HESI Exit October

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Sample questions from HESI Exit October

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

1. 1.A client with acute heart failure is receiving oxygen and IV diuretics. Which finding requires the nurse's immediate action?

   • A.Potassium level of 3.6 mEq/L
   • B.Bilateral ankle edema of 2+
   • C.Urine output of 40 mL/hr
   • D.Oxygen saturation of 86% on 2 L/min nasal cannula

   Rationale: An oxygen saturation of 86% indicates significant hypoxemia and requires prompt assessment and intervention, such as increasing oxygen per protocol and notifying the provider. The urine output is adequate, ankle edema is an expected volume-overload finding, and the potassium level is within the usual reference range. In an unstable client, address impaired oxygenation before less urgent findings.

2. 2.A nurse is teaching a client with heart failure about home management. Which instructions should the nurse include? Select all that apply.

   • A.Limit sodium as directed by the health care provider.
   • B.Weigh yourself every morning after voiding.
   • C.Report a gain of 2 lb (0.9 kg) in 24 hours.
   • D.Take prescribed medications even when symptoms improve.
   • E.Use a salt substitute freely instead of table salt.

   Rationale: Daily weights under consistent conditions help detect fluid retention, and a rapid gain of 2 lb in a day should be reported. Taking prescribed medications consistently and following the individualized sodium limit support control of heart failure. Salt substitutes may contain potassium and can be unsafe for some clients, so they should not be used freely without provider guidance.

3. 3.A client with type 1 diabetes is diaphoretic and confused; a bedside glucose reading is 48 mg/dL. The client is awake and can swallow. What should the nurse do first?

   • A.Administer the scheduled dose of insulin.
   • B.Give 15 g of a rapid-acting oral carbohydrate.
   • C.Give a high-protein snack and recheck in 1 hour.
   • D.Call the provider before treating the low glucose.

   Rationale: An awake client who can swallow should receive about 15 g of rapid-acting carbohydrate, followed by a glucose recheck in 15 minutes. Insulin would worsen hypoglycemia, and protein alone does not correct it quickly. Treatment should not be delayed while waiting for a provider when the client is symptomatic.

4. 4.A client with a suspected ischemic stroke arrives at the emergency department 1 hour after symptom onset. Which information is most important to obtain first when evaluating eligibility for thrombolytic therapy?

   • A.The client's most recent bowel movement
   • B.The client's preferred pharmacy
   • C.The time the client was last known to be well
   • D.The client's usual diet

   Answer and rationale are in the full material.

5. 5.A nurse is caring for a client with chronic obstructive pulmonary disease who is experiencing increased dyspnea. Which actions are appropriate? Select all that apply.

   • A.Position the client upright and encourage a forward-leaning posture.
   • B.Encourage pursed-lip breathing during exhalation.
   • C.Titrate prescribed oxygen to the target saturation range.
   • D.Assess breath sounds, work of breathing, and mental status.
   • E.Withhold all oxygen because it can suppress respiratory drive.

   Answer and rationale are in the full material.