New Gen HESI Exit Study Guide

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Sample questions from New Gen HESI Exit Study Guide

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

1. 1.An RN is coordinating care for four clients on a medical-surgical unit. Which task is most appropriate to delegate to experienced unlicensed assistive personnel (UAP)?

   • A.Assess a client who reports dizziness during the first walk after surgery.
   • B.Reinforce teaching about a newly prescribed anticoagulant.
   • C.Assist a stable client with an established repositioning schedule and report skin changes.
   • D.Determine whether a client's pain medication was effective.

   Rationale: Assisting a stable client with routine repositioning and reporting observations are appropriate UAP tasks. Assessing new dizziness requires RN judgment. Medication teaching or reinforcement requires a licensed nurse according to applicable scope and policy. Evaluating a response to pain medication also requires nursing judgment.

2. 2.A client with acute kidney injury has a potassium level of 6.8 mEq/L and new peaked T waves. The client is receiving continuous cardiac monitoring, and the nurse has notified the provider. Which prescribed intervention should the nurse implement first?

   • A.Administer IV calcium gluconate.
   • B.Administer IV regular insulin with dextrose.
   • C.Administer an oral potassium-binding medication.
   • D.Provide teaching about a potassium-restricted diet.

   Rationale: IV calcium gluconate stabilizes cardiac cell membranes when hyperkalemia causes ECG changes, reducing the immediate risk of lethal dysrhythmias. Insulin with dextrose shifts potassium into cells but does not provide the same immediate membrane stabilization. Oral potassium binders remove potassium more slowly. Dietary teaching supports longer-term management but does not address the emergency. Calcium does not lower the potassium level, so additional treatment is still necessary.

3. 3.An adult with pneumonia has a temperature of 39.2 C, heart rate of 124/min, respiratory rate of 30/min, blood pressure of 84/46 mm Hg, and oxygen saturation of 86% on room air. The client is newly confused. Which action should the nurse take first?

   • A.Obtain a sputum specimen before starting other interventions.
   • B.Give the prescribed oral antipyretic and reassess in 30 minutes.
   • C.Complete a comprehensive admission history with the family.
   • D.Apply supplemental oxygen and activate the rapid response system.

   Rationale: Severe hypoxemia, hypotension, and acute confusion indicate immediate respiratory and circulatory instability with suspected sepsis. Oxygen and rapid escalation take priority, followed promptly by sepsis interventions such as IV fluids, cultures, and antibiotics as ordered. Sputum collection must not delay stabilization. An antipyretic does not correct hypoxemia or shock. A comprehensive history can wait until urgent treatment is underway.

4. 4.One hour after a vaginal birth, a client has heavy vaginal bleeding. The uterus feels boggy and is displaced to the right. Which action should the nurse take first while another staff member summons assistance?

   • A.Assist the client to walk to the bathroom without support.
   • B.Massage the uterine fundus.
   • C.Prepare the client for discharge teaching about normal lochia.
   • D.Wait for a hemoglobin result before intervening.

   Answer and rationale are in the full material.

5. 5.During a home visit, an older adult whose spouse recently died says, "I saved all my sleeping pills. Tonight I plan to take them so I can be with my spouse." Which response by the nurse is most appropriate?

   • A.Stay with the client, activate emergency assistance, and limit access to the pills if it can be done safely.
   • B.Ask the client to promise not to take the pills and schedule a visit for tomorrow.
   • C.Explain that grief is normal and suggest attending a support group next week.
   • D.Respect the client's privacy by leaving and keeping the statement confidential.

   Answer and rationale are in the full material.