HESI EXIT Family Nurse Practitioner FINAL EXAMS
1. Which of the following signs would indicate to the FNP that a patient might have an airway
occlusion and needs assistance?
A. Holding throat with both hands
The ability to cough, talk, or cry indicates an incomplete occlusion of the airway.
Holding the throat with both hands indicates a complete occlusion .
2. Expected objective findings in acute otitis media include:
D. Tympanic membrane immobility
An immobile TM is the hallmark of AOM.
Itching and crackling in the ear is common in patients with serous otitis.
The bony landmarks usually appear prominent when the TM is retracted, a condition usually seen with
eustachian tube dysfunction. Usually the nodes in the anterior cervical chain are enlarged and painful .
3. Young adults may develop which kind of rash when they are infected with erythema
infectious?
D. Reddened exanthema on hands and feet with distinct margins at wrist and ankle joints
Young adults may have papular-pruritic “gloves and socks” syndrome .
4. Which factor in a patient’s history places him at high risk for skin cancer?
C. Work on a crew that paves highways
The factor that places a patient at greatest risk for skin cancer is exposure to ultraviolet light; because of
sun exposure, the man who works on a highway crew would be at greatest risk .
5. Which of the following physical findings would be expected in a patient with peritoneal
irritation?
A. Abdominal guarding
Peritoneal irritation would lead to guarding and possible rebound tenderness. The Iliopsoas sign is an
indicator of peritoneal irritation. In many cases, bowel sounds would decrease in the presence of
peritoneal irritation
A liver below the costal margin may indicate hepatic inflammation, as seen in hepatitis.
Increased bowel sounds might be seen in gastroenteritis.
Engorged veins around the umbilicus are seen with ascites.
6. At what age would the FNP expect to see a child use his or her pincher grasp?
C. 9 months
A child normally uses a pincher grasp around the age of 9 months.
, 7. An adolescent presents for a sport’s physical examination. He has a family history of premature
cardiac death. He is non symptomatic and appears in good health. The FNP should use which
technique during the examination to help determine the presence of abnormal heart sounds?
B. Have the patient perform the Valsalva maneuver.
In hypertrophic cardiomyopathy a murmur may not be detected, but performing the Valsalva maneuver
will accentuate the murmur if it is present.
8. An FNP reviews both the patient log of a patient with type 2 diabetes and current lab results.
Which findings indicate that the target value of the particular test is being met?
B. HS glucose levels between 100 and 140 mg/dL
The HS blood glucose matches a target level. The target levels for type 2 diabetes are FBS 80 to 120
mg/dL .
9. Which of the following actions best demonstrates that a 31-year-old woman has achieved the
appropriate developmental task for her age group?
D. Married with two sons and an active social life
The appropriate developmental task for this age is Intimacy versus Isolation. This refers not only to
physical intimacy but also to friendships, work colleagues, and parenting relationships. Marriage, family,
and social activity is most reflective of the Intimacy task being met .
10. Which of the following comments by a patient with Osgood-Schlatter disease is consistent with
the diagnosis?
B. “My knee hurts when I run or jump.”
OS is an overuse syndrome; the pain occurs with running, jumping, going up steps, and kneeling .
11. In a patient with Bell’s palsy, which of the following physical exam findings is consistent with the
diagnosis?
B. Inability to puff out cheek
In Bell’s palsy, unilateral paresis or paralysis of the facial nerve occurs. Bell’s palsy symptoms include
facial weakness accompanied by change in taste sensation, hyperacusis, and decreased lacrimation.
12. Which factor in the patient’s history should cause the FNP to suspect deep vein thrombosis? D.
Oral contraceptive pill use
DVT should be suspected in the following circumstances: pregnancy, smoking, oral contraceptive use,
older age, or clotting disorders.
, 13. Which of the following is not a trait found in a person suffering from PTSD?
A. Hypersomnia
The DSM IV identifies PTSD as consisting of three clusters of symptoms: reexperiencing, avoidance, and
hyperarousal.
Hypersomnia is not a trait of PTSD .
14. Besides abdominal or flank pain, what would the best indicator be in a patient with a kidney
stone?
A. Hematuria
Hematuria is generally seen in all patients with kidney stones.
The other findings may not be seen in all patients with kidney stones.
15. Which of the following objective findings is pathognomonic for infectious mononucleosis?
D. Lymphadenopathy
The localized inflammatory response produces the lymphadenopathy that is almost always present in
infectious mononucleosis.
If lymphadenopathy is not present, the diagnosis of mononucleosis should be questioned. Although
usually present in infectious mononucleosis, the rash, facial edema, and sore throat could also occur
with other illnesses .
16. What is the primary difference between tender points and trigger points as objective findings in
a physical examination?
C. Palpation of trigger points causes radiation of pain; palpation of tender points does not.
On physical examination, palpation of trigger points causes radiation of pain; palpation of tender points
does not. The other options are false.
17. Visual acuity testing of a young man hoping to enter the military indicates 20/40 vision. The FNP
interprets these findings to the man correctly as:
B. Ability to see from 20 feet what the normal eye sees at 40 feet
Visual acuity assessed with the Snellen chart requires measurement of vision from a distance of 20 feet
(the numerator in the 20/40 finding). A finding of 20/40 vision indicates that the man can see from 20
feet what the normal eye can see from 40 feet away from the chart.
18. In assessing a patient suspected of having dementia, the FNP should assess whether the patient
has difficulty in which of the following?
D. Balancing the checkbook
Difficulty getting dressed or walking may be associated with arthritis or a mobility problem.
, Reading the newspaper may be related to a visual problem.
Inability to balance the checkbook is a sign of a problem with reasoning ability and complex cognitive
tasks (indications of dementia).
19. An FNP student sees a patient and reports finding annular lesions of 3 days’ duration. When you
enter the room with the student, you expect to see skin lesions arranged in:
B. Circular or ring shape
Annular lesions are round or ring shaped; a pattern merging is reticular, while groups of
vesicles are known as clustered (or dermatomal) if they follow one dermatome.
A snake-like pattern of lesions is referred to as gyrate.
20. The FNP suspects that a 6-year-old child has been abused. Which finding would increase the
index of suspicion for that diagnosis?
D. Multiple bruises on arms and face ranging from purple to yellow
Bruising in different stages of healing may indicate multiple episodes of trauma over time—a key
indicator of child abuse. Bruises on the knees and lower legs are common in childhood from play
injuries; bruises on arms and face would be less likely to be associated with typical injury during playtime
.
21. At what age would the FNP expect to see a child copy a circle?
C. 3 years
A child normally can copy a circle at 3 years .
22. After intense rectal itching, which of the following symptoms is most typical of pinworms in
children?
B. Perianal excoriation
Perianal excoriation is common, particularly in children. They scratch the perianal area because of all the
itching .
23. Which of the following findings in a 70-year-old man would increase the suspicion of prostate
cancer?
D. Firm, distinct lesion palpable
A firm, distinct palpable lesion is descriptive of prostatic malignancy and should be referred immediately
24. A patient is brought to the clinic with a nosebleed. Which of the following objective descriptions
is consistent with a posterior nosebleed?
A. Blood seen in oropharynx
1. Which of the following signs would indicate to the FNP that a patient might have an airway
occlusion and needs assistance?
A. Holding throat with both hands
The ability to cough, talk, or cry indicates an incomplete occlusion of the airway.
Holding the throat with both hands indicates a complete occlusion .
2. Expected objective findings in acute otitis media include:
D. Tympanic membrane immobility
An immobile TM is the hallmark of AOM.
Itching and crackling in the ear is common in patients with serous otitis.
The bony landmarks usually appear prominent when the TM is retracted, a condition usually seen with
eustachian tube dysfunction. Usually the nodes in the anterior cervical chain are enlarged and painful .
3. Young adults may develop which kind of rash when they are infected with erythema
infectious?
D. Reddened exanthema on hands and feet with distinct margins at wrist and ankle joints
Young adults may have papular-pruritic “gloves and socks” syndrome .
4. Which factor in a patient’s history places him at high risk for skin cancer?
C. Work on a crew that paves highways
The factor that places a patient at greatest risk for skin cancer is exposure to ultraviolet light; because of
sun exposure, the man who works on a highway crew would be at greatest risk .
5. Which of the following physical findings would be expected in a patient with peritoneal
irritation?
A. Abdominal guarding
Peritoneal irritation would lead to guarding and possible rebound tenderness. The Iliopsoas sign is an
indicator of peritoneal irritation. In many cases, bowel sounds would decrease in the presence of
peritoneal irritation
A liver below the costal margin may indicate hepatic inflammation, as seen in hepatitis.
Increased bowel sounds might be seen in gastroenteritis.
Engorged veins around the umbilicus are seen with ascites.
6. At what age would the FNP expect to see a child use his or her pincher grasp?
C. 9 months
A child normally uses a pincher grasp around the age of 9 months.
, 7. An adolescent presents for a sport’s physical examination. He has a family history of premature
cardiac death. He is non symptomatic and appears in good health. The FNP should use which
technique during the examination to help determine the presence of abnormal heart sounds?
B. Have the patient perform the Valsalva maneuver.
In hypertrophic cardiomyopathy a murmur may not be detected, but performing the Valsalva maneuver
will accentuate the murmur if it is present.
8. An FNP reviews both the patient log of a patient with type 2 diabetes and current lab results.
Which findings indicate that the target value of the particular test is being met?
B. HS glucose levels between 100 and 140 mg/dL
The HS blood glucose matches a target level. The target levels for type 2 diabetes are FBS 80 to 120
mg/dL .
9. Which of the following actions best demonstrates that a 31-year-old woman has achieved the
appropriate developmental task for her age group?
D. Married with two sons and an active social life
The appropriate developmental task for this age is Intimacy versus Isolation. This refers not only to
physical intimacy but also to friendships, work colleagues, and parenting relationships. Marriage, family,
and social activity is most reflective of the Intimacy task being met .
10. Which of the following comments by a patient with Osgood-Schlatter disease is consistent with
the diagnosis?
B. “My knee hurts when I run or jump.”
OS is an overuse syndrome; the pain occurs with running, jumping, going up steps, and kneeling .
11. In a patient with Bell’s palsy, which of the following physical exam findings is consistent with the
diagnosis?
B. Inability to puff out cheek
In Bell’s palsy, unilateral paresis or paralysis of the facial nerve occurs. Bell’s palsy symptoms include
facial weakness accompanied by change in taste sensation, hyperacusis, and decreased lacrimation.
12. Which factor in the patient’s history should cause the FNP to suspect deep vein thrombosis? D.
Oral contraceptive pill use
DVT should be suspected in the following circumstances: pregnancy, smoking, oral contraceptive use,
older age, or clotting disorders.
, 13. Which of the following is not a trait found in a person suffering from PTSD?
A. Hypersomnia
The DSM IV identifies PTSD as consisting of three clusters of symptoms: reexperiencing, avoidance, and
hyperarousal.
Hypersomnia is not a trait of PTSD .
14. Besides abdominal or flank pain, what would the best indicator be in a patient with a kidney
stone?
A. Hematuria
Hematuria is generally seen in all patients with kidney stones.
The other findings may not be seen in all patients with kidney stones.
15. Which of the following objective findings is pathognomonic for infectious mononucleosis?
D. Lymphadenopathy
The localized inflammatory response produces the lymphadenopathy that is almost always present in
infectious mononucleosis.
If lymphadenopathy is not present, the diagnosis of mononucleosis should be questioned. Although
usually present in infectious mononucleosis, the rash, facial edema, and sore throat could also occur
with other illnesses .
16. What is the primary difference between tender points and trigger points as objective findings in
a physical examination?
C. Palpation of trigger points causes radiation of pain; palpation of tender points does not.
On physical examination, palpation of trigger points causes radiation of pain; palpation of tender points
does not. The other options are false.
17. Visual acuity testing of a young man hoping to enter the military indicates 20/40 vision. The FNP
interprets these findings to the man correctly as:
B. Ability to see from 20 feet what the normal eye sees at 40 feet
Visual acuity assessed with the Snellen chart requires measurement of vision from a distance of 20 feet
(the numerator in the 20/40 finding). A finding of 20/40 vision indicates that the man can see from 20
feet what the normal eye can see from 40 feet away from the chart.
18. In assessing a patient suspected of having dementia, the FNP should assess whether the patient
has difficulty in which of the following?
D. Balancing the checkbook
Difficulty getting dressed or walking may be associated with arthritis or a mobility problem.
, Reading the newspaper may be related to a visual problem.
Inability to balance the checkbook is a sign of a problem with reasoning ability and complex cognitive
tasks (indications of dementia).
19. An FNP student sees a patient and reports finding annular lesions of 3 days’ duration. When you
enter the room with the student, you expect to see skin lesions arranged in:
B. Circular or ring shape
Annular lesions are round or ring shaped; a pattern merging is reticular, while groups of
vesicles are known as clustered (or dermatomal) if they follow one dermatome.
A snake-like pattern of lesions is referred to as gyrate.
20. The FNP suspects that a 6-year-old child has been abused. Which finding would increase the
index of suspicion for that diagnosis?
D. Multiple bruises on arms and face ranging from purple to yellow
Bruising in different stages of healing may indicate multiple episodes of trauma over time—a key
indicator of child abuse. Bruises on the knees and lower legs are common in childhood from play
injuries; bruises on arms and face would be less likely to be associated with typical injury during playtime
.
21. At what age would the FNP expect to see a child copy a circle?
C. 3 years
A child normally can copy a circle at 3 years .
22. After intense rectal itching, which of the following symptoms is most typical of pinworms in
children?
B. Perianal excoriation
Perianal excoriation is common, particularly in children. They scratch the perianal area because of all the
itching .
23. Which of the following findings in a 70-year-old man would increase the suspicion of prostate
cancer?
D. Firm, distinct lesion palpable
A firm, distinct palpable lesion is descriptive of prostatic malignancy and should be referred immediately
24. A patient is brought to the clinic with a nosebleed. Which of the following objective descriptions
is consistent with a posterior nosebleed?
A. Blood seen in oropharynx
