2020 HESI Clinical Analysis Exit Exam Version 3 With Answers (129 Solved Questions)

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1.After placing a 36- week- gestation newborn in an isolette and drying theinfant with several blankets, what should the nurse implement next?a.Place erythromycin ophthalmic ointment in both eyes2.A client in the third trimester of pregnancy complains of frequent nasalstiffness and occasional nosebleeds. Her chest circumference has increasedby 5 cm during the pregnancy, and she uses thoracic breathing. Herdiaphragm is elevated and she has an increased costal angle. Whichintervention should the nurse implement?a.Examine the client for signs of tissue anoxia, such as pallor3.A terminally ill male hospice client who is at home is showing decreasedawareness of his surroundings. His appetite is poor and he often refuses oralintake of solids and liquids. For the past several days he has been unable toget out of bed. Which action should the hospice nurse implement?a.Teach the family how to assist the client to a wheelchair4.A woman was admitted yesterday afternoon with severe abdominal pain. Herpregnancy test and ultrasound were negative, so an exploratory laparotomywas completed during the night. When coffee ground materials is observed inthe drainage from the nasogastric tube (NGT), which intervention should thenurse implement?a.Verify correct placement of the nasogastric tube5.The nurse is reviewing the laboratory values for a client with acutepancreatitis who reports of the abdominal pain is not as severe as it was onadmission. Which laboratory test should the nurse review to evaluate theclients clinical recovery?a.Lipase6.While assessing a client who had a laparotomy the previous day, the nursenotices that 300 mL of dark red fluid has drained from the nasogastric tube inthe last hour. Which action should the nurse take first?a.Assess the clients level of pain7.The nurse is reviewing the recommended preventative care for clients withasthma, chronic bronchitis, and emphysema. Which health care measure ismost important for the nurse to recommend to these clients?a.Avoid large crowded areas during the colder months of the year8.The mother of a one-moth-old infant calls the clinic to report that the back ofher infant’s head is flat. How should the nurse respond?a.Position the infant on the stomach occasionally when awake andactive9.A woman is brought to the labor and delivery unti after delivering a terminfant and the placenta in the hospital parking lot 10 minutes ago. Whichaction should the nurse perform first?a.Place the infant to the breast for bonding10. A client has a new prescription for the maximum recommended dosage ofpipercillin/tazobactam for nosocomial pneumonia. The nurse should reportwhich laboratory finding to the healthcare provider before administering theprescribed dose?a.Presence of gram positive bacteria in the sputum2020 HESI EXIT V3

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11. A client who is admitted with diabetic ketoacidosis (DKA) is demonstratingKussmaul breathing and has a severe headache along with nausea. Herarterial blood gases (ABG) are: pH 7.50; PaCO2 30 mmHg; HCO3 24 mEq/L(24mmol/L). Which assessment finding warrants immediate intervention bythe nurse?a.Fruity breath12. When perfomring postural drainage on a client with Chronic ObstructivePulmonary disease (COPD), which approach should the nurse use?a.Expalin that the client may be placed in five positions13. A young male client with testicular cancer has a living will that describes hisdesire that no extraordinary measures be taken to save his life. Thehealthcare provider knows the client has a good prognosis and refuses towrite a “do not resuscitate” (DNR) prescription. Which action should thenurse take?a.Place a DNR bracelet on the clients arm14. In observing a clients face, which assessment finding requires the mostimmediate intervention by the nurse?a.Oral mucosa is cyanotic15. The nurse is assessing a client with cirrhosis and notes that the client has apositive Babinski reflex. Which action should the nurse take in response tothe finding?a.Complete a thorough neurological assessment16. Which action should the nurse take first after obtaining a urine specimen forculture and sensitivity from an indwelling urinary catheter?a.Label the container with the client’s identifiers17. The home health nurse observes an older client with unilateral weaknessplace the walker in front of the chair for support while rising to a standingposition. Which action should the nurse take?a.Instruct the client to use the arms of the chair for support18. A client with cancer complains of fever, chills, malaise, and headachefollowing administration of a colony-stimulating factor. Which nursingintervention is most beneficial in helping to reduce the flu-like symptoms?a.Monitor lab values for an increase in WBCs19. Which laboratory value should the nurse review prior to administering theinitial dose of a statin medication?a.Serum liver enzymes20. Following a lumbar puncture, a client voices several concerns. Which concernindicates to the nurse that the client is experiencing a complication of theprocedure?a.I have a headache that gets worse when I sit up21. The nurse is caring for a client withdrawing from a fentanyl citrate addiction.The client receives a prescription for clonidine 0.2 mg PO taken twice daily.Which action should the nurse take?a.Advise to sit up slowly from a reclining position

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22. A 7-year-old child is admitted to the hospital with a diagnosis of acuterheumatic fever. In obtaining a health history form the child’s mother, therecent occurrence of what illness is most significant?a.Sore throat23. Following discharge teaching, a client with a duodenal ulcer tells the nurse ofplans to eat plenty of dairy products, such as milk, to help coat and protecttheir ulcer. Which is the best follow-up action by the nurse?a.Review with the client the need to avoid foods that are rich in milkand cream24. The nurse assesses a client with cirrhosis and find 4+ pitting edema of thefeet and legs, and massive ascites. Which mechanism contributes to edemaand ascites in clients with cirrhosis?a.Hypoalbuminemia that results in a decreased colloidal oncoticpressure25. The nurse is caring for an adolescent client with an intestinal obstructionwho presents with severe, colicky abdominal pain, nauseas, vomiting, andabdominal distention. Which pathophysiological mechanism supports theclient’s clinical presentation?a.A weakened diaphragm with high abdominal pressure26. An adult who was recently diagnosed with glaucoma tells the nurse, “it feelslike I am driving through a tunnel.” The client expresses great concern aboutgoing blind. Which nursing instruction is most important for the nurse toprovide to this client?a.Maintain prescribed eye drop regimen27. The charge nurse is making assignments on a cardiac unit. Which client isbest to assign to a new graduate who is orienting to the unit? A clienta.With atrial fibrillation whose saline lock is infiltrated28. Penicillin G procaine 240,000 units intramuscularly is prescribed for a 4-year-old child who has streptococcal respiratory infection. The medicationvial is labeled 1,200,000 units/2mL. How many mL should the nurseadminister?a.0.429. A client in labor states, “I think my water just broke!” The nurse notes thatthe umbilical cord is on the perineum. What action should the nurse performfirst?a.Place the client in trendelenburg30. A client who was recently diagnosed with anorexia nervosa collapses at anoutpatient clinic. While taking the blood pressure, the client begins todemonstrate cloudy consciousness, stupor, and has slurred speech. The nurseobtains blood glucose of 50 mg/dL, heart rate of 116 beats/minute, andblood pressure of 88/50 mmHg. Which intervention is most important forthe nurse to implement?a.Position client with head flat and feet elevated31. The nurse is planning care for a 16-year-old, who has juvenile idiopathicarthritis (JIA)> the nurse includes activities to strengthen and mobilize the

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