HESI RN EXIT Exam Questions and Answers 2022
In planning care for a 6 month-old infant, what must the nurse provide to assist in the
development of
... [Show More] trust?
A) Food
B) Warmth
C) Security
D) Comfort -Correct Answer- C) Security
A nurse has just received a medication order which is not legible. Which statement
best reflects assertive communication?
A) "I cannot give this medication as it is written. I have no idea of what you mean."
B) "Would you please clarify what you have written so I am sure I am reading it
correctly?"
C) "I am having difficulty reading your handwriting. It would save me time if you
would be more careful."
D) "Please print in the future so I do not have to spend extra time attempting to read
your writing." -Correct Answer- B) "Would you please clarify what you have written
so I am sure I am reading it
correctly?"
What is the most important consideration when teaching parents how to reduce risks
in the home?
A) Age and knowledge level of the parents
B) Proximity to emergency services
C) Number of children in the home
D) Age of children in the home -Correct Answer- D) Age of children in the home
A 35 year-old client with sickle cell crisis is talking on the telephone but stops as the
nurse enters the room to request something for pain. The nurse should
A) Administer a placebo
B) Encourage increased fluid intake
C) Administer the prescribed analgesia
D) Recommend relaxation exercises for pain control -Correct Answer- C) Administer
the prescribed analgesia
While caring for a toddler with croup, which initial sign of croup requires the nurse's
immediate attention?
A) Respiratory rate of 42
B) Lethargy for the past hour
C) Apical pulse of 54
D) Coughing up copious secretions -Correct Answer- A) Respiratory rate of 42
A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial
assessment, the nurse would anticipate which of the following assessment findings?
A) Lethargy
B) Heat intolerance
C) Diarrhea
D) Skin eruptions -Correct Answer- A) Lethargy
The emergency room nurse admits a child who experienced a seizure at school. The
father comments that this is the first occurrence, and denies any family history of
epilepsy. What is the best response by the nurse?
A) "Do not worry. Epilepsy can be treated with medications."
B) "The seizure may or may not mean your child has epilepsy."
C) "Since this was the first convulsion, it may not happen again."
D) "Long term treatment will prevent future seizures." -Correct Answer- B) "The
seizure may or may not mean your child has epilepsy."
Alcohol and drug abuse impairs judgment and increases risk taking behavior. What
nursing diagnosis best applies?
A) Risk for injury
B) Risk for knowledge deficit
C) Altered thought process
D) Disturbance in self-esteem -Correct Answer- A) Risk for injury
Which these findings would the nurse more closely associate with anemia in a 10
month-old infant?
A) Hemoglobin level of 12 g/dI
B) Pale mucosa of the eyelids and lips
C) Hypoactivity
D) A heart rate between 140 to 160 -Correct Answer- B) Pale mucosa of the eyelids
and lips
The nurse is caring for a client in hypertensive crisis in an intensive care unit. The
priority assessment in the first hour of care is
A) Heart rate
B) Pedal pulses
C) Lung sounds
D) Pupil responses -Correct Answer- D) Pupil responses
Which of these clients who are all in the terminal stage of cancer is least appropriate
to suggest the use of patient controlled analgesia (PCA) with a pump?
A) A young adult with a history of Down's syndrome
B) A teenager who reads at a 4th grade level
C) An elderly client with numerous arthritic nodules on the hands
D) A preschooler with intermittent episodes of alertness -Correct Answer- D) A
preschooler with intermittent episodes of alertness
The nurse is about to assess a 6 month-old child with nonorganic failure-to thrive
(NOFTT). Upon entering the room, the nurse would expect the baby to be
A) Irritable and "colicky" with no attempts to pull to standing
B) Alert, laughing and playing with a rattle, sitting with support
C) Skin color dusky with poor skin turgor over abdomen
D) Pale, thin arms and legs, uninterested in surroundings -Correct Answer- D) Pale,
thin arms and legs, uninterested in surroundings
As the nurse is speaking with a group of teens which of these side effects of
chemotherapy for cancer would the nurse expect this group to be more interested in
during the discussion?
A) Mouth sores
B) Fatigue
C) Diarrhea
D) Hair loss -Correct Answer- D) Hair loss
While caring for a client who was admitted with myocardial infarction (MI) 2 days
ago, the nurse notes today's temperature is 101.1 degrees Fahrenheit (38.5
degreesCelsius). The appropriate nursing intervention is to
A) Call the health care provider immediately
B) Administer acetaminophen as ordered as this is normal at this time
C) Send blood, urine and sputum for culture
D) Increase the client's fluid intake -Correct Answer- B) Administer acetaminophen
as ordered as this is normal at this time
A client is admitted for first and second degree burns on the face, neck, anterior
chest and hands. The nurse's priority should be
A) Cover the areas with dry sterile dressings
B) Assess for dyspnea or stridor
C) Initiate intravenous therapy
D) Administer pain medication -Correct Answer- B) Assess for dyspnea or stridor
Which of these clients who call the community health clinic would the nurse ask to
come in that day to be seen by the health care provider?
A) I started my period and now my urine has turned bright red.
B) I am an diabetic and today I have been going to the bathroom every hour.
C) I was started on medicine yesterday for a urine infection. Now my lower belly
hurts when I go to the bathroom.
D) I went to the bathroom and my urine looked very red and it didn't hurt when I
went. -Correct Answer- D) I went to the bathroom and my urine looked very red and
it didn't hurt when I went.
Which of these parents' comment for a newborn would most likely reveal an initial
finding of a suspected pyloric stenosis?
A) I noticed a little lump a little above the belly button.
B) The baby seems hungry all the time.
C) Mild vomiting that progressed to vomiting shooting across the room.
D) Irritation and spitting up immediately after feedings. -Correct Answer- C) Mild
vomiting that progressed to vomiting shooting across the room.
The nurse is assessing a child for clinical manifestations of iron deficiency anemia.
Which factor would the nurse recognize as cause for the findings?
A) Decreased cardiac output
B) Tissue hypoxia
C) Cerebral edema
D) Reduced oxygen saturation -Correct Answer- B) Tissue hypoxia
The nurse would expect the cystic fibrosis client to receive supplemental pancreatic
enzymes along with a diet
A) High in carbohydrates and proteins
B) Low in carbohydrates and proteins
C) High in carbohydrates, low in proteins
D) Low in carbohydrates, high in proteins -Correct Answer- A) High in carbohydrates
and proteins
In evaluating the growth of a 12 month-old child, which of these findings would the
nurse expect to be present in the infant?
A) Increased 10% in height
B) 2 deciduous teeth
C) Tripled the birth weight
D) Head > chest circumference -Correct Answer- C) Tripled the birth weight
A Hispanic client in the postpartum period refuses the hospital food because it is
"cold." The best initial action by the nurse is to
A) 1Have the unlicensed assistive personnel (UAP) reheat the food if the client
wishes
B) Ask the client what foods are acceptable or bad
C) Encourage her to eat for healing and strength
D) Schedule the dietitian to meet with the client as soon as possible -Correct
Answer- B) Ask the client what foods are acceptable or bad
The father of an 8 month-old infant asks the nurse if his infant's vocalizations are
normal for his age. Which of the following would the nurse expect at this age?
A) Cooing
B) Imitation of sounds
C) Throaty sounds
D) Laughter -Correct Answer- B) Imitation of sounds
The nurse should recognize that physical dependence is accompanied by what
findings when alcohol consumption is first reduced or ended?
A) Seizures
B) Withdrawal
C) Craving
D) Marked tolerance -Correct Answer- B) Withdrawal
Immediately following an acute battering incident in a violent relationship, the
batterer may respond to the partner's injuries by
A) Seeking medical help for the victim's injuries
B) Minimizing the episode and underestimating the victim's injuries
C) Contacting a close friend and asking for help
D) Being very remorseful and assisting the victim with medical care -Correct AnswerB) Minimizing the episode and underestimating the victim's injuries
A client with pneumococcal pneumonia had been started on antibiotics 16 hours
ago.During the nurse's initial evening rounds the nurse notices a foul smell in the
room. The client makes all of these statements during their conversation. Which
statement would alert the nurse to a complication?
A) "I have a sharp pain in my chest when I take a breath.
"B) "I have been coughing up foul-tasting, brown, thick sputum.
" C) "I have been sweating all day.
"D) "I feel hot off and on." -Correct Answer- "B) "I have been coughing up foultasting, brown, thick sputum.
The nurse is performing an assessment on a client in congestive heart failure.
Auscultation of the heart is most likely to reveal
A) S3 ventricular gallop
B) Apical click
C) Systolic murmur
D) Split S2 -Correct Answer- A) S3 ventricular gallop
Which of these observations made by the nurse during an excretory urogram
indicate a complicaton?
A) The client complains of a salty taste in the mouth when the dye is injected
B) The client's entire body turns a bright red color
C) The client states "I have a feeling of getting warm."
D) The client gags and complains " I am getting sick." -Correct Answer- B) The
client's entire body turns a bright red color
A client is diagnosed with a spontaneous pneumothorax necessitating the insertion
of a chest tube. What is the best explanation for the nurse to provide this client?
A) "The tube will drain fluid from your chest.
"B) "The tube will remove excess air from your chest."
C) "The tube controls the amount of air that enters your chest.
" D) "The tube will seal the hole in your lung." -Correct Answer- "B) "The tube will
remove excess air from your chest."
The nurse is reviewing laboratory results on a client with acute renal failure. Which
one of the following should be reported immediately?
A) Blood urea nitrogen 50 mg/dl
B) Hemoglobin of 10.3 mg/dl
C) Venous blood pH 7.30
D) Serum potassium 6 mEq/L -Correct Answer- D) Serum potassium 6 mEq/L
The nurse is caring for a client undergoing the placement of a central venous
catheter line. Which of the following would require the nurse's immediate attention?
A) Pallor
B) Increased temperature
C) Dyspnea
D) Involuntary muscle spasms -Correct Answer- C) Dyspnea
The nurse is performing a physical assessment on a client who just had an
endotracheal tube inserted. Which finding would call for immediate action by the
nurse?
A) Breath sounds can be heard bilaterally
B) Mist is visible in the T-Piece
C) Pulse oximetry of 88
D) Client is unable to speak -Correct Answer- C) Pulse oximetry of 88
A nurse checks a client who is on a volume-cycled ventilator. Which finding indicates
that the client may need suctioning?A) Drowsiness
B) Complaint of nausea
C) Pulse rate of 92
D) Restlessness -Correct Answer- D) Restlessness
During the evaluation phase for a client, the nurse should focus on
A) All finding of physical and psychosocial stressors of the client and in the family
B) The client's status, progress toward goal achievement, and ongoing re-evaluation
C) Setting short and long-term goals to insure continuity of care from hospital to
home
D) Select interventions that are measurable and achievable within selected
timeframes -Correct Answer- B) The client's status, progress toward goal
achievement, and ongoing re-evaluation
The school nurse suspects that a third grade child might have Attention Deficit
Hyperactivity Disorder. Prior to referring the child for further evaluation, the nurse
should
A) Observe the child's behavior on at least 2 occasions
B) Consult with the teacher about how to control impulsivity
C) Compile a history of behavior patterns and developmental accomplishments
D) Compare the child's behavior with classic signs and symptoms -Correct AnswerC) Compile a history of behavior patterns and developmental accomplishments
Which of the actions suggested to the RN by the PN during a planning conference
for a 10 month-old infant admitted 2 hours ago with bacterial meningitis would be
acceptable to add to the plan of care?
A) Measure head circumference
B) Place in airborne isolation
C) Provide passive range of motion
D) Provide an over-the-crib protective top -Correct Answer- A) Measure head
circumference
A client is admitted with a diagnosis of hepatitis B. In reviewing the initial laboratory
results, the nurse would expect to find elevation in which of the following values?
A) Blood urea nitrogen
B) Acid phosphatase
C) Bilirubin
D) Sedimentation Rate -Correct Answer- C) Bilirubin
The nurse is discussing nutritional requirements with the parents of an 18 month-old
child. Which of these statements about milk consumption is correct?
A) May drink as much milk as desired
B) Can have milk mixed with other foods
C) Will benefit from fat-free cow's milk
D) Should be limited to 3-4 cups of milk daily -Correct Answer- D) Should be limited
to 3-4 cups of milk daily
The nurse is talking with a client. The client abruptly says to the nurse, "The moon is
full. Astronauts walk on the moon. Walking is a good health habit." The client's
behavior most likely indicates
A) Neologisms
B) Dissociation
C) Flight of ideas
D) Word salad -Correct Answer- C) Flight of ideas
A mother asks about expected motor skills for a 3 year-old child. Which of the
following would the nurse emphasize as normal at this age? A) Jumping rope
B) Tying shoelaces
C) Riding a tricycle
D) Playing hopscotch -Correct Answer- C) Riding a tricycle
A home health nurse is caring for a client with a pressure sore that is red, with
serous drainage, is 2 inches in diameter with loss of subcutaneous tissue. The
appropriate dressing for this wound is
A) A transparent film dressing
B) Wet dressing with debridement granules
C) Wet to dry with hydrogen peroxide
D) Moist saline dressing -Correct Answer- D) Moist saline dressing
The nurse enters a 2 year-old child's hospital room in order to administer an oral
medication. When the child is asked if he is ready to take his medicine, he
immediately says, "No!" What would be the most appropriate next action?
A) Leave the room and return five minutes later and give the medicine
B) Explain to the child that the medicine must be taken now C) Give the medication
to the father and ask him to give it
D) Mix the medication with ice cream or applesauce -Correct Answer- A) Leave the
room and return five minutes later and give the medicine
A nurse is doing pre conceptual counseling with a woman who is planning a
pregnancy. Which of the following statements suggests that the client understands
the connection between alcohol consumption and fetal alcohol syndrome?
A) "I understand that a glass of wine with dinner is healthy.
"B) "Beer is not really hard alcohol, so I guess I can drink some.
"C) "If I drink, my baby may be harmed before I know I am pregnant.
" D) "Drinking with meals reduces the effects of alcohol." -Correct Answer- "C) "If I
drink, my baby may be harmed before I know I am pregnant.
A client has returned from a cardiac catheterization. Which one of the following
assessments would indicate the client is experiencing a complication from the
procedure?
A) Increased blood pressure
B) Increased heart rate
C) Loss of pulse in the extremity
D) Decreased urine output -Correct Answer- C) Loss of pulse in the extremity
A 60 year-old male client had a hernia repair in an outpatient surgery clinic. He is
awake and alert, but has not been able to void since he returned from surgery 6
hours ago.He received 1000 mL of IV fluid. Which action would be most likely to help
him void?
A) Have him drink several glasses of water
B) Crede' the bladder from the bottom to the top
C) Assist him to stand by the side of the bed to void
D) Wait 2 hours and have him try to void again -Correct Answer- C) Assist him to
stand by the side of the bed to void
The nurse is caring for a client who requires a mechanical ventilator for
breathing.The high pressure alarm goes off on the ventilator. What is the first action
the nurse should perform?
A) Disconnect the client from the ventilator and use a manual resuscitation bag
B) Perform a quick assessment of the client's condition
C) Call the respiratory therapist for help
D) Press the alarm re-set button on the ventilator -Correct Answer- B) Perform a
quick assessment of the client's condition
The nurse is preparing a client who will undergo a myelogram. Which of the following
statements by the client indicates a contraindication for this test?
A) "I can't lie in 1 position for more than thirty minutes.
"B) "I am allergic to shrimp."
C) "I suffer from claustrophobia.
"D) "I developed a severe headache after a spinal tap." -Correct Answer- "B) "I am
allergic to shrimp."
The health care provider order reads "aspirate nasogastric feeding (NG) tuber every
4 hours and check pH of aspirate." The pH of the aspirate is 10. Which action should
the nurse take?
A) Hold the tube feeding and notify the provider
B) Administer the tube feeding as scheduled
C) Irrigate the tube with diet cola soda
D) Apply intermittent suction to the feeding tube -Correct Answer- A) Hold the tube
feeding and notify the provider
To prevent unnecessary hypoxia during suctioning of a tracheostomy, the nurse
must
A) Apply suction for no more than 10 seconds
B) Maintain sterile technique
C) Lubricate 3 to 4 inches of the catheter tip
D) Withdraw catheter in a circular motion -Correct Answer- A) Apply suction for no
more than 10 seconds
An antibiotic IM injection for a 2 year-old child is ordered. The total volume of the
injection equals 2.0 ml The correct action is to
A) Administer the medication in 2 separate injections
B) Give the medication in the dorsal gluteal site
C) Call to get a smaller volume ordered
D) Check with pharmacy for a liquid form of the medication skip -Correct Answer- A)
Administer the medication in 2 separate injections
The nurse receives an order to give a client iron by deep injection. The nurse know
that the reason for this route is to
A) Enhance absorption of the medication
B) Ensure that the entire dose of medication is given
C) Provide more even distribution of the drug
D) Prevent the drug from tissue irritation Skip -Correct Answer- D) Prevent the drug
from tissue irritation Skip
A client with heart failure has Lanoxin (digoxin) ordered. What would the nurse
expect to find when evaluating for the therapeutic effectiveness of this drug?
A) Diaphoresis with decreased urinary output
B) Increased heart rate with increase respirations
C) Improved respiratory status and increased urinary output D) Decreased chest
pain and decreased blood pressure -Correct Answer- C) Improved respiratory status
and increased urinary output
While providing home care to a client with congestive heart failure, the nurse is
asked how long diuretics must be taken. What is the nurse's best response?
A) "As you urinate more, you will need less medication to control fluid.
"B) "You will have to take this medication for about a year."
C) "The medication must be continued so the fluid problem is controlled.
"D) "Please talk to your health care provider about medications and treatments." -
Correct Answer- C) "The medication must be continued so the fluid problem is
controlled.
A client is being discharged with a prescription for chlorpromazine
(Thorazine).Before leaving for home, which of these findings should the nurse teach
the client to report? A) Change in libido, breast enlargement
B) Sore throat, fever
C) Abdominal pain, nausea, diarrhea
D) Dsypnea, nasal congestion -Correct Answer- B) Sore throat, fever
A mother brings her 6-year-old child, who has just stepped on a rusty nail, to the
pediatrician's office. Upon inspection, the nurse notes that the nail went through the
shoe and pierced the bottom of the child's foot. Which action should the nurse
implement first?
A. Cleanse the foot with soap and water and apply an antibiotic ointment
B. Provide teaching about the need for a tetanus booster within the next 72 hours.
C. have the mother check the child's temperature q4h for the next 24 hours
D. transfer the child to the emergency department to receive a gamma globulin
injection -Correct Answer- A. Cleanse the foot with soap and water and apply an
antibiotic ointment
A 26-year-old female client is admitted to the hospital for treatment of a simple
goiter, and levothyroxine sodium (Synthroid) is prescribed. Which symptoms indicate
to the nurse that the prescribed dosage is too high for this client? The client
experiences:
A. Bradycardia and constipation
B. Lethargy and lack of appetite
C. Muscle cramping and dry, flushed skin
D. Palpitations and shortness of breath -Correct Answer- D. Palpitations and
shortness of breath
A client with a history of heart failure presents to the clinic with a nausea, vomiting,
yellow vision and palpitations. Which finding is most important for the nurse to
assess to the client? -Correct Answer- Obtain a list of medications taken for cardiac
history
The pathophysiological mechanism are responsible for ascites related to liver
failure? (Select all that apply) -Correct Answer- A. Fluid shifts from intravascular to
interstitial area due to decreased serum
protein
B. Increased hydrostatic pressure in portal circulation increases
fluid shifts into abdomen
C. Increased circulating aldosterone levels that increase sodium and water
retention
The nurse is auscultating a client's heart sounds. Which description should the nurse
use to document this sound? (Please listen to the audio first to select the option that
applies) -Correct Answer- Murmur
A client is admitted with a pressure ulcer in the sacral area. The partial thickness
wound is 4cm by 7cm, the wound base is red and moist with no exudate and the
surrounding skin is intact. Which of the following coverings is most appropriate for
this wound?
A) Transparent dressing
B) Dry sterile dressing with antibiotic ointment
C) Wet to dry dressing
D) Occlusive moist dressing -Correct Answer- D) Occlusive moist dressing
A 30 month-old child is admitted to the hospital unit. Which of the following toys
would be appropriate for the nurse to select from the toy room for this child?
A) Cartoon stickers
B) Large wooden puzzle
C) Blunt scissors and paper
D) Beach ball -Correct Answer- B) Large wooden puzzle
A nurse is to present information about Chinese folk medicine to a group of student
nurses. Based on this cultural belief, the nurse would explain that illness is attributed
to the
A) Yang, the positive force that represents light, warmth, and fullness
B) Yin, the negative force that represents darkness, cold, and emptiness
C) Use of improper hot foods, herbs and plants
D) A failure to keep life in balance with nature and others -Correct Answer- B) Yin,
the negative force that represents darkness, cold, and emptiness
A 2 year-old child has just been diagnosed with cystic fibrosis. The child's father asks
the nurse "What is our major concern now, and what will we have to deal with in the
future?" Which of the following is the best response?
A) "There is a probability of life-long complications."
B) "Cystic fibrosis results in nutritional concerns that can be dealt with."
C) "Thin, tenacious secretions from the lungs are a constant struggle in cystic
fibrosis."
D) "You will work with a team of experts and also have access to a support group
that the family can attend." -Correct Answer- C) "Thin, tenacious secretions from the
lungs are a constant struggle in cystic fibrosis."
Which type of accidental poisoning would the nurse expect to occur in children under
age 6?
A) Oral ingestion
B) Topical contact
C) Inhalation
D) Eye splashes -Correct Answer- A) Oral ingestion
A client was admitted to the psychiatric unit with a diagnosis of bipolar disorder. He
constantly bothers other clients, tries to help the housekeeping staff, demonstrates
pressured speech and demands constant attention from the staff. Which activity
would be best for the client?
A) Reading
B) Checkers
C) Cards
D) Ping-pong -Correct Answer- D) Ping-pong
The nurse is caring for a client who has developed cardiac tamponade. Which
finding
would the nurse anticipate?
A) Widening pulse pressure
B) Pleural friction rub
C) Distended neck veins
D) Bradycardia -Correct Answer- C) Distended neck veins
Which nursing action is a priority as the plan of care is developed for a 7 year-old
child hospitalized for acute glomerulonephritis?
A) Assess for generalized edema
B) Monitor for increased urinary output
C) Encourage rest during hyperactive periods
D) Note patterns of increased blood pressure -Correct Answer- D) Note patterns of
increased blood pressure
The nurse is caring for a child receiving chest physiotherapy (CPT). Which of the
following actions by the nurse would be appropriate?
A) Schedule the therapy thirty minutes after meals
B) Teach the child not to cough during the treatment
C) Confine the percussion to the rib cage area
D) Place the child in a prone position for the therapy -Correct Answer- C) Confine the
percussion to the rib cage area
Why is it important for the nurse to monitor blood pressure in clients receiving
antipsychotic drugs?
A) Orthostatic hypotension is a common side effect
B) Most antipsychotic drugs cause elevated blood pressure
C) This provides information on the amount of sodium allowed in the diet
D) It will indicate the need to institute anti parkinsonian drugs -Correct Answer- A)
Orthostatic hypotension is a common side effect
The nurse is teaching the client to select foods rich in potassium to help prevent
digitalis toxicity. Which choice indicates the client understands dietary needs?
A) Three apricots
B) Medium banana
C) Naval orange
D) Baked potato -Correct Answer- D) Baked potato
An 86 year-old nursing home resident who has decreased mental status is
hospitalized with pneumonic infiltrates in the right lower lobe. When the nurse assists
the client with a clear liquid diet, the client begins to cough. What should the nurse
do next?
A) Add a thickening agent to the fluids
B) Check the client's gag reflex
C) Feed the client only solid foods
D) Increase the rate of intravenous fluids -Correct Answer- B) Check the client's gag
reflex
The nurse is planning care for a client with a CVA. Which of the following measures
planned by the nurse would be most effective in preventing skin breakdown?
A) Place client in the wheelchair for four hours each day
B) Pad the bony prominence
C) Reposition every two hours
D) Massage reddened bony prominence -Correct Answer- C) Reposition every two
hours
A nurse is assessing several clients in a long term health care facility. Which client is
at highest risk for development of decubitus ulcers?
A) A 79 year-old malnourished client on bed rest
B) An obese client who uses a wheelchair
C) A client who had 3 incontinent diarrhea stools
D) An 80 year-old ambulatory diabetic client -Correct Answer- C) A client who had 3
incontinent diarrhea stools
Constipation is one of the most frequent complaints of elders. When assessing this
problem, which action should be the nurse's priority?... [Show Less]