LATEST HESI EXAM 2024 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED
ANSWERS (
A pt presses the call bell and requests pain medication for a severe headache. To assess the
quality of the pt. Pain, which approach should the nurse use? - CORRECT ANSWER>>Ask the
patient to describe the pain
The nurse is wearing personal protective equipment while caring for a pt. When exiting the
room, which PPE should be removed first? - CORRECT ANSWER>>Gloves
An older pt is brought to the ED with a sudden onset of confusion that occurred after
experiencing a fall at home. The daughter, who has power of attorney, has brought the client's
prescriptions. Which information should the nurse provide first when reporting to the
healthcare provider using SBAR communication? - CORRECT ANSWER>>Increasing confusion of
the pt.
A pt tells the nurse about working out with a personal trainer and swimming three times a
week in an effort to lose weight and sleep better. The pt states that it still is taking hours to fall
asleep at night. Which action should the nurse implement? - CORRECT ANSWER>>Ask the pt for
a description of the exercise schedule that is being followed
2 days prior to discharge from the rehab facility, the nurse is teaching a pt who is recovering
from Guillain-Barre syndrome about home. Which actions should the nurse include when
providing discharge teaching to the pt and spouse? SATA - CORRECT ANSWER>>-review safe
transfer strategies
-develop a nutritional plan
-help identify community support
The nurse implements a tertiary prevention program for type 2 diabetes in a rural health clinic.
Which outcome indicates that the program was effective? - CORRECT ANSWER>>pt who
develop disease complications promptly received rehabilitation
The nurse has received funding to design a health promotion project for African American
women who are at risk for developing breast cancer. Which resource is most important in
,designing this program? - CORRECT ANSWER>>participation of community leaders in planning
the program
A pt with multiple injuries is being treated in the burn trauma unit just hours after the injuries
occurred. The healthcare provider instructs the nurse to avoid auto contamination when
performing dressing changes. Which intervention is most important for the nurse to
implement? - CORRECT ANSWER>>use gown, mask, and gloves with dressing changes
A pt is recovering in the critical care unit following a cardiac cath. IV nitro and heparin are
infusing. The pt is sedated but responds to instructions. After changing positions, the pt
complains of pain at the right groin insertion site. What action should the nurse implement? -
CORRECT ANSWER>>Stimulate the pt to take deep breaths
Prior to obtaining a trapeze bar for a pt with limited mobility, which pt assessment is most
important for the nurse to obtain? - CORRECT ANSWER>>upper body muscle strength
While the nurse is assessing an older pt fall risk, the pt reports living at home alone and never
falling. Which action should the nurse take? - CORRECT ANSWER>>Continue to obtain pt data
needed to complete the fall risk survey
The nurse is feeding an older adult who was admitted with aspiration pneumonia. The pt is
weak and begins coughing while attempting to drink through a straw. Which intervention
should the nurse implement? - CORRECT ANSWER>>Teach coughing and deep breathing
exercises
The nurse is teaching the pt about home care after surgery for an ileal conduit placement.
When reviewing the information, which statement should the nurse recognize as needing
additional education? - CORRECT ANSWER>>Empty the pouch when it is half full.
A 12 week gestation is admitted to the antepartum unit with a dx of hyperemesis gravidarum.
Which action is most important for the nurse to implement? - CORRECT ANSWER>>initiate
prescribed IV fluids
A pt with dyspnea is being admitted to the medical unit. To best prepare for the pt arrival, the
nurse should ensure that the pt bed is in which position? - CORRECT ANSWER>>Picture with the
bed sitting up
,A pt who is scheduled for a bronchoscopy in the morning is anxious and asking the nurse
numerous questions about the procedure. In preparing the pt for the procedure, which
intervention has the highest priority? - CORRECT ANSWER>>Instruct pt to write down questions
While caring for a pt post operative dressing, the nurse observes purulent drainage at the
wound. Before reporting this finding to the provider, the nurse should review which of the pt
lab values? - CORRECT ANSWER>>culture for sensitive organisms
A pt with a lower respiratory tract infection receives a prescription for ciprofloxacin 500mg PO
every 12hrs. When the client requests an afternoon snack, which dietary choice should the
nurse provide? - CORRECT ANSWER>>Cinnamon apple sauce
An older male reporting abd pain is admitted from a facility. It has been 7 days since his last BM
and his abd is distended, and he just vomited 150ml of dark brown emesis. In what order
should the nurse implement these interventions? - CORRECT ANSWER>>Send emesis to lab
Elevate HOB
complete focused assessment
offers PRN pain meds
A patient who recently received a prescription for ramelteon to treat sleep deprivation reports
experiencing several side effects since taking the med. Which side effect should the nurse
report to the healthcare provider? - CORRECT ANSWER>>Somnambulism
A pt is scheduled for a spiral CT scan with contrast to evaluate for pulmonary embolism. Which
information in the client's history requires follow up by the nurse? - CORRECT ANSWER>>take
metformin for type 2 diabetes
The nurse should withhold which medication if the client's serum potassium level is 6.2 mEq/? -
CORRECT ANSWER>>Spironolactone
A nurse receives a report on a pt who is four hours post-total abdominal hysterectomy. The
previous nurse reports that it was necessary to change the client's perineal pad hourly and that
it is again saturated. The previous nurse also reports that the client's urinary output has
decreased. Which action should the nurse implement first? - CORRECT ANSWER>>Assess for
weakness or dizziness
, A pt who is admitted for primary hypothyroidism has early signs of myxedema coma. In
assessing the pt, in which sequence should the nurse complete these actions? - CORRECT
ANSWER>>-Observe breathing patterns
-assess blood pressure
-measure body temp
-palpate for pedal edema
The nurse is taking the blood pressure measurement of a client with Parkinson's disease. Which
information in the admission assessment is relevant to the nurse's plan for taking the blood
pressure reading? SATA - CORRECT ANSWER>>Blurred Vision
Flat Affect
frequent syncope
After administering a proton pump inhibitor, which action should the nurse take to evaluate the
effectiveness of the medication? - CORRECT ANSWER>>Ask the pt about gastrointestinal pain
A pt is receiving enoxaparin 30 mg subcutaneously twice a day. In assessing for adverse effects
of the medication, which serum laboratory value most important for the nurse to monitor -
CORRECT ANSWER>>platelet count
A pediatric client is taking the beta-adrenergic blocking agent propranolol. In developing a
teaching plan, the nurse should teach the parents to report which sign of overdose? - CORRECT
ANSWER>>Bradycardia
The nurse is demonstrating correct transfer procedures to the unlicensed assistive personnel
working on a rehab unit. The UAP asks the nurse how to safely move a physically disabled pt
from the... wheelchair to the bed. Which action should the nurse recommend? - CORRECT
ANSWER>>Place the pt locked wheelchair on the pt strong side next to the bed
The nurse has completed the diet teaching of a client who is being discharged following tx of a
leg wound. A high protein diet is encouraged to promote wound healing. Which lunch choice by
the pt indicates that the teaching was effective? - CORRECT ANSWER>>A tuna fish sandwich
with chips and ice cream
When conducting diet teaching for a pt who was dx with a myocardial infarction, which snack
foods should the nurse encourage the pt to eat? SATA - CORRECT ANSWER>>Fresh Turkey slices
and berries
chick bouillon soup and toast