HESI PN EXIT EXAM V3 LATEST VERSION 2022-2024 ALL 110 QUESTIONS AND VERIFIED ANSWERS PLUS RATIONALES/PN HESI EXIT EXAM V3

HESI PN EXIT EXAM V3 LATEST

VERSION 2022-2024 ALL 110

QUESTIONS AND VERIFIED

ANSWERS PLUS RATIONALES/PN

HESI EXIT EXAM V3

1. An adult client experiences a gasoline tank fire when riding a motorcycle and is admitted to

the emergency department (ED) with full thickness burns to all surfaces of both lower

extremities. What percentage of body surface area should the nurse document in the

electronic medical record (EMR)?

 9 %

 18 %

 36 %

 45 %

 Rational: according to the rule of nines, the anterior and posterior surfaces of one

lower extremity is designated as 18 %of total body surface area (TBSA), so both

extremities equals 36% TBSA, other options are incorrect.

2. A client with hyperthyroidism is receiving propranolol (Inderal). Which finding indicates that

the medication is having the desired effect?

 Decrease in serum T4 levels

 Increase in blood pressure

 Decrease in pulse rate

 Goiter no longer palpable

3. An older male client with type 2 diabetes mellitus reports that has experiences legs pain

when walking short distances, and that the pain is relieved by rest. Which client behavior

indicates an understanding of healthcare teaching to promote more effective arterial

circulation?

 Consistently applies TED hose before getting dressed in the morning.

 Frequently elevated legs thorough the day.

 Inspect the leg frequently for any irritation or skin breakdown

 Completely stop cigarette/ cigar smoking.

 Rationale: Stopping cigarette smoking helps to decrease vasoconstriction and

improve arterial circulation to the extremity.

4. A community health nurse is concerned about the spread of communicable diseases among

migrant farm workers in a rural community. What action should the nurse take to promote the

success of a healthcare program designed to address this problem?

Establish trust with community leaders and respect cultural and family

values

5. The nurse performs a prescribed neurological check at the beginning of the shift on a client

who was admitted to the hospital with a subarachnoid brain attack (stroke). The client’s

Glasgow Coma Scale (GCS) score is 9. What information is most important for the nurse to

determine?

 The client’s previous GCS score

 When the client’s stroke symptoms started

 If the client is oriented to time

 The client’s blood pressure and respiration rate

 Rationale: The normal GCS is 15, and it is most important for the nurse to

determine if it abnormal score a sign of improvement or a deterioration in the

client’s condition

6. The charge nurse in a critical care unit is reviewing clients’ conditions to determine who is

stable enough to be transferred. Which client status report indicates readiness for transfer

from the critical care unit to a medical unit?

Chronic liver failure with a hemoglobin of 10.1 and slight bilirubin elevation

7. Based on principles of asepsis, the nurse should consider which circumstance to be sterile?

 One inch- border around the edge of the sterile field set up in the operating room

 A wrapped unopened, sterile 4x4 gauze placed on a damp table top.

 An open sterile Foley catheter kit set up on a table at the nurse waist level

 Sterile syringe is placed on sterile area as the nurse riches over the sterile field.

 Rationale: A sterile package at or above the waist level is considered sterile. The

edge of sterile field is contaminated which include a 1-inch border (A). A sterile

objects become contaminated by capillary action when sterile objects become in

contact with a wet contaminated surface.

8. An unlicensed assistive personnel (UAP) reports that a client’s right hand and fingers spasms

when taking the blood pressure using the same arm. After confirming the presence of spams

what action should the nurse take?

 Ask the UAP to take the blood pressure in the other arm