HESI PN EXIT EXAM MADE EASY WITH KEY CONCEPTS AND
LATEST A+ EXAM TIPS
The nurse who is working on a surgical unit receives change of shift report on a
group of clients for the upcoming shift. A client with which condition requires the
most immediate attention by the nurse?
a. Gunshot wound three hours ago with dark drainage of 2 cm noted on the
dressing.
b. Mastectomy 2 days ago with 50 ml bloody drainage noted in the Jackson-pratt
drain.
c. Collapsed lung after a fall 8h ago with 100 ml blood in the chest tube collection
container
d. Abdominal-perineal resection 2 days ago with no drainage on dressing who
has fever and chills.
Abdominal-perineal resection 2 days ago with no drainage on dressing who has fever
and chills.
Rationale: the client with an abdominal- perineal resection is at risk for peritonitis and
needs to be immediately assessed for other signs and symptoms for sepsis.
The nurse is caring for a client who had gastric bypass surgery yesterday. Which
intervention is most important for the nurse to implement during the first 24
postoperative hours?
a. Insert an indwelling urinary catheter
b. Monitor for the appearance of an incisional hernia
c. Instruct the client to eat small frequent meals
d. Measure hourly urinary output.
Measure hourly urinary output.
,Rationale: a serious early complications of gastric bypass surgery is an anastomoses
leak, often resulting in death.
When preparing to discharge a male client who has been hospitalized for an
adrenal crisis, the client expresses concern about having another crisis. He tells
the nurse that he wants to stay in the hospital a few more days. Which
intervention should the nurse implement?
a. Administer anti-anxiety medication prior to providing discharge instructions
b. Schedule an appointment for an out-patient psychosocial assessment.
c. Obtain a blood cortisol level after last dose of synthetic ACTH
d. Encourage the healthcare provider to delay the client's discharge.
Schedule an appointment for an out-patient psychosocial assessment.
Rationale: Emotional stress can precipitate another adrenal crisis and should be
monitored with periodic psychosocial assessments. A may be indicated but does not
address the problem after discharge. A blood cortisol level is to diagnosis not to monitor
the ongoing disease process. Canceling the discharge only delays the resolution of the
problem.
An adult female client tells the nurse that though she is afraid her abusive
boyfriend might one day kill her, she keeps hoping that he will change. What
action should the nurse take first?
a. Report the finding to the police department
b. Discuss treatment options for abusive partners
c. Determine the frequency and type of client's abuse
d. Explore client's readiness to discuss the situation.
Explore client's readiness to discuss the situation
Rationale: By assessing the client's level of readiness to discuss her situation the nurse
can begin to stablish trust so that further action can be taken to protect her. The nurse
needs the client's permission to report the abuse to the police department, which may
,be obtained after trust is established. B might be an option during the discussion it is
most important that the client has a safe refuge even if the abusive partner does not
commit seeking help.
In caring for a client with Cushing syndrome, which serum laboratory value is
most important for the nurse to monitor?
a. Lactate
b. Glucose
c. Hemoglobin
d. Creatinine
Glucose
Rationale: Cushing syndrome, caused by excess corticosteroids causes hyperglycemia
and the client's serum glucose level should be monitor for this side effect.
Azithromycin is prescribed for an adolescent female who has lower lobe
pneumonia and recurrent chlamydia. What information is most important for the
nurse to provide to this client
a. Have partner screened for human immunodeficiency virus
b. Report a sudden onset arthralgia to the healthcare provider
c. Decrease intake of high-fat-foods, caffeine, and alcohol
d. Use two forms of contraception while taking this drug.
Use two forms of contraception while taking this drug.
Rationale: Antibiotic, especially broad-spectrum drugs, like azithromycin, decrease the
effectiveness of oral contraceptives and some spermicides, so the adolescent should be
encouraging to use at least two forms of contraception to prevent pregnancy
A client in the emergency center demonstrates rapid speech, flight of ideas, and
reports sleeping only three hours during the past 48h. Based on these finding, it
is most important for the nurse to review the laboratory value for which
, medication?
a. Olanzapine
b. Divalproex.
c. Lorazepam
d. Fluoxetine
Divalproex.
Rationale: divalproex is the first line of treatment for bipolar disorder BPD because it
has a high therapeutic index, few side effects, and a rapid onset in controlling symptoms
and preventing recurrent episodes of mania and depression. The serum value of
divalproex should be determined since the client is exhibiting symptoms of mania, which
may indicate non-compliance with the medication regimen
A male client who is admitted to the mental health unit for treatment of bipolar
disorder has a slightly slurred speech pattern and an unsteady gait. Which
assessment finding is most important for the nurse to report to the healthcare
provider?
a. Blood alcohol level of 0.09%
b. Serum lithium level of 1.6 mEq/L or mmol/l (SI)
c. Six hours of sleep in the past three days.
d. Weight loss of 10 pounds (4.5 kg) in past month.
Serum lithium level of 1.6 mEq/L or mmol/l (SI)
Rationale: The therapeutic level of Serum lithium is 0.8 to 1.5 mEq/L or mmol/l (SI).
Slurred speech and ataxia are sign of lithium toxicity
A client was admitted to the cardiac observation unit 2 hours ago complaining of
chest pain. On admission, the client's EKG showed bradycardia, ST depression,
but no ventricular ectopy. The client suddenly reports a sharp increase in pain,
telling the nurse, "I feel like an elephant just stepped on my chest" The EKG now
shows Q waves and ST segment elevations in the anterior leads. What
LATEST A+ EXAM TIPS
The nurse who is working on a surgical unit receives change of shift report on a
group of clients for the upcoming shift. A client with which condition requires the
most immediate attention by the nurse?
a. Gunshot wound three hours ago with dark drainage of 2 cm noted on the
dressing.
b. Mastectomy 2 days ago with 50 ml bloody drainage noted in the Jackson-pratt
drain.
c. Collapsed lung after a fall 8h ago with 100 ml blood in the chest tube collection
container
d. Abdominal-perineal resection 2 days ago with no drainage on dressing who
has fever and chills.
Abdominal-perineal resection 2 days ago with no drainage on dressing who has fever
and chills.
Rationale: the client with an abdominal- perineal resection is at risk for peritonitis and
needs to be immediately assessed for other signs and symptoms for sepsis.
The nurse is caring for a client who had gastric bypass surgery yesterday. Which
intervention is most important for the nurse to implement during the first 24
postoperative hours?
a. Insert an indwelling urinary catheter
b. Monitor for the appearance of an incisional hernia
c. Instruct the client to eat small frequent meals
d. Measure hourly urinary output.
Measure hourly urinary output.
,Rationale: a serious early complications of gastric bypass surgery is an anastomoses
leak, often resulting in death.
When preparing to discharge a male client who has been hospitalized for an
adrenal crisis, the client expresses concern about having another crisis. He tells
the nurse that he wants to stay in the hospital a few more days. Which
intervention should the nurse implement?
a. Administer anti-anxiety medication prior to providing discharge instructions
b. Schedule an appointment for an out-patient psychosocial assessment.
c. Obtain a blood cortisol level after last dose of synthetic ACTH
d. Encourage the healthcare provider to delay the client's discharge.
Schedule an appointment for an out-patient psychosocial assessment.
Rationale: Emotional stress can precipitate another adrenal crisis and should be
monitored with periodic psychosocial assessments. A may be indicated but does not
address the problem after discharge. A blood cortisol level is to diagnosis not to monitor
the ongoing disease process. Canceling the discharge only delays the resolution of the
problem.
An adult female client tells the nurse that though she is afraid her abusive
boyfriend might one day kill her, she keeps hoping that he will change. What
action should the nurse take first?
a. Report the finding to the police department
b. Discuss treatment options for abusive partners
c. Determine the frequency and type of client's abuse
d. Explore client's readiness to discuss the situation.
Explore client's readiness to discuss the situation
Rationale: By assessing the client's level of readiness to discuss her situation the nurse
can begin to stablish trust so that further action can be taken to protect her. The nurse
needs the client's permission to report the abuse to the police department, which may
,be obtained after trust is established. B might be an option during the discussion it is
most important that the client has a safe refuge even if the abusive partner does not
commit seeking help.
In caring for a client with Cushing syndrome, which serum laboratory value is
most important for the nurse to monitor?
a. Lactate
b. Glucose
c. Hemoglobin
d. Creatinine
Glucose
Rationale: Cushing syndrome, caused by excess corticosteroids causes hyperglycemia
and the client's serum glucose level should be monitor for this side effect.
Azithromycin is prescribed for an adolescent female who has lower lobe
pneumonia and recurrent chlamydia. What information is most important for the
nurse to provide to this client
a. Have partner screened for human immunodeficiency virus
b. Report a sudden onset arthralgia to the healthcare provider
c. Decrease intake of high-fat-foods, caffeine, and alcohol
d. Use two forms of contraception while taking this drug.
Use two forms of contraception while taking this drug.
Rationale: Antibiotic, especially broad-spectrum drugs, like azithromycin, decrease the
effectiveness of oral contraceptives and some spermicides, so the adolescent should be
encouraging to use at least two forms of contraception to prevent pregnancy
A client in the emergency center demonstrates rapid speech, flight of ideas, and
reports sleeping only three hours during the past 48h. Based on these finding, it
is most important for the nurse to review the laboratory value for which
, medication?
a. Olanzapine
b. Divalproex.
c. Lorazepam
d. Fluoxetine
Divalproex.
Rationale: divalproex is the first line of treatment for bipolar disorder BPD because it
has a high therapeutic index, few side effects, and a rapid onset in controlling symptoms
and preventing recurrent episodes of mania and depression. The serum value of
divalproex should be determined since the client is exhibiting symptoms of mania, which
may indicate non-compliance with the medication regimen
A male client who is admitted to the mental health unit for treatment of bipolar
disorder has a slightly slurred speech pattern and an unsteady gait. Which
assessment finding is most important for the nurse to report to the healthcare
provider?
a. Blood alcohol level of 0.09%
b. Serum lithium level of 1.6 mEq/L or mmol/l (SI)
c. Six hours of sleep in the past three days.
d. Weight loss of 10 pounds (4.5 kg) in past month.
Serum lithium level of 1.6 mEq/L or mmol/l (SI)
Rationale: The therapeutic level of Serum lithium is 0.8 to 1.5 mEq/L or mmol/l (SI).
Slurred speech and ataxia are sign of lithium toxicity
A client was admitted to the cardiac observation unit 2 hours ago complaining of
chest pain. On admission, the client's EKG showed bradycardia, ST depression,
but no ventricular ectopy. The client suddenly reports a sharp increase in pain,
telling the nurse, "I feel like an elephant just stepped on my chest" The EKG now
shows Q waves and ST segment elevations in the anterior leads. What
