NGN HESI EXIT EXAM 2 VERSIONS 2024
AND 2023 EACH VERSION WITH 160
QUESTIONS WITH DETAILED VERIFIED
ANSWERS (100% CORRECT) / A+ GRADE
ASSURED
HESI
... [Show More] EXIT 2024
An older client is admitted with fluid volume deficit and
dehydration. Which assessment finding is the best indicator
of hydration that the nurse should report to the healthcare
provider?
A. Urine specific gravity is 1.040
B. Systolic blood pressure decreases 10 points when
standing
C. The client denies being thirsty
D. Skin tenting occurs when the client's forearm is pinched -
....ANSWER...D. Skin tenting occurs when the client's
forearm is pinched
The healthcare provider prescribes methylergonovine
maleate for a postpartum client with uterine atony. What
finding should indicate to the nurse to withhold the next
dose of the medication?
A. Difficulty locating the uterine fundus
B. Excessive lochia
C. Saturation of more than one pad per hour
D. Hypertension - ....ANSWER...D. Hypertension
After an inservice about electronic health record (EHR)
security and safeguarding client information, the nurse
observes a colleague going home with printed copies of
client information in a uniform pocket. Which action should
the nurse take?
A. File a detailed incident report with the specific hiring
facility
B. Warn the colleague that their actions are unprofessional
C. Comment anonymously about the action on a staff
discussion board
D. Communicate the colleague's actions to the unit charge
nurse - ....ANSWER...A. File a detailed incident report with
the specific hiring facility
The nurse is evaluating a tertiary prevention program for
clients with cardiovascular disease implemented in a rural
health clinic. Which outcome indicates the program is
effective?
A. At-risk clients received an increased number of routine
health screenings
B. Clients reported having new confidence in making
healthy food choices
C. Clients who incurred disease complications promptly
received rehabilitation
D. Client relapse of 30% in a 5-year community-wide antismoking campaign - ....ANSWER...C. Clients who incurred
disease complications promptly received rehabilitation
While caring for a client's postoperative dressing, the nurse
observes purulent drainage at the wound. Before reporting
this finding to the healthcare provider, the nurse should
review which of the client's laboratory values?
A. Culture for sensitive organisms
B. Serum blood glucose (BG) level
C. Creatinine level
D. Serum albumin - ....ANSWER...A. Culture for sensitive
organisms
A client is admitted with acute pancreatitis. The client
admits to drinking a pint of bourbon daily. The nurse
medicates the client for pain and monitors vital signs every 2
hours. Which finding should the nurse report immediately to
the healthcare provider?
A. Anorexia and abdominal distention
B. Abdominal pain and vomiting
C. Confusion and tremors
D. Yellowing and itching of skin - ....ANSWER...C.
Confusion and tremors
A client with leukemia who is receiving a myleosuppressive
chemotherapy has a platelet count of 25,000/mm3. Which
intervention is most important for the nurse to include in this
client's plan of care?
A. Assess urine and stool for occult blood
B. Monitor for signs of activity intolerance
C. Require visitors to wear respiratory masks
D. Obtain client's temperature q4 hours - ....ANSWER...A.
Assess urine and stool for occult blood
When assessing a 6-month-old infant, the nurse determines
that the anterior fontanel is bulging. In which situation
would this findings be most significant?
A. Crying
B. Sitting upright
C. Vomiting
D. Straining on stool - ....ANSWER...B. Sitting upright
A client who is admitted to the intensive care unit with
syndrome of inappropriate antidiuretic hormone (SIADH)
has developed osmotic demyelination. Which intervention
should the nurse implement first?
A. Patch one eye
B. Evaluate swallow
C. Reorient often
D. Range of motion - ....ANSWER...B. Evaluate swallow
The nurse is caring for a client with chronic obstructive
disease (COPD) who uses oxygen at 2L/minute per nasal
cannula continuously. The nurse observes that the client is
having increased shortness of breath with respirations at 23
breaths/minute. Which action should the nurse implement
first?
A. Determine if the client is experiencing any anxiety
B. Auscultate the client's bilateral lung sounds and oxygen
saturation
C. Notify the healthcare provider about the client's distress
D. Assess the delivery mechanism of the oxygen tank,
tubing, and cannula - ....ANSWER...D. Assess the delivery
mechanism of the oxygen tank, tubing, and cannula
A client with a history of using illicit drugs intravenously is
admitted with Kaposi's sarcoma. Which intervention should
the nurse include in this client's admission plan of care?
A. Assess for symptoms of AIDS dementia
B. Monitor for secondary infections
C. Identify local HIV support groups
D. Observe for adverse drug reactions - ....ANSWER...B.
Monitor for secondary infections
An older woman who has difficulty hearing is being
discharged from day surgery following a cataract extraction
and lens implantation. Which intervention is most important
for the nurse to implement to help ensure the client's
compliance with self care?
A. Have the client vocalize the instructions provided
B. Ensure that someone will stay with the client for 24 hours
C. Speak clearly and face the client for lip reading
D. Provide written instructions for eye drop administration -
....ANSWER...A. Have the client vocalize the instructions
provided
An older woman with history of atrial fibrillation fell at
home and fractured her left hip. She is currently taking
warfarin 5 mg daily and has an international normalized
ratio (INR) value of 5.0. Upon admission, which
prescription should the nurse expect to implement?
A. Administer Vitamin K injection
B. Start continuous heparin infusion
C. Continue warfarin at same dose
D. Transfuse unit of packed red blood cells -
....ANSWER...A. Administer Vitamin K injection
A 12-year-old client who had an appendectomy two days
ago is receiving 0.9% normal saline at 50mL/hr. The client's
urine specific gravity is 1.035. Which action should the
nurse implement?
A. Assess bowel sounds in all quadrants
B. Encourage popsicles and fluids of choice
C. Evaluate postural blood pressure measurements
D. Obtain a specimen for urinalysis - ....ANSWER...B.
Encourage popsicles and fluids of choice
Which instruction should the nurse provide to a client who is
preparing to have a cystoscopy?
A. Report any allergies to shellfish or iodine
B. Report any painful urination, blood in urine, or fever
C. Lay prone for 24 hours after the procedure
D. Avoid strenuous activity and sports for at least 2 weeks -
....ANSWER...B. Report any painful urination, blood in
urine, or fever
What statement by a client who is 24 hours post-subtotal
thyroidectomy requires an immediate investigation by the
nurse?
A. "When I get out of bed quickly, I feel a little dizzy."
B. "The dressing over my incision feels like it is too tight
C. "I'm most comfortable when the head of the bed is raised"
D. "This IV infusion makes me urinate more often than
usual" - ....ANSWER...A. "When I get out of bed quickly, I
feel a little dizzy."
An older adult male who is in his early 70s admitted to the
emergency department because of a COPD exacerbation.
The client is struggling to breath and the healthcare team is
preparing for endotracheal intubation. The spouse's wife,
who is 30 years younger than the client, asks the nurse to
stop the procedure and provides the nurse a copy of the
client's living will. Which action should the nurse take?
A. Facilitate a family meeting with the palliative care team
B. Notify the healthcare provider of the client's wishes
C. Place a certified copy of the living will in the client's
record
D. Alert the nursing staff of the client's do not resuscitate
status - ....ANSWER...B. Notify the healthcare provider of
the client's wishes
While caring for a toddler receiving oxygen via face mask,
the nurse observes that the child's lips and nares are dry and
cracked. Which intervention should the nurse implement?
A. Use a topical lidocaine analgesic for cracked lips
B. Use a water soluble lubricant on affected oral and nasal
mucosa
C. Ask the mother what she usually uses on the child's lips
and nose
D. Apply a petroleum jelly to the child's lips and nose -
....ANSWER...B. Use a water soluble lubricant on affected
oral and nasal mucosa
An unlicensed assistive personnel (UAP) is assigned to
provide personal care for a client who's prescribed activity is
bedrest with bedside commode use. The UAP reports to the
nurse that the client is so obese that the UAP feels unable to
safely assist the client in transferring from the bed to the
bedside commode. How should the nurse respond?
A. Determine the client's level of mobility and need for
assistance
B. Instruct the UAP that all clients deserve equal care
C. Advise the client to maintain bedrest so that safety can be
ensured
D. Assign another UAP to care for the client -
....ANSWER...A. Determine the client's level of mobility
and need for assistance
Which information is most important for the nurse to obtain
when determining a client's risk for obstructive sleep apnea
syndrome (OSAS)?
A. Body mass index
B. Breath sounds
C. Self-description of pain
D. Level of consciousness - ....ANSWER...A. Body mass
index
The nurse is caring for a client who is entering the second
stage of labor. Which action should the nurse implement
first?
A. Prepare the client for spinal anesthesia
B. Empty the client's bladder using a straight catheter
C. Convey to the client that birth is imminent
D. Prepare the coach to accompany the client to delivery -
....ANSWER...C. Convey to the client that birth is imminent
A nurse determines that more than 25% of the students at a
middle school are overweight. The nurse presents the
information at a parent-teacher meeting. What action is most
important for the nurse to include in the meeting?
A. Provide information on ways to increase activity for the
family
B. Have several teachers talk about health risks associated
with obesity
C. Distribute a shopping list of suggested healthy snack
ideas
D. Determine the parents' degree of concern -
....ANSWER...A. Provide information on ways to increase
activity for the family
The nurse is assigning rooms for four clients, each newly
diagnosed, and being admitted to the acute neuro unit for
treatment. The client with which condition should be
assigned the only private room available?
A. Bacterial meningitis
B. Viral encephalitis
C. Septic shock
D. Brain abscess - ....ANSWER...A. Bacterial meningitis
A male client on the psychiatric unit is making sexual
advances towards a female nurse. Which action should this
nurse implement first?
A. Document as specifically as possible the client's behavior
in the nurse's notes
B. Discuss with the client why he is making sexual advances
toward the nurse
C. Tell the client in a matter-of-fact manner to stop the
sexual advances
D. Request an immediate team meeting to discuss the
inappropriate behavior - ....ANSWER...C. Tell the client in a
matter-of-fact manner to stop the sexual advances
After several months of chronic fatigue, morning stiffness,
and joint pain, a young adult is diagnosed with rheumatoid
arthritis, and the healthcare provider prescribes prednisone.
Which education should the nurse provide the client with
regard to taking prednisone?
A. Take prednisone doses before meals on an empty
stomach
B. Wear sunglasses when exposed to bring sunlight
C. If sequential doses are missed, notify the healthcare
provider
D. Schedule a monthly laboratory visit for a complete blood
count - ....ANSWER...C. If sequential doses are missed,
notify the healthcare provider
The nurse is caring for four clients. Client A, who has
emphysema and whose oxygen saturation is 94%; Client B,
with a postoperative hemoglobin of 8.2 mg/dL; Client C,
newly admitted with a potassium level of 3.8 mEq/L; and
Client D, scheduled for an appendectomy who has a white
blood cell count of 14,000 mm3. Which intervention should
the nurse implement?
A. Move Client D into an isolation room 24 hours before
surgery
B. Increase Client A's oxygen to 4 liters a minute per
cannula
C. Ask the dietician to add a banana to Client C's breakfast
tray
D. Verify that Client B has two units of packed cells
available - ....ANSWER...D. Verify that Client B has two
units of packed cells available
Which laboratory results should the nurse closely monitor in
a client who has end-stage renal disease (ESRD)?
A. Leukocytes, neutrophils, and thyroxine
B. Serum potassium, calcium, and phosphorus
C. Blood pressure, heart rate, and temperature [Show Less]