HESI RN EXIT EXAM | QUESTIONS AND VERIFIED ANSWERS |100% CORRECT| (2023/ 2024 Newly Updated)
QUESTION
A client with pneumococcal pneumonia had been
... [Show More] 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."
Answer:
B: "I have been coughing up foul tasting, brown, thick sputum."
QUESTION
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
Answer:
A: S3 ventricular gallop
QUESTION
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."
Answer:
B: The client's entire body turns a bright red color
QUESTION
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."
Answer:
B: "The tube will remove excess air from your chest."
QUESTION
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
Answer:
D: Serum potassium 6 mEq/L
QUESTION
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
Answer:
C: Dyspnea
QUESTION
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
Answer:
C: Pulse oximetry of 88
QUESTION
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
Answer:
D: restlessness
QUESTION
The most effective nursing intervention to prevent atelectasis from developing in a post operative client is to
A) Maintain adequate hydration
B) Assist client to turn, deep breathe, and cough
C) Ambulate client within 12 hours
D) Splint incision
Answer:
The correct answer is B: Assist client to turn, deep breathe, and cough
QUESTION
When caring for a client with a post right thoracotomy who has undergone an upper lobectomy, the nurse focuses on pain management to promote
A) Relaxation and sleep
B) Deep breathing and coughing
C) Incisional healing
D) Range of motion exercises
Answer:
The correct answer is B: Deep breathing and coughing
QUESTION
A nurse is to collect a sputum specimen for acid-fast bacillus (AFB) from a client. Which action should the nurse take first?
A) Ask client to cough sputum into container
B) Have the client take several deep breaths
C) Provide a appropriate specimen container
D) Assist with oral hygiene
Answer:
D: Assist with oral hygiene
QUESTION
The nurse is caring for a child immediately after surgical correction of a ventricular septal defect. Which of the following nursing assessments should be a priority?
A) Blanch nail beds for color and refill
B) Assess for post operative arrhythmias
C) Auscultate for pulmonary congestion
D) Monitor equality of peripheral pulses
Answer:
B: Assess for post operative arrhythmias
QUESTION [Show Less]