in a hospital room - (Answer)Coming upon a client and visitor engaged in sexual activity requires the
nurse to use clinical judgement and sensitivity. The nurse should leave and provide privacy.
Eczema pruritis - (Answer)Antiinflammatory actions of topical corticosteroids and oral antihistamines
provide relief from severe itching. (pruritis)
Paralytic ileus- volvulus - (Answer)A paralytic ileus develops due to local inflammatory reactions of the
bowel and its innervation that cause the failure of normal peristalsis action through the GI tract. The
intestinal volvulus that occured due to surgery is the pathological mechanism associated with the pt
presentation.
Cardiac ablation- delegate - (Answer)Ablation therapy uses radiofrequency, microwave, laser or
cryothermy to ablate areas of the cardiac system that are the source of ectopic cardiac dysrhythmias,
which can cause syncope. Skin preparation including hair removal can be delegated to the UAP.
TIAs- POC - (Answer)A TIA is an arterial event that causes temporary O2 deficit to the brain and
manifests with signs of a stroke or CVA, which resolves in less than 24 hours without permanent
A client is admitted to the intensive care unit with diabetes insipidus due to a pituitary gland tumor.
Which potential complication should the nurse monitor closely?
A. Hypokalemia
B. Ketonuria.
C. Peripheral edema
D. Elevated blood pressure - (Answer)A. Hypokalemia
Pituitary tumors that suppress antidiuretic hormone (ADH) result in diabetes insipidus, which causes
massive polyuria and serum electrolyte imbalances, including hypokalemia, which can lead to lethal
arrhythmias.
A 3-year-old boy was successfully toilet trained prior to his admission to the hospital for injuries
sustained from a fall. His parents are very concerned about this regression in toileting. Which
information should the nurse provide the parents?
A. A retraining program will need to be initiated when the child returns home.
B. Diapering will be provided since hospitalization is stressful to preschoolers.
C. Children usually resume their toileting behaviors when they leave the hospital.
D. A potty chair will be brought from home so he can maintain his toileting skills. - (Answer)C. Children
usually resume their toileting behaviors when they leave the hospital.
The parents should be reassured that once the child is back in his familiar environment, he is likely to
resume using the toileting behaviors (C). Retraining (A) is unlikely to be needed and such information
might be distressing to the parents. (B) does not address the parents' concern. Bringing a potty chair
from home (B) is likely to increase the child's stress because he is being encouraged to perform toileting
skills while he remains in unfamiliar surroundings.
The family of an older woman reports that they are no longer capable of caring for her at home. While
performing the admission assessment at a long-term care facility, the nurse determines that the client is
in continent of urine, has dry mucous membranes, and has a large bruise on the coccyx. What
interventions should the nurse include in the plan of care? (Select all that apply.)
A. Thicken liquids and provide pureed foods.
B. Apply a barrier cream to perianal areas.
C. Report suspicion of elder abuse.
, D. Implement toilet training program.
E. Offer beverages at frequent intervals. - (Answer)B. Apply a barrier cream to perianal areas.
D. Implement toilet training program.
E. Offer beverages at frequent intervals.
The plan of care should include measures to prevent skin breakdown due to the incontinence using a
barrier cream (B) and a toileting program (D) to help reduce the incidence of incontinence. Dry mucous
membranes indicate the need for increased fluids (E). Further assessment is needed before the other
interventions are indicated.
Sleep apnea - obesity - (Answer)Obesity is a risk factor for OSAS, and calculation of BMI provides data
related to obesity. A BMI of 30.00 and above is considered obese.
pyloric stenosis- preop - (Answer)Hydrating an infant prior to surgery with prescribed IV fluids is the
highest priority bc vomiting associated with pyloric stenosis often contributes to dehydration.
diabetes insipidus - (Answer)Pituitary tumors that suppress ADH result in DI, which can cause massive
polyuria and serum electrolytes imbalances, including hypokalemia which can lead to lethal arrythmias.
acute pancreatitis - care - (Answer)The pathophysiologic processes in AP result form oral fluid and food
ingestion that causes secretion of pancreatic enzymes, which destroy ductal tissue and pancreatic cells,
resulting in autodigestion and fibrosis of the pancreas. The main focus of nursing care is reducing pain
caused by pancreatic destruction through interventions that decrease GI activity such as keeping the pt
NPO.
Sex in a hospital room - (Answer)Coming upon a client and visitor engaged in sexual activity requires the
nurse to use clinical judgement and sensitivity. The nurse should leave and provide privacy.
Eczema pruritis - (Answer)Antiinflammatory actions of topical corticosteroids and oral antihistamines
provide relief from severe itching. (pruritis)
Paralytic ileus- volvulus - (Answer)A paralytic ileus develops due to local inflammatory reactions of the
bowel and its innervation that cause the failure of normal peristalsis action through the GI tract. The
intestinal volvulus that occured due to surgery is the pathological mechanism associated with the pt
presentation.
Cardiac ablation- delegate - (Answer)Ablation therapy uses radiofrequency, microwave, laser or
cryothermy to ablate areas of the cardiac system that are the source of ectopic cardiac dysrhythmias,
which can cause syncope. Skin preparation including hair removal can be delegated to the UAP.
TIAs- POC - (Answer)A TIA is an arterial event that causes temporary O2 deficit to the brain and
manifests with signs of a stroke or CVA, which resolves in less than 24 hours without permanent
