HESI EXIT FINAL EXAM QUESTIONS AND ANSWERS UPDATED (2024/2025) (VERIFIED ANSWERS)
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Course
Hesi exit
Institution
Hesi Exit
HESI EXIT FINAL EXAM QUESTIONS AND ANSWERS UPDATED (2024/2025) (VERIFIED ANSWERS)HESI EXIT FINAL EXAM QUESTIONS AND ANSWERS UPDATED (2024/2025) (VERIFIED ANSWERS)HESI EXIT FINAL EXAM QUESTIONS AND ANSWERS UPDATED (2024/2025) (VERIFIED ANSWERS)HESI EXIT FINAL EXAM QUESTIONS AND ANSWERS UPDATED (2024...
HESI EXIT FINAL EXAM QUESTIONS AND
ANSWERS UPDATED (2024/2025)
(VERIFIED ANSWERS)
The home care nurse visits a client with a halo fixator traction device.
Which client statement MOST concerns the nurse?
1. "My wife looks at the pin sites every day."
2. "I like to bathe in the tub."
3. "I drove to the library yesterday."
4. "I drink with a straw." - ANS ✓1) Assessment: outcome desired; risk of
infection at pin sites; client should be taught signs of inflammation and infection
2) Implementation: outcome desired; showers increase risk of infection at
pin sites
3) CORRECT - Implementation: outcome not desired and may be a problem;
client is not able to turn with halo device; increases the risk of injury to self
and others
4) Implementation: outcome desired; difficulty manipulating cup or glass
due to immobilized neck
The nurse cares for a client diagnosed with depression. Which statement by
the client indicates improvement?
1. "I have been sleeping 6 hours at night."
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2. "I have lost 2 lbs in the past week."
3. "Lately, I have trouble watching television."
4. "I have much less muscle tension now." - ANS ✓1) CORRECT - Assessment:
outcome desired; clients with depression may have increased or decreased sleep
time
2) Assessment: outcome not desired; lack of appetite is a frequent sign of
depression
3) Assessment: outcome not desired; lack of concentration is sign of
depression
4) Assessment: outcome not desired; is a sign of anxiety
The nurse on the maternity unit must accept a transfer client from a
medical/surgical unit. The nurse considers which transfer client
appropriate?
1. A 38-year-old client with a diagnosis of systemic lupus erythematosus.
2. A 45-year-old client receiving daily external radiation therapy
treatments for breast cancer.
3. A 58-year-old client receiving antibiotic treatment for cellulitis of the left
leg.
4. A 74-year-old client who has received intravenous antibiotics for 7 days.
- ANS ✓1) CORRECT - Implementation: outcome desired; autoimmune disease;
not infectious
2) Implementation: outcome not desired; possible skin damage and
suppression of bone marrow with decreased white-blood-cell levels;
increased risk for infection
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3) Implementation: outcome not desired; generalized skin infection of
deeper connective tissue; usually caused by Streptococcus or
Staphylococcus; increased risk for infection
4) Implementation: outcome not desired; elderly clients receiving long-
term antibiotic therapy are at risk for Clostridium difficile infection; highly
contagious; increased risk for infection
The nurse in the outclient surgery unit prepares a 4-year-old child for
surgery. It is MOST important for the nurse to make which of these
statements?
1. "Your parents are going to leave a half hour before the surgery."
2. "You're going to talk with some other children who had this surgery."
3. "If you have this surgery, your parents will buy you a new toy."
4. "Take this doll and show me where the operation will be done." - ANS
✓1) Implementation: outcome not desired; parents are encouraged to remain
with child
2) Implementation: outcome not desired; appropriate only for school-aged
and adolescent children
3) Implementation: outcome not desired; not appropriate
4) CORRECT - Implementation: outcome desired; encourage expression of
feelings (e.g., anger); fear mutilation; allow child to play with models of
equipment
The nurse cares for a client diagnosed with Alzheimer's disease. The client
is confused and incontinent of urine. What is the MOST important action for
the nurse to take?
1. Insert an indwelling urinary drainage catheter.
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2. Perform intermittent catheterization every 4 hours.
3. Offer the bedpan to the client every 2 hours.
4. Assist the client to a bedside commode every 2 hours. - ANS ✓1)
Implementation: outcome not desired; increases risk of infection; catheter-
related infections are most common hospital-acquired infection
2) Implementation: outcome not desired; increases chance of infection
3) Implementation: outcome appropriate but not priority; does not keep
client independent and active
4) CORRECT - Implementation: outcome desired; keeps client active and
independent
The nurse cares for a client with a history of type 1 diabetes mellitus who
has just returned to the surgical acute-care unit after a right below-knee
amputation. The client's capillary blood glucose is 480 mg/dL. The
postoperative orders indicate 6 units of regular insulin subcutaneously
should be administered. Which of the following is the FIRST action the
nurse should take?
1. Check the client records to see if insulin was given prior to surgery.
2. Administer the 6 units of regular insulin subcutaneously.
3. Administer the insulin when oral fluids are tolerated.
4. Contact the healthcare provider. - ANS ✓1) Assessment: outcome desired
but not priority; client needs insulin coverage now
2) CORRECT - Implementation: outcome desired; sliding scale-receives
predetermined amount of insulin according to glucose level; surgery and
infection increase insulin needs
3) Implementation: outcome not desired; needs insulin regardless of oral
intake due to elevated blood glucose
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HESI EXIT
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