HESI Naxlex

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Sample questions from HESI Naxlex

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

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

   • A.A 46-year-old 2 hours after thyroidectomy who is restless and has inspiratory stridor
   • B.A 58-year-old with diabetes whose premeal glucose is 248 mg/dL
   • C.A 72-year-old with COPD whose oxygen saturation is 90% on the prescribed 2 L/min, unchanged from baseline
   • D.A 35-year-old receiving antibiotics who reports mild nausea

   Rationale: Restlessness and stridor after thyroid surgery suggest airway obstruction from edema or bleeding, which can rapidly become fatal. The stable COPD saturation is within the reported baseline, and hyperglycemia and mild nausea are not immediate threats. Airway concerns take priority over the other needs.

2. 2.In a rehabilitation unit, an RN is assigning care to an experienced assistive personnel (AP). Which task is appropriate to delegate?

   • A.Evaluate a client's response to a newly administered opioid
   • B.Obtain routine vital signs for a stable client awaiting discharge
   • C.Teach a client how to use a walker on stairs
   • D.Assess a client reporting new chest pressure

   Rationale: Obtaining routine vital signs for a stable client is a predictable task that can be delegated to trained AP. Assessing new chest pressure and evaluating medication response require nursing judgment. Teaching also requires the nurse to assess learning needs and confirm understanding.

3. 3.A provider prescribes a medication dose that is substantially higher than the usual dose listed in the medication reference. The client is stable. What should the nurse do first?

   • A.Administer the dose because the prescription is signed
   • B.Give half the prescribed dose and document the change
   • C.Withhold the medication and clarify the prescription with the provider
   • D.Ask another nurse to verify the dose and then administer it

   Rationale: The nurse should hold a potentially unsafe dose and clarify the order with the prescriber before administration. A second check does not make an implausible prescription safe, and the nurse cannot independently change the dose. Medication safety requires resolving discrepancies before giving the drug.

4. 4.A client with decision-making capacity refuses a prescribed blood transfusion after discussing the risks with the provider. Which response by the nurse is best?

   • A.Explain that the client must accept treatment to remain hospitalized
   • B.Ask the family to authorize the transfusion instead
   • C.Administer the transfusion because it is prescribed
   • D.Respect the refusal and notify the provider

   Answer and rationale are in the full material.

5. 5.A client is being discharged with a new prescription for warfarin. Which action is most important before the client leaves?

   • A.Ask the client to schedule a dental cleaning within 1 week
   • B.Provide a printed list of foods that contain vitamin C
   • C.Tell the client to stop the medication if bruising occurs
   • D.Confirm the client can explain the dose, bleeding precautions, and follow-up INR plan

   Answer and rationale are in the full material.