HESI Midterm Comprehensive Exit

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Sample questions from HESI Midterm Comprehensive Exit

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

1. 1.A client with chronic obstructive pulmonary disease is admitted with increased dyspnea. The client is using accessory muscles, has an oxygen saturation of 86% on room air, and is alert. Which action should the nurse take first?

   • A.Encourage the client to drink warm fluids
   • B.Teach the client pursed-lip breathing
   • C.Obtain a sputum specimen for culture
   • D.Apply controlled oxygen as prescribed and reassess the response

   Rationale: The low oxygen saturation and increased work of breathing require prompt support of oxygenation; use the prescribed controlled oxygen and reassess closely. A sputum culture may guide treatment but does not address the immediate problem. Fluids and pursed-lip breathing can help with secretion clearance and dyspnea but should not delay oxygen support. The exam takeaway is to address an acute threat to breathing before nonurgent diagnostics or teaching.

2. 2.A nurse is caring for a client with a suspected acute stroke who has facial droop and difficulty speaking. Which actions are appropriate during the initial assessment and care? Select all that apply.

   • A.Check the blood glucose level
   • B.Determine the time the client was last known to be well
   • C.Lower the head of the bed flat for all clients
   • D.Activate the facility's stroke response process
   • E.Keep the client NPO until swallowing ability is assessed

   Rationale: The last-known-well time helps determine eligibility for time-sensitive treatment, and swallowing must be assessed before oral intake to reduce aspiration risk. Hypoglycemia can mimic stroke, so checking glucose is appropriate. Activating the stroke response process helps expedite imaging and treatment. A flat position is not appropriate for every client and may worsen aspiration risk or respiratory status; positioning should be individualized.

3. 3.A client with type 1 diabetes is diaphoretic and shaky. The client is alert and has a blood glucose of 52 mg/dL. What should the nurse do first?

   • A.Recheck the blood glucose in 1 hour
   • B.Give 15 g of a fast-acting carbohydrate
   • C.Give a high-protein snack only
   • D.Administer the scheduled long-acting insulin

   Rationale: An alert client with hypoglycemia should receive a fast-acting carbohydrate, followed by a glucose recheck after about 15 minutes and further treatment as needed. Long-acting insulin could worsen the hypoglycemia. Protein alone does not rapidly raise blood glucose. Waiting an hour delays treatment of a potentially worsening episode. The takeaway is to treat symptomatic hypoglycemia promptly and reassess.

4. 4.A client with a suspected pulmonary embolism suddenly develops severe dyspnea and chest pain. Which action should the nurse take first?

   • A.Apply oxygen and assess respiratory status
   • B.Encourage the client to ambulate
   • C.Offer oral fluids
   • D.Obtain a routine dietary history

   Answer and rationale are in the full material.

5. 5.A client with heart failure reports increasing shortness of breath when lying flat and has new bilateral crackles. Which finding is most important for the nurse to report?

   • A.The client has a heart rate of 88/min
   • B.The client prefers to sleep with two pillows
   • C.The client has gained 2.3 kg (5 lb) in 3 days
   • D.The client reports mild fatigue after walking

   Answer and rationale are in the full material.