HESI Exit Exam 2023 UPDATE WITH NGN QUESTIONS AND VERIFIED ANSWERS WITH RATIONALE DOWNLOAD TO SCORE GRADE A

Following discharge teaching, a male client with duodenal ulcer tells the nurse the he will drink plenty of 

dairy products, such as milk, to help coat and protect his ulcer. What is the best follow-up action by the 

nurse?

a. Remind the client that it is also important to switch to decaffeinated coffee and tea.

b. Suggest that the client also plan to eat frequent small meals to reduce discomfort

c. Review with the client the need to avoid foods that are rich in milk and cream.

d. Reinforce this teaching by asking the client to list a dairy food that he might select.

Review with the client the need to avoid foods that are rich in milk and cream

Rationale: Diets rich in milk and cream stimulate gastric acid secretion and should be avoided.

A male client with hypertension, who received new antihypertensive prescriptions at his last visit returns 

to the clinic two weeks later to evaluate his blood pressure (BP). His BP is 158/106 and he admits that he 

has not been taking the prescribed medication because the drugs make him "feel bad". In explaining the 

need for hypertension control, the nurse should stress that an elevated BP places the client at risk for 

which pathophysiological condition?

a. Blindness secondary to cataracts

b. Acute kidney injury due to glomerular damage

c. Stroke secondary to hemorrhage

d. Heart block due to myocardial damage

Stroke secondary to hemorrhage

Rationale: Stroke related to cerebral hemorrhage is major risk for uncontrolled hypertension.

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 the side rails. What 

action should the nurse implement?

a. Ensure that the UAP has placed the pillows effectively to protect the client.

b. Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows.

c. Assume responsibility for placing the pillows while the UAP completes another task.

d. Ask the UAP to use some of the pillows to prop the client in a side lying position.

Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows

Rationale: The nurse should instruct the UAP to pad the side rails with soft blankest because the use of 

pillows could result in suffocation and would need to be removed at the onset of the seizure. The nurse 

can delegate paddling the side rails to the UAP

An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for the past 12 

days. Which assessment finding requires immediate follow-up

a. Describes life without purpose

b. Complains of nausea and loss of appetite

c. States is often fatigued and drowsy

d. Exhibits an increase in sweating.

Describes life without purpose

Rationale: Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor that is known to 

increase the risk of suicidal thinking in adolescents and young adults with major depressive disorder. B, C 

and D are side effects

A 60-year-old female client with a positive family history of ovarian cancer has developed an abdominal 

mass and is being evaluated for possible ovarian cancer. Her Papanicolau (Pap) smear results are 

negative. What information should the nurse include in the client's teaching plan

a. Further evaluation involving surgery may be needed

b. A pelvic exam is also needed before cancer is ruled out

c. Pap smear evaluation should be continued every six month

d. One additional negative pap smear in six months is needed.

Further evaluation involving surgery may be needed

Rationale: An abdominal mass in a client with a family history for ovarian cancer should be evaluated 

carefully