HESI Exit Exam Questions With
Complete Solutions
/.LA 5-week-old infant developed projectile vomiting over the last 2 weeks is dx with
hypertrophic pyloric stenosis. Which intervention should the nurse plan to implement? -
Answer-✅Maintain intravenous fluid therapy per RX
/.Nurse is assigned to 2 critical care clients. One client was admitted yesterday with
pneumonia is being mechanically ventilated and has an elevated temp. The other client
had a thoracotomy two days ago and now complaining of incisional pain. Which
intervention should the nurse implement first? - Answer-✅Assess level of
consciousness and vital signs for both clients.
/.Client has an abdominal dehiscence when the surgical staples are removed. What
intervention should the nurse implement? - Answer-✅Apply sterile saline gauze
/.While assessing a client who is admitted with HF and pulmonary edema, the nurse
identifies dependent peripheral edema, irregular HR and persistent cough that produces
pink blood-tinged sputum. After initiating continuous tele and positioning the client which
intervention should the nurse implement? - Answer-✅Obtain sputum sample
Initiate hourly urine output measurements
Document degree of edema
Admitted IV diuretics
/.Client is admitted to the ER following MVA in which the client sustained a head injury.
Which assessment data would provide the earliest indication that the client is
experiencing increased ICP? - Answer-✅Lethargy
/.An S3 sound is auscultated in client in the 3rd trimester of pregnancy. What
intervention should the nurse take? - Answer-✅Document in the clients records
/.Male client discharged 3 days ago post exploratory laparotomy biopsy is admitted to
the hospital with warm, red, tender, swollen lower leg. The nurse is prepping to initiate
heparin therapy. What additional intervention should the nurse include in plan if care? -
Answer-✅Maintain the client on bed rest.
/.During an assessment by the home health nurse of an older man who lives alone, the
client reports that he is troubled by constipation. To formulate a plan of care, what
additional information should the nurse obtain? - Answer-✅Daily food and fluid intake
Current prescribed and over the counter medications.
Next scheduled visit with the healthcare provider
, Methods currently used to treat constipation.
/.Well the nurse is assessing an older client fall risk the client reports living at home
alone and never following. Which action should the nurse take? - Answer-✅Continue to
obtain client data needed to complete a fall risk survey.
/.A three-year-old boy successfully toilet trained prior to this admission to the hospital for
injuries sustained from a fall. His parents are very concerned that the child has
regressed in his toilet behaviors, which information should the nurse provide the
parents? - Answer-✅Children usually resume their toileting behaviors when they leave
the hospital.
/.A heparin infusion if it is prescribed for a client who weighs 240 pounds. After
administering a body starts at 80 units per kilogram, the nurse calculates the infusion
rate for the heparin solution at 18 units per kilogram per hour. The available solution is
heparin sodium 25,000 units and 5% dextrose injection 250 ML's. The nurse should
program temptation come to deliver how many ML's per hour nearest whole number -
Answer-✅O: 18 units/kg/hr
W: 220 PDS = 100 Kg
A: 25,000 units/250 ml
18*100Kg*1 hr*250 ml/ 25,000 units= 18
/.An adult mail with a 6 cm to the racic aneurysm is being prepared for surgery. The
nurse reports of the healthcare provided at the client blood pressure is 220/112 mmHg
so an anti-hypertensive agent is added to the client IV infusion. Which finding warrant
immediate intervention by the nurse? - Answer-✅Reports a sharp pain between the
shoulder blades.
/.A client with postpartum depression who is admitted to the behavioral health unit? -
Answer-✅Eats food
/.A client morning assessment includes bounding peripheral pulses, waking of 2
pounds, hitting ankle edema, and moist crackles bilaterally. Which invention is most
important from the nurse to include in the quiet plan of care? - Answer-✅Administer
prescribed diuretic (Lasix)
/.A postpartum client who is bottlefeeding has encouragement. What is the best
recommendation for the nurse to provide this clt? - Answer-✅Apply ice packs for the
swelling.
/.Client with me diagnosed with type two diabetes mellitus received a prescription for
Met Forman 500 mg PO twice daily. What information to the nurse include in this clients
teaching plan? - Answer-✅Take metformin with him morning and evening meals.
Report persistent polyurea to the healthcare provider. Recognize signs and symptoms
of hypoglycemia
Complete Solutions
/.LA 5-week-old infant developed projectile vomiting over the last 2 weeks is dx with
hypertrophic pyloric stenosis. Which intervention should the nurse plan to implement? -
Answer-✅Maintain intravenous fluid therapy per RX
/.Nurse is assigned to 2 critical care clients. One client was admitted yesterday with
pneumonia is being mechanically ventilated and has an elevated temp. The other client
had a thoracotomy two days ago and now complaining of incisional pain. Which
intervention should the nurse implement first? - Answer-✅Assess level of
consciousness and vital signs for both clients.
/.Client has an abdominal dehiscence when the surgical staples are removed. What
intervention should the nurse implement? - Answer-✅Apply sterile saline gauze
/.While assessing a client who is admitted with HF and pulmonary edema, the nurse
identifies dependent peripheral edema, irregular HR and persistent cough that produces
pink blood-tinged sputum. After initiating continuous tele and positioning the client which
intervention should the nurse implement? - Answer-✅Obtain sputum sample
Initiate hourly urine output measurements
Document degree of edema
Admitted IV diuretics
/.Client is admitted to the ER following MVA in which the client sustained a head injury.
Which assessment data would provide the earliest indication that the client is
experiencing increased ICP? - Answer-✅Lethargy
/.An S3 sound is auscultated in client in the 3rd trimester of pregnancy. What
intervention should the nurse take? - Answer-✅Document in the clients records
/.Male client discharged 3 days ago post exploratory laparotomy biopsy is admitted to
the hospital with warm, red, tender, swollen lower leg. The nurse is prepping to initiate
heparin therapy. What additional intervention should the nurse include in plan if care? -
Answer-✅Maintain the client on bed rest.
/.During an assessment by the home health nurse of an older man who lives alone, the
client reports that he is troubled by constipation. To formulate a plan of care, what
additional information should the nurse obtain? - Answer-✅Daily food and fluid intake
Current prescribed and over the counter medications.
Next scheduled visit with the healthcare provider
, Methods currently used to treat constipation.
/.Well the nurse is assessing an older client fall risk the client reports living at home
alone and never following. Which action should the nurse take? - Answer-✅Continue to
obtain client data needed to complete a fall risk survey.
/.A three-year-old boy successfully toilet trained prior to this admission to the hospital for
injuries sustained from a fall. His parents are very concerned that the child has
regressed in his toilet behaviors, which information should the nurse provide the
parents? - Answer-✅Children usually resume their toileting behaviors when they leave
the hospital.
/.A heparin infusion if it is prescribed for a client who weighs 240 pounds. After
administering a body starts at 80 units per kilogram, the nurse calculates the infusion
rate for the heparin solution at 18 units per kilogram per hour. The available solution is
heparin sodium 25,000 units and 5% dextrose injection 250 ML's. The nurse should
program temptation come to deliver how many ML's per hour nearest whole number -
Answer-✅O: 18 units/kg/hr
W: 220 PDS = 100 Kg
A: 25,000 units/250 ml
18*100Kg*1 hr*250 ml/ 25,000 units= 18
/.An adult mail with a 6 cm to the racic aneurysm is being prepared for surgery. The
nurse reports of the healthcare provided at the client blood pressure is 220/112 mmHg
so an anti-hypertensive agent is added to the client IV infusion. Which finding warrant
immediate intervention by the nurse? - Answer-✅Reports a sharp pain between the
shoulder blades.
/.A client with postpartum depression who is admitted to the behavioral health unit? -
Answer-✅Eats food
/.A client morning assessment includes bounding peripheral pulses, waking of 2
pounds, hitting ankle edema, and moist crackles bilaterally. Which invention is most
important from the nurse to include in the quiet plan of care? - Answer-✅Administer
prescribed diuretic (Lasix)
/.A postpartum client who is bottlefeeding has encouragement. What is the best
recommendation for the nurse to provide this clt? - Answer-✅Apply ice packs for the
swelling.
/.Client with me diagnosed with type two diabetes mellitus received a prescription for
Met Forman 500 mg PO twice daily. What information to the nurse include in this clients
teaching plan? - Answer-✅Take metformin with him morning and evening meals.
Report persistent polyurea to the healthcare provider. Recognize signs and symptoms
of hypoglycemia
