HESI COMPREHENSIVE EXIT EXAM 1 AND RATIONALE
NURSING EXIT COMPETENCY CLINICAL READINESS
EXAM REVIEW 2026/2027 || MULTIPLE QUESTIONS WITH
100% CORRECT ANSWERS || EXPERT-VERIFIED & GRADED
A+ || BLUEPRINT FOR GUARANTEED SUCCESS!!!
The nurse is monitoring neurological vital signs for a male client who lost
consciousness after falling and hitting his head. Which assessment finding is the
earliest and most sensitive indication of altered cerebral function?
a. Unequal pupils.
b. Loss of central reflexes.
c. Inability to open the eyes.
d. Change in level of consciousness.
D
(Neurological vital signs include serial assessments of TPR, blood pressure, and
components of the Glasgow coma scale (GCS), which includes verbal,
musculoskeletal, and pupillary responses. A change in the client's level of
consciousness, as indicated by responses to commands during the GCS, is the
first and the most sensitive sign of change in cerebral function. The other
assessment data choices are late signs of altered cerebral function.)
A nurse is planning to teach self-care measures to a female client about
prevention of yeast infections. Which instructions should the nurse provide?
a. Use a douche preparation no more than once a month.
b. Increase daily intake of fiber and leafy green vegetables.
c. Select nylon underwear that is loose-fitting, white, and comfortable.
d. Avoid tight-fitting clothing and do not use bubble-bath or bath salts.
D
(A common genital tract infection in females is candidiasis, which is an
overgrowth of the normal vaginal flora of Candida albicans that thrives in an
environment that is warm and moist and is perpetuated by tight-fitting clothing,
underwear, or pantyhose made of nonabsorbent materials. The client should
wear clothing that is loose fitting and absorbent, such as cotton underwear, and
avoid using bubble-bath or bath salts which further irritate sensitive genital
tissue. Douching is not recommended because it can irritate vaginal tissue, alter
pH, and contribute to fungal growth. While increasing dietary fiber intake
encourages healthy, nutritional guidelines, it is not the focus of the teaching.
,Cotton, not nylon undergarments, provide absorbancy and reduce moisture in
the perineal area.)
A client who has active tuberculosis (TB) is admitted to the medical unit. What
action is most important for the nurse to implement?
a. Place an isolation cart in the hallway.
b. Fit the client with a respirator mask.
c. Don a clean gown for client care.
d. Assign the client to a negative air-flow room.
D
(Active tuberculosis requires implementation of airborne precautions, so the
client should be assigned to a negative pressure air-flow room. Although
isolation gowns and isolation carts should be implemented for clients in
isolation with contact precautions, it is most important that air flow from the
room is minimized when the client has TB. The respirator mask should be
implemented when the client leaves the isolation environment.)
The nurse is planning to conduct nutritional assessments and diet teaching to
clients at a family health clinic. Which individual has the greatest nutritional
and energy demands?
a. A pregnant woman.
b. A teenager beginning puberty.
c. A 3-month-old infant.
d. A school-aged child.
A
A pregnant woman's metabolic demands are 20 to 24% more than the basic
metabolic rate. The other clients require only 15 to 20% more than the basic
metabolic rate.
What nursing delivery of care provides the nurse to plan and direct care of a
group of clients over a 24-hour period?
a. Team nursing.
b. Primary nursing.
c. Case management.
d. Functional nursing.
B
,(Primary nursing is a model of delivery of care where a nurse is accountable for
planning care for clients around the clock. Functional nursing is a care delivery
model that provides client care by assignment of functions or tasks. Team
nursing is a care delivery model where assignments to a group of clients are
provided by a mixed-staff team. Case management is the delivery of care that
uses a collaborative process of assessment, planning, facilitation, and advocacy
for options and services to meet an individual's health needs and promote
quality cost-effective outcomes.)
Which approach should the nurse use when preparing a toddler for a procedure?
a. Demonstrate the procedure using a doll.
b. Avoid asking the child to make choices.
c. Plan a teaching session to last about 20 minutes.
d. Show equipment but prevent child from handling it.
A
(Imitation is one of the most distinguishing characteristics of toddler play, so
demonstration of a procedure on a doll enables a non-threatening, dramatic
experience that can help prepare the toddler for the actual procedure. The
primary developmental task in toddlerhood is acquiring a sense of autonomy, so
giving choices whenever possible to a toddler is recommended, not avoiding
asking the toddler to make a choice. Since the toddler's attention span is short,
teaching sessions should be brief and can be repeated for reinforcement.
Showing the equipment before its use helps relieve anxiety, but the child should
be allowed to handle some of the equipment to prevent frustration and alleviate
fear.)
The nurse is caring for a client who is the daughter of a local politician. When
the nurse approaches a man who is reading the names on the hall doors, he
identifies himself as a reporter for the local newspaper and requests information
about the client's status. Which standard of nursing practice should the nurse use
to respond?
a. Caring.
b. Veracity.
c. Advocacy.
d. Confidentiality.
D
(Confidentiality is the nurse's primary responsibility and is supported by
, HIPAA, which mandates that personal information is not disclosed and access
to sensitive client information is limited. Caring involves the nurse's concern
about how the client experiences the world. Veracity is the nurse's duty to tell
the truth and not deceive others. Advocacy is support of the client's best
interests.)
A male client diagnosed with antisocial personality disorder is morbidly obese
and is placed on a low fat, low calorie diet. At dinner the nurse notes that he is
trying to get other clients on the unit to give him part of their meals. What
intervention should the nurse implement?
a. Remove the client from the table and have him sit alone.
b. Send the client back to his room and do not allow him to eat.
c. Report the behavior to the on-call psychologist immediately.
d. Confront the client about the consequences of the behavior.
D
(The nurse should provide a reality check by helping the client realize that there
are consequences to his behavior. Removing the client from the room or table
does not help the client realize that his behavior is manipulative and harmful to
himself as well as others. This behavior needs to be documented, but does not
need to be reported immediately.)
The nurse is assessing a client who complains of weight loss, racing heart rate,
and difficulty sleeping. The nurse determines the client has moist skin with fine
hair, prominent eyes, lid retraction, and a staring expression. These findings are
consistent with which disorder?
a. Grave's disease.
b. Cushing syndrome.
c. Multiple sclerosis.
d. Addison's disease.
A
(This client is exhibiting symptoms associated with hyperthyroidism or Grave's
disease, which is an autoimmune condition affecting the thyroid. Cushing
syndrome, multiple sclerosis, or Addison's disease are not associated with these
symptoms.)
Which information should the nurse give a client with chronic kidney disease
(CKD)?
NURSING EXIT COMPETENCY CLINICAL READINESS
EXAM REVIEW 2026/2027 || MULTIPLE QUESTIONS WITH
100% CORRECT ANSWERS || EXPERT-VERIFIED & GRADED
A+ || BLUEPRINT FOR GUARANTEED SUCCESS!!!
The nurse is monitoring neurological vital signs for a male client who lost
consciousness after falling and hitting his head. Which assessment finding is the
earliest and most sensitive indication of altered cerebral function?
a. Unequal pupils.
b. Loss of central reflexes.
c. Inability to open the eyes.
d. Change in level of consciousness.
D
(Neurological vital signs include serial assessments of TPR, blood pressure, and
components of the Glasgow coma scale (GCS), which includes verbal,
musculoskeletal, and pupillary responses. A change in the client's level of
consciousness, as indicated by responses to commands during the GCS, is the
first and the most sensitive sign of change in cerebral function. The other
assessment data choices are late signs of altered cerebral function.)
A nurse is planning to teach self-care measures to a female client about
prevention of yeast infections. Which instructions should the nurse provide?
a. Use a douche preparation no more than once a month.
b. Increase daily intake of fiber and leafy green vegetables.
c. Select nylon underwear that is loose-fitting, white, and comfortable.
d. Avoid tight-fitting clothing and do not use bubble-bath or bath salts.
D
(A common genital tract infection in females is candidiasis, which is an
overgrowth of the normal vaginal flora of Candida albicans that thrives in an
environment that is warm and moist and is perpetuated by tight-fitting clothing,
underwear, or pantyhose made of nonabsorbent materials. The client should
wear clothing that is loose fitting and absorbent, such as cotton underwear, and
avoid using bubble-bath or bath salts which further irritate sensitive genital
tissue. Douching is not recommended because it can irritate vaginal tissue, alter
pH, and contribute to fungal growth. While increasing dietary fiber intake
encourages healthy, nutritional guidelines, it is not the focus of the teaching.
,Cotton, not nylon undergarments, provide absorbancy and reduce moisture in
the perineal area.)
A client who has active tuberculosis (TB) is admitted to the medical unit. What
action is most important for the nurse to implement?
a. Place an isolation cart in the hallway.
b. Fit the client with a respirator mask.
c. Don a clean gown for client care.
d. Assign the client to a negative air-flow room.
D
(Active tuberculosis requires implementation of airborne precautions, so the
client should be assigned to a negative pressure air-flow room. Although
isolation gowns and isolation carts should be implemented for clients in
isolation with contact precautions, it is most important that air flow from the
room is minimized when the client has TB. The respirator mask should be
implemented when the client leaves the isolation environment.)
The nurse is planning to conduct nutritional assessments and diet teaching to
clients at a family health clinic. Which individual has the greatest nutritional
and energy demands?
a. A pregnant woman.
b. A teenager beginning puberty.
c. A 3-month-old infant.
d. A school-aged child.
A
A pregnant woman's metabolic demands are 20 to 24% more than the basic
metabolic rate. The other clients require only 15 to 20% more than the basic
metabolic rate.
What nursing delivery of care provides the nurse to plan and direct care of a
group of clients over a 24-hour period?
a. Team nursing.
b. Primary nursing.
c. Case management.
d. Functional nursing.
B
,(Primary nursing is a model of delivery of care where a nurse is accountable for
planning care for clients around the clock. Functional nursing is a care delivery
model that provides client care by assignment of functions or tasks. Team
nursing is a care delivery model where assignments to a group of clients are
provided by a mixed-staff team. Case management is the delivery of care that
uses a collaborative process of assessment, planning, facilitation, and advocacy
for options and services to meet an individual's health needs and promote
quality cost-effective outcomes.)
Which approach should the nurse use when preparing a toddler for a procedure?
a. Demonstrate the procedure using a doll.
b. Avoid asking the child to make choices.
c. Plan a teaching session to last about 20 minutes.
d. Show equipment but prevent child from handling it.
A
(Imitation is one of the most distinguishing characteristics of toddler play, so
demonstration of a procedure on a doll enables a non-threatening, dramatic
experience that can help prepare the toddler for the actual procedure. The
primary developmental task in toddlerhood is acquiring a sense of autonomy, so
giving choices whenever possible to a toddler is recommended, not avoiding
asking the toddler to make a choice. Since the toddler's attention span is short,
teaching sessions should be brief and can be repeated for reinforcement.
Showing the equipment before its use helps relieve anxiety, but the child should
be allowed to handle some of the equipment to prevent frustration and alleviate
fear.)
The nurse is caring for a client who is the daughter of a local politician. When
the nurse approaches a man who is reading the names on the hall doors, he
identifies himself as a reporter for the local newspaper and requests information
about the client's status. Which standard of nursing practice should the nurse use
to respond?
a. Caring.
b. Veracity.
c. Advocacy.
d. Confidentiality.
D
(Confidentiality is the nurse's primary responsibility and is supported by
, HIPAA, which mandates that personal information is not disclosed and access
to sensitive client information is limited. Caring involves the nurse's concern
about how the client experiences the world. Veracity is the nurse's duty to tell
the truth and not deceive others. Advocacy is support of the client's best
interests.)
A male client diagnosed with antisocial personality disorder is morbidly obese
and is placed on a low fat, low calorie diet. At dinner the nurse notes that he is
trying to get other clients on the unit to give him part of their meals. What
intervention should the nurse implement?
a. Remove the client from the table and have him sit alone.
b. Send the client back to his room and do not allow him to eat.
c. Report the behavior to the on-call psychologist immediately.
d. Confront the client about the consequences of the behavior.
D
(The nurse should provide a reality check by helping the client realize that there
are consequences to his behavior. Removing the client from the room or table
does not help the client realize that his behavior is manipulative and harmful to
himself as well as others. This behavior needs to be documented, but does not
need to be reported immediately.)
The nurse is assessing a client who complains of weight loss, racing heart rate,
and difficulty sleeping. The nurse determines the client has moist skin with fine
hair, prominent eyes, lid retraction, and a staring expression. These findings are
consistent with which disorder?
a. Grave's disease.
b. Cushing syndrome.
c. Multiple sclerosis.
d. Addison's disease.
A
(This client is exhibiting symptoms associated with hyperthyroidism or Grave's
disease, which is an autoimmune condition affecting the thyroid. Cushing
syndrome, multiple sclerosis, or Addison's disease are not associated with these
symptoms.)
Which information should the nurse give a client with chronic kidney disease
(CKD)?
