HESI B Exit Exam

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Sample questions from HESI B Exit Exam

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

1. 1.A client's potassium is 6.3 mEq/L, and the cardiac monitor shows peaked T waves. Which prescription should the nurse implement first?

   • A.Administer IV calcium gluconate
   • B.Prepare the client for hemodialysis
   • C.Restrict dietary potassium
   • D.Give oral sodium polystyrene sulfonate

   Rationale: IV calcium gluconate stabilizes the cardiac membrane and is the immediate priority when hyperkalemia is causing ECG changes. Sodium polystyrene sulfonate and hemodialysis can reduce total body potassium but do not provide the same immediate cardiac protection. Dietary restriction helps prevent further potassium elevation but does not treat the acute dysrhythmia risk.

2. 2.A client admitted with pneumonia has a temperature of 39.2 C, increasing confusion, and hypotension. Blood cultures have been obtained, and IV antibiotics are prescribed. Which actions should the nurse take now? Select all that apply.

   • A.Reassess blood pressure and mental status after interventions
   • B.Administer the prescribed IV antibiotics promptly
   • C.Restrict fluids to prevent pulmonary edema
   • D.Begin the prescribed isotonic crystalloid bolus
   • E.Delay antibiotics until the culture results are available
   • F.Obtain a serum lactate level as prescribed

   Rationale: Prompt antibiotics after cultures, isotonic fluid resuscitation, reassessment of perfusion, and a lactate level are appropriate actions for suspected sepsis. Waiting for culture results delays treatment, and fluid restriction can worsen hypotension and impaired tissue perfusion. The nurse should monitor the client's response closely, including respiratory status during fluid administration.

3. 3.In the emergency department, a client with a history of asthma develops wheezing and difficulty speaking in full sentences. Which prescribed medication should the nurse administer first?

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

   Rationale: Inhaled albuterol is a rapid-acting bronchodilator used to relieve acute bronchospasm. Prednisone may reduce airway inflammation but has a slower onset, while fluticasone and montelukast are controller therapies rather than immediate rescue medications. The client's difficulty speaking signals significant respiratory distress requiring prompt relief and reassessment.

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

   • A.A client with diabetes who has a blood glucose level of 248 mg/dL and is asking for lunch
   • B.A client with heart failure who has bilateral ankle edema and a 1-kg weight gain this week
   • C.A client 2 hours after thyroidectomy who reports tingling around the mouth and has inspiratory stridor
   • D.A client with chronic kidney disease who has a potassium level of 5.2 mEq/L and no ECG changes

   Answer and rationale are in the full material.

5. 5.Refer to the client's chart. Which findings require immediate intervention for suspected postoperative hemorrhage? Select all that apply.

   • A.The heart rate increased from 92/min to 124/min
   • B.Urine output is 15 mL during the past hour
   • C.The blood pressure decreased from 118/72 mm Hg to 88/54 mm Hg
   • D.The temperature is 37.2 C
   • E.The client reports thirst and dizziness when sitting up
   • F.The surgical dressing has a small, unchanged area of dried drainage

   Answer and rationale are in the full material.