2020 HESI EXIT V6 Completed A++++
2020 HESI EXIT V6
1. A nurse assessing the newborn of a mother with diabetes understands that
hypoglycemia is
... [Show More] related to what pathophysiological process?
A) Disruption of fetal glucose supply
B) Pancreatic insufficiency
C) Maternal insulin dependency
D) Reduced glycogen reserves
The correct answer is A: Disruption of fetal glucose supply
2. The nurse is teaching a parent about side effects of routine immunizations. Which of
the following must be reported immediately?
A) Irritability
B) Slight edema at site
C) Local tenderness
D) Temperature of 102.5 F
The correct answer is D: Temperature of 102.5 F
3. The parents of a toddler ask the nurse how long their child will have to sit in a car
seat while in the automobile. What is the nurse’s best response to the parents?
A) “Your child must use a care seat until he weighs at least 40 pounds."
B) The child must be 5 years of age to use a regular seat belt.
C) “Your child must reach a height of 50 inches to sit in a seat belt."
D) “The child can use a regular seat belt when he can sit still."
The correct answer is A: “Your child must use a care seat until he weighs at least 40
pounds."
4. A 16 year-old boy is admitted for Ewing's sarcoma of the tibia. In discussing his care
with the parents, the nurse understands that the initial treatment most often includes
A) Amputation just above the tumor
B) Surgical excision of the mass
C) Bone marrow graft in the affected leg
D) Radiation and chemotherapy
The correct answer is D: Radiation and chemotherapy
5. A client complains of some discomfort after a below the knee amputation. Which
action by the nurse is appropriate to do initially?
A) Conduct guided imagery or distraction
B) Ensure that the stump is elevated for the initial day
C) Wrap the stump snugly in an elastic bandage
D) Administer opioid narcotics as ordered
The correct answer is B: Ensure that the stump is elevated for the initial day
6. What is the best way that parents of pre-schoolers can begin teaching their child
about injury prevention?A) Set good examples themselves
B) Protect their child from outside influences
C) Make sure their child understands all the safety rules
D) Discuss the consequences of not wearing protective devices
The correct answer is A: Set good examples themselves
7. Which oxygen delivery system would the nurse apply that would provide the highest
concentrations of oxygen to the client?
A) Venturi mask
B) Partial rebreather mask
C) Non-rebreather mask
D) Simple face mask
The correct answer is C: Non-rebreather mask
8. The nurse is teaching the mother of a 5 month-old about nutrition for her baby.
Which statement by the mother indicates the need for further teaching?
A) "I'm going to try feeding my baby some rice cereal."
B) "When he wakes at night for a bottle, I feed him."
C) "I dip his pacifier in honey so he'll take it."
D) "I keep formula in the refrigerator for 24 hours."
The correct answer is C: "I dip his pacifier in honey so he''ll take it."
9. The nurse is performing an assessment on a client who is cachectic and has
developed an enterocutaneous fistula following surgery to relieve a small bowel
obstruction. The client's total protein level is reported as 4.5. Which of the following
would the nurse anticipate?
A) Additional potassium will be given IV
B) Blood for coagulation studies will be drawn
C) Total parenteral nutrition (TPN) will be started
D) Serum lipase levels will be evaluated
The correct answer is C: Total parenteral nutrition (TPN) will be started
10. A newborn weighed 7 pounds 2 ounces at birth. The nurse assesses the newborn at
home 2 days later and finds the weight to be 6 pounds 7 ounces. What should the nurse
tell the parents about this
weight loss?
A) The newborn needs additional assessments
B) The mother should breast feed more often
C) A change to formula is indicated
D) The loss is within normal limits
The correct answer is D: The loss is within normal limits11. During a situation of pain management, which statement is a priority to consider for
the ethical guidelines of the nurse?
A) The client's self-report is the most important consideration
B) Cultural sensitivity is fundamental to pain management
C) Clients have the right to have their pain relieved
D) Nurses should not prejudge a client's pain using their own values
The correct answer is A: The client''s self report is the most important consideration
12. A 35-year-old client of Puerto Rican-American descent is diagnosed with ovarian
cancer. The client states “I refuse both radiation and chemotherapy because they are
'hot.'” The next action for the nurse to take is to
A) Document the situation in the notes
B) Report the situation to the health care provider
C) Talk with the client's family about the situation
D) Ask the client to talk about the concerns about the "hot"treatments
The correct answer is D: Ask the client to talk about the concerns about the "hot"treatments
13. Which of the following drugs should the nurse anticipate administering to
aclient before they are to receive electroconvulsive therapy?
A) Benzodiazepines
B) Chlorpromazine (Thorazine)
* C) Succinylcholine (Anectine)
D) Thiopental sodium (Pentothal Sodium)
The correct answer is C: Succinylcholine (Anectine)
14. A client is brought to the emergency room following a motor vehicle accident.
Whenassessing the client one-half hour after admission, the nurse notes several physical
changes. Which changes would require the nurse's immediate attention?
A) Increased restlessness
B) Tachycardia
C) Tracheal deviation
D) Tachypnea
The correct answer is C: Tracheal deviation
15. Which approach is a priority for the nurse who works with clients from manydifferent cultures?
A) Speak at least 2 other languages of clients in the neighborhood
B) Learn about the cultures of clients who are most often encountered
C) Have a list of persons for referral when interaction with these clients occur
D) Recognize personal attitudes about cultural differences and real or expected biases
The correct answer is D: Recognize personal attitudes about cultural differences and real
or expected biases
16. A client with chronic obstructive pulmonary disease (COPD) and a history of
coronary artery disease is receiving Aminophylline, 25mg/hour. Which one of the
following findings by the nurse would require immediate intervention?
A) Decreased blood pressure and respirations.
B) Flushing and headache.
C) Restlessness and palpitations.
D) Increased heart rate and blood pressure.
The correct answer is C: Restlessness and palpitations.
17. The nurse is planning care for an 8 year-old child. Which of the following should be
included in the plan of care?
A) Encourage child to engage in activities in the playroom
B) Promote independence in activities of daily living
C) Talk with the child and allow him to express his opinions
D) Provide frequent reassurance and cuddling
The correct answer is A: Encourage child to engage in activities in the playroom
.
18. A pregnant client who is at 34 weeks gestation is diagnosed with a pulmonary
embolism (PE). Which of these mediations would the nurse anticipate the health care
provider ordering?
A) Oral Coumadin therapy
B) Heparin 5000 units subcutaneously b.i.d.
C) Heparin infusion to maintain the PTT at 1.5-2.5 times the control value
D) Heparin by subcutaneous injection to maintain the PTT at 1.5 times the control value
The correct answer is D: Heparin by subcutaneous injection to maintain the PTT at 1.5
times the control value
19. The nurse is caring for a client with Hodgkin's disease who will be receiving
radiation therapy. The nurse recognizes that, as a result of the radiation therapy, the client
is most likely to experienceA) High fever
B) Nausea
C) Face and neck edema
D) Night sweats
The correct answer is B: Nausea
20. While assessing the vital signs in children, the nurse should know that the apical
heart rate is preferred until the radial pulse can be accurately assessed at about what age?
A) 1 year of age
B) 2 years of age
C) 3 years of age
D) 4 years of age
The correct answer is B: 2 years of age
21. Which of these clients, who all have the findings of a board-like abdomen, would
the nurse suggest that the health care provider examine first?
A) An elderly client who stated that "My awful pain in my right side suddenly stopped
about 3 hours ago."
B) A pregnant woman of 8 weeks newly diagnosed with an ectopic pregnancy
C) A middle-aged client admitted with diverticulitis and has taken only clear liquids for
the past week
D) A teenager with a history of falling off a bicycle and did not hit the handle bars
The correct answer is A: An elderly client who stated that "My awful pain in my right
side suddenly stopped about 3 hours ago."
22. A client with a panic disorder has a new prescription for Xanax (Alprazolam). In
teaching the client about the drug's actions and side effects, which of the following
should the nurse emphasize?
A) Short-term relief can be expected
B) The medication acts as a stimulant
C) Dosage will be increased as tolerated
D) Initial side effects often continue
The correct answer is A: Short-term relief can be expected
23. Which of these questions is priority when assessing a client with hypertension?
A) "What over-the-counter medications do you take?"
B) "Describe your usual exercise and activity patterns."
C) "Tell me about your usual diet."
D) "Describe your family's cardiovascular history."The correct answer is A: "What over-the-counter medications do you take?" [Show Less]