HESI 2022 EXIT EXAM1 QUESTIONS WITH
ANSWERS GRADED A+
A nurse who has recently completed orientation is beginning work in the
labor and delivery unit for the first time. When making assignments, which
client should the charge nurse assign to this new nurse? - ANSWER-A
multiparous client who is dilated 5 cm and 50% effaced
A client with human immunodeficiency virus (HIV) infection has white
lesions in the oral cavity that resemble milk curds. Nystatin (Mycostatin)
preparation is prescribed as a swish and swallow. Which information is most
important for the nurse to provide the client? - ANSWER-Oral hygiene should
be performed before the medication.
A client who is admitted with emphysema is having difficulty breathing. In
which position should the nurse place the client? - ANSWER-Sitting upright
and forward with both arms supported on an over the bed table
A client with chronic renal insufficiency (CRI) is taking 25 mg of
hydrochlorothiazide (HCTZ) PO and 40 mg of furosemide (Lasix) PO daily.
Today, at a routine clinic visit, the client's serum potassium level is 4 mEq/L.
What is the most likely cause of this client's potassium level? - ANSWER-The
client's renal function has affected his potassium level.
A registered nurse (RN) delivers telehealth services to clients via electronic
communication. Which nursing action creates the greatest risk for
professional liability and has the potential for a malpractice lawsuit? -
ANSWER-Sending medical records to health care providers via the Internet
Which pathophysiologic response supports the contraindication for
opioids, such as morphine, in clients with increased intracranial pressure
(ICP)?
A.Sedation produced by opioids is a result of a prolonged half-life when
the ICP is elevated.
B.Higher doses of opioids are required when cerebral blood flow is reduced
by an elevated ICP.
C.Dysphoria from opioids contributes to altered levels of consciousness
with an elevated ICP.
D.Opioids suppress respirations, which increases Pco2 and contributes to
an elevated ICP. - ANSWER-D
The greatest risk associated with opioids such as morphine (D) is respiratory
depression that causes an increase in Pco2, which increases ICP and masks
the early signs of intracranial bleeding in head injury. (A, B, and C) do not
support the risks associated with opioid use in a client with increased ICP.
,HESI 2022 EXIT EXAM1 QUESTIONS WITH
ANSWERS GRADED A+
The charge nurse of a medical surgical unit is alerted to an impending disaster
requiring implementation of the hospital's disaster plan. Specific facts about
the nature of this disaster are not yet known. Which instruction should the
charge nurse give to the other staff members at this time?
A.Prepare to evacuate the unit, starting with the bedridden clients.
B.UAPs should report to the emergency center to handle transports.
C.The licensed staff should begin counting wheelchairs and IV poles on the
unit.
D.Continue with current assignments until more instructions are received. -
ANSWER- D
When faced with an impending disaster, hospital personnel may be alerted
but should continue with current client care assignments until further
instructions are received (D). Evacuation is typically a response of last
resort that begins with clients who are most able to ambulate (A). (B) is
premature and is likely to increase the chaos if incoming casualties are
anticipated. (C) is poor utilization of personnel.
The nurse assesses a client while the UAP measures the client's vital signs.
The client's vital signs change suddenly, and the nurse determines that the
client's condition is worsening. The nurse is unsure of the client's
resuscitative status and needs to check the client's medical record for any
advanced directives. Which action should the nurse implement?
A. Ask the UAP to check for the advanced directive while the nurse
completes the assessment.
B. Assign the UAP to complete the assessment while the nurse checks for the
advanced directive.
C. Check the medical record for the advanced directive and then
complete the client assessment.
D.Call for the charge nurse to check the advanced directive while
continuing to assess the client. - ANSWER-D
Because the client's condition is worsening, the nurse should remain with
the client and continue the assessment while calling for help from the
charge nurse to determine the client's resuscitative status (D). (A and B) are
tasks that must be completed by a nurse and cannot be delegated to the
UAP. (C) is contraindicated.
The nurse is preparing a client for surgery scheduled in 2 hours. A UAP is
helping the nurse. Which task is important for the nurse to perform, rather
than the UAP?
A.Remove the client's nail polish and dentures.
B.Assist the client to the restroom to void.
C.Obtain the client's height and weight.
D.Offer the client emotional support. - ANSWER-D
By using therapeutic techniques to offer support (D), the nurse can
determine any client concerns that need to be addressed. (A, B, and C) are
all actions that can be performed by the UAP under the supervision of the
,HESI 2022 EXIT EXAM1 QUESTIONS WITH
ANSWERS GRADED A+
nurse.
, HESI 2022 EXIT EXAM1 QUESTIONS WITH
ANSWERS GRADED A+
Until the census on the obstetrics (OB) unit increases, an unlicensed
assistive personnel (UAP) who usually works in labor and delivery and the
newborn nursery is assigned to work on the postoperative unit. Which
client would be best for the charge nurse to assign to this UAP?
A.An adolescent who was readmitted to the hospital because of a
postoperative infection
B.A woman with a new colostomy who requires discharge teaching
C.A woman who had a hip replacement and may be transferred to the home
care unit
D.A man who had a cholecystectomy and currently has a nasogastric tube
set to intermittent suction - ANSWER-C
The charge nurse will be responsible for providing a report to the home care
unit if the transfer occurs (A). The client is infected and an employee who
works on an OB unit should be assigned to clean cases in case the employee
is required to return to the OB unit (B). This requires the skills of a registered
nurse (RN) to do discharge teaching and provide emotional support (D). This
may require skills beyond the level of this UAP.
A male client is admitted for observation after being hit on the head with a
baseball bat. Six hours after admission, the client attempts to crawl out of
bed and asks the nurse why there are so many bugs in his bed. His vital
signs are stable, and the pulse oximeter reading is 98% on room air. Which
intervention should the nurse perform first?
A.Administer oxygen per nasal cannula at 2
L/min. B.Plan to check his vital signs again
in 30 minutes.
C.Notify the health care provider of the change in mental
status. D.Ask the client why he thinks there are bugs in the
bed. - ANSWER-C
One of the earliest signs of increased intracranial pressure (ICP) is a change
in mental status (C). It is important to act early and quickly when symptoms
of increased ICP occur. Because his oxygen saturation is normal, the
administration of oxygen (A) is not the top priority. Vital signs should be
monitored frequently (B), but the client's confusion should be reported
immediately. (D) is not a useful intervention.
The nurse is monitoring a client who is receiving bedside conscious sedation
with midazolam hydrochloride (Versed). In assessing the client, the nurse
determines that the client has slurred speech with diplopia. Based on this
finding, what action should the nurse take?
A.Open the airway with a chin lift-head tilt maneuver.
B.Obtain a fingerstick glucose reading.
C.Administer flumazenil (Romazicon).
D.Continue to monitor the client. - ANSWER-D
The desired level III in conscious sedation includes slurred speech, glazed
eyes, and marked diplopia. Because this is the desired outcome of the
ANSWERS GRADED A+
A nurse who has recently completed orientation is beginning work in the
labor and delivery unit for the first time. When making assignments, which
client should the charge nurse assign to this new nurse? - ANSWER-A
multiparous client who is dilated 5 cm and 50% effaced
A client with human immunodeficiency virus (HIV) infection has white
lesions in the oral cavity that resemble milk curds. Nystatin (Mycostatin)
preparation is prescribed as a swish and swallow. Which information is most
important for the nurse to provide the client? - ANSWER-Oral hygiene should
be performed before the medication.
A client who is admitted with emphysema is having difficulty breathing. In
which position should the nurse place the client? - ANSWER-Sitting upright
and forward with both arms supported on an over the bed table
A client with chronic renal insufficiency (CRI) is taking 25 mg of
hydrochlorothiazide (HCTZ) PO and 40 mg of furosemide (Lasix) PO daily.
Today, at a routine clinic visit, the client's serum potassium level is 4 mEq/L.
What is the most likely cause of this client's potassium level? - ANSWER-The
client's renal function has affected his potassium level.
A registered nurse (RN) delivers telehealth services to clients via electronic
communication. Which nursing action creates the greatest risk for
professional liability and has the potential for a malpractice lawsuit? -
ANSWER-Sending medical records to health care providers via the Internet
Which pathophysiologic response supports the contraindication for
opioids, such as morphine, in clients with increased intracranial pressure
(ICP)?
A.Sedation produced by opioids is a result of a prolonged half-life when
the ICP is elevated.
B.Higher doses of opioids are required when cerebral blood flow is reduced
by an elevated ICP.
C.Dysphoria from opioids contributes to altered levels of consciousness
with an elevated ICP.
D.Opioids suppress respirations, which increases Pco2 and contributes to
an elevated ICP. - ANSWER-D
The greatest risk associated with opioids such as morphine (D) is respiratory
depression that causes an increase in Pco2, which increases ICP and masks
the early signs of intracranial bleeding in head injury. (A, B, and C) do not
support the risks associated with opioid use in a client with increased ICP.
,HESI 2022 EXIT EXAM1 QUESTIONS WITH
ANSWERS GRADED A+
The charge nurse of a medical surgical unit is alerted to an impending disaster
requiring implementation of the hospital's disaster plan. Specific facts about
the nature of this disaster are not yet known. Which instruction should the
charge nurse give to the other staff members at this time?
A.Prepare to evacuate the unit, starting with the bedridden clients.
B.UAPs should report to the emergency center to handle transports.
C.The licensed staff should begin counting wheelchairs and IV poles on the
unit.
D.Continue with current assignments until more instructions are received. -
ANSWER- D
When faced with an impending disaster, hospital personnel may be alerted
but should continue with current client care assignments until further
instructions are received (D). Evacuation is typically a response of last
resort that begins with clients who are most able to ambulate (A). (B) is
premature and is likely to increase the chaos if incoming casualties are
anticipated. (C) is poor utilization of personnel.
The nurse assesses a client while the UAP measures the client's vital signs.
The client's vital signs change suddenly, and the nurse determines that the
client's condition is worsening. The nurse is unsure of the client's
resuscitative status and needs to check the client's medical record for any
advanced directives. Which action should the nurse implement?
A. Ask the UAP to check for the advanced directive while the nurse
completes the assessment.
B. Assign the UAP to complete the assessment while the nurse checks for the
advanced directive.
C. Check the medical record for the advanced directive and then
complete the client assessment.
D.Call for the charge nurse to check the advanced directive while
continuing to assess the client. - ANSWER-D
Because the client's condition is worsening, the nurse should remain with
the client and continue the assessment while calling for help from the
charge nurse to determine the client's resuscitative status (D). (A and B) are
tasks that must be completed by a nurse and cannot be delegated to the
UAP. (C) is contraindicated.
The nurse is preparing a client for surgery scheduled in 2 hours. A UAP is
helping the nurse. Which task is important for the nurse to perform, rather
than the UAP?
A.Remove the client's nail polish and dentures.
B.Assist the client to the restroom to void.
C.Obtain the client's height and weight.
D.Offer the client emotional support. - ANSWER-D
By using therapeutic techniques to offer support (D), the nurse can
determine any client concerns that need to be addressed. (A, B, and C) are
all actions that can be performed by the UAP under the supervision of the
,HESI 2022 EXIT EXAM1 QUESTIONS WITH
ANSWERS GRADED A+
nurse.
, HESI 2022 EXIT EXAM1 QUESTIONS WITH
ANSWERS GRADED A+
Until the census on the obstetrics (OB) unit increases, an unlicensed
assistive personnel (UAP) who usually works in labor and delivery and the
newborn nursery is assigned to work on the postoperative unit. Which
client would be best for the charge nurse to assign to this UAP?
A.An adolescent who was readmitted to the hospital because of a
postoperative infection
B.A woman with a new colostomy who requires discharge teaching
C.A woman who had a hip replacement and may be transferred to the home
care unit
D.A man who had a cholecystectomy and currently has a nasogastric tube
set to intermittent suction - ANSWER-C
The charge nurse will be responsible for providing a report to the home care
unit if the transfer occurs (A). The client is infected and an employee who
works on an OB unit should be assigned to clean cases in case the employee
is required to return to the OB unit (B). This requires the skills of a registered
nurse (RN) to do discharge teaching and provide emotional support (D). This
may require skills beyond the level of this UAP.
A male client is admitted for observation after being hit on the head with a
baseball bat. Six hours after admission, the client attempts to crawl out of
bed and asks the nurse why there are so many bugs in his bed. His vital
signs are stable, and the pulse oximeter reading is 98% on room air. Which
intervention should the nurse perform first?
A.Administer oxygen per nasal cannula at 2
L/min. B.Plan to check his vital signs again
in 30 minutes.
C.Notify the health care provider of the change in mental
status. D.Ask the client why he thinks there are bugs in the
bed. - ANSWER-C
One of the earliest signs of increased intracranial pressure (ICP) is a change
in mental status (C). It is important to act early and quickly when symptoms
of increased ICP occur. Because his oxygen saturation is normal, the
administration of oxygen (A) is not the top priority. Vital signs should be
monitored frequently (B), but the client's confusion should be reported
immediately. (D) is not a useful intervention.
The nurse is monitoring a client who is receiving bedside conscious sedation
with midazolam hydrochloride (Versed). In assessing the client, the nurse
determines that the client has slurred speech with diplopia. Based on this
finding, what action should the nurse take?
A.Open the airway with a chin lift-head tilt maneuver.
B.Obtain a fingerstick glucose reading.
C.Administer flumazenil (Romazicon).
D.Continue to monitor the client. - ANSWER-D
The desired level III in conscious sedation includes slurred speech, glazed
eyes, and marked diplopia. Because this is the desired outcome of the
