HESI PN EXIT EXAM 2023 TEST BANK /PN HESI EXIT
EXAM TEST BANK ACTUAL EXAM 400 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (100% VERIFIED ANSWERS) |ALREADY
GRADED A+
The nurse is assisting a father to change the diaper of his 2-day-old infant. The
father notices several bluish-black pigmented areas on the infant’s buttocks and
asks the nurse, “What did you do to my baby?” Which response is best for the
nurse to provide?
A.”What makes you think we did anything to your baby?”
B.”Are you or any of your blood relatives of Asian descent?”
C.”Those are stork bites and will go away in about 2 years.”
D.”Those are Mongolian spots and will gradually fade in 1 or 2 years.” –
ANSWER- D
Rationale: Mongolian spots (D) are areas of bluish-black or gray-blue
pigmentation seen primarily on the dorsal area and buttocks of infants of Asian or
African decent or dark-skinned babies. (A) is a defensive answer. Although
Mongolian spots occur more frequently in those of Asian and African decent, (B)
does not respond to the father’s concern. Telangiectatic nevi, frequently referred to
as stork bites (C), appear reddish-purple or red and are usually on the face or head
and neck area.
The nurse is planning a community teaching program regarding the use of folic
acid to prevent neural tube birth defects. Which community group is likely to
benefit most from this program?
A.Parents of children with spina bifida
B.High school girls in a health class
C.Individuals interested in having children
D.Postpartum women attending a baby care class – ANSWER- C
Rationale: Folic acid is needed early in pregnancy to prevent neural tube defects;
the group most likely to be considering pregnancy is (C). Parents with children
who already have a neural tube defect such as spina bifida (A) are not as invested
in the content as (C). High school age students (B) may have interest in the topic
but as a group are less likely to anticipate the likelihood that problems could occur
in their lives than (C). (D) may be interested if planning future pregnancies, but
have higher learning priorities during the postpartum period.
A client who is on the outpatient surgical unit is preparing for discharge after a
myringotomy with placement of ventilating tubes. Which response by the client
indicates that further teaching is necessary?
A.”I will avoid coughing, sneezing, and forceful nose blowing.”
B.”Swimming can begin on the tenth postoperative day.”
C.”Any mild discomfort can be managed with acetaminophen.”
D.”Drainage from my ears is expected after the surgery.” – ANSWER- B
Rationale: The purpose of the ventilating tubes in the tympanic membrane is to
equalize pressure and drain fluid collection from the middle ear. The tube’s patency
allows air and water to enter the middle ear, so the client should be reeducated if
the client swims (B) or allows water to enter the external ear. (A, C, and D) reflect
correct responses.
A male client with arterial peripheral vascular disease (PVD) complains of pain in
his feet. Which instruction should the nurse give to the UAP to relieve the client’s
pain quickly?
A.Help the client dangle his legs.
B.Apply compression stockings.
C.Assist with passive leg exercises.
D.Ambulate three times a day. – ANSWER- A
Rationale: The client who has arterial PVD may benefit from dependent
positioning, and this can be achieved with bedside dangling (A), which will
promote gravitation of blood to the feet, improve blood flow, and relieve pain. (B)
is indicated for venous insufficiency (C) and indicated for bed rest. Ambulation
(D) is indicated to facilitate collateral circulation and may improve long-term
complaints of pain.
Which situation demonstrates proper application of client confidentiality
requirements for the Health Insurance Portability and Accountability Act
(HIPAA)?
A.Clients’ names are not used while they are in a public waiting room.
B.Nurses should not recommend any community self-help groups by specific
name, such as Alcoholics Anonymous.
C.Clients must pick up their filled prescriptions from a pharmacy in person with a
photo identification card.
D.Old medical records are kept in a locked file cabinet in the department. –
ANSWER- D
Rationale: Past medical records must be “secured” and “reasonably protected”
from inadvertent viewing (D). A locked room or file cabinet can serve this
purpose, and when any protected health information (PHI) is discarded, it must be
shredded. A person’s name only (without their diagnosis or treatment) is not
considered confidential or PHI (A). Nurses may suggest categories of community
resources, with examples, such as Alcoholics Anonymous (B), but cannot market a
specific program in which they have a financial interest. Others can pick up a
client’s filled prescriptions (C).
Prior to administering an oral suspension, which intervention is most important for
the nurse to implement?
A.Assess the client’s ability to swallow liquids.
B.Obtain applesauce in which to mix the medication.
C.Determine the client’s food likes and dislikes.
D.Auscultate the client’s breath sounds. – ANSWER- A
Rationale: An oral suspension is a liquid, so the nurse needs to assess the client’s
ability to swallow liquids (A) to ensure that the client will not choke. If the client
has difficulty swallowing liquids, a thickening substance may be used (B). If a
food product is used to thicken the liquid, (C) would be beneficial. (D) may also be
warranted, but only if the client is at risk for aspiration, determined by (A).
A client with schizophrenia tells the nurse, “The world is coming to an end. All the
violence in the Middle East is soon going to destroy the entire world!” How should
the nurse respond?
A.”Let’s play some dominoes for a few minutes.”
B.”I don’t think the violence means the world is ending.”
C.”The news makes you have upsetting thoughts.”
D.”Listening to the news seems to be frightening you.” – ANSWER- D
Rationale: A client’s delusional statements are best addressed by identifying the
feeling associated with the delusion (D). Distraction (A) may be helpful but
ignores the feelings that the client is experiencing. Delusional clients often argue
with statements that contradict their belief system (B). The client is unlikely to
understand the relationship between the news and the thoughts experienced (C).
A client with glomerulonephritis is scheduled for a creatinine clearance test to
determine the need for dialysis. Which information should the nurse provide the
client prior to the test?