HESI EXIT RN EXAM
(750 QUESTIONS AND ANSWERS, RATIONALE OF EACH
ANSWER INCLUDED)
1. Following .discharge .teaching, .a .male .client .with .duodenal .ulcer .tells
. the .nurse .the .he .will .drink .plenty .of .dairy .products, .such .as .milk, .to
. help .coat .and .protect .his .ulcer. .What .is .the .best .follow-up .action .by
. the .nurse?
a- Remind .the .client .that .it .is .also .important .to .switch .to .decaffeinated
. coffee .and .tea.
b- Suggest .that .the .client .also .plan .to .eat .frequent .small .meals .to
. reduce .discomfort
c- Review .with .the .client .the .need .to .avoid .foods .that .are .rich .in
milk .and cream.
d- Reinforce .this .teaching .by .asking .the .client .to .list .a .dairy .food .that .he
. might .select.
Rationale: .Diets .rich .in .milk .and .cream .stimulate .gastric .acid .secretion
. and .should .be .avoided.
2. A .male .client .with .hypertension, .who .received .new .antihypertensive
. prescriptions .at .his .last .visit .returns .to .the .clinic
, two .weeks .later .to .evaluate .his .blood .pressure .(BP). .His .BP .is
. 158/106 .and .he .admits .that .he .has .not .been .taking .the .prescribed
. medication .because .the .drugs .make .him .“feel .bad”. .In .explaining .the
. need .for .hypertension .control, .the .nurse .should .stress .that .an .elevated
. BP .places .the .client .at .risk .for .which .pathophysiological .condition?
a- Blindness .secondary .to .cataracts
b- Acute .kidney .injury .due .to .glomerular .damage
c- Stroke .secondary .to .hemorrhage
d- Heart .block .due .to .myocardial .damage
Rationale: .Stroke .related .to .cerebral .hemorrhage .is .major .risk .for
. uncontrolled .hypertension.
3. The .nurse .observes .an .unlicensed .assistive .personnel .(UAP)
. positioning .a .newly .admitted .client .who .has .a .seizure .disorder. .The
. client .is .supine .and .the .UAP .is .placing .soft .pillows .along .the .side
. rails. .What .action .should .the .nurse .implement?
a- Ensure .that .the .UAP .has .placed .the .pillows .effectively .to .protect .the
. client.
b- Instruct .the .UAP .to .obtain .soft .blankets .to .secure .to .the .side .rails
, instead .of .pillows.
a- Assume .responsibility .for .placing .the .pillows .while .the .UAP
. completes .another .task.
b- Ask .the .UAP .to .use .some .of .the .pillows .to .prop .the .client .in .a .side
. lying .position.
Rationale: .The .nurse .should .instruct .the .UAP .to .pad .the .side .rails .with
. soft .blankest .because .the .use .of .pillows .could .result .in .suffocation .and
. would .need .to .be .removed .at .the .onset .of .the .seizure. .The .nurse .can
. delegate .paddling .the .side .rails .to .the .UAP
4. An .adolescent .with .major .depressive .disorder .has .been .taking
. duloxetine .(Cymbalta) .for .the .past .12 .days. .Which .assessment
. finding .requires .immediate .follow-up?
a- Describes .life .without .purpose
b- Complains .of .nausea .and .loss .of .appetite
c- States .is .often .fatigued .and .drowsy
d- Exhibits .an .increase .in .sweating.
Rationale: .Cymbalta .is .a .selective .serotonin .and .norepinephrine
. reuptake .inhibitor .that .is .known .to .increase .the .risk .of .suicidal
. thinking .in .adolescents .and .young .adults .with .major .depressive
, disorder. .B, .C .and .D .are .side .effects
5. A .60-year-old .female .client .with .a .positive .family .history .of
. ovarian .cancer .has .developed .an .abdominal .mass .and .is .being
. evaluated .for .possible .ovarian .cancer. .Her .Papanicolau .(Pap)
. smear .results .are .negative. .What .information .should .the .nurse
. include .in .the .client‟s .teaching .plan?
a- Further .evaluation .involving .surgery .may .be .needed
b- A .pelvic .exam .is .also .needed .before .cancer .is .ruled .out
c- Pap .smear .evaluation .should .be .continued .every .six .month
d- One .additional .negative .pap .smear .in .six .months .is . needed.
Rationale: .An .abdominal .mass .in .a .client .with .a .family .history .for
. ovarian .cancer .should .be .evaluated .carefully
6. A .client .who .recently .underwear .a .tracheostomy .is .being
. prepared .for .discharge .to .home. .Which .instructions .is .most
. important .for .the .nurse .to .include .in .the .discharge .plan?
a- Explain .how .to .use .communication .tools.
b- Teach .tracheal .suctioning .techniques .c-
. Encourage .self-care .and .independence.
d- .Demonstrate .how .to .clean .tracheostomy .site.
(750 QUESTIONS AND ANSWERS, RATIONALE OF EACH
ANSWER INCLUDED)
1. Following .discharge .teaching, .a .male .client .with .duodenal .ulcer .tells
. the .nurse .the .he .will .drink .plenty .of .dairy .products, .such .as .milk, .to
. help .coat .and .protect .his .ulcer. .What .is .the .best .follow-up .action .by
. the .nurse?
a- Remind .the .client .that .it .is .also .important .to .switch .to .decaffeinated
. coffee .and .tea.
b- Suggest .that .the .client .also .plan .to .eat .frequent .small .meals .to
. reduce .discomfort
c- Review .with .the .client .the .need .to .avoid .foods .that .are .rich .in
milk .and cream.
d- Reinforce .this .teaching .by .asking .the .client .to .list .a .dairy .food .that .he
. might .select.
Rationale: .Diets .rich .in .milk .and .cream .stimulate .gastric .acid .secretion
. and .should .be .avoided.
2. A .male .client .with .hypertension, .who .received .new .antihypertensive
. prescriptions .at .his .last .visit .returns .to .the .clinic
, two .weeks .later .to .evaluate .his .blood .pressure .(BP). .His .BP .is
. 158/106 .and .he .admits .that .he .has .not .been .taking .the .prescribed
. medication .because .the .drugs .make .him .“feel .bad”. .In .explaining .the
. need .for .hypertension .control, .the .nurse .should .stress .that .an .elevated
. BP .places .the .client .at .risk .for .which .pathophysiological .condition?
a- Blindness .secondary .to .cataracts
b- Acute .kidney .injury .due .to .glomerular .damage
c- Stroke .secondary .to .hemorrhage
d- Heart .block .due .to .myocardial .damage
Rationale: .Stroke .related .to .cerebral .hemorrhage .is .major .risk .for
. uncontrolled .hypertension.
3. The .nurse .observes .an .unlicensed .assistive .personnel .(UAP)
. positioning .a .newly .admitted .client .who .has .a .seizure .disorder. .The
. client .is .supine .and .the .UAP .is .placing .soft .pillows .along .the .side
. rails. .What .action .should .the .nurse .implement?
a- Ensure .that .the .UAP .has .placed .the .pillows .effectively .to .protect .the
. client.
b- Instruct .the .UAP .to .obtain .soft .blankets .to .secure .to .the .side .rails
, instead .of .pillows.
a- Assume .responsibility .for .placing .the .pillows .while .the .UAP
. completes .another .task.
b- Ask .the .UAP .to .use .some .of .the .pillows .to .prop .the .client .in .a .side
. lying .position.
Rationale: .The .nurse .should .instruct .the .UAP .to .pad .the .side .rails .with
. soft .blankest .because .the .use .of .pillows .could .result .in .suffocation .and
. would .need .to .be .removed .at .the .onset .of .the .seizure. .The .nurse .can
. delegate .paddling .the .side .rails .to .the .UAP
4. An .adolescent .with .major .depressive .disorder .has .been .taking
. duloxetine .(Cymbalta) .for .the .past .12 .days. .Which .assessment
. finding .requires .immediate .follow-up?
a- Describes .life .without .purpose
b- Complains .of .nausea .and .loss .of .appetite
c- States .is .often .fatigued .and .drowsy
d- Exhibits .an .increase .in .sweating.
Rationale: .Cymbalta .is .a .selective .serotonin .and .norepinephrine
. reuptake .inhibitor .that .is .known .to .increase .the .risk .of .suicidal
. thinking .in .adolescents .and .young .adults .with .major .depressive
, disorder. .B, .C .and .D .are .side .effects
5. A .60-year-old .female .client .with .a .positive .family .history .of
. ovarian .cancer .has .developed .an .abdominal .mass .and .is .being
. evaluated .for .possible .ovarian .cancer. .Her .Papanicolau .(Pap)
. smear .results .are .negative. .What .information .should .the .nurse
. include .in .the .client‟s .teaching .plan?
a- Further .evaluation .involving .surgery .may .be .needed
b- A .pelvic .exam .is .also .needed .before .cancer .is .ruled .out
c- Pap .smear .evaluation .should .be .continued .every .six .month
d- One .additional .negative .pap .smear .in .six .months .is . needed.
Rationale: .An .abdominal .mass .in .a .client .with .a .family .history .for
. ovarian .cancer .should .be .evaluated .carefully
6. A .client .who .recently .underwear .a .tracheostomy .is .being
. prepared .for .discharge .to .home. .Which .instructions .is .most
. important .for .the .nurse .to .include .in .the .discharge .plan?
a- Explain .how .to .use .communication .tools.
b- Teach .tracheal .suctioning .techniques .c-
. Encourage .self-care .and .independence.
d- .Demonstrate .how .to .clean .tracheostomy .site.
