HESI EXIT EXAM VERIFIED QUESTIONS AND ANSWERS

HESI EXIT EXAM VERIFIED QUESTIONS AND ANSWERS
The healthcare provider prescribes methylergonovine maleate for a postpartumclient
with uterine atony. What findings should indicate to the nurse to withhold the next doseof the medication?
A. Excessive lochia. B. Saturation of more than one pad per hour. C. Hypertension. D. Difficulty locating the uterine fundus. Answer
C. Hypertension. Rationale
Methylergonovine, an ergot alkaloid, has vasoconstrictive effects that can exaggerateprimary hypertension. The nurse should withhold the medication if the client's bloodpressure is elevated (C) and notify the healthcare provider. (A, B, and D) are signs of
uterine atony and are indications for the use of the medication. The nurse has completed the diet teaching of a male client who is being dischargedfollowing treatment of a leg wound. A high protein diet is encouraged to promote woundhealing. Which lunch choice by the client indicates that the teaching was effective?A. A peanut butter sandwich with soda and cookies. B. A tunafish sandwich with chips and ice cream. C. A salad with three kinds of lettuce and fruit. D. Vegetable soup, crackers, and milk. Answer
B. A tunafish sandwich with chips and ice cream. Rationale
(B) contains the highest amount of protein. Four ounces of tuna contains 11 g of protein, and ice cream 5 g of protein per cup. Chips are a fat with virtually no protein value. (A)
contains 4 grams of protein per tablespoon. (C) contains only 1 gramof protein per 1cupserving. (D) may have beef flavoring but it consist mostly of vegetables and wouldtherefore be low in protein. The nurse discontinues a continuous IV heparin infusion for a male client on strict bedrest, and is now preparing to administer the client's first dose of in enoxaparin (Lovenox). Prior to giving this subcutaneous injection, which assessment finding requires additional
intervention by the nurse?
A. Current lab report indicates an aPTT at 1.5 times the client's control. B. Several bruised areas are noted on the client's upper extremities bilaterally. C. The client states that his right calf is aching, and wants pain medication. D. The spouse is assisting the client who is shaving with an electric razor.
Answer
C. The client states that his right calf is aching, and wants pain medication. Rationale
A calf ache severe enough for the client to request pain medication (C) should be
reported to the healthcare provider immediately so that an adjustment in the
anticoagulation therapy can be made. Calf pain may be a sign of deep vein thrombosisindicative of ineffective anticoagulant heparin therapy. (A and B) are expected findings. Shaving with an electric razor is recommended to reduce the possibility of bleeding(D)
and does not require intervention. While the nurse is providing morning care for a client with chronic obstructive
pulmonary disease (COPD), the client becomes very dyspneic and starts to panic. What
action should the nurse implement first?
A. Instruct the client to perform diaphragmatic breathing. B. Use a calm voice to tell the client to breathe slowly. C. Administer two puffs of a metered-dose inhaler. D. Assist the client to an upright position. Answer
D. Assist the client to an upright position. Rationale
The nurse should first assist the client to an upright position (D), which allows the lungsto expand fully. After this, the nurse can implement (A, B, and C) as needed. A female client's estranged husband arrives at the hospital and demands that his wifehave no other visitors. The client becomes angry and insists that the estranged husbandbebarred from visiting her. Which intervention should the nurse implement?
A. Obtain a prescription to allow client to dictate who can visit. B. Request a multidisciplinary care conference to discuss husband's demands. C. Have the hospital's medical-legal department meet with the client. D. Encourage the client to speak with husband regarding his disruptive behavior. Answer
B. Request a multidisciplinary care conference to discuss husband's demands. Rationale
A multi-disciplinary care conference involves the healthcare team to evaluate difficult
situations that conflict with client safety and autonomy. During this conference, theclient's wishes regarding her health care decisions can be clarified to all teammembers. All other options are not indicated. The nurse working in a critical care unit is assigned the care of two clients, one withpneumonia who is being mechanically ventilated and the other who had a thoracotomyyesterday and is complaining of incisional pain. What should the nurse to first?
A. Assess the level of consciousness and vital signs for both clients. B. Complete a head to toe assessment of the client with pneumonia.
C. Change the surgical dressing to observe the appearance of the incision. D. Review the plan of care and the medications that are due for both clients. Answer
A. Assess the level of consciousness and vital signs for both clients. Rationale
Assessing the level of consciousness and vital signs for both clients (A) provides a quickmeasurement of priority need. Before a complete assessment (B) is done on one client, the nurse should at least do a quick assessment of the other client. Changing the dressingand observing the incision (C) may be indicated, but only after both clients are quicklyassessed. Reviewing the plan of care and medications due for administration (D) shouldwait until the nurse has evaluated both clients for any urgent clinical needs.

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