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Nursing HESI-Exit Sample Question Answers
Question # 1
A nurse is at a local swimming pool, and a man collapses with a cardiac arrest after exiting the pool. The man is still wet when the nurse begins cardiopulmonary resuscitation (CPR), and another person brings the automated external defibrillator (AED). Which of the following should the nurse do next?
A. Apply the AED pads and deliver a shock B. Wipe the chest dry with an available cloth or towel. C. Continue CPR because a client who is wet cannot receive a shock. D. Wipe the chest with an alcohol hand wipe to speed the evaporation of the water.
Answer: B
Explanation:
The area of contact for the automated external defibrillator (AED) pads must be dry, so the nurse should
wipe the chest dry with an available dry cloth or ask someone else to do it while she continues
cardiopulmonary resuscitation (CPR). The chest should not be wiped with alcohol because this could cause a
spark and a fire when the AED shocks the heart. The pads should also not be placed over medicine patches.
pacemakers, or implanted defibrillators. Different models of AEDs have slightly different directions, but most
have audible directions and pictures that are easy to follow.
Question # 2
A client is receiving end-of-life care and tells the nurse that he has not always lived the way he should have or treated his children well. Which of the following responses is the most appropriate?
A. "What kinds of things have you done?" B. "There are things that you regret" C. "I'm sure those things don't matter anymore." D. "it’s not too late to ask for forgiveness."
Answer: B Explanation: If a client receiving end-of-life care tells the nurse that he has not always lived the way he should have or
treated his children well the most appropriate response is: "There are things that you regret." This states the
point that the client is making without being judgmental or questioning. At the end of life, clients often think
back over their lives and consider both positive and negative aspects. They often are not seeking advice but
rather an opportunity to verbalize feelings
Question # 3
The nurse is conducting an aphasia assessment of a client who has suffered a stroke. Which of the following observations should the nurse include in the assessment? Select all that apply,
A. Spontaneous speech B. Comprehension of the spoken and written word C. Ability to name objects D. Ability to describe objects E. Ability to write F. Ability to recall four named items after five minutes
Answer: A, B, C, E
Explanation:
An aphasia assessment includes observations of spontaneous speech (fluent, no fluent.
grammatical errors, and slow or hesitant speech). comprehension of spoken language (ability to follow simple
and then more complex commands), comprehension of written language (ability to read and follow written
commands), ability to name items (but not describe), ability to recall four named items (immediately, not after
five minutes), and the ability to write. The nurse should observe the client carefully during the assessment for
signs of frustration or fatigue.
Question # 4
A pregnant woman undergoes a 40-minute monsters test for evaluation of fetal heart rate (FHR) accelerations. Which of the following test results is normal (reactive)?
A. One acceleration of the FHR of 10 beats per minute (bpm) above the baseline for 10 seconds B. Two accelerations of the FHR of 10 bpm above the baseline for 15 seconds C. No accelerations of the FHR D. Three accelerations of the FHR of 15 bpm above the baseline for 20 seconds
Answer: D
Explanation:
A no stress test measures the fetus's heart rate and accelerations during a 20- to 40-minute period. The
mother is in the semi-Fowler s position with support placed beneath the right hip so the uterus is displaced to
the left. An ultrasound transducer is placed on the abdomen to measure the FHR, and a tocodynamometer is
placed over the funds area of the uterus to monitor uterine contractions and fetal movement. A normal
(reactive) result is 2 or more accelerations of the FHR of 15 bpm above baseline for 215 seconds. An abnormal
(nonreactive) result is less than 2 accelerations of the FHR in a 40-minute period.
Question # 5
A client complains of sleeping poorly, arousing many times during the night, awakening with a headache, and feeling tired and sluggish in the morning and throughout the day. For which of the following tests does the nurse anticipate that the client will be scheduled?
A. Electroencephalogram B. Electrocardiogram C. Nocturnal polysomnogram D. Magnetic resonance imaging (MRI) of the brain
Answer: C
Explanation:
Because these signs and symptoms are indicative of obstructive sleep apnea the client will likely be
scheduled for a nocturnal polysomnogram. For the test, which is generally conducted in a sleep center,
electrodes are placed on the head, face, and body as well as sensors to evaluate respiratory effort, snoring,
airflow, and oxygen saturation. The client spends the night in the sleep center so the different stages of sleep
can be observed.
Question # 6
The nurse is assisting a client with colostomy irrigation. The client is positioned on the toilet and has removed the colostomy pouch, and the irrigation bag is filled with 1000 mL of warm water. Place the following actions (in Roman numerals) in the correct order from first to last. I) Allow 15-20 minutes for evacuation and then fold the sleeve, secure it, and leave it in place for 30-45 minutes before removing it. II) Allow the solution to flow in for 5-10 minutes and then clamp the tubing and close the top of the irrigation sleeve. III) Apply gloves, lubricate the cone tip, and insert it into the stoma, holding it securely. IV) Apply the irrigation sleeve over the stoma. V) Hang the irrigation solution bag with the bottom 20 inches above the stoma. 1. _______ 2. _______ 3. _______ 4. _______ 5. _______
A. V, IV, III, II, I B. V, IV, III, I, II C. V, I, III, II, IV D. I, IV, III, II, V C. V, I, III, II, IV D. I, IV, III, II, V
Answer: A
Explanation:
Order of actions:
1. V: Hang the irrigation solution bag with the bottom 20 inches above the stoma.
2. IV: Apply the irrigation sleeve over the stoma.
3. III: Apply gloves, lubricate the cone tip, and insert it into the stoma, holding it securely,
4. II: Allow the solution to flow in for 5—10 minutes and then clamp the tubing and close the top of the irrigation
sleeve.
5. I: Allow 15—20 minutes for evacuation and then fold the sleeve, secure it, and leave it in place for 30—45
minutes before removing it.
Question # 7
Which of the following findings are indicative of peripheral arterial insufficiency? Select all that apply.
A. Throbbing cramping pain that increases with exercise B. Aching pain that increases with dependency C. Capillary refill time of less than two seconds D. Shiny skin with decreased hair E. Brown pigment about the ankles and lower legs F. Pale color on elevation and redness on dependency
Answer: A, D, F
Explanation:
Peripheral arterial insufficiency is characterized by throbbing, cramping pain that increases
with exercise; shiny skin with decreased hair: pale color on elevation,' and redness on dependency. The skin is
cool to the touch because of impaired circulation. Clients may complain of numbness, tingling, or reduced
sensation. Capillary refill is greater than seconds. Ulcerations tend to occur on the tips of the toes or at the
sites of trauma and are deep and well delineated.
Question # 8
A diabetic client self-administers insulin four times daily. Which of the following statements by the client indicates the need for further education?
A. "I flush the used needles down the toilet." B. "I carry glucose tablets with me at all times." C. "I eat a little dessert occasionally." D. "I avoid wearing sandals."
Answer: A
Explanation:
Clients should never flush needles or sharps down the toilet but should instead store and dispose of
them in accordance with state or local regulations. In some places. needles and sharps must be placed in
special sharps containers, but in other places, they may be placed in any secure, puncture-proof container with
a lid. People who must dispose of needles and sharps in the community should contact their local refuse
disposal service for information about disposal.
Question # 9
A client who served three tours of duty in Afghanistan has been diagnosed with post-traumatic stress disorder (PTSD). Which of the following signs and symptoms should the nurse expect the client to exhibit? Select all that apply
A. Recurring flashbacks B. Detachment from others C. Anger D. Hyper acute memory regarding the events associated with the trauma E. Nightmares F. Excessive sleeping
Answer: A, B, C, E Explanation:
The diagnostic criteria for PTSD includes exposure to actual or threatened death, serious
injury, or sexual violation. The disturbance causes clinically significant distress or impairment. Diagnosis is
based on behavioral symptoms which include:
•Re-experiencing (flashbacks, spontaneous memories of the traumatic event, nightmares, or other intense
psychological distress)
•Avoidance (estrangement from others or diminished interest in activities, to an inability to remember key aspects
of the event)
•Negative cognitions and mood (wide range of feelings from a persistent and distorted sense of blame of self or
others to distressing memories, feelings, thoughts or external reminders of the event)
•Arousal (aggressive, reckless, or self-destructive behavior; insomnia; hyper vigilance or related problems)
Symptoms usually present within three months of a traumatic event, although the reaction may be delayed for
many months or years in some individuals.
Question # 10
The nurse finds a client smoking marijuana in the hospital and tells her that no smoking or use of drugs is allowed in the facility. The client responds by shouting, "What business is it of yours? Leave me alone!" Which of the following initial responses is the best for the nurse to use to defuse the situation?
A. "It’s my business because I'm your nurse." B. "If you don't put that out immediately, I will call security." C. "You are violating the facility policies and the law!" D. "I'm sorry, but I have to ask you again to put out your marijuana cigarette."
Answer: D Explanation:
In a crisis situation, such as a client shouting at the nurse and refusing to stop smoking marijuana, the
best initial response is to remain calm and simply repeat the request. Challenges and threats often cause the
client who is angry and belligerent to escalate her behavior. The nurse should not intrude on the client's
personal space and should be aware of body language and nonverbal communication so as not to appear to be
challenging. If possible, the nurse should try to identify the cause of the client’s behavior by asking, "Are you
feeling nervous about your upcoming tests?" so the nurse can better understand the whole situation.
Question # 11
A client undergoing "cold-turkey/' withdrawal from years of substance abuse is most at risk of serious lifethreatening complications with which of the following substanc
A. Heroin B. Cocaine C. Alcohol D. Marijuana
Answer: C
Explanation:
Alcohol, benzodiazepines, and barbiturates pose the greatest risk to life if clients attempt to undergo
"cold-turkey" withdrawal. Patients may experience seizures. heart attacks, or strokes. Withdrawal from alcohol
may result in delirium tremens (DTs). Clients undergoing withdrawal from opiates, such as heroin, may
palpitations, and sweating). However. the symptoms are rarely life threatening. Those withdrawing from
cocaine and marijuana have milder withdrawal symptoms (anxiety, insomnia. headaches. and depression).
Question # 12
A 43-year-old client has developed progressive front temporal dementia and is exhibiting inappropriate and compulsive behaviors, difficulty with language, and impaired judgment. Which statement by the client's wife suggests that she has not accepted a permanent role change in their relationship?
A. "I need my husband to take care of financial matters." B. "It's so frustrating that my husband refuses to bathe." C. "My husband doesn't pay attention to anything I try to tell him." D. "I want my husband to do the things that he can still manage independently."
Answer: A
Explanation:
The statement "I need my husband to take care of financial matters" suggests that the client's wife has
not accepted that her husband's condition will continue to deteriorate and, because of behavioral and language
difficulties, he will not be able to manage their financial affairs. She will need to assume responsibilities that
were previously handled by her husband, who will become increasingly dependent. This change in roles can be
very difficult for a spouse, especially as the behaviors worsen and profound personality changes occur.
Question # 13
A transient homeless client with a history of mental illness and substance abuse is to be discharged. Which of the following support systems are most likely to provide social support for the client? Select all that apply.
A. Self-help programs B. Internet-based programs C. Community agencies D. Governmental agencies E. Friends F. Family
Answer: A, C, D Explanation:
Because this client is transient and homeless, he probably does not have easy access to a
computer or friends and family who can help, so he will most likely have to rely on public agencies and
services, such as self-help programs. community agencies (including mental health outreach services), and
government agencies (such as Medicaid or Social Security). Although the nurse can provide homeless clients
with information, follow-up can be poor among homeless and transient populations.
Question # 14
An elderly preoperative client seems very anxious but denies concerns when the nurse asks; however, the client's son confides that the client is very superstitious and believes it is bad luck that he is in room 113. Which of the following actions is the best response?
A. Reassure the client that the room number will not affect his surgery outcome. B. Contact the admissions department and request that the client be reassigned to a different room. C. Ask the physician for medication to relax the client. D. Ask the son to stay with the client to reassure him.
Answer: B
Explanation:
The nurse should contact the admissions department and ask that the client be reassigned to a different
room. Although superstitions may seem irrational at times, fear and anxiety can negatively impact recovery.
Anxiety before surgery is common, but severe anxiety can result in an increased induction time and an
increased need for analgesia in the postoperative period. Superstitions can compound the fear because the
client may feel that the negative outcomes he fears (e.g„ pain or disability) are more likely to occur.
Question # 15
The physician has ordered that a serum trough level be drawn for a medication. Which of the following is the correct time to draw blood for a trough level?
A. At the midpoint in time between two scheduled doses of the drug B. At the time the drug peaks C. Immediately after a scheduled dose is administered D. Immediately before a scheduled dose is due
Answer: D
Explanation:
The trough time is when the blood level is at its lowest (in the trough), so the serum trough level should
be drawn immediately before a scheduled dose of the medication is due. Blood levels of a drug may also be
measured at the peak time. This will vary from drug to drug and should always be checked at the time
prescribed. When drawing blood for trough and peak levels, Ws important that the medication doses be
administered on time.
Question # 16
The computers for documenting client care and treatment are located at the nursing station. Which of the following is the most important consideration regarding the computers?
A. The height of the computer stations B. The ratio of computers to staff C. The positioning of the computer screens away from the line of sight of unauthorized persons D. The brand of computer and operating system
Answer: C
Explanation:
Although these are all important considerations, the installed height, the ratio of computers to staff, and
the brand of computer are focused on the needs of the staff. However, the positioning of the computer screens
away from the line of sight of clients and visitors is essential for maintaining client confidentiality. The screens
must be positioned so that others cannot read what is being documented about a client. Computers must be
kept in a secure area. In some cases, privacy screens or filters may be used.
Question # 17
Which of the following statements by the client suggests that the client has given made informed consent for a craniotomy?
A. "I know that surgery could cause a stroke, and I'm scared." B. "I told the doctor I didn't want to know anything about the surgery, and she agreed." C. "I have one more question before I sign the consent form." D. "This is a really complicated procedure. So many things could go wrong."
Answer: B
Explanation:
The statement that indicates the client has not given informed consent is: "I told the doctor I didn't want
to know anything about the surgery, and she agreed." The physician has a responsibility to inform the client of
the risks and benefits of the treatment and any alternative treatment options even if the client does not want
this information. A client who refuses to receive the information may be in denial or may not yet be
emotionally prepared to deal with the reality of the treatment.
Question # 18
Following a disaster with multiple victims and danger to those present, which group should have priority for protection from injury?
A. The victims B. The firefighters and police officers C. The bystanders and news reporters D. The healthcare providers
Answer: D
Explanation:
Healthcare providers should have priority for protection from injury because if they are injured, then no
one will be available to provide care to the others who are injured. Police officers and firefighters are usually
the first responders in a disaster, and they must determine when it is safe for healthcare providers to enter the
area and provide care. In some cases, this may mean that care for the injured is delayed because of unsafe
conditions.
Question # 19
For which of the following reasons would the nurse use the Braden Scale to assess a client?
A. To determine if the client is suffering from delirium B. To determine if the client is at risk for developing pressure sores C. To determine if the client is at risk for falls D. To determine if the client is at risk for substance abuse
Answer: B Explanation:
The Braden Scale is used to determine if the client is at risk for developing pressure sores. The scale
assesses six different areas with scores of 1—4 or 1—3. The lower the total score, the higher the risk. The six
areas are sensory perception, moisture, activity, mobility, usual nutrition pattern, and friction and sheer. The
Braden Scale is used to help identify the need for a support surface and the type of support surface appropriate
for the client's needs.
Question # 20
A client in Dunlop traction experiences numbness of the thumb and index finger and cannot move the thumb to touch the tips of the other fingers. The capillary refill time is four seconds. Which of the following actions is indicated?
A. Remove and reapply the forearm elastic bandage more loosely. B. Decrease the weights on the traction. C. Release the counter traction. D. Increase the weights on the traction.
Answer: A
Explanation:
Numbness of the thumb and index finger, inability move the thumb to touch the tips of the other fingers,
and a capillary refill time greater than three seconds are all indications that the radial nerve is compressed.
While the arm is supported. the elastic bandage on the forearm should be removed and reapplied more loosely,
and then the circulation is reevaluated to determine if this alleviates the problem. If the numbness, impaired
movement, and slow capillary refill persist, then further evaluation is indicated.
Question # 21
The nurse has documented a treatment on the wrong client's record. Which of the following methods of indicating the error is correct?
A. The nurse draws a straight line through the incorrect entry, writes "error" above it, and initials the correction. B. The nurse uses correction fluid to cover the incorrect entry. C. The nurse draws multiple lines through the incorrect entry so it is unreadable, writes "error" above it, and initials the correction. D. The nurse leaves the incorrect entry in place, writes "error" in the margin, and initials and dates the notation.
Answer: A
Explanation:
The correct method of indicating that information has been documented on the wrong record is to draw
a straight line (one only) through the incorrect documentation, write "error" above it. and initial the
correction. No attempt should be made to obliterate the entry with correction fluid, erasure, or drawing
multiple lines through it because the entry must remain readable for legal reasons so that it does not appear
that the client's record has been altered
Question # 22
A client has had a long leg cast removed after eight weeks. Which of the following actions is the correct method of cleansing the skin after cast removal?
A. Advise the client to use a bath brush on his skin during a shower. B. Advise the client to soak in a tub of water and wash his leg with a washcloth. C. Apply a cold-water enzyme wash to the client's skin, leave it in place for 20 minutes, and then rinse it off with warm water D. Wash the skin with hot, soapy water and then rinse with warm water.
Answer: C
Explanation:
After a cast is removed, the skin is covered with fatty deposits and dead skin. The nurse should apply a
cold-water enzyme wash to the skin, leave it in place for about 20 minutes, and then rinse or soak the leg in
warm water to remove the enzyme wash. The skin can then be gently washed with warm water and mild soap,
but it should not be rubbed vigorously or scrubbed. The skin should be gently patted dry, and an emollient is
applied.
Question # 23
When assisting a client with range-of-motion exercises, which movements should be carried out on the client's elbows? Select all that apply.
A. Supination B. Flexion C. Circumduction D. Pronation E. Rotation F. Hyperextension
Answer: B
Explanation:
The elbow comprises the simplest type of joint: the hinge. The only movements a hinge joint can
perform are flexion and extension. Flexion involves the biceps brachiI) Brachialis, and Brachioradialis muscles,
and extension uses the triceps brachiI) Three bones (the humerus, ulna, and radius) come together at the
elbow but in two different joints—the hinged elbow joint and the pivot proximal radioulnar joint, which allows
the forearm to separate and pronated.
Question # 24
A client has returned from surgery after removal of a tumor of the colon and creation of a temporary colostomy. She refuses to take a deep breath and cough then refuses to turn. Which of the following should the nurse assess first in trying to understand her lack of cooperation?
A. Delirium status B. Vital signs C. Oxygen saturation D. Level of pain
Answer: D
Explanation:
The nurse should assess the client's level of pain. Deep breathing, coughing, and turning may be very
painful in the first 24—48 hours after major surgery, but they are necessary to prevent atelectasis and other
complications. Clients who are in pain are often very reluctant to cooperate, so the nurse should ensure that
the client has received adequate analgesia prior to the first time she is asked to deep breathe, cough, and turn.
Question # 25
A nurse must teach a client how to do wound care and dressing changes prior to discharge. Which of the following are barriers to learning? Select all that apply.
A. The client is 55 years old. B. The client is fearful. C. The client is illiterate. D. The client is weak and frail. E. The client has many questions about the procedures. F. The client is hard of hearing.
Answer: B, C, D, F
Explanation:
Although advanced age may be a barrier to learning, age should not be A concern for a 55-
year-old unless she has cognitive impairment. However, fear and lack of literacy may impact the client's ability
to learn. Clients who are weak and frail may not be able to concentrate fully, and those who are hard of hearing
may miss important points, especially if the nurse is unaware of the hearing deficit. Asking questions is usually
a good sign that the client is alert and attentive.
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