2021-2022 HESI RN Child Care Exit Exam With Answers (160 Solved Questions)

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1.The school nurse is preparing a presentation for an elementary school teacher to informthem about when a child should be referred to the school clinic for further follow-up.The teachers should be instructed to report which situations to the schoolnurse?(Select all that apply)a.Refuses to complete written homework assignmentsb.Thirst and frequent requests for bathroom breaksc.Bruises on both knees after the weekendd.Sunburn with blisters on face, arms, and handse.Shaking that changes the child’s handwriting2.When preparing a child for discharge from the hospital following a cystectomy and aurinary diversion to treat bladder cancer, which instruction is most important for thenurse to include in the client’s discharge teaching plan?a.Report any signs of cloudy urine outputb.Frequently empty bladder to avoid distentionc.Follow instructions for self-care toiletingd.Seek counseling for body image3.A client with renal lithiasis is receiving morphine sulfate every four hours for pain andrenal colic. Which assessment finding should prompt the nurse to administer PRN doseof naloxone?a.Unresponsive to verbal or tactile stimulib.Respiratory rate of 12 breaths per minutec.Statements about visual hallucinationsd.Complaints of increasing flank pain4.The mother of a 7-month-oldbrings the infant to the clinic, because the skin in thediaper area is excoriated and red, but there are no blisters or bleeding. The motherreports no evidence of watery stools. Which nursing intervention should the nurseimplement?a.Instruct the motherto change the child’s diaper more oftenb.Encourage the mother to apply lotion with each diaper changec.Ask the mother to decrease the infant’s intake of fruits for 24 hoursd.Tell the mother to cleanse with soap and water at each diaper change5.The nurse is having difficulty palpating a client’s posterior tibial pulse while the client islying in a supine position. Which of the following interventions is best for the nurse totake?a.Extend the client’s arm fully while supporting the elbow and attempt to re-palpateb.Apply less pressure when palpating over the middle of the dorsum of the footc.Use an ultrasound stethoscope, and place behind and below the medial boned.Help the client to a prone position with the knee slightly flexed and palpate again6.The nurse initiates a tertiary prevention program for type 2 diabetes mellitus in a ruralhealth clinic. Which outcome indicates that the program was effective?a.Average client scores improved on specific risk factor knowledge testsb.Only 30% of client did not attendself-management education sessionsc.More than 50% of at-risk clients were diagnosed earl in the disease process

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d.Client who developed disease complications promptly received rehabilitation7.A client is recovering in the critical care until following a cardiacatheterization. IVnitroglycerin and heparin are infusing. The client is sedated but responds to verbalinstructions. After changing positions, the client complains of pain at the right goinginsertion site. What action should the nurse implement?a.Stimulate the client to take deep breathsb.Evaluate the integrity of the IV insertion sitec.Assess distal lower extremity capillary refilld.Check femoral site for hematoma formation8.A 7-year old is admitted to the hospital with persistent vomiting, and nasogastrictubeattached to low intermittent suction is applied. Which finding is most important for thenurse to report to the healthcare provider?a.Shift intake of 640mL IV fluids plus 30mL PO ice chipsb.Serum pH of 7.45c.Serum potassium of 3.0 mg/dld.Gastric output of100 mL in the last 8 hours9.A morbidly obese client is scheduled for gastric bypass surgery. The client completes therequired preoperative nutritional counseling and signs the operative permit. Topromote effective discharge planning, which intervention is most important for thenurse to implement?a.Discuss small, low fat, low sugar meal preparation techniquesb.Advise the client to arrange for dietary counseling after being dischargedc.Encourage the client to keep a daily diary for two weeksd.Suggest that theclient’s spouse do the family grocery shopping10.The nurse is admitting a client from the post-anesthesia unit to the postoperativesurgical care unit. Which prescription should the nurse implement first?a.Cefazolin 1-gram IVPB q6 hoursb.Complete blood cellcount (CBC) in AMc.Straight catheterization if unable to voidd.Advance from clear liquid as tolerated11.Which needle should the nurse use to administer IV fluids via c lient’s implanted port?a.5cc syringe & needleb.Butterfly stickc.**click on the image thatisn’t any of the other options**d.Vacutainer12.An older client is referred to a rehabilitation facility following a cerebrovascular accident(CVA). The client is aphasic with left-sided paresis and ishavingdifficulty swallowing.Which intervention is most important for the nurse to include in the client’s plan ofcare?a.Use pictures and gestures to communicateb.Arrange for daily home care assistancec.Facilitate a consultation for speech therapyd.Initiate passive range of motion exercises

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13.A client has had several episodes of clear, watery diarrhea that started yesterday. Whataction should the nurse implement?a.Assess the client for the presence of hemorrhoidsb.Administer a prescribed PRN antiemeticc.Check the client’s hemoglobin leveld.Review the client’s current list of medications14.A mother runs intothe emergency department with a toddler in her arms and tells thenurse that her child got into some cleaning products. The child smells of chemicals onhands, face, and on the front of the child’s clothes. After ensuring the airway is patent,what action should the nurse implement first?a.Call poison control emergency numberb.Determine type of chemical exposurec.Obtain equipment of for gastric lavaged.Assess child for altered sensorium15.When should the nurse conduct an Allen’s test?a.Prior to attempting a cardiac output calculationb.When pulmonary artery pressures are obtainedc.Just before arterial blood gasses are drawn peripherallyd.To assess for presence of deep vein thrombosis in the leg16.A nurse with 10-years’ experience working in the emergency department is reassignedto the perinatal unit to work an 8-hour shift. Which client is best to assign to this nurse?a.A mother with an infected episiotomyb.A client who is leaking clear fluidc.A client at 28-weeks’ gestation in pre-term labord.A mother who just delivered a 9-pound baby17.A 300mL unit of packed red blood cells is prescribed for a client with heart failure (HF)who has 3+ pitting edema, shortness of breath with any activity, and cracked in bothlung bases. At what rate should the nurse administer the blood?a.150 mL/hourb.75 mL/hourc.300 mL/hourd.50 mL/hour18.The nurse enters the room of the client with Parkinson's disease who is taking carbidopalevodopa. The client is arising slowly from the chair while the unlicensed assistivepersonnel(UAP)stands next to the chair. What action should the nurse take?a.Tell theUAPto assist the client in moving more quicklyb.Offer PRN LG 6 to reduce painful movementc.Affirm that the client should arise slowly from the chaird.Demonstrate how to help the client move more efficiently19.Which assessmentis more important for the nurse to include in the daily plan of care fora client with a burnt extremity?a.Range of motionb.Distal pulse intensityc.Extremity sensation

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d.Presence of exitexudate20.Client is receiving continuous ambulatoryperitoneal dialysissince the arteriovenousgraft in the right arm is no longer availabletouse for hemodialysis. The client has lostweight, has increasing peripheral edema, and has a serum albumin level of 1.5g/dL.Which intervention is the priority for the nurse to implement?a.Instruct the client to continue to follow the prescribed rigid fluid restrictionamountb.evaluate pat and see of the AV graft for resumption of hemodialysisc.ensure the client receives frequent small mealscontainingcomplete proteinsd.recommend the use of support stockingsto enhance venous return21.An older adult client with systemic inflammatory response syndrome(SIRS)has atemperature of 101.8 F (38.8 C),heart rate of 110beats/minute,and a respiratory rateof 24 breaths/minute. Which additional findingismost important to report to the healthcare provider?a.Capillary glucose reading of 110mg/dL (6.1 mmol/L SI)b.serum creatine of 2.0 mg/dL (176.8 micromol/L SI)c.Hemoglobin of 12g/dL (120 g/dL SI)d.blood pressure of 134/88 mm hg22.the nurse completes auscultation of the thoracic region of an older adult client. Whichfinding is considered normal for this older adult client?a.High pitched wheezingb.Hyperresonancec.medium cracklesd.vesicular sounds23.a client who is admitted for primary hypothyroidism has early signs of myxedema coma.In assisting the client, in which sequence should the nurse hascompletes theseactions?(Rank the first action at the top with the remainder in descending order)Step 1. observe breathing patternsStep 2. assess blood pressureStep 3. measure body temperatureStep 4. palpate for pedal edema24.What is the primary goal when planning nursing care for a client with degenerativejointdisease(DJD)?a.achieve satisfactory pain controlb.obtain adequate rest and sleepc.improve stress management skillsd.reduce risk of infection25.the home care nurse provides self-care instructions for a client with chronic venousinsufficiency caused by deep vein thrombosis. Which instructionsshould the nurseinclude in the client's discharge teaching plan?(Select all that apply)a.Avoid prolonged standing or sittingb.use recliner for long periods of sittingc.continue wearing elastic stockingsd.maintain the bed flat while sleeping

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e.cross legs at kneesbut not at ankles26.One hour after a lung biopsy, a client returns to the surgical unit. The client is drowsybut easily aroused and follows commands accurately. Which intervention is mostimportant for the nurse to implement?a.Encourage range ofmotion exercisesb.notify family oftheclient's return to the roomc.reinforce use of incentives spirometryd.offer fluids if gag reflex is intact27.An older woman who was recently diagnosed with end stage metastatic breast cancer isadmitted because she isexperiencing shortness of breath and confusion. The clientrefuses to eat and continuously asks to go home. Arterial blood gases indicate hypoxia.Which intervention is most important for the nurse to implement?a.Prepare for emergent oral intubationb.offer sips of favorite beveragesc.clarify end of life desiresd.initiate comfort measures28.the health care provider prescribed the antibioticCefdinir 300 mg PO every 12 hoursfora client with a postoperative wound infection. Which foods should the nurse encouragethis client to eat?a.Yogurt and/or buttermilkb.avocados and cheesec.green leafy vegetablesd.fresh fruits29.a client with cirrhosis of the liver is having numerous, liquidy, incontinent stools andcontinues to be confused.Inreviewofthe client's laboratory studies, the nurseidentifies an elevated serum ammonia level. Based on this finding, which prescription isthe most important for the client to receive?a.Loperamideb.IV human albuminc.Lactulosed.Furosemide30.After a routine physical examination, theHCPadmits a woman with a history ofSystemic Lupus Erythematous (SLE)to the hospital, because she has3+ pitting ankleedemaand blood in her urine. Which assessment finding warrants immediateintervention by the nurse?a.Blood pressure 170/98b.joint and muscle achesc.urine outputof 300 mL/hrd.dark, rust colored urine31.the nurse is preparing a client with anacoustic neuromafor a magnetic resonanceimage(MRI).which client complaint is life threatening and should be reported to thehealth care provider immediately?a.Intensifying headacheb.facial numbness

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c.difficulty with balanced.right ear hearing loss32.**too blurry for me to see this question**33.An unresponsive male victim of a motor vehicle accident is brought to the emergencydepartment where it is determined thatimmediate surgery is required to save his life.The client is accompanied by a close friend, but no family member is available. Whataction should the nurse take first?a.Ask the man's friend to sign the informed consent since the client isunresponsiveb.notify the unit manager that an emergency court order is needed to allow thesurgeryc.continue to provide life support until a thorough search for a guardian iscompletedd.carry on with the surgical preparation of the client without a signed informedconsent34.a young adult female with chronic kidney disease(CKD) due toepisodesofpyelonephritis is hospitalized withbasilarcrackles and peripheral edema. She iscomplaining of severe nausea and the cardiac monitor indicates sinus tachycardia withfrequent premature ventricular contractions. Her blood pressure is 200/100 mm Hg,andher temperature is 101F. Which PRNmedication should the nurse administer first?a.Enalaprilb.Furosemidec.Acetaminophend.Promethazine35.**Picture of a mannequin with NG tube inserted with tape still on the face**The nurseassesses a client who has just returned from a diagnostic study, as seen in the picture.The client has a prescription for a nasogastric tube to low intermittent suction andreportsfeelings of nausea. What action should the nurse implement first?a.Remove tape from cheekb.administer an IVantiemeticc.auscultates bowel soundsd.connect the tube to suction36.following breakfast, the nurse is preparing to administer 0900 medications to clients ona medical floor. Which medication should be held until a later time?a.The mucosal barrier, sucrafalta (CARAFATE), for a client diagnosed with pepticulcerdiseaseb.the antiplatelet agentAspirin, for a client who is scheduled to be dischargedwithin an hourc.the antifungalNystatinsuspension for a client who has just brushed his teethd.the loop diureticFurosemide, for a client with a serum potassium level of4.2mEq/L (4.2 mmol)37.A client with a history of upper respiratory symptoms is admitted with chest tightness, aproductive cough, and difficulty breathing. The clients arterial blood gases indicaterespiratory acidosis. An increase in which laboratory testresults supports this finding?

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a.Arterial pHb.PaCO2c.HCO3d.PaO238.One week after an above the knee amputation(AKA)to the left leg, a male client seemsupset and reports that his left foot feels“numb.”which action should the nurseimplement?a.Assess thewound for signs of inflammation or drainageb.assess the right foot for signs of diminished circulationc.offer assurance that the numb feeling is temporaryd.reinforce learning about the cause of this sensation39.when providing client care, the nurse identifies aproblem and develops a related clinicalquestion. Next, the nurse intends to gather evidence so that the decision-makingprocess in response to the problem and clinical question is evidence-based. Whengathering evidence, which consideration is most important?a.Frequency that the problem occursb.past experience with similar problemsc.relevance to the situationd.related personal values40.when obtaining isolation supplies needed to care for a client, which information is mostimportant for the nurse to obtain?a.Antimicrobial medication administration scheduleb.client's most recent white blood cell countc.mode of transmission of the infectious Organismd.initial port of entry41.an older adult who lives alone in a two-story house is admitted after falling whileshopping period X rays revealed a fractured left hip. With no immediate family in thearea, the client is concerned about Pets at Home. Which interventions should the nurseimplement first?(Select all that apply)a.alert social worker of client’s concernsb.palpateand mark pedal pulsesc.assess ability to bear weight when standingd.support left leg with two pillowse.evaluate pain using a standard pain scale42.A client with a history of heavy alcohol intake is admitted with acute pancreatitis. Theclient reports severe abdominal pain radiating to the back. And positioning the client,which instruction should the nurse provide to the unlicensed assistive personnel(UAP)a.motivate the client to stimulate peristalsisb.maintain the client in a supine positionc.assist the client tohis side with his knees to his chestd.tell client to deep breathe and cough every two hours43.a client is admitted to a medical unit with the diagnosis of gastritis and chronic heavyalcohol abuse. Which should the nurse administer to prevent the development ofWernicke’sSyndrome?

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