HESI RN
HESI 799 RN Exit Exam Questions
Question 1 of 5
A male client is having abdominal pain after a left femoral angioplasty and stent, and is asking for additional pain medication for right lower quadrant pain (9/10). Two hours ago, he received hydrocodone/acetaminophen 7.5/7.50 mg. His vital signs are elevated from the previous hour: temperature 97.8 F, heart rate 102 beats per minute, respiration 20 breaths per minute. His abdomen is swollen, the groin access site is tender, peripheral pulses are present, but the left leg is larger than the right. Preoperatively, clopidogrel was prescribed for a history of previous peripheral stents. Another nurse is holding manual pressure on the femoral arterial access site which may be leaking into the abdomen. What data is needed to make this report complete?
Correct Answer: B
Rationale: The correct answer is B. Immediate evaluation by the surgeon is necessary due to the possibility of an internal hemorrhage, which is a life-threatening condition. Choice A is incorrect as lung status and oxygen saturation are not the priority in this situation. Choice C is not relevant to the current urgent issue. Choice D, while providing additional history, is not pertinent to the immediate concern of a potential internal hemorrhage post angioplasty and stent placement.
Question 2 of 5
Sublingual nitroglycerin is administered to a male client with unstable angina who complains of crushing chest pain. Five minutes later, the client becomes nauseated, and his blood pressure drops to 60/40 mm Hg. Which intervention should the nurse implement?
Correct Answer: B
Rationale: The correct intervention in this situation is to infuse a rapid IV normal saline bolus. The client's drop in blood pressure to 60/40 mm Hg after nitroglycerin administration indicates hypotension, which may suggest a right ventricular infarction. Normal saline bolus helps to increase intravascular volume, improve cardiac output, and support blood pressure. Administering a second dose of nitroglycerin would further decrease blood pressure. External chest compressions are not indicated as the client's heart is still beating, and there is no indication for CPR. Giving an antiemetic medication is not the priority in this situation where hypotension is the main concern.
Question 3 of 5
Following a gunshot wound to the abdomen, a young adult male had an emergency bowel resection and received multiple blood products while in the operating room. His current blood pressure is 78/52 mm Hg, he is being mechanically ventilated, and his oxygen saturation is 87%. His laboratory values include hemoglobin 7.0 g/dL, platelets 20,000/mm³, and white blood cells 1,500/mm³. Based on these assessment findings, which intervention should the nurse implement first?
Correct Answer: A
Rationale: The client is exhibiting signs of severe anemia and hypovolemic shock, indicated by low hemoglobin levels and hypotension. The first priority is to address the low hemoglobin by transfusing packed red blood cells to improve oxygen-carrying capacity and perfusion to vital organs. While obtaining blood and sputum cultures is important for identifying potential infections, infusing normal saline can help with volume expansion but does not address the primary issue of severe anemia. Titrating oxygen to maintain an oxygen saturation of 90% is crucial but should follow the administration of packed red blood cells to optimize oxygen delivery.
Question 4 of 5
A 35-year-old female client has just been admitted to the post-anesthesia recovery unit following a partial thyroidectomy. Which statement reflects the nurse's accurate understanding of the expected outcome for the client following this surgery?
Correct Answer: C
Rationale: After a partial thyroidectomy, the client may be advised to avoid eating seafood due to its high iodine content, which can affect the thyroid function. Choice A is incorrect because after a partial thyroidectomy, supplemental hormonal therapy may be necessary. Choice B is incorrect as the thyroid does not regenerate after a partial thyroidectomy. Choice D is incorrect; the remaining portion of the thyroid is not typically removed at a later date unless there are specific medical reasons to do so.
Question 5 of 5
Which assessment finding indicates to the nurse a client's readiness for pulmonary function tests?
Correct Answer: A
Rationale: The correct answer is A: 'Expresses an understanding of the procedure.' This choice indicates that the client is mentally prepared for the pulmonary function tests, as understanding the procedure shows readiness and cooperation. Choices B, C, and D are incorrect. Choice B, 'NPO for 6 hrs,' pertains to fasting status and is not directly related to readiness for the test. Choice C, 'No known drug allergies,' is important information but does not specifically indicate readiness for pulmonary function tests. Choice D, 'Intravenous access intact,' is related to vascular access and not a direct indicator of readiness for the pulmonary function tests.