HESI Exit and NCLEX Readiness Study Guide

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Sample questions from HESI Exit and NCLEX Readiness Study Guide

This material has 20 questions with answers and rationales. Here are the first 5.

1. 1.An RN receives reports on four clients. Which client should the RN assess first?

   • A.A client with pneumonia who is newly confused, has a blood pressure of 84/46 mm Hg, and is breathing 32/min
   • B.A client with chronic arthritis requesting medication for pain rated 6/10
   • C.A client awaiting discharge who needs instruction about an oral antibiotic
   • D.A client with stable heart failure whose weight is unchanged from yesterday

   Rationale: A is correct because new confusion, hypotension, and tachypnea indicate acute respiratory and perfusion instability. B requires timely pain care but lacks evidence of immediate deterioration. C requires teaching after unstable clients are addressed. D describes stability without an urgent change.

2. 2.A client with type 1 diabetes is alert, can swallow safely, and has a glucose of 58 mg/dL. Which action is best?

   • A.Administer the scheduled rapid-acting insulin before treating the low glucose
   • B.Give approximately 15 g of rapid-acting carbohydrate and recheck glucose in 15 minutes
   • C.Give a high-fat snack and recheck glucose in two hours
   • D.Withhold all treatment until a venous laboratory result is available

   Rationale: B is correct because this client can safely receive oral rapid carbohydrate, followed by prompt reassessment. A can worsen hypoglycemia. C delays absorption and reassessment. D creates an unnecessary treatment delay when a clinically actionable bedside result is available.

3. 3.Which prescription should the nurse clarify before implementation?

   • A.Obtain a 12-lead ECG for new chest pressure
   • B.Administer prescribed aspirin after checking allergy and bleeding concerns
   • C.Administer potassium chloride 20 mEq by intravenous push
   • D.Begin continuous cardiac monitoring for symptomatic hyperkalemia

   Rationale: C is correct because intravenous potassium must never be given by push; it can cause fatal dysrhythmias. A is appropriate for possible acute coronary syndrome. B includes relevant safety checks. D is appropriate because hyperkalemia can produce dangerous rhythm disturbances.

4. 4.A client develops sudden facial drooping and unilateral arm weakness. After activating the stroke response and addressing immediate airway needs, which information is especially important to obtain?

   • A.The client's usual bedtime
   • B.The last time the client was known to be at neurological baseline
   • C.Whether the client prefers tablets or liquid medications
   • D.The date of the client's last routine dental visit

   Answer and rationale are in the full material.

5. 5.A postoperative client receiving an opioid is difficult to awaken and has a respiratory rate of 6/min. Oxygen saturation is 95% while receiving supplemental oxygen. Which response is best?

   • A.Allow uninterrupted sleep because oxygen saturation is acceptable
   • B.Document adequate pain control and reassess in one hour
   • C.Encourage oral fluids to increase medication clearance
   • D.Activate emergency assistance, support ventilation, and administer naloxone according to protocol

   Answer and rationale are in the full material.