HESI Exit Exam Practice

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Sample questions from HESI Exit Exam Practice

This material has 108 questions with answers and rationales. Here are the first 5.

1. 1.A nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client with heart failure who has new pink, frothy sputum and severe dyspnea
   • B.A client with diabetes whose blood glucose is 248 mg/dL and who requests a snack
   • C.A client 1 day after surgery reporting incisional pain of 7 on a 0-to-10 scale
   • D.A client with pneumonia whose temperature is 38.1 C (100.6 F) after receiving acetaminophen

   Rationale: Pink, frothy sputum and severe dyspnea suggest acute pulmonary edema, an immediate threat to oxygenation. The elevated glucose, postoperative pain, and fever require follow-up but are less urgent in the absence of additional instability. Use the airway, breathing, circulation framework to prioritize.

2. 2.A client with type 1 diabetes is awake, diaphoretic, and shaky; the blood glucose is 54 mg/dL. What should the nurse do first?

   • A.Give 15 g of a rapid-acting oral carbohydrate
   • B.Administer the scheduled dose of rapid-acting insulin
   • C.Give glucagon intramuscularly
   • D.Recheck the blood glucose in 1 hour

   Rationale: An alert client who can swallow should receive 15 g of fast-acting carbohydrate, followed by a glucose recheck in about 15 minutes. Insulin could worsen hypoglycemia, and glucagon is generally used when oral treatment is not safe or possible. Waiting an hour delays treatment of a potentially worsening low glucose.

3. 3.A client with suspected pulmonary tuberculosis is admitted. Which infection-control action is appropriate?

   • A.Place the client in a negative-pressure room and use a fit-tested respirator
   • B.Use droplet precautions and wear a surgical mask within 1 m (3 ft)
   • C.Use contact precautions and dedicate a blood pressure cuff
   • D.Place the client in a positive-pressure room and wear gloves

   Rationale: Pulmonary tuberculosis requires airborne precautions, including a negative-pressure room and a fit-tested respirator. Droplet precautions do not adequately prevent airborne transmission, and contact precautions alone are insufficient. Positive-pressure rooms protect immunocompromised clients from outside organisms rather than containing airborne pathogens.

4. 4.A client has a potassium level of 6.4 mEq/L and peaked T waves on the electrocardiogram. Which prescribed intervention should the nurse implement first?

   • A.Administer intravenous calcium gluconate
   • B.Give oral potassium chloride
   • C.Encourage foods high in potassium
   • D.Administer a potassium-sparing diuretic

   Answer and rationale are in the full material.

5. 5.A nurse is preparing to administer digoxin to an adult client. The apical pulse is 54/min. What should the nurse do?

   • A.Withhold the dose and notify the provider
   • B.Administer the dose and recheck the pulse in 1 hour
   • C.Give the dose with an antacid
   • D.Ask the client to walk before administering the dose

   Answer and rationale are in the full material.