ne
tz
sh
ne
la 2020 HESI EXIT V4
tz
1. Parents of a 7 year-old child call the clinic nurse because their daughter was sent home
sh
Sp
from school because of a rash. The child had been seen the day before by the healthcare
ne
provider and diagnosed with Fifth Disease (erythema infectiosum). What is the most
la
appropriate action by the nurse?
tz
sh
A) Tell the parents to bring the child to the clinic for further evaluation
Sp
B) Refer the school officials to printed materials about this viral illness
ne
C) Inform the teacher that the child is receiving antibiotics for the rash
la
D) Explain that this rash is not contagious and does not require isolation
tz
sh
Sp
The correct answer is D: Explain that this rash is not contagious and does not require
ne
isolation
la
tz
sh
Sp
2. When making a home visit to a client with chronic pyelonephritis, which nursing
ne
action has the highest priority?
la
A) Follow-up on lab values before the visit
tz
sh
B) Observe client findings for the effectiveness of antibiotics
Sp
C) Ask for a log of urinary output
ne
D) As for the log of the oral intake
la
The correct answer is C: Ask for a log of urinary output
tz
sh
Sp
ne
la
3. The nurse is caring for a newborn who has just been diagnosed with hypospadias.
tz
After discussing the defect with the parents, the nurse should expect that sh
Sp
A) Circumcision can be performed at any time
ne
B) Initial repair is delayed until ages 6-8
la
C) Post-operative appearance will be normal
D) Surgery will be performed in stages
tz
sh
Sp
The correct answer is D: Surgery will be performed in stages
ne
la
tz
sh
4. The nurse is assessing a client on admission to a community mental health center.
Sp
ne
The client discloses that she has been thinking about ending her life. The nurse's
best response would be
la
tz
A) "Do you want to discuss this with your pastor?"
sh
Sp
B) "We will help you deal with those thoughts."
ne
C) "Is your life so terrible that you want to end it?"
la
D) "Have you thought about how you would do it?"
tz
The correct answer is D: "Have you thought about how you would do it?"
sh
Sp
ne
la
sh
Sp
la
Sp
, ne
tz
sh
ne
la
tz
5. The nursing care plan for a client with decreased adrenal function should include
sh
Sp
A) Encouraging activity
ne
B) Placing client in reverse isolation
la
C) Limiting visitors
tz
sh
D) Measures to prevent constipation
Sp
The correct answer is C: Limiting visitors
ne
la
tz
sh
Sp
6. The nurse is caring for a client with acute pancreatitis. After pain management,
ne
which intervention should be included in the plan of care?
la
A) Cough and deep breathe every 2 hours
tz
B) Place the client in contact isolation
sh
Sp
C) Provide a diet high in protein
ne
D) Institute seizure precautions
la
The correct answer is A: Cough and deep breathe every 2 hours
tz
sh
Sp
ne
7. Which of the following conditions assessed by the nurse would contraindicate the
la
use of benztropine (Cogentin)?
tz
sh
A) Neuromalignant syndrome
Sp
ne
B) Acute extrapyramidal syndrome
la
C) Glaucoma, prostatic hypertrophy
tz
D) Parkinson's disease, atypical tremors sh
Sp
The correct answer is C: Glaucoma, prostatic hypertrophy
ne
la
tz
sh
8. The nurse is caring for a client in the coronary care unit. The display on the cardiac
Sp
monitor indicates ventricular fibrillation. What should the nurse do first?
ne
A) Perform defibrillation
la
B) Administer epinephrine as ordered
tz
sh
C) Assess for presence of pulse
Sp
ne
D) Institute CPR
The correct answer is C: Assess for presence of pulse
la
tz
sh
Sp
ne
9. During the use of an interpreter to teach a client about a procedure to do in the home
la
the nurse should take which approach?
tz
A) Speak directly to the interpreter while presenting information and use pauses for
sh
Sp
questions
ne
B) Talk to the interpreter in advance and leave the client and interpreter alone
la
sh
Sp
la
Sp
, ne
tz
sh
ne
C) Include a family member and direct communications to that person
la
D) Face the client while presenting the information as the interpreter talks in the native
tz
language
sh
Sp
The correct answer is D: Face the client while presenting the information as theinterpreter
talks in the native language . ne
la
tz
sh
10. A client is in her third month of her first pregnancy. During the interview, she tells
Sp
the nurse that she has several sex partners and is unsure of the identity of the
ne
baby's father. Which of the following nursing interventions is a priority?
la
A) Counsel the woman to consent to HIV screening
tz
sh
B) Perform tests for sexually transmitted diseases
Sp
ne
C) Discuss her high risk for cervical cancer
la
D) Refer the client to a family planning clinic
tz
The correct answer is A: Counsel the woman to consent to HIV screening
sh
Sp
ne
la
11. A client is discharged following hospitalization for congestive heart failure. The
tz
sh
nurse teaching the family suggests they encourage the client to rest frequently in
Sp
which ofthe following positions?
ne
A) High Fowler's
la
B) Supine
tz
sh
C) Left lateral
Sp
ne
D) Low Fowler's
The correct answer is A: High Fowler''s
la
tz
sh
Sp
ne
12. A nurse who is evaluating a mentally retarded 2 year-old in a clinic should stress
la
which goal when talking to the child's mother?
A) Teaching the child self care skills
tz
sh
Sp
B) Preparing for independent toielting
ne
C) Promoting the child's optimal development
la
D) Helping the family decide on long term care
tz
sh
The correct answer is C: Promoting the child''s optimal development
Sp
ne
la
tz
13. The nurse is caring for a client with trigeminal neuralgia (tic douloureaux). To assist
sh
Sp
the client with nutrition needs, the nurse should
ne
A) Offer small meals of high calorie soft food
la
B) Assist the client to sit in a chair for meals
tz
C) Provide additional servings of fruits and raw vegetables
sh
Sp
D) Encourage the client to eat fish, liver and chicken
ne
The correct answer is A: Offer small meals of high calorie soft food
la
sh
Sp
la
Sp
, ne
tz
sh
ne
la
tz
14. The nurse is assessing a 2 year-old client with a possible diagnosis of congenital
sh
Sp
heart disease. Which of these is most likely to be seen with this diagnosis?
ne
A) Several otitis media episodes in the last year
la
B) Weight and height in 10th percentile since birth
tz
sh
C) Takes frequent rest periods while playing
Sp
D) Changing food preferences and dislikes
ne
The correct answer is C: Takes frequent rest periods while playing
la
tz
sh
Sp
ne
15. The nurse is caring for a 10 year-old on admission to the burn unit. One assessment
la
parameter that will indicate that the child has adequate fluid replacement is
tz
A) Urinary output of 30 ml per hour
sh
Sp
B) No complaints of thirst
ne
C) Increased hematocrit
la
D) Good skin turgor around burn
tz
sh
The correct answer is A: Urinary output of 30 ml per hour
Sp
ne
16. Upon examining the mouth of a 3 year-old child, the nurse discovers that the teeth
la
have chalky white-to-yellowish staining with pitting of the enamel. Which of the
tz
sh
following conditions would most
Sp
ne
likely explain these findings?
la
A) Ingestion of tetracycline
tz
B) Excessive fluoride intake sh
Sp
C) Oral iron therapy
ne
D) Poor dental hygiene
la
The correct answer is B: Excessive fluoride intake
tz
sh
Sp
ne
17. The nurse is reassigned to work at the Poison Control Center telephone hotline. In
la
which of these cases of childhood poisoning would the nurse suggest that parents
tz
sh
have the child drink orange juice?
Sp
ne
A) An 18 month-old who ate an undetermined amount of crystal drain cleaner
B) A 14 month-old who chewed 2 leaves of a philodendron plant
la
tz
C) A 20 month-old who is found sitting on the bathroom floor beside an empty bottle of
sh
Sp
diazepam (Valium)
ne
D) A 30 month-old who has swallowed a mouthful of charcoal lighter fluid
la
The correct answer is A: An 18 month-old who ate an undetermined amount of crystal
tz
drain cleaner
sh
Sp
ne
la
sh
Sp
la
Sp
tz
sh
ne
la 2020 HESI EXIT V4
tz
1. Parents of a 7 year-old child call the clinic nurse because their daughter was sent home
sh
Sp
from school because of a rash. The child had been seen the day before by the healthcare
ne
provider and diagnosed with Fifth Disease (erythema infectiosum). What is the most
la
appropriate action by the nurse?
tz
sh
A) Tell the parents to bring the child to the clinic for further evaluation
Sp
B) Refer the school officials to printed materials about this viral illness
ne
C) Inform the teacher that the child is receiving antibiotics for the rash
la
D) Explain that this rash is not contagious and does not require isolation
tz
sh
Sp
The correct answer is D: Explain that this rash is not contagious and does not require
ne
isolation
la
tz
sh
Sp
2. When making a home visit to a client with chronic pyelonephritis, which nursing
ne
action has the highest priority?
la
A) Follow-up on lab values before the visit
tz
sh
B) Observe client findings for the effectiveness of antibiotics
Sp
C) Ask for a log of urinary output
ne
D) As for the log of the oral intake
la
The correct answer is C: Ask for a log of urinary output
tz
sh
Sp
ne
la
3. The nurse is caring for a newborn who has just been diagnosed with hypospadias.
tz
After discussing the defect with the parents, the nurse should expect that sh
Sp
A) Circumcision can be performed at any time
ne
B) Initial repair is delayed until ages 6-8
la
C) Post-operative appearance will be normal
D) Surgery will be performed in stages
tz
sh
Sp
The correct answer is D: Surgery will be performed in stages
ne
la
tz
sh
4. The nurse is assessing a client on admission to a community mental health center.
Sp
ne
The client discloses that she has been thinking about ending her life. The nurse's
best response would be
la
tz
A) "Do you want to discuss this with your pastor?"
sh
Sp
B) "We will help you deal with those thoughts."
ne
C) "Is your life so terrible that you want to end it?"
la
D) "Have you thought about how you would do it?"
tz
The correct answer is D: "Have you thought about how you would do it?"
sh
Sp
ne
la
sh
Sp
la
Sp
, ne
tz
sh
ne
la
tz
5. The nursing care plan for a client with decreased adrenal function should include
sh
Sp
A) Encouraging activity
ne
B) Placing client in reverse isolation
la
C) Limiting visitors
tz
sh
D) Measures to prevent constipation
Sp
The correct answer is C: Limiting visitors
ne
la
tz
sh
Sp
6. The nurse is caring for a client with acute pancreatitis. After pain management,
ne
which intervention should be included in the plan of care?
la
A) Cough and deep breathe every 2 hours
tz
B) Place the client in contact isolation
sh
Sp
C) Provide a diet high in protein
ne
D) Institute seizure precautions
la
The correct answer is A: Cough and deep breathe every 2 hours
tz
sh
Sp
ne
7. Which of the following conditions assessed by the nurse would contraindicate the
la
use of benztropine (Cogentin)?
tz
sh
A) Neuromalignant syndrome
Sp
ne
B) Acute extrapyramidal syndrome
la
C) Glaucoma, prostatic hypertrophy
tz
D) Parkinson's disease, atypical tremors sh
Sp
The correct answer is C: Glaucoma, prostatic hypertrophy
ne
la
tz
sh
8. The nurse is caring for a client in the coronary care unit. The display on the cardiac
Sp
monitor indicates ventricular fibrillation. What should the nurse do first?
ne
A) Perform defibrillation
la
B) Administer epinephrine as ordered
tz
sh
C) Assess for presence of pulse
Sp
ne
D) Institute CPR
The correct answer is C: Assess for presence of pulse
la
tz
sh
Sp
ne
9. During the use of an interpreter to teach a client about a procedure to do in the home
la
the nurse should take which approach?
tz
A) Speak directly to the interpreter while presenting information and use pauses for
sh
Sp
questions
ne
B) Talk to the interpreter in advance and leave the client and interpreter alone
la
sh
Sp
la
Sp
, ne
tz
sh
ne
C) Include a family member and direct communications to that person
la
D) Face the client while presenting the information as the interpreter talks in the native
tz
language
sh
Sp
The correct answer is D: Face the client while presenting the information as theinterpreter
talks in the native language . ne
la
tz
sh
10. A client is in her third month of her first pregnancy. During the interview, she tells
Sp
the nurse that she has several sex partners and is unsure of the identity of the
ne
baby's father. Which of the following nursing interventions is a priority?
la
A) Counsel the woman to consent to HIV screening
tz
sh
B) Perform tests for sexually transmitted diseases
Sp
ne
C) Discuss her high risk for cervical cancer
la
D) Refer the client to a family planning clinic
tz
The correct answer is A: Counsel the woman to consent to HIV screening
sh
Sp
ne
la
11. A client is discharged following hospitalization for congestive heart failure. The
tz
sh
nurse teaching the family suggests they encourage the client to rest frequently in
Sp
which ofthe following positions?
ne
A) High Fowler's
la
B) Supine
tz
sh
C) Left lateral
Sp
ne
D) Low Fowler's
The correct answer is A: High Fowler''s
la
tz
sh
Sp
ne
12. A nurse who is evaluating a mentally retarded 2 year-old in a clinic should stress
la
which goal when talking to the child's mother?
A) Teaching the child self care skills
tz
sh
Sp
B) Preparing for independent toielting
ne
C) Promoting the child's optimal development
la
D) Helping the family decide on long term care
tz
sh
The correct answer is C: Promoting the child''s optimal development
Sp
ne
la
tz
13. The nurse is caring for a client with trigeminal neuralgia (tic douloureaux). To assist
sh
Sp
the client with nutrition needs, the nurse should
ne
A) Offer small meals of high calorie soft food
la
B) Assist the client to sit in a chair for meals
tz
C) Provide additional servings of fruits and raw vegetables
sh
Sp
D) Encourage the client to eat fish, liver and chicken
ne
The correct answer is A: Offer small meals of high calorie soft food
la
sh
Sp
la
Sp
, ne
tz
sh
ne
la
tz
14. The nurse is assessing a 2 year-old client with a possible diagnosis of congenital
sh
Sp
heart disease. Which of these is most likely to be seen with this diagnosis?
ne
A) Several otitis media episodes in the last year
la
B) Weight and height in 10th percentile since birth
tz
sh
C) Takes frequent rest periods while playing
Sp
D) Changing food preferences and dislikes
ne
The correct answer is C: Takes frequent rest periods while playing
la
tz
sh
Sp
ne
15. The nurse is caring for a 10 year-old on admission to the burn unit. One assessment
la
parameter that will indicate that the child has adequate fluid replacement is
tz
A) Urinary output of 30 ml per hour
sh
Sp
B) No complaints of thirst
ne
C) Increased hematocrit
la
D) Good skin turgor around burn
tz
sh
The correct answer is A: Urinary output of 30 ml per hour
Sp
ne
16. Upon examining the mouth of a 3 year-old child, the nurse discovers that the teeth
la
have chalky white-to-yellowish staining with pitting of the enamel. Which of the
tz
sh
following conditions would most
Sp
ne
likely explain these findings?
la
A) Ingestion of tetracycline
tz
B) Excessive fluoride intake sh
Sp
C) Oral iron therapy
ne
D) Poor dental hygiene
la
The correct answer is B: Excessive fluoride intake
tz
sh
Sp
ne
17. The nurse is reassigned to work at the Poison Control Center telephone hotline. In
la
which of these cases of childhood poisoning would the nurse suggest that parents
tz
sh
have the child drink orange juice?
Sp
ne
A) An 18 month-old who ate an undetermined amount of crystal drain cleaner
B) A 14 month-old who chewed 2 leaves of a philodendron plant
la
tz
C) A 20 month-old who is found sitting on the bathroom floor beside an empty bottle of
sh
Sp
diazepam (Valium)
ne
D) A 30 month-old who has swallowed a mouthful of charcoal lighter fluid
la
The correct answer is A: An 18 month-old who ate an undetermined amount of crystal
tz
drain cleaner
sh
Sp
ne
la
sh
Sp
la
Sp
