HESI Exit Pharm RN

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Sample questions from HESI Exit Pharm RN

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.Refer to the client's chart. Which actions should the nurse take now to address the client's worsening respiratory status? Select all that apply.

   • A.Offer oral fluids before reassessing breathing.
   • B.Prepare to administer the prescribed bronchodilator.
   • C.Encourage the client to ambulate in the hallway.
   • D.Raise the head of the bed and apply prescribed oxygen.
   • E.Reassess respiratory status after interventions.
   • F.Notify the rapid response team.

   Rationale: The oxygen saturation has fallen from 93% to 86% while respirations increased to 32/min, indicating acute deterioration; positioning, oxygen, and prompt escalation are warranted. The charted wheezing and prescribed bronchodilator support administering that medication, followed by reassessment. Ambulation and oral fluids do not address the immediate hypoxemia and could worsen risk.

2. 2.In the intensive care unit, a client with septic shock has a mean arterial pressure of 58 mm Hg after receiving an initial fluid bolus. Which intervention should the nurse anticipate?

   • A.Administration of a loop diuretic
   • B.Administration of an oral antihypertensive
   • C.Restriction of all intravenous fluids
   • D.Initiation of a prescribed vasopressor infusion

   Rationale: A MAP of 58 mm Hg remains below the usual target of at least 65 mm Hg in septic shock, so a vasopressor such as norepinephrine may be needed after fluid resuscitation. A diuretic or fluid restriction could worsen inadequate perfusion. An oral antihypertensive is inappropriate in hypotension.

3. 3.A client with a new ileostomy has a dusky, dry stoma. Which action should the nurse take?

   • A.Irrigate the ileostomy with tap water.
   • B.Document the finding as an expected change.
   • C.Notify the surgeon promptly.
   • D.Apply a heating pad to the abdomen.

   Rationale: A healthy stoma is moist and pink to red; dusky color and dryness may indicate impaired perfusion and require prompt evaluation. Heat can cause injury, and routine irrigation is not appropriate for an ileostomy. Documenting without escalation could delay treatment of ischemia.

4. 4.Which intervention is most appropriate for the client's current neurologic change?

   • A.Lower the head of the bed and offer food.
   • B.Activate the stroke response and determine the time last known well.
   • C.Administer an oral anticoagulant immediately.
   • D.Reassess the client in 2 hours before notifying the provider.

   Answer and rationale are in the full material.

5. 5.Which action is appropriate when a client has a generalized tonic-clonic seizure?

   • A.Turn the client to the side and protect the head.
   • B.Offer water as soon as the jerking stops.
   • C.Insert a padded tongue blade between the teeth.
   • D.Restrain the client's arms and legs.

   Answer and rationale are in the full material.