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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Document preview page 1

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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions)

2020-2021 HESI RN Pediatrics Review Exit Exam With Answers improves your problem-solving abilities with past exam examples.

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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 1 preview imageHESI EXIT RN EXAM OVER 700 QUESTIONS,ANSWERS RATIONALE NEW 2020/20211. Following discharge teaching, a male client with duodenal ulcertells the nurse the he will drink plenty of dairy products, such asmilk, to help coat and protect his ulcer. What is the best follow-upaction by the nurse?a- Remind the client that it is also important to switch to decaffeinatedcoffee and tea.b- Suggest that the client also plan to eat frequent small meals toreduce discomfortc- Review with the client the need to avoid foods that are rich inmilk and cream.d- Reinforce this teaching by asking the client to list a dairy food that hemight select.Rationale: Diets rich in milk and cream stimulate gastric acid secretionand should be avoided.2. A male client with hypertension, who received newantihypertensive prescriptions at his last visit returns to the clinictwo weeks later to evaluate his blood pressure (BP). His BP is158/106 and he admits that he has not been taking the prescribedmedication because the drugs make him “feel bad”. In explainingthe need for hypertension control, the nurse should stress that anelevated BP places the client at risk for which pathophysiologicalcondition?
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 2 preview image
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 3 preview imagea- Blindness secondary to cataractsb- Acute kidney injury due to glomerular damagec- Stroke secondary to hemorrhaged- Heart block due to myocardial damageRationale: Stroke related to cerebral hemorrhage is major risk foruncontrolled hypertension.3. The nurse observes an unlicensed assistive personnel (UAP)positioning a newly admitted client who has a seizure disorder.The client is supine and the UAP is placing soft pillows along theside rails. What action should the nurse implement?a- Ensure that the UAP has placed the pillows effectively to protect theclient.b- Instruct the UAP to obtain soft blankets to secure to the side railsinstead of pillows.a- Assume responsibility for placing the pillows while the UAPcompletes another task.b- Ask the UAP to use some of the pillows to prop the client in a sidelying position.Rationale: The nurse should instruct the UAP to pad the side rails withsoft blankest because the use of pillows could result in suffocation andwould need to be removed at the onset of the seizure. The nurse candelegate paddling the side rails to the UAP4. An adolescent with major depressive disorder has been takingduloxetine (Cymbalta) for the past 12 days. Which assessmentfinding requires immediate follow-up?
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 4 preview imagea- Describes life without purposeb- Complains of nausea and loss of appetitec- States is often fatigued and drowsyd- Exhibits an increase in sweating.Rationale: Cymbalta is a selective serotonin and norepinephrinereuptake inhibitor that is known to increase the risk of suicidalthinking in adolescents and young adults with major depressivedisorder. B, C and D are side effects5. A 60-year-old female client with a positive family history ofovarian cancer has developed an abdominal mass and is beingevaluated for possible ovarian cancer. Her Papanicolau (Pap)smear results are negative. What information should the nurseinclude in the client’s teaching plan?a- Further evaluation involving surgery may be neededb- A pelvic exam is also needed before cancer is ruled outc- Pap smear evaluation should be continued every six monthd- One additional negative pap smear in six months is needed.Rationale: An abdominal mass in a client with a family history forovarian cancer should be evaluated carefully6. A client who recently underwear a tracheostomy is beingprepared for discharge to home. Which instructions is mostimportant for the nurse to include in the discharge plan?a- Explain how to use communication tools.b- Teach tracheal suctioning techniquesc- Encourage self-care and independence.d- Demonstrate how to clean tracheostomy site.
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 5 preview imageRationale: Suctioning helps to clear secretions and maintain an openairway, which is critical.7. In assessing an adult client with a partial rebreather mask, thenurse notes that the oxygen reservoir bag does not deflatecompletely during inspiration and the client’s respiratory rate is14 breaths / minute. What action should the nurse implement?a- Encourage the client to take deep breathsb- Remove the mask to deflate the bagc- Increase the liter flow of oxygend- Document the assessment dataRational: reservoir bag should not deflate completely during inspirationand the client’s respiratory rate is within normal limits.8. During a home visit, the nurse observed an elderly client withdiabetes slip and fall. What action should the nurse take first?a- Give the client 4 ounces of orange juiceb- Call 911 to summon emergency assistancec- Check the client for lacerations or fracturesd- Asses clients blood sugar levelRationale: After the client falls, the nurse should immediately assess forthe possibility of injuries and provide first aid as needed9. At 0600 while admitting a woman for a schedule repeat cesareansection (C-Section), the client tells the nurse that she drank a cupa coffee at 0400 because she wanted to avoid getting a headache.Which action should the nurse take first?a- Ensure preoperative lab results are available
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 6 preview imageb- Start prescribed IV with lactated Ringer’sc- Inform the anesthesia care providerd- Contact the client’s obstetrician.Rationale: Surgical preoperative instruction includes NPO after midnightthe day of surgery to decrease the risk of aspiration should vomitingoccur during anesthesia. While it is possible the C-section will be doneon schedule or rescheduled for later in the day, the anesthesia providershould be notified first.10.After placing a stethoscope as seen in the picture, the nurseauscultates S1 and S2 heart sounds. To determine if an S3 heartsound is present, what action should the nurse take first?a- Side the stethoscope across the sternum.b- Move the stethoscope to the mitral sitec- Listen with the bell at the same locationd- Observe the cardiac telemetry monitorRationale: The nurse uses the bell of the stethoscope to hear low-pitchedsounds such as S3 and S4. The nurse listens at the same site using thediaphragm the diaphragm and bell before moving systematically to thenext sites.11.A 66-year-old woman is retiring and will no longer have ahealth insurance through her place of employment. Which agencyshould the client be referred to by the employee health nurse forhealth insurance needs?a- Woman, Infant, and Children programb- Medicaidc- Medicared- Consolidated Omnibus Budget Reconciliation Act provision.Rationale: Title XVII of the social security Act of 1965 created
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 7 preview imageMedicare Program to provide medical insurance for person more than 65years or older, disable or with permeant kidney failure, WIC providessupplemental nutrition to meet the needs of pregnant of breastfeedingwoman, infants and children up to age of 6. Medicaid provides financialassistance to pay for medical services for poor older adults, blind,disable and families with dependent children. COBRA(D) health benefitprovisions is a limited insurance plan for those who has been laid off orbecome unemployed.12.A client who is taking an oral dose of a tetracycline complainsof gastrointestinal upset. What snack should the nurse instructthe client to take with the tetracycline?a- Fruit-flavored yogurt.b- Cheese and crackers.c- Cold cereal with skim milk.d- Toasted wheat bread and jellyRationale: Dairy products decrease the effect of tetracycline, so thenurse instructs the client to eat a snack such as toast, which contains nodairy products and may decrease GI symptoms.13.Following a lumbar puncture, a client voices severalcomplaints. What complaint indicated to the nurse that the clientis experiencing a complication?a- “I am having pain in my lower back when I move my legs”b- “My throat hurts when I swallow”c- “I feel sick to my stomach and am going to throw upd- I have a headache that gets worse when I sit up”Rationale: A post-lumbar puncture headache, ranging from mild tosevere, may occur as a result of leakage of cerebrospinal fluid at thepuncture site. This complication is usually managed by bedrest,
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 8 preview imageanalgesic, and hydration.14.An elderly client seems confused and reports the onset ofnausea, dysuria, and urgency with incontinence. Which actionshould the nurse implement?a- Auscultate for renal bruitsb- Obtain a clean catch mid-stream specimenc- Use a dipstick to measure for urinary ketoned- Begin to strain the client’s urine.Rationale: This elderly is experiencing symptoms of urinary tractinfection. The nurse should obtain a clean catch mid-stream specimen todetermine the causative agent so an anti-infective agent can beprescribed.15.The nurse is assisting the mother of a child withphenylketonuria (PKU) to select foods that are in keeping withthe child’s dietary restrictions. Which foods are contraindicatedfor this child?a- Wheat productsb- Foods sweetened with aspartame.c- High fat foodsd- High calories foods.Rationale: Aspartame should not be consumed by a child with PKUbecause ut is converted to phenylalanine in the body. Additionally,milk and milk products are contraindicated for children with PKU.16.Before preparing a client for the first surgical case of the day, apart-time scrub nurse asks the circulating nurse if a 3-minutesurgical hand scrub is adequate preparation for this client. Whichresponse should the circulating nurse provide?
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 9 preview imagea- Ask a more experience nurse to perform that scrub since it is the firsttime of the dayb- Validate the nurse is implementing the OR policy for surgical handscrubc- Inform the nurse that hand scrubs should be 3 minutes between cases.d- Direct the nurse to continue the surgical hand scrub for a 5-minute duration.Rationale: The surgical hand scrub should last for 5 to 10 mints, so thenurse should be directed to continue the vigorous scrub using areliable agent for the total duration of 5 mints. It is not necessary toreassign staff (A). The length of the hand scrub and subsequent scrubsduring the day require the same process for the same amount of time,(B and C)17.Which breakfast selection indicates that the client understandsthe nurse’s instructions about the dietary management ofosteoporosis?a- Egg whites, toast and coffee.b- Bran muffin, mixed fruits, and orange juice.c- Granola and grapefruit juiced- Bagel with jelly and skim milk.Rationale: D includes dairy products which contain calcium and doesnot include any foods that inhibit calcium absorption. The primarydietary implication of osteoporosis is the need for increased calcium andreduction in foods that decrease calcium absorption, such as caffeine andexcessive fiber.18.The charge nurse of a critical care unit is informed at thebeginning of the shift that less than the optimal number ofregistered nurses will be working that shift. In planningassignments, which client should receive the most care hours by a
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 10 preview imageregistered nurse (RN)?a- A 34-year -old admitted today after an emergency appendendectomywho has a peripheral intravenous catheter and a Foley catheter.b- A 48-year-old marathon runner with a central venous catheter who isexperiencing nausea and vomiting due to electrolyte disturbancefollowing a race.c- A 63-year-old chain smoker admitted with chronic bronchitis who isreceiving oxygen via nasal cannula and has a saline-locked peripheralintravenous catheter.d- An 82-year-old client with Alzheimer’s disease newly-fracturesfemur who has a Foley catheter and soft wrist restrains appliedRationale: (D) describe the client at the most risk for injury andcomplications because of the factor listed. (A) has complete the recoveryperiod form anesthesia but requires critical care because of the invasivelines and new abdominal incision. (B) is likely to be in excellentphysical condition and has one invasive line needed for rehydration. (C)is essentially stable, despite having a chronic condition.19.Za- Cleanse the foot with soap and water and apply an antibioticointmentb- Provide teaching about the need for a tetanus booster within the next72 hours.c- have the mother check the child's temperature q4h for the next 24hoursd- transfer the child to the emergency department to receive a gammaglobulin injectionRationale: The nurse should cleanse the wound first and implement Bnext.20.The mother of an adolescent tells the clinic nurse, “My son has
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 11 preview imageathlete’s foot, I have been applying triple antibiotic ointment fortwo days, but there has been no improvement.” What instructionshould the nurse provide?a- Antibiotics take two weeks to become effective against infections suchas athlete’s foot.b- Continue using the ointment for a full week, even after the symptomsdisappear.c- Applying too much ointment can deter its effectiveness. Apply a thinlayer to prevent maceration.d- Stop using the ointment and encourage complete drying of the feetand wearing clean socks.Rationale: Athlete’s foot (tinea pedi) is a fungal infection that afflictsthe feet and causes scaliness and cracking of the skin between the toesand on the soles of the feet. The feet should be ventilated, dried wellafter bathing, and clean socks should be placed on the feet afterbathing. Antifungal ointments may be prescribed, but antibioticointments are not useful.21.A 26-year-old female client is admitted to the hospital fortreatment of a simple goiter, and levothyroxine sodium(Synthroid) is prescribed. Which symptoms indicate to the nursethat the prescribed dosage is too high for this client? The clientexperiencesa- Palpitations and shortness of breathb- Bradycardia and constipationc- Lethargy and lack of appetited- Muscle cramping and dry, flushed skinRationale: An overdose of thyroid preparation generally manifestssymptoms of an agitated state such as tremors, palpitations, shortness ofbreath, tachycardia, increased appetite, agitation, sweating and diarrhea.
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 12 preview image22.A client with a history of heart failure presents to the clinicwith a nausea, vomiting, yellow vision and palpitations. Whichfinding is most important for the nurse to assess to the client?a- Determine the client’s level of orientation and cognitionb- Assess distal pulses and signs of peripheral edemac- Obtain a list of medications taken for cardiac history.d- Ask the client about exposure to environmental heat.Rationale: The client is presenting with signs of digitalis toxicity. A listof medication, which is likely to include digoxin (Lanoxin) for heartfailure, can direct further assessment in validating digitalis toxicity withserum labels greater than 2 mg/ml that is contributing to client’spresenting clinical picture.23.The healthcare provider prescribes an IV solution ofisoproterenol (Isuprel) 1 mg in 250 ml of D5W at 300 mcg/hour.The nurse should program the infusion pump to deliver howmany ml/hour? (Enter numeric value only.)a- 75Rationale: Convert mg to mcg and use the formula D/H x Q. 300mcg/hour / 1,000 mcg x 250 ml = 3/1 x 25 = 75 ml/hour24.The pathophysiological mechanisms are responsible for ascitesrelated to liver failure? (Select all that apply)a- Bleeding that results from a decreased production of the body’sclotting factorsb- Fluid shifts from intravascular to interstitial area due todecreased serum proteinc- Increased hydrostatic pressure in portal circulation increases fluidshifts into abdomend- Increased circulating aldosterone levels that increase sodium andwater retention
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 13 preview imagee- Decreased absorption of fatty acids in the duodenum leading toabdominal distention.Rationale: When liver fail production of albumin is reduced. Sincealbumin is the primary serum protein creating intravascular osmoticpressure, decreased serum protein allows a fluids shift into theinterstitial space. Pressure increases in the portal circulation © whenvenous return from the upper GI tract cannot flow freely into sclerosedliver, which cause a pressure gradient to further Increase fluid shiftsinto the abdomen. A failing liver ineffectively inactivates steroidalhormones, such as aldosterone resulting in sodium and water retention.25.The nurse is auscultating a client’s heart sounds. Whichdescription should the nurse use to document this sound? (Pleaselisten to the audio first to select the option that applies)a- S1 S2b- S1 S2 S3c-Murmurd- Pericardial friction rub.Rationale: A murmur is auscultated as a swishing sound that isassociated with the blood turbulence created by the heart or valvulardefect. B is associate with Heart Failure.26.The healthcare provider prescribes celtazidime (Fortax) 35 mgevery 8 hours IM for an infant. The 500 mg vial is labeled withthe instruction to add 5.3 ml diluent to provide a concentration of100 mg/ml. How many ml should the nurse administered for eachdose? (Enter numeric value only. If rounding is required, roundto the nearest tenth)a- 0.4Rationale: 35mg/100mg x 1 = 0.35 = 0.4 ml
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 14 preview image27.The nurse notes that a client has been receivinghydromorphone (Dilaudid) every six hours for four days. Whatassessment is most important for the nurse to complete?a- Auscultate the client's bowel soundsb- Observe for edema around the anklesc- Measure the client’s capillary glucose leveld- Count the apical and radial pulses simultaneouslyRationale: hydromorphone is a potent opioid analgesic that slowsperistalsis and frequently causes constipation, so it is most important toAuscultate the client's bowel sounds28.A female client is admitted with end stage pulmonary disease isalert, oriented, and complaining of shortness of breath. The clienttells the nurse that she wants “no heroic measures” taken if shestops breathing, and she asks the nurse to document this in hermedical record. What action should the nurse implement?a- Ask the client to discuss “do not resuscitate” with her healthcareprovider29.A client is receiving a full strength continuous enteral tubefeeding at 50 ml/hour and has developed diarrhea. The client hasa new prescription to change the feeding to half strength. Whatintervention should the nurse implement?a- Add equal amounts of water and feeding to a feeding bag andinfuse at 50ml/hourb- Continue the full strength feeding after decreasing the rate of infusionto 25 ml/hr.c- Maintain the present feeding until diarrhea subsides and the begin thenext new prescription.d- Withhold any further feeding until clarifying the prescription withhealthcare provides.
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 15 preview imageRationale: Diluting the formula can help alleviate the diarrhea.Diarrhea can occur as a complication of enteral tube feeding and canbe due to a variety of causes including hyperosmolar formula.30.A female client reports that her hair is becoming coarse andbreaking off, that the outer part of her eyebrows havedisappeared, and that her eyes are all puffy. Which follow-upquestion is best for the nurse to ask?a- “Is there a history of female baldness in your family?”b- “Are you under any unusual stress at home or work?”c- “Do you work with hazardous chemicals?”d- “Have you noticed any changes in your fingernails?”Rationale: The pattern of reported manifestations is suggestive ofhypothyroidism. A question about the fingernails adds data to theclinical picture.31.After a third hospitalization 6 months ago, a client is admittedto the hospital with ascites and malnutrition. The client is drowsybut responding to verbal stimuli and reports recently spitting upblood. What assessment finding warrants immediate interventionby the nurse?a- Bruises on arms and legsb- Round and tight abdomenc- Pitting edema in lower legsd- Capillary refill of 8 secondsRationale: The client is bleeding and hypovolemia is likely. Capillaryrefill is greater than 3 to 5 seconds indicates poor perfusion and requiresimmediate attention32.After the nurse witnesses a preoperative client sign the surgical
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2020-2021 HESI RN Pediatrics Review Exit Exam With Answers (756 Solved Questions) - Page 16 preview imageconsent form, the nurse signs the form as a witness. What are thelegal implications of the nurse’s signature on the client’s surgicalconsent form? (Select all that apply)a- The client voluntarily grants permission for the procedure to bedoneb- The surgeon has explained to the client why the surgery is necessary.c- The client is competent to sign the consent without impairment ofjudgmentd- The client understands the risks and benefits associated with theproceduree- After considering alternatives to surgery, the client elects to have theprocedure.Rationale: Inform consent is required for any invasive procedure. Thenurse’s signature as a witness to the client’s signature on surgicalconsent indicates that the client voluntary gives consent for thescheduled procedure. C is competent to give consent, and D andunderstand the risk and benefits of the procedure.33.Following surgery, a male client with antisocial personalitydisorder frequently requests that a specific nurse be assigned tohis care and is belligerent when another nurse is assigned. Whataction should the charge nurse implement?a- Ask the client to explain why he constantly request the nurseb- Encourage the client to verbalize his feelings about the nursec- Reassure the client that his request will be met whenever possible.d- Advise the client that assignments are not based on client requestsRationale: Those with antisocial personality disorders are manipulativein order to meet their own needs. The charge nurse must set limits onthis behavior. The client’s superficial charm and emotional maturityprevent effective therapeutic communication and (A and B) will be usedto the client’s advantage. C encourage further manipulative behavior.
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