2019 HESI Exit EXAM Ver. 2 100

2019 HESI Exit EXAM (Ver. 2) 100 % Correct Questions and Answers - A+ Rated Guide

• A client with a diagnosis of Methicillin resistant Staphylococcus aureus

(MRSA) has died. Which type of precautions is the appropriate type to use when performing postmortem care?

• airborne precautions
• droplet precautions
• contact precautions
• compromised host precautions

The correct answer is C: contact precautions

• The nurse is reviewing with a client how to collect a clean catch urine

specimen.Which sequence is appropriate teaching?

• Void a little, clean the meatus, then collect specimen
• clean the meatus, begin voiding, then catch urine stream
• Clean the meatus, then urinate into container
• Void continuously and catch some of the urine

The correct answer is B: clean the meatus, begin voiding, then catch urine

stream

• The provider orders Lanoxin (digoxin) 0.125 mg PO and furosomide 40

mg every day. Which of these foods would the nurse reinforce for the client to eat at least daily?

• spaghetti
• watermelon
• chicken
• tomatoes

The correct answer is B: watermelon

• A nurse is stuck in the hand by an exposed needle. What immediate

action should the nurse take?

• Look up the policy on needle sticks
• Contact employee health services 1 / 4

• Immediately wash the hands with vigor
• Notify the supervisor and risk management

The correct answer is C: Immediately wash the hands with vigor

• As the nurse observes the student nurse during the administration of a

narcotic analgesic IM injection, the nurse notes that the student begins to give the medication without first aspirating. What should the nurse do?

A) Ask the student: "What did you forget to do?”

• Stop. Tell me why aspiration is needed.

C) Loudly state: “You forgot to aspirate.”

• Walk up and whisper in the student’s ear “Stop. Aspirate. Then inject.”

The correct answer is D: Walk up and whisper in the student’s ear “Stop.

Aspirate. Then inject.”

• A client with Guillain Barre is in a non responsive state, yet vital signs

are stable and breathing is independent. What should the nurse document to most accurately describe the client's condition?

• Comatose, breathing unlabored
• Glascow Coma Scale 8, respirations regular
• Appears to be sleeping, vital signs stable
• Glascow Coma Scale 13, no ventilator required

The correct answer is B: Glascow Coma Scale 8, respirations regular

• A client enters the emergency department unconscious via ambulance

from the client’s work place. What document should be given priority to guide the direction of care for this client?

• The statement of client rights and the client self determination act
• Orders written by the health care provider
• A notarized original of advance directives brought in by the partner
• The clinical pathway protocol of the agency and the emergency

department

The correct answer is C: A notarized original of advance directives

brought in by the partner

• The charge nurse has a health care team that consists of 1 PN, 1

unlicensed assistive 2 / 4

personnel (UAP) and 1 PN nursing student. Which assignment should be questioned by the nurse manager?

• An admission at the change of shifts with atrial fibrillation and heart

failure - PN

• Client who had a major stroke 6 days ago - PN nursing student
• A child with burns who has packed cells and albumin IV running -

charge nurse

• An elderly client who had a myocardial infarction a week ago - UAP

The correct answer is A: An admission at the change of shifts with atrial

fibrillation and heart failure - PN

• A mother brings her 3 month-old into the clinic, complaining that the

child seems to be spitting up all the time and has a lot of gas. The nurse expects to find which of the following on the initial history and physical assessment?

• Increased temperature and lethargy
• Restlessness and increased mucus production
• Increased sleeping and listlessness
• Diarrhea and poor skin turgor

The correct answer is B: Restlessness and increased mucus production

• As the nurse takes a history of a 3 year-old with neuroblastoma, what

comments by the parents require follow-up and are consistent with the diagnosis?

• "The child has been listless and has lost weight."
• "The urine is dark yellow and small in amounts."
• "Clothes are becoming tighter across her abdomen."
• "We notice muscle weakness and some unsteadiness."

The correct answer is C: "Clothes are becoming tighter across her

abdomen."

• The nurse knows that which statement by the mother indicates that

the mother understands safety precautions with her four month-old infant and her 4 year-old child?

• "I strap the infant car seat on the front seat to face backwards."
• "I place my infant in the middle of the living room floor on a blanket to

play with my

• year old while I make supper in the kitchen." 3 / 4

• "My sleeping baby lies so cute in the crib with the little buttocks stuck

up in the air while the four year old naps on the sofa."

• "I have the 4 year-old hold and help feed the four month-old a bottle in

the kitchen while I make supper."

The correct answer is D: "I have the four year-old hold and help feed the

four month-old a bottle in the kitchen

• Upon completing the admission documents, the nurse learns that the

87 year-old client does not have an advance directive. What action should the nurse take?

• Record the information on the chart
• Give information about advance directives
• Assume that this client wishes a full code
• Refer this issue to the unit secretary

The correct answer is B: Give information about advance directives

• A nurse administers the influenza vaccine to a client in a clinic. Within

15 minutes after the immunization was given, the client complains of itchy and watery eyes, increased anxiety, and difficulty breathing. The nurse expects that the first action in the sequence of care for this client will be to

• Maintain the airway

B) Administer epinephrine 1:1000 as ordered

• Monitor for hypotension with shock
• Administer diphenhydramine as ordered

The correct answer is B: Administer epinephrine 1:1000 as ordered .

• Which of these children at the site of a disaster at a child day care

center would the triage nurse put in the "treat last" category?

• An infant with intermittent bulging anterior fontanel between crying

episodes

• A toddler with severe deep abrasions over 98% of the body
• A preschooler with 1 lower leg fracture and the other leg with an upper

leg fracture

• A school-age child with singed eyebrows and hair on the arms

The correct answer is B: A toddler with severe deep abrasions over 98%

of the body .

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