HESI RN Exit September and November Version Study Guide

Free preview · Original latest version

Sample questions from HESI RN Exit September and November Version Study Guide

This material has 24 questions with answers and rationales. Here are the first 5.

1. 1.The RN receives handoff for four clients. Which client should the RN assess first?

   • A.A client with COPD whose oxygen saturation is 90% on the prescribed oxygen flow and who is speaking comfortably
   • B.A client 4 hours after abdominal surgery with new restlessness, heart rate 122/min, and blood pressure 86/48 mm Hg
   • C.A client with diabetes whose premeal glucose is 186 mg/dL
   • D.A client with chronic heart failure who has unchanged bilateral ankle edema

   Rationale: B is correct because acute mental status change, tachycardia, and hypotension suggest shock, possibly from postoperative hemorrhage. A describes a potentially acceptable prescribed oxygenation range without distress. C describes an unchanged chronic finding. D requires routine management but is not the immediate threat.

2. 2.A client arrives with new facial drooping and right arm weakness. The last-known-well time was 45 minutes ago. Which action is appropriate while the stroke pathway is activated?

   • A.Check bedside blood glucose
   • B.Offer water to assess swallowing
   • C.Give oral aspirin before imaging
   • D.Delay evaluation until a family member arrives

   Rationale: C is correct because hypoglycemia can mimic stroke and is rapidly reversible. A is unsafe before hemorrhage is excluded and treatment is determined. B risks aspiration before an approved swallowing screen. D delays time-sensitive care; family information can be collected while assessment proceeds.

3. 3.A client with severe asthma is receiving emergency treatment. Which finding requires the most immediate escalation?

   • A.Persistent expiratory wheezing while speaking in sentences
   • B.A productive cough after hydration
   • C.Heart rate 106/min after a beta-agonist treatment
   • D.Minimal air movement with increasing drowsiness

   Rationale: A is correct because markedly reduced air movement and drowsiness suggest impending respiratory failure. B still requires reassessment but indicates more airflow and preserved speech. C may occur with beta-agonists and must be interpreted in context. D alone does not indicate imminent failure.

4. 4.A client with DKA has glucose 468 mg/dL and potassium 3.1 mEq/L. An IV insulin infusion is prescribed. Which action should the nurse take?

   • A.Restrict all IV fluids until the glucose decreases
   • B.Start insulin immediately because the glucose is elevated
   • C.Notify the prescriber and implement potassium replacement before insulin according to protocol
   • D.Give sodium polystyrene sulfonate before insulin

   Answer and rationale are in the full material.

5. 5.An alert client with diabetes is sweating and reports shakiness. Blood glucose is 58 mg/dL, and swallowing is intact. What should the nurse do first?

   • A.Administer the scheduled rapid-acting insulin
   • B.Give 15 g of rapid-acting carbohydrate
   • C.Provide a high-fat meal and recheck glucose in 2 hours
   • D.Administer glucagon instead of oral treatment

   Answer and rationale are in the full material.