HESI Exist C

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Sample questions from HESI Exist C

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

1. 1.A 68-year-old client is admitted to the emergency department with crushing chest pain, diaphoresis, and nausea. Blood pressure is 88/54 mm Hg, heart rate is 118/min, and the electrocardiogram shows ST-segment elevation in leads II, III, and aVF. Which action should the nurse take first?

   • A.Administer prescribed sublingual nitroglycerin
   • B.Establish large-bore intravenous access and prepare for emergency reperfusion
   • C.Obtain a detailed medication history
   • D.Encourage the client to cough and breathe deeply

   Rationale: The client has an acute ST-elevation myocardial infarction with hypotension, so rapid intravenous access and preparation for reperfusion are priorities. Nitroglycerin can worsen hypotension, and a medication history must not delay urgent treatment. Coughing and deep breathing do not address the immediate cardiac emergency.

2. 2.A 74-year-old client with heart failure is receiving intravenous furosemide. The client reports new muscle weakness; potassium is 2.8 mEq/L, blood pressure is 104/66 mm Hg, and heart rate is 96/min. Which action is most appropriate?

   • A.Administer the next dose of furosemide as scheduled
   • B.Hold the medication and notify the health care provider
   • C.Encourage the client to restrict dietary potassium
   • D.Document the finding as an expected effect

   Rationale: Severe hypokalemia can cause weakness and life-threatening dysrhythmias, so the nurse should hold the loop diuretic and promptly notify the provider. Giving another dose could worsen potassium loss, and restricting potassium is inappropriate. The finding is clinically significant, not an expected effect to document without intervention.

3. 3.A 59-year-old client with type 1 diabetes is found confused and diaphoretic on a medical unit. Blood glucose is 42 mg/dL, and the client can swallow safely. Which intervention should the nurse perform first?

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

   Rationale: A conscious client who can swallow should receive rapid-acting oral carbohydrate for symptomatic hypoglycemia. Long-acting insulin would lower glucose further, and glucagon is generally used when oral treatment is not safe or possible. Waiting an hour to recheck delays treatment of a potentially dangerous low glucose.

4. 4.A 23-year-old client with type 1 diabetes arrives at the emergency department with abdominal pain, vomiting, and deep rapid respirations. Glucose is 486 mg/dL, pH is 7.18, and potassium is 5.4 mEq/L. Which prescription should the nurse implement first?

   • A.Begin isotonic intravenous fluid replacement
   • B.Administer intravenous sodium bicarbonate
   • C.Give subcutaneous long-acting insulin
   • D.Restrict oral and intravenous fluids

   Answer and rationale are in the full material.

5. 5.A 71-year-old client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by nasal cannula. The client becomes increasingly drowsy; respiratory rate is 10/min and oxygen saturation is 90%. Which action should the nurse take first?

   • A.Increase oxygen to 6 L/min
   • B.Assess respiratory effort and obtain an arterial blood gas as prescribed
   • C.Remove the oxygen immediately
   • D.Encourage the client to lie flat and rest

   Answer and rationale are in the full material.