HESI Exit Exam Test

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Sample questions from HESI Exit Exam Test

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 first to address the client's current deterioration? Select all that apply.

   • A.Apply oxygen and raise the head of the bed
   • B.Reassess the client in 1 hour before intervening
   • C.Obtain a 12-lead ECG and place the client on continuous cardiac monitoring
   • D.Administer the prescribed IV potassium replacement
   • E.Notify the rapid response team

   Rationale: Apply oxygen and elevate the head of the bed because the client is increasingly dyspneic and hypoxemic; obtain ECG monitoring because the worsening tachycardia and low oxygen saturation require immediate assessment. Activate the rapid response team for the acute decline shown by the change from SpO2 95% to 88% and increasing respiratory rate. Potassium replacement is not supported by the chart and could be harmful without a confirmed indication; waiting an hour delays care for an unstable client.

2. 2.Which assessment finding in a client with acute pancreatitis requires the most immediate follow-up?

   • A.Nausea after eating
   • B.Serum lipase is elevated
   • C.Pain radiates to the back
   • D.New confusion and oxygen saturation of 86%

   Rationale: New confusion with hypoxemia suggests impaired oxygenation and possible systemic deterioration, requiring immediate assessment and intervention. Elevated lipase, radiating abdominal pain, and nausea are common in pancreatitis but are not as immediately threatening as compromised oxygenation. The priority is to address airway and breathing before routine symptom management.

3. 3.A client with chronic obstructive pulmonary disease is receiving oxygen by nasal cannula. Which finding best indicates that oxygen therapy is effective?

   • A.The client becomes difficult to arouse
   • B.The client's respiratory rate increases from 20 to 32/min
   • C.The client's oxygen saturation is within the prescribed target range and alertness is maintained
   • D.The client's oxygen flow is increased without a new assessment

   Rationale: Effective oxygen therapy improves oxygenation while maintaining the client's baseline mental status and the prescribed target saturation. Tachypnea and reduced alertness may indicate worsening respiratory status, not improvement. Oxygen should be titrated to the prescribed target with reassessment rather than increased without evaluating the client.

4. 4.Refer to the client's chart. Which findings support concern for worsening heart failure and require prompt intervention? Select all that apply.

   • A.Heart rate decreases from 88 to 84/min
   • B.SpO2 91% on room air, down from 96%
   • C.Urine output of 20 mL/hr
   • D.Weight gain of 2.0 kg since yesterday
   • E.New crackles and increasing dyspnea

   Answer and rationale are in the full material.

5. 5.A newborn is receiving phototherapy for hyperbilirubinemia. Which nursing action is appropriate?

   • A.Cover the newborn's eyes and expose as much skin as prescribed
   • B.Keep the newborn fully clothed under the lights
   • C.Withhold feedings to reduce bilirubin production
   • D.Apply lotion to prevent skin dryness

   Answer and rationale are in the full material.