HESI RN Exit Exam-Mcphs-Worchester BSN Proctored Exam

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Sample questions from HESI RN Exit Exam-Mcphs-Worchester BSN Proctored Exam

This material has 150 questions with answers and rationales. Here are the first 5.

1. 1.In the emergency department, a client with a history of type 1 diabetes is confused and diaphoretic. A bedside glucose is 48 mg/dL, and the client can swallow safely. Which action should the nurse take first?

   • A.Administer 15 g of rapid-acting oral carbohydrate and recheck glucose in 15 minutes.
   • B.Prepare to administer intravenous dextrose before attempting oral treatment.
   • C.Give the scheduled dose of rapid-acting insulin to prevent rebound hyperglycemia.
   • D.Encourage the client to eat a high-protein meal and recheck glucose in 1 hour.

   Rationale: A conscious client who can swallow safely should receive 15 g of rapid-acting carbohydrate, followed by a glucose recheck in 15 minutes. Insulin would worsen the hypoglycemia, and protein does not raise glucose quickly enough for immediate treatment. Intravenous dextrose is appropriate when the client cannot safely take oral carbohydrate or has severe hypoglycemia requiring that route.

2. 2.Refer to the client's chart. Which actions should the nurse take in response to the client's current condition? Select all that apply.

   • A.Increase the prescribed maintenance intravenous fluid rate.
   • B.Administer the prescribed intravenous furosemide.
   • C.Reassess respiratory status and oxygen saturation after interventions.
   • D.Apply oxygen and position the client upright.
   • E.Activate the rapid response system.

   Rationale: Applying oxygen and positioning the client upright address the severe hypoxemia and respiratory distress documented at 1000. The rapid response system is indicated because the client has worsening breathing, crackles, and an oxygen saturation of 86% despite supplemental oxygen. The prescribed furosemide is appropriate for the findings of acute pulmonary congestion; increasing maintenance fluids could worsen it. Reassessment is essential to evaluate the response to urgent interventions.

3. 3.A client states, "My chest feels tight, and I cannot catch my breath." The client has asthma and is using accessory muscles; wheezing is audible. Which prescribed medication should the nurse administer first?

   • A.Inhaled fluticasone
   • B.Oral montelukast
   • C.Oral prednisone
   • D.Inhaled albuterol

   Rationale: Inhaled albuterol is a short-acting bronchodilator that provides rapid relief of acute bronchospasm. Fluticasone and montelukast are controller medications and do not promptly reverse an acute attack. Prednisone can reduce airway inflammation but has a slower onset and is not a substitute for immediate bronchodilation.

4. 4.At change of shift, the nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client with pneumonia whose temperature is 38.1 C (100.6 F) and who is due for acetaminophen
   • B.A client with chronic kidney disease who reports mild nausea after breakfast
   • C.A client 4 hours after thyroidectomy who is restless and has noisy inspiratory breathing
   • D.A client with a leg cast who reports itching beneath the cast

   Answer and rationale are in the full material.

5. 5.A client with an acute ischemic stroke has dysphagia and a weak cough. Which action is most important before the client receives oral food, fluids, or medication?

   • A.Crush oral medications and mix them with applesauce.
   • B.Complete a prescribed swallow screening.
   • C.Place the client supine to conserve energy.
   • D.Offer small sips of water through a straw.

   Answer and rationale are in the full material.