HESI RN FUNDAMENTALS EXIT EXAM 2023 / FUNDAMENTALS RN HESI EXIT 2023 ACTUAL EXAM ALL 55 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+

HESI RN FUNDAMENTALS EXIT EXAM 2023 /

FUNDAMENTALS RN HESI EXIT 2023 ACTUAL EXAM

ALL 55 QUESTIONS AND CORRECT DETAILED

ANSWERS WITH RATIONALES (VERIFIED ANSWERS)

|ALREADY GRADED A+

The nurse is teaching a client how to perform progressive muscle

relaxation techniques to relieve insomnia. A week later the client reports

that he is still unable to sleep, despite following the same routine every

night. Which action should the nurse take first?

A. Instruct the client to add regular exercise as a daily routine.

B. Determine if the client has been keeping a sleep diary.

C. Encourage the client to continue the routine until sleep is achieved.

D. Ask the client to describe the routine he is currently following. -

ANSWER- D

Rationale: The nurse should first evaluate whether the client has

been adhering to the original instructions. A verbal report of the

client's routine will provide more specific information than the

client's written diary. The nurse can then determine which changes

need to be made. The routine practiced by the client is clearly

unsuccessful, so encouragement alone is insufficient.

Ten minutes after signing an operative permit for a fractured hip, an

older client states, "The aliens will be coming to get me soon!" and falls

asleep. Which action should the nurse implement next?

A. Make the client comfortable and allow the client to sleep.

B. Assess the client's neurologic status.

C. Notify the surgeon about the comment.

D. Ask the client's family to co-sign the operative permit. - ANSWERB

Rationale: This statement may indicate that the client is confused.

Informed consent must be provided by a mentally competent

individual, so the nurse should further assess the client's neurologic

status to be sure that the client understands and can legally provide

consent for surgery. Option A does not provide sufficient follow-up.

If the nurse determines that the client is confused, the surgeon must

be notified and permission obtained from the next of kin.

A nurse is working in an occupational health clinic when an employee

walks in and states that he was struck by lightning while working in a

truck bed. The client is alert but reports feeling faint. Which assessment

will the nurse perform first?

A. Pulse characteristics

B. Open airway

C. Entrance and exit wounds

D. Cervical spine injury - ANSWER- A

Rationale: Lightning is a jolt of electrical current and can produce a

"natural" defibrillation, so assessment of the pulse rate and

regularity is a priority. Because the client is talking, he has an open

airway, so that assessment is not necessary. Assessing for options C

and D should occur after assessing for adequate circulation.

The nurse who is preparing to give an adolescent client a prescribed

antipsychotic medication notes that parental consent has not been

obtained. Which action should the nurse take?

A. Review the chart for a signed consent for hospitalization.

B. Get the health care provider's permission to give the medication.

C. Do not give the medication and document the reason.

D. Complete an incident report and notify the parents. - ANSWER- C

Rationale: The nurse should not give the medication and should

document the reason because the client is a minor and needs a

guardian's permission to receive medications. Permission to give

medications is not granted by a signed hospital consent or a health

care provider's permission, unless conditions are met to justify

coerced treatment. Option D is not necessary unless the medication

had previously been administered.

A hospitalized client has had difficulty falling asleep for two nights and

is becoming irritable and restless. Which action by the nurse is best?

A. Determine the client's usual bedtime routine and include these rituals

in the plan of care as safety allows.

B. Instruct the UAP not to wake the client under any circumstances

during the night.

C. Place a "Do Not Disturb" sign on the door and change assessments

from every 4 to every 8 hours.

D. Encourage the client to avoid pain medication during the day, which

might increase daytime napping. - ANSWER- A

Rationale: Including habitual rituals that do not interfere with the

client's care or safety may allow the client to go to sleep faster and

increase the quality of care. Options B, C, and D decrease the

client's standard of care and compromise safety.

The nurse is assisting a client to the bathroom. When the client is 5 feet

from the bathroom door, he states, "I feel faint." Before the nurse can get

the client to a chair, the client starts to fall. Which is the priority action

for the nurse to take?

A. Check the client's carotid pulse.

B. Encourage the client to get to the toilet.

C. In a loud voice, call for help.

D. Gently lower the client to the floor. - ANSWER- D

Rationale: Option D is the most prudent intervention and is the

priority nursing action to prevent injury to the client and the nurse.

Lowering the client to the floor should be done when the client

cannot support his own weight. The client should be placed in a bed

or chair only when sufficient help is available to prevent injury.

Option A is important but should be done after the client is in a safe

position. Because the client is not supporting himself, option B is

impractical. Option C is likely to cause chaos on the unit and might

alarm the other clients.

A male client is laughing at a television program with his wife when the

evening nurse enters the room. He says his foot is hurting and he would

like a pain pill. How should the nurse respond?

A. Ask him to rate his pain on a scale of 1 to 10.

B. Encourage him to wait until bedtime so the pill can help him sleep.