2022 HESI RN Nursing Diagnosis Exit Exam With Answers (160 Solved Questions)

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1.A male client with stomach cancer returns to the unit following a total gastrectomy. He has anasogastric tube to suction and is receiving Lactated Ringer’s solution at 75 mL/hour IV. Onehourafter admission to the unit, the nurse notes 300 mL of blood in the suction canister, theclient’s heart rate is 155 beats/minute, and his blood pressure is 78/48 mmHg. In addition toreportingthefindingtothesurgeon.Whichactionshouldthenurseimplementfirst?a.Measureanddocumenttheclient’surinaryoutput.b.Requesttheclient’sreservedunit ifpackedredbloodcells.c.Preparetheplacementofacentralvenouscatheter.d.Increasethe infusionrateofLactatedRinger’ssolution.2.anadult male who fell 20 feet from the roof of this home has multiple injuries, including a rightpneumothorax. Chest tubes were inserted in the emergency department prior to his transfer totheintensivecareunit (ICU).thenurse notesthatthe suctioncontrolchamberisbubblingatthe-10 cm H2O mark, with fluctuation in the water seal, and over the past hour 75 ml of bright redbloodismeasuredinthecollectionchamber.Whichinterventionshouldthenurse implement?a.Addsterilewater tothesuctioncontrolchamber.b.Givebloodfromthe collectionchamberasautotransfusionc.Manipulatebloodintubingtodrainintochamber.d.Increasewallsuctiontoeliminatefluctuationinwaterseal.3.A client who received hemodialysis yesterday isexperiencing a blood pressure of 200/100mmHg, heart rate 110 beats/minute, and respiratory rate 36 breaths/minute. The client ismanifestingshortnessofbreath,bilateral2+pedaledema,andanoxygensaturationonroomairof89%.Whichactionshouldthenursetakefirst?a.Elevatethefootofthebed.b.Restricttheclient’sfluid.c.Beginsupplementaloxygen.d.Preparetheclientforhemodialysis.

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4.A client with Addison’s crisis is admitted for treatment with adrenal corticalsupplementation.Based on the client’s admitting diagnosis, which findings require immediate action by the nurse?(Selectall thatapply)a.Headacheandtremorsb.Irregularheart ratec.Skinhyperpigmentationd.Posturalhypotensione.Palloranddiaphoresis5.An older client is admitted with fluid volume deficit and dehydration. Which assessment findingisthebest indicatorofhydrationthatthenurseshouldreporttothehealthcareprovider?a.Urinespecificgravityis1.040b.Systolicbloodpressuredecreases10pointswhenstanding.c.Theclientdeniesbeingthirsty.d.Skintentingoccurswhentheclient’sforearmispinched.6.After an inservice about electronic health record (EHR) security and safeguarding clientinformation, the nurse observes a colleague going home with printed copies of clientinformationina uniformpocket. Whichactionshouldthenursetake?a.Fileadetailedincidentreportwiththespecifichiringfacility.b.Warnthecolleaguethat theiractionsareunprofessional.c.Commentanonymouslyaboutthe actionofastaffdiscussionboard.d.Communicatethe colleague’sactionstotheunit chargenurse.

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7.The nurse is evaluating a tertiary prevention program for clients with cardiovascular diseaseimplementedinarural healthclinic.Whichoutcomeindicatetheprogramis effective?a.At-riskclientsreceivedanincreasednumberofroutinehealthscreenings.b.Clientsreportedhavingnewconfidenceinmakinghealthyfoodchoices.c.Clientswhoincurreddiseasecomplicationspromptlyreceived rehabilitation.d.Clientrelapserateof30%ina5-yearcommunity-wideanti-smokingcampaign.8.The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who usesoxygen at 2 L/minute per nasal cannula continuously. The nurse observes that the client ishaving increased shortness of breath with respirations at 23 breaths/minute. Which actionshouldthenurseimplementfirst?a.Determineiftheclientisexperiencinganyanxiety.b.Auscultatethe client’sbilaterallungsoundsandoxygensaturation.c.Notifythe healthcareproviderabouttheclient’sdistress.d.Assessthe deliverymechanismofthe oxygentank,tubing,andcannula.9.Which statement by a client who is 24 hourspost-subtotal thyroidectomy requires animmediateinvestigationbythenurse?a.“WhenI getoutofbedquickly,I feela littledizzy.”b.“Thedressingovermyincisionfeelslikeit istootight.”c.“I’mmostcomfortablewhentheheadofthebedisraised.”d.“ThisIVinfusionmakesmeurinatemoreoftenthanusual.”

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10.An older adult male who is in his early 70’s is admitted to the emergency department because ofaCOPDexacerbation.Thisclientis strugglingtobreatheandthehealthcare teamispreparingfor endotracheal intubation. The spouse’s wife, who is 30 years younger than the client, asks thenurse to stop the procedure and provide the nurse a copy of the client’s living will. Which actionshouldthenursetake?a.Facilitate a family meeting with the palliative care team.b.Notifythehealthcareprovideroftheclient’swishes.c.Placea certifiedcopyofthelivingwillintheclient’s record.d.Alertthenursingstaffoftheclient’sdon’tresuscitatestatus.11.An unlicensedassistive personnel (UAP) is assigned to provide personal care for a client whoseprescribed activity is bedrest with bedside commode use. The UAP reports to the nurse that theclient is so obese that the UAP feels unable to safely assist the client in transferring from the bedtothebedsidecommode.Howshouldthenurserespond?a.Determinetheclient’slevelofmobilityandneedforassistance.b.InstructtheUAPthatallclientsdeserveequalcare.c.Advicetheclienttomaintainbedrestsothatsafetycanbe ensured.d.Assignanother UAPtocarefortheclient.12.A nurse determines that more than 25% of the students at a middle school are overweight. Thenurse presents the information at the parent-teacher meeting. What action is most importantforthenursetoincludeinthemeeting?a.Provideinformationonwaystoincreaseactivityforthefamily.b.Have several teachers talk about health risks associated with obesity.c.Distributea shoppinglistofsuggestedhealthysnackitems.d.Determinetheparents’ degreeofconcernabouttheirchildren’sweight.

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13.After several months of chronic fatigue, morning stiffness, and join pain, a young adult isdiagnosed with rheumatoid arthritis, and the healthcare provider prescribes prednisone. Whicheducationshouldthenurseprovidetheclientwithregardtotakingprednisone?a.Takeprednisonedosesbeforemealsonanemptystomach.b.Wearsunglasseswhenexposedtobright sunlight.c.Ifsequentialdosesaremissed,notifythehealthcareprovider.d.Scheduleamonthlylaboratoryvisitfora completebloodcount.14.Thepsychiatricnurseiscaringforclientsonanadolescentunit.Whichclientrequiresthenurse’simmediateattention?a.A16-year-oldclientdiagnosedwithmajordepressionwhorefusestoparticipateingroup.b.A 14-year-old client with anorexia nervosa who is refusing to eat the evening snack.c.An18-year-oldclientwithantisocialbehaviorwhoisbeingyelledatbyotherclientsd.A17-year-oldclientdiagnosedwithbipolardisorderwhois pacingaroundthelobby..15.Thenurse caringforachildwithmononucleosiscanexpectthechildtoexhibitwhichsymptoms?a.Positive Epstein-Barr, and malaise.b.Earpainandfever.c.ElevatedWBCandsedimentationrate.d.IncreasedBUNandserumcreatinine.16.A client arrives for an annual physical exam and complains of having calf pain. The client’s healthhistory reveals peripheral atrial disease. Which question should the nurse ask the clientaboutexpectedfindingrelatedtochronic arterialsymptoms?a.Wereyourlegseversuddenlyswollen,red,warm,andpainful?b.Doesthecalfpainoccur whenwalkingshortdistances?c.Didyoureceivetreatment forweepingulcersonlowerlegs?d.Haveyouexperiencedankleedemaandvaricoseveins?

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17.The nurse is preparing to send a client to the cardiac catheterization lab for an angioplasty.Which client report is most important for them to explore further prior to the start of theprocedure?a.Dranka glass ofwaterinthepast2hours.b.Reportsleftchestwallpainpriortoadmission.c.Verbalize a fear of being in a confined space.d.Experiencefacialswellingaftereatingcrab.18.The nurse is assessing a 4-year-old child with eczema. Thechild’s skin is dry and scaly, and themother reports that the child frequently scratches the lesions on the skin to the point of causingbleeding.Whichguidelineisindicatedforcare of thischild?a.Keepthe nailstrimmedshort.b.Applybabylotiontotheskintwicedaily.c.Bathethechilddailywithbathoil.d.Allowthechildtowearonly100%cottonclothing.19.Anewmotheronthepostpartumunitrunsoutoftheroomscreamingthather newborninfant’scribis emptyandthebabyismissing. Whatactionshouldthenursetakefirst?a.Determineifthenewbornisinthenursery.b.Activatethelockdownprocedure.c.Ask the mother if any visitors were expected to arrive.d.MatchIDbandsofallinfants andmothersontheunit.20.While providing ahealth history, a female client tells the clinic nurse that she frequently thinksabouthurtingherself. Whichquestionis mostimportantfor thenursetoask?a.“Doyouoftenhavefeelingofsadness?”b.“Areyouhavingproblemsconcentrating?”c.“Haveyouthoughabouttakingyourlife?”d.“Whatproblemsareyoufacingright now?”21.Acollege student bringsadormroommate tothe campusclinic because the roommatehasbeen talking to someone who is not present. The client tells the nurse that thevoices are saying,“kill,kill.”Whatquestionshouldthenurseasktheclientnext?a.“Whendidthesevoicesbegin?”b.“Haveyoutakenanyhallucinogens?”c.“Areyouplanningtoobeythevoices?”d.“Doyoubelieve thevoicesare real?”

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22.Thenurse is developing a plan of care for a client who reports tingling of the feet and who isnewlydiagnosedwithperipheralvasculardisease.Whichoutcomeshouldthenurse includeintheplanofcareforthisclient?a.Theclientwillexpressacceptanceoftheirnewlydiagnosedhealthstatus.b.Thenurse willencouragetheclient towalkthirtyminuteseveryday.c.Theclient’sbloodpressurereadingswillbelessthan160/90mmHg.d.Theclient’s skinonthelowerlegswillbe intactatthenextclinical visit.23.When conducting diet teaching for a client who was diagnosed with hypertension, which foodshouldthenurseencouragetheclienttoeat?(selectallthatapply.)a..Fruitswithoutsauceb.Cannedsoup.c.Freshorfrozenvegetableswithoutsauce.d.Cottagecheese.e.Pickledolives.24.A client with bacterial meningitis is receiving phenytoin. Which assessment finding indication tothenursethattheclientisexperiencinga therapeuticresponse tothephenytoin?a.Increasedtimeofambulationbetweenperiodsofrest.b.Decrease inintracranialpressure andcerebraledema.c.Absenceofseizureactivityforthedurationoftreatment.d.Normalelectroencephalogramafterdrugadministration.25.The nurseobserves a client prepare a meal in the kitchen of a rehabilitation facility prior todischarge. Which behaviors indicate the client understands how to maintain balance safely?(Selectall thatapply)c.Widensstancewhileworkingnearthesink.d.Bendsfromthewaisttopicktrashoff thefloor.e.Leansforwardtopull a panfromahighshelf.26.An older client is admitted to the hospital because of recurring transient ischemic attacks.Neurological serial assessments for the past 24 hours were within normal limits. One day afteradmission, the client suddenly becomes confused and combative indicating impaired mentalstatus(IMS).Whatinterventionshouldthenurseimplementfirst?a.Document neurologic changes.b.Reduceenvironmentalstimuli.c.Administerprescribedneuroleptic.d.Reviewmedicationsforinteractions.a.Bringsa heavycanclosetobodybeforelifting.b.Lockskneeswhilepreparingfoodonthecounter.

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27.Thecharge nurse in an extended care facility is organizing unit activities for the day. Whichactionmaybesafelydelegatedtothe practicalnurse(PN)?a.Measuretheclient’sbodyweight eachmorning.b.Establishbloodpressureparametersforclientmonitoringc.Evaluateastaffmemberprovidingwound care.d.Evaluateclientteachingthroughreturndemonstration.28.During shift report, the charge nurse receives notice of several problems. Which problem shouldthenurseaddress first?a.Thecensusreporthasnotbeencompleted.b.Aclient’swifehas askedtospeak withthe chargenurse.c.One staff member has not reported to work.d.Abucketof waterwasspilledinthehallway.29.An older adult client with chronic emphysema is admitted to theemergency room from homewith acute onset of weakness, palpitations, and vomiting. Which information is most importantforthenursetoobtainduringtheinitial interview?a.Historyofsmokingoverthepast6months.b.Sleeppatternsduringtheprevious fewweek.c.Activitylevelpriortoonsetofsymptoms.d.Recentcompliancewithprescribedmedications.30.The nurse is feeding an older adult who was admitted with aspiration pneumonia. The client isweak and begins coughing while attempting todrink through a straw. Which intervention shouldthenurseimplement?a.Assesstheclient’soralcavityforulcerations.b.Monitortheclientwhenusingastrawforliquids.c.Teachcoughinganddeepbreathingexercises.d.Requestthicknectarliquidsforthe client.31.A male client with right-sided weakness calls for assistance with ambulating to the bathroom.Whatactionshouldthenurseimplement?a.Bringabedsidecommodetotheclient.b.Standontheclient’srightsideashe walks.c.Walkdirectlybehindtheclient toprevent afall.d.Givetheclientacanetoholdinhis righthand.

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32.An older client is admitted to the psychiatric unit for assessment of a recent onset of dementia.The nurse notes that in the evening thisclient often becomes restless, confused, and agitated.Whichinterventionismostimportantforthenursetoimplement?a.Ask family members to remain with the client in the evening from 1700 to 2100 p.m.b.Ensurethattheclientisassignedtoa roomclosetothenurses’station.c.Postponeadministrationofnighttimemedicationsuntilafter2300p.m.d.AdministeraprescribedPRNbenzodiazepineattheonset ofaconfusedstate.33.Thenurse iscaringforaclientwhoishavingasicklecellcrisis.Whatinterventionshouldthenurseincludeinthisclient’splanofcare?a.EnsureadequateIVandoralfluidintake.b.Provideicepacks tomajorjointareas.c.Spaceanalgesicstopreventaddictiontonarcotics.d.Re-enforcetheimportanceofnutritionalbalance.34.The nurse is teaching a primigravida about preeclampsia. Which finding are indicators ofpreeclampsiaandshouldbe reportedtothehealthcareprovider?(selectallthatapply.)a.Blurred visionb.Headache.c.Lackofappetite.d.Urinaryfrequency.e.Chillsandfever.f.Swollenhands.35.A new nurse preparing to irrigate an intravenous catheter is attaching a 24-gauge needle. Whichactionshouldthechargenurseimplement?a.Suggest the nurse use a 20-gauge needle.b.Directthenurse tochange theIVtubing.c.Instructthenurse toremovetheneedle.d.Promptthenurse toapplypovidonetothesite.36.A client with syndrome of inappropriate antidiuretic hormone secretion (SIDH) is admitted withhyponatremia. Whichintervention is most important for the nurse to include in the plan of caretoprotecttheclientfrominjury?a.Initiateseizureprecautions.b.Assessneurologicalstatusevery8hours.c.Limitoralwaterintake.d.AdministerahypertonicIVfluidsasprescribed.

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37.Thenurse isassignedtoprovidecareforaclientwhois scheduledfora laparoscopiccholecystectomyintwohours,at0900,whatnursingactionismostimportant?a.ConfirmthattheclienthasbeenNPOsincemidnight.b.Reviewpostoperativeinstructionswiththeclient.c.Offertoassistthe clienttotherestroomtovoid.d.Determinewhentheclientlasthadpainmedication.38.The nurse is conducinga visual screening of a group of older adults. Which finding should thenursereporttothehealthcareprovider immediately?a.Gradualonset ofcontinuouseyepainandblurredvision.b.Recentchangeinthe abilitytoreadanddriveafterdark.c.Gray-white circle around the iris of both eyes.d.Cloudyopacityofthecrystallinelens.39.A15-year-old male client was recently diagnosed with type 1 diabetes mellitus. He tells thenurse that he is having difficulty adhering to his meal plan when he is with his friends. Whatnursinginterventionisbestforthenursetoimplement?a.Recommendhe avoidfastfoodrestaurantsuntilheisfamiliarwithhisprescribeddiet.b.Advisehimtotakehisownfoodwithhimwhengoingtofastfoodrestaurantswithhisfriends.c.Encouragehimtofindactivitiestodowithhis friendsthatdonotinvolveeating.d.Assisthiminidentifyingpopularfastfoodsthatarewithinhismealplanfordiabetes.40.A male client in the final stages ofterminal cancer tells his nurse that he wishes he could just beallowed to die. The client states that he is tired of fighting his illness and is only continuingtreatmentsbecausehisfamilywantshimtolive. Whichactionshouldthenurse take?a.Notifythefamilythattreatmentshavebeendiscontinued.b.Arrange a meeting with the family, physician, and client.c.Askthechaplaintodiscussdeathissueswiththeclient.d.Requestaconsultationwiththehospitalsocial worker.41.Five days after surgical fixation of a fractured femur, a client suddenly reports chest pain anddifficultyinbreathing…..hadapulmonaryembolus.Whatactionshouldthenursetakefirst?a.Bringtheemergencycrashcart tothebedside.b.Prepare a continuous heparin infusion per protocol.c.Providesupplementaloxygen.d.Notifythe healthcareprovider.

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