2023-2024 HESI RN Child Care Exit Exam Version 3 With Answers (160 Solved Questions)

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RNHESIEXITEXAM2023-2024-VERSION3(V3) ALL 160 QUESTIONS & ANSWERSINCLUDED-GUARANTEEDPASSA+!!!ALLBRAND NEW•WhichinformationisapriorityfortheRNtoreinforcetoanolderclientafterintravenouspylegraphy?•Eatalight dietfortherestoftheday•Restforthenext 24 hourssincethepreparationand thetestistiring.•Duringwakinghoursdrinkatleast18-ounceglassoffluideveryhourforthenext2days•Measuretheurineoutputforthe nextdayand immediatelynotifythehealth careproviderifitshoulddecrease.ThecorrectanswerisD: Measuretheurineoutput forthenextdayandimmediatelynotifythehealth care provider if it should decrease.•Aclienthasalteredrenal functionandisbeingtreatedathome.Thenurserecognizesthatthe most accurate indicator of fluid balance during the weekly visits is•differenceintheintakeandoutput•changesinthemucousmembranes

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•skinturgor•weeklyweightThecorrectanswerisD:weeklyweight•AclienthasbeendiagnosedwithZollinger-Ellisonsyndrome.Whichinformationismost important for the nurse to reinforce with the client?•Itisaconditioninwhichoneormoretumorscalledgastrinomasforminthepancreasorin the upper part of the small intestine (duodenum)•Itiscriticaltoreportpromptlytoyourhealthcareprovideranyfindings ofpepticulcersc)Treatmentconsistsofmedicationstoreduceacidandhealanypepticulcersand,ifpossible,surgery to remove any tumorsD)Withtheaverageageatdiagnosisat50 yearsthepepticulcersmayoccuratunusualareasof the stomach or intestineThecorrectanswerisB:Itiscriticaltoreportpromptlytoyourhealthcareprovideranyfindings of peptic ulcers.•Aprimigravidainthethirdtrimesterishospitalizedforpreeclampsia.Thenursedetermines that the client’s blood pressure is increasing. Which action should the nursetake first?•Checktheprotein levelinurine•Havetheclientturntotheleftside•Takethetemperature

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•Monitor theurineoutputThecorrectanswerisB: Havethe clientturntotheleftside•Thenurseis caringfor aclient in atrial fibrillation. Theatrial heartrateis 250 andthe ventricularrateis controlledat75.Whichofthefollowingfindingsiscauseforthemostconcern?•Diminishedbowelsounds•Lossofappetite•Acold,palelowerleg•TachypneaThecorrectanswerisC:Acold,palelowerleg•Theclientwithinfectiveendocarditismust beassessedfrequentlybythehomehealthnurse.Whichfindingsuggeststhatantibiotictherapyisnoteffective,andmustbereportedbythenurse immediately to the healthcare provider?•Nauseaandvomiting•Feverof103degreesFahrenheit(39.5degreesCelsius)•Diffusemacularrash•MuscletendernessThecorrectanswerisB:Feverof103degreesF(39.5degreesC)

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•Aclientwhohadavasectomyisinthepostrecoveryunitatanoutpatientclinic.Whichof these points is most important to be reinforced by the nurse?•Untilthehealthcareproviderhasdeterminedthatyourejaculatedoesn'tcontainsperm, continue to use another form of contraception.•Thisproceduredoesn'timpedetheproductionofmalehormonesortheproductionofspermin the testicles. The sperm can no longer enter your semen and no sperm are in your ejaculate.•After your vasectomy, strenuous activity needs to be avoided for at least 48 hours. If yourworkdoesn'tinvolvehardphysicallabor, youcanreturnto yourjobas soonasyoufeeluptoit. The stitches generally dissolve in seven to ten days.•Thehealthcareprovideratthisclinicrecommendsrest,ice,an athleticsupporterorover-the-counter pain medication to relieve any discomfort.ThecorrectanswerisA:Untilthehealthcareproviderhasdeterminedthatyourejaculatedoesn't contain sperm, continue to use another form of contraception.•Aclientwhoistohaveantineoplasticchemotherapytells thenursesofafearofbeingsickall the time and wishes to try acupuncture. Which of these beliefs stated by the client wouldbe incorrect about acupuncture?•Someneedlesgoasdeep as3inches,dependingonwherethey'replacedin thebodyandwhat the treatment is for. The needles usually are left in for 15 to 30 minutes.•IntraditionalChinesemedicine,imbalancesinthebasicenergeticflowoflife—knownasqi or chi—are thought to cause illness.

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•Theflowoflifeisbelievedtoflowthrough majorpathwaysornerveclustersinyourbody.•Byinsertingextremelyfineneedlesintosomeoftheover400acupuncture pointsinvarious combinations it is believed that energy flow will rebalance to allow the body'snatural healing mechanisms to take over.ThecorrectanswerisC:Theflowoflifeisbelievedtoflowthroughmajorpathwaysornerveclusters in your body.•ThenurseisdiscussingwithagroupofstudentsthediseaseKawasaki.Whatstatementmade by a student about Kawasaki disease is incorrect?•Italsocalledmucocutaneouslymphnodesyndromebecauseitaffectsthemucousmembranes (inside the mouth, throat and nose), skin and lymph nodes.•Inthesecondphaseofthedisease,findingsincludepeelingoftheskinonthehandsandfeet with joint and abdominal pain•Kawasakidiseaseoccursmostofteninboys,childrenyoungerthanage5andchildrenofHispanicdescent•Initiallyfindingsareasuddenhighfever,usuallyabove104degrees Fahrenheit,whichlasts1 to2 weeksThecorrectanswerisC:Kawasakidiseaseoccurs mostofteninboys,children youngerthanage 5 and children of Hispanic descent•Aclienthasviralpneumoniaaffecting2/3oftherightlung.Whatwouldbethebestposition to teach the client to lie in every other hour during first 12 hours after admission?

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•Side-lyingontheleftwiththeheadelevated10degrees•Side-lyingontheleftwiththeheadelevated35degrees•Side-lyingontherightwiltheheadelevated10degrees•Side-lyingontherightwiththeheadelevated35degreesThecorrectanswerisA:Side-lyingontheleftwiththeheadelevated10degrees•A client has an indwelling catheter with continuous bladder irrigation after undergoing atransurethralresectionoftheprostate(TURP)12hoursago.Whichfindingatthistimeshouldbe reported to the health care provider?•Light,pinkurine•Occasionalsuprapubiccramping•Minimaldrainageintotheurinarycollectionbag•Complaintsofthefeeling ofpullingontheurinarycatheterThecorrectanswerisC:minimaldrainageintotheurinarycollectionbag•AnurseisperformingCPRonanadultwhowentintocardiopulmonaryarrest.Anothernurseenterstheroominresponsetothecall.Aftercheckingtheclient’spulseandrespirations, what should be the function of the second nurse?•RelievethenurseperformingCPR•Gogetthecodecart•Participatewiththecompressionsorbreathing

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•Validatetheclient'sadvanceddirectiveThecorrectanswerisC:Participatewiththecompressionsorbreathing•Thenurseassessesa72 year-oldclientwhowasadmittedforrightsidedcongestiveheart failure. Which of the following would the nurse anticipate finding?•Decreasedurinaryoutput•Jugularveindistention•Pleuraleffusion•BibasilarcracklesThecorrectanswerisB:Jugularveindistention•Aclientwithheartfailurehasaprescriptionfordigoxin.Thenurseisawarethatsufficient potassium should be included in the diet because hypokalemia in combinationwith thismedication•Canpredisposetodysrhythmias•Maylead tooliguria•Maycauseirritabilityandanxiety•SometimesaltersconsciousnessThecorrectanswerisA:Canpredisposetodysrhythmias•Anurseassessesa youngadultintheemergencyroomfollowingamotorvehicleaccident.Whichofthefollowingneurological signsisofmostconcern?

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•Flaccidparalysis•Pupilsfixedanddilated•Diminishedspinalreflexes•ReducedsensoryresponsesThecorrectanswerisB:Pupilsfixedanddilated•A14 year-oldwith ahistoryofsickle celldiseaseisadmittedtothehospitalwithadiagnosis ofvaso-occlusivecrisis. Whichstatementsbytheclientwould bemostindicativeoftheetiology of this crisis?•”Iknewthiswouldhappen.I'vebeeneatingtoomuchredmeatlately."•”Ireallyenjoyedmyfishingtripyesterday.Icaught2fish."•”Ihavereallybeenworkinghardpracticingwiththedebateteamatschool."•”Iwenttothehealthcareproviderlastweekfora coldandIhavegottenworse."ThecorrectanswerisD:"IwenttothedoctorlastweekforacoldandIhavegottenworse."•Whichthesefindingswouldthenursemorecloselyassociatewithanemiaina10month-oldinfant?•Hemoglobinlevelof12g/dI•Palemucosaof theeyelids andlips•Hypoactivity•Aheartratebetween140to160

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ThecorrectanswerisB:Palemucosaoftheeyelidsandlips•Thenurseiscaringforaclientinhypertensivecrisisinanintensivecareunit.Thepriority assessment in the first hour of care is•Heartrate•Pedalpulses•Lungsounds•PupilresponsesThecorrectanswerisD:Pupilresponses•Whichoftheseclientswhoareallintheterminalstageofcancerisleastappropriate to suggest the use of patient controlled analgesia (PCA) with a pump?•AyoungadultwithahistoryofDown'ssyndrome•Ateenagerwhoreadsata4thgradelevel•Anelderlyclient withnumerousarthriticnodulesonthehands•ApreschoolerwithintermittentepisodesofalertnessThecorrectanswerisD:Apreschoolerwithintermittentepisodesofalertness•Thenurseisabouttoassessa6month-oldchildwithnonorganicfailure-tothrive (NOFTT). Upon entering the room, the nurse would expect the baby to be•Irritableand"colicky"withnoattemptstopulltostanding•Alert,laughingand playingwith arattle, sittingwithsupport•Skincolorduskywithpoorskinturgoroverabdomen•Pale,thinarmsandlegs,uninterestedinsurroundingsThecorrectanswerisD:Pale,thinarmsandlegs, uninterestedinsurroundings

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•As the nurse is speaking with a group of teens which of these side effects ofchemotherapyforcancer wouldthenurseexpectthisgrouptobemoreinterestedin during the discussion?•Mouthsores•Fatigue•Diarrhea•HairlossThecorrectanswerisD:Hairloss•Whilecaringforaclientwhowasadmittedwithmyocardialinfarction(MI)2days ago, the nurse notes today's temperature is 101.1 degrees Fahrenheit (38.5degrees Celsius). The appropriatenursingintervention isto•Callthehealthcareproviderimmediately•Administeracetaminophenasorderedasthisisnormalatthistime•Sendblood,urineandsputumforculture•Increasetheclient'sfluidintakeThecorrectanswerisB:Administeracetaminophenasorderedasthisisnormalatthistime•Aclientisadmittedforfirstandseconddegreeburnsontheface,neck,anteriorchest and hands. The nurse's priority should be•Covertheareaswith drysteriledressings•Assessfordyspneaorstridor•Initiateintravenoustherapy

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•AdministerpainmedicationThecorrectanswerisB: Assessfordyspneaorstridor•Whichoftheseclientswhocallthecommunityhealthclinicwouldthenurseaskto come in that day to be seen by the health care provider?•Istarted myperiod and now myurinehas turned brightred.•IamandiabeticandtodayIhavebeengoingtothebathroom everyhour.•Iwasstartedonmedicine yesterdayforaurineinfection.Nowmylowerbellyhurts when I go to the bathroom.•Iwent to thebathroom andmyurinelookedveryredand it didn’thurt whenIwent.Thecorrectanswer isD:Iwentto thebathroom andmyurinelookedveryred anditdidn’thurtwhenIwent.•Amiddleaged womantalkstothenurseinthehealthcareprovider’sofficeabout uterine fibroids also called leiomyomas or myomas. What statement by thewoman indicates more education is needed?•Iamoneoutofevery4 womenthatgetfibroids, andofwomenmyage–betweenthe 30s or 40s, fibroids occurs more frequently.•Myfibroidsarenoncanceroustumorsthatgrowslowly.•MyassociatedproblemsIhavehad arepelvicpressureandpain,urinaryincontinence, frequent urination or urine retention and constipation.•Fibroidsthatcausenoproblemsstillneedtobetakenout.ThecorrectanswerisD:Fibroidsthatcausenoproblemsstillneedtobetakenout.

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•Anelderlyclientadmittedafterafallbeginstoseizeandlosesconsciousness.What action by the nurse is appropriate to do next?•Staywith clientand observeforairwayobstruction•Collectpillowsandpadthesiderailsofthebed•Placeanoralairwayinthemouthandsuction•Announceacardiacarrest,andassistwithintubationThecorrectanswerisA:Staywithclientandobserveforairwayobstruction•Anurseisprovidingcaretoaprimigravidawhosemembranesspontaneouslyruptured (ROM) 4 hours ago. Labor is to be induced. At the time of the ROM the vitalsigns were T-99.8 degrees F, P-84, R-20, BP-130/78, and fetal heart tones (FHT) 148beats/min. Which assessment findings taken now may be an early indication that theclient is developing a complication of labor?•FHT168beats/min•Temperature100degreesFahrenheit.•Cervicaldilationof4•BP138/88ThecorrectanswerisA:FHT168beats/min•Aclientwithpneumococcalpneumoniahadbeenstartedonantibiotics16hoursago.Duringthenurse’sinitialeveningroundsthenursenoticesafoulsmellintheroom.The client makes all of these statements during their conversation. Which statementwould alert the nurse to a complication?•"Ihave asharppainin mychestwhenItakeabreath."•"Ihavebeencoughingupfoul-tasting,brown,thicksputum."

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•"Ihavebeen sweatingallday."•"Ifeelhotoffandon."ThecorrectanswerisB:"Ihavebeen coughingupfoultasting,brown,thicksputum."•Thenurseisperformingan assessmentonaclientincongestiveheartfailure.Auscultationoftheheartismostlikelytoreveal•S3ventriculargallop•Apicalclick•Systolicmurmur•SplitS2ThecorrectanswerisA:S3ventriculargallop•Whichoftheseobservationsmadebythenurseduringanexcretoryurogramindicate a complicaton?•Theclientcomplainsofasaltytasteinthemouth whenthedyeisinjected•Theclient’sentirebodyturnsabrightredcolor•Theclient states“Ihaveafeelingofgettingwarm.”•Theclientgagsandcomplains“ Iamgettingsick.”ThecorrectanswerisB:Theclient’s entirebodyturnsabrightredcolor•Aclientisdiagnosedwithaspontaneouspneumothoraxnecessitatingtheinsertionof a chest tube. What is the best explanation for the nurse to provide this client?•"Thetubewilldrainfluidfrom yourchest."•"Thetubewillremoveexcessairfromyourchest."•"Thetubecontrols theamount ofairthatentersyourchest."•"Thetube willseal theholeinyourlung."

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ThecorrectanswerisB:"Thetubewillremoveexcessairfromyourchest."•Thenurseisreviewinglaboratoryresultsonaclientwithacuterenalfailure.Which one of the following should be reported immediately?•Bloodureanitrogen50mg/dl•Hemoglobinof10.3mg/dl•VenousbloodpH7.30•Serumpotassium 6mEq/LThecorrectanswerisD:Serumpotassium6mEq/L•Thenurseiscaringforaclientundergoingtheplacementofacentralvenouscatheter line. Which of the following would require the nurse’s immediate attention?•Pallor•Increasedtemperature•Dyspnea•Involuntary muscle spasmsThecorrectanswerisC:Dyspnea•The nurse is performing a physical assessment on a client who just had anendotrachealtubeinserted.Whichfindingwouldcallforimmediateactionbythenurse?•Breathsoundscanbeheardbilaterally•MistisvisibleintheT-Piece•Pulseoximetryof88•Clientisunabletospeak

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ThecorrectanswerisC: Pulseoximetryof88•Anursechecksaclientwhoisonavolume-cycledventilator.Whichfindingindicates that the client may need suctioning?•drowsiness•complaintofnausea•pulserate of92•restlessnessThecorrectanswerisD:restlessness•Themosteffectivenursinginterventiontopreventatelectasisfromdevelopingina post operative client is to•Maintainadequatehydration•Assistclienttoturn,deepbreathe,andcough•Ambulateclientwithin12hours•SplintincisionThecorrectanswerisB:Assistclienttoturn,deepbreathe,andcough•Whencaringforaclient withapostrightthoracotomywhohasundergoneanupper lobectomy, the nurse focuses on pain management to promote•Relaxationandsleep•Deepbreathingandcoughing•Incisionalhealing•RangeofmotionexercisesThecorrectanswerisB:Deepbreathingandcoughing•Anurseistocollectasputumspecimenforacid-fastbacillus(AFB)fromaclient.

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