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HESI Exit (RN) 2025 Exam-7

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Title HESI Exit (RN) 2025 Exam-7

Type Nursing

Category RN Nursing Exams

Subcategory EXIT HESI Exams-RN

Domain HESI Exit exams (RN)-2025

Fragment N/A

Module RN-NURSING

Status active

Rating 95.00%

Attempts 15

Year 2025

Duration 320 min

Questions 10

Pass Score 90%

Difficulty Intermediate

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1 :
Fifteen minutes after receiving sulfamethoxazole-trimethoprim (SMZ-TMP), the client reports a burning sensation over the abdomen, chest, and groin. Which intervention is most important for the nurse to implement?

Check neurological vital signs.

Auscultate lung sounds for wheezing.

Review the client's list of drug allergies.

Document findings in the medical record.

Hint : 💭A sudden burning sensation after a new drug often points to an immediate hypersensitivity reaction that can affect the airway.

Correct Answers:

Auscultate lung sounds for wheezing.

Rationale :

💊Allergic reactions can cause immediate respiratory compromise such as bronchospasm or airway obstruction, which may present with wheezing.

⚠️Assessing lung sounds helps detect early signs of anaphylaxis, a potentially life-threatening condition requiring rapid intervention.

💨Clients experiencing burning, flushing, or urticaria after medication may progress to respiratory distress, so assessing airway status is priority.

🩺While reviewing allergies and documenting findings are important, they are secondary to airway assessment, as airway maintenance is always the first priority.

📌Core Message

In a suspected allergic reaction, the nurse must first assess airway and breathing by listening for wheezing.

2 :
The school nurse is implementing standards to manage students and provide a safe and healthy school setting. Which action is most important for the nurse to implement?

Maintain student immunization records.

Develop an emergency plan for the school.

Ensure that medical supplies are available.

Conduct annual student health assessments.

Hint : 🧠Safety management in schools starts with being prepared for unexpected emergencies rather than only focusing on routine records.

Correct Answers:

Develop an emergency plan for the school.

Rationale :

🚨A comprehensive emergency plan ensures preparedness for urgent situations such as injuries, allergic reactions, or disasters.

🏫It allows for systematic response among staff and students, promoting safety and coordinated care.

📋While maintaining immunization records and health assessments is vital, they are preventive measures, not immediate safety actions.

💡Emergency planning provides the foundation for crisis response, fulfilling the nurse’s primary duty of ensuring a safe environment.

📌Core Message

A school nurse’s top priority is to establish an emergency preparedness plan to ensure student safety.

3 :
Which environmental factor is most significant when planning care for a client with osteomalacia?

Quiet, calm surroundings.

Cool, moist air.

Stimulating sounds and activity.

Adequate sunlight.

Hint : 🌤️The most natural way to increase vitamin D levels comes from environmental exposure.

Correct Answers:

Adequate sunlight.

Rationale :

☀️Osteomalacia results from vitamin D deficiency, which impairs calcium absorption and causes bone softening.

💊Sunlight exposure activates vitamin D synthesis in the skin, improving bone mineralization.

🏥Other factors such as quiet surroundings or cool air have no role in the pathophysiology of osteomalacia.

🦴Ensuring adequate sunlight helps enhance bone strength and calcium utilization, addressing the underlying cause.

📌Core Message

Adequate sunlight is vital for vitamin D production and the prevention of bone demineralization in osteomalacia.

4 :
A client receives a new prescription for zafirlukast. Prior to administering the medication, the nurse should review the electronic medical record for which condition?

Obesity.

Cholecystitis.

Diabetes mellitus.

Cerebrovascular accident.

Hint : 🧾When a drug relies on hepatic metabolism, always check for liver-related conditions before giving it.

Correct Answers:

Cholecystitis.

Rationale :

💁‍♂️Zafirlukast, a leukotriene receptor antagonist, is metabolized by the liver, making it unsafe in hepatic impairment such as cholecystitis.

💉Clients with liver disease have reduced ability to metabolize medications, increasing the risk of toxicity.

🧠Conditions like obesity or diabetes do not directly alter zafirlukast metabolism.

⚕️Assessing hepatic function ensures safe drug administration and prevents adverse effects.

📌Core Message

Zafirlukast should be avoided in clients with liver disease, so cholecystitis must be reviewed before administration.

5 :
A nurse is caring for a client.

History and Physical Examination
Nurses’ Notes
Vital signs
Orders

A 57-year-old male is brought to the Emergency Department (ED) by Emergency Medical Services (EMS) due to chest pain. The client was mowing his lawn when he developed chest pain described as tightness and pressure. The pain gradually increased over approximately 30 minutes. The client attempted to rest, but the pain remained unrelieved after 20 minutes, prompting his wife to call EMS.

The client denies previous episodes of similar pain.

Past medical History:

Hypertension

Obesity

20-year history of smoking (quit 5 years ago)

Current Medication:

Metoprolol succinate ER 25 mg PO daily

1230 hrs:

Emergency Department Presentation

Neurological:

Alert and oriented to person, place, time, and situation

Agitated

Denies headaches

Cardiovascular:

Chest pain: pressure and tightness, unrelieved by rest

Rapid, regular rhythm

Normal heart tones

Radial and pedal pulses: 2+

Capillary refill: 2 seconds

Respiratory:

Rapid, shallow respirations

Breath sounds clear bilaterally

Gastrointestinal:

Within normal limits (WNL)

Genitourinary:

Within normal limits (WNL)

Musculoskeletal:

Within normal limits (WNL)

Pain Assessment:

Pain score: 7/10

Quality: tightness and pressure

Duration: began approximately 2 hours ago, progressively worsening

Not relieved by rest

1230 hrs:

Temperature: 98.1°F (36.7°C) orally

Heart rate: 121 beats/minute

Respirations: 21 breaths/minute

Blood pressure: 162/98 mm Hg

Oxygen saturation: 92% on room air

Body mass index [BMI]: 32 kg/m² (normal 18 to 24.9 kg/m²)

Pain: 7 on a 0 to 10 scale, tightness and pressure in chest

1245 hrs:

12-lead electrocardiogram (ECG)

Laboratory tests:

Prothrombin time (PT)

International normalized ratio (INR)

Troponin T

Troponin I

C-reactive protein

Cholesterol panel: Total cholesterol, triglycerides, HDL, LDL

Titrate oxygen via nasal cannula to maintain SpO₂ > 94%

Insert peripheral IV (PIV) access device and maintain per protocol

The healthcare provider (HCP) places prescriptions for further diagnostics. Click to indicate if the listed symptoms are consistent with angina, myocardial infarction, or both. Each column must have at least one response option selected.

Symptoms	Myocardial infarction	Angina
Feelings of fear
Occurring without cause
Pain only relieved by opioids
Chest pain radiating down arm
Pain relived by nitroglycerin
Epigastric distress

Hint : 💭When chest pain is relieved by nitroglycerin, think of temporary ischemia; when pain persists even at rest, it often signals tissue necrosis.

Correct Answers

Feelings of fear [ Myocardial infarction ]
Occurring without cause [ Myocardial infarction ]
Pain only relieved by opioids [ Myocardial infarction ]
Chest pain radiating down arm [ Myocardial infarction ; Angina ]
Pain relived by nitroglycerin [ Angina ]
Epigastric distress [ Myocardial infarction ; Angina ]

Rationale :

❤️Myocardial infarction (MI) occurs when coronary blood flow is completely obstructed, causing myocardial necrosis and resulting in severe, unrelieved pain even at rest.

💊Pain during an MI is typically not relieved by nitroglycerin and often requires opioids for relief, due to the extent of tissue ischemia.

👩🏻‍🤝‍🧑🏿Clients experiencing MI frequently exhibit autonomic nervous system responses, such as feelings of fear, anxiety, or impending doom, due to decreased oxygenation and perfusion.

💁‍♂️In angina pectoris, pain occurs with exertion or stress and is typically relieved by rest or nitroglycerin, as there is temporary ischemia without tissue damage.

📌Core Message

Myocardial infarction causes unrelieved rest pain requiring opioids, while angina involves exertional pain relieved by nitroglycerin.

6 :
A nurse is caring for a client.

History and Physical
Nurses' Notes
Vital Signs
Orders
Imaging Studies

The client denies previous episodes of similar pain.

Past medical History:

Hypertension

Obesity

20-year history of smoking (quit 5 years ago)

Current Medication:

Metoprolol succinate ER 25 mg PO daily

1230 hrs:

Emergency Department Presentation

Neurological:

Alert and oriented to person, place, time, and situation

Agitated

Denies headaches

Cardiovascular:

Chest pain: pressure and tightness, unrelieved by rest

Rapid, regular rhythm

Normal heart tones

Radial and pedal pulses: 2+

Capillary refill: 2 seconds

Respiratory:

Rapid, shallow respirations

Breath sounds clear bilaterally

Gastrointestinal:

Within normal limits (WNL)

Genitourinary:

Within normal limits (WNL)

Musculoskeletal:

Within normal limits (WNL)

Pain Assessment:

Pain score: 7/10

Quality: tightness and pressure

Duration: began approximately 2 hours ago, progressively worsening

Not relieved by rest

1230 hrs:

Temperature: 98.1°F (36.7°C) orally

Heart rate: 121 beats/minute

Respirations: 21 breaths/minute

Blood pressure: 162/98 mm Hg

Oxygen saturation: 92% on room air

Body mass index [BMI]: 32 kg/m² (normal 18 to 24.9 kg/m²)

Pain: 7 on a 0 to 10 scale, tightness and pressure in chest

1245 hrs:

12-lead electrocardiogram (ECG)

Laboratory tests:

Prothrombin time (PT)

International normalized ratio (INR)

Troponin T

Troponin I

C-reactive protein

Cholesterol panel: Total cholesterol, triglycerides, HDL, LDL

Titrate oxygen via nasal cannula to maintain SpO₂ > 94%

Insert peripheral IV (PIV) access device and maintain per protocol

1300:

12-lead electrocardiogram (ECG)

Sinus tachycardia (ST) with a

1st degree heart block PR interval (PRI) 0.22 seconds

ST depression.

Initial testing is complete, and the nurse is reviewing the results. Choose the most likely options for the information missing from the statement by selecting from the lists of options provided. The nurse determines that the client hasas evidenced by ST depression on electrocardiogram and.

Hint : 🧠When ST depression appears but cardiac enzymes remain normal, the problem is ischemia, not infarction.

Correct Answers

Blank 1 Correct Option: new onset angina
Blank 2 Correct Option: normal troponin

Rationale :

📉ST depression indicates myocardial ischemia rather than infarction.

🧪Normal troponin levels confirm no cardiac muscle damage, ruling out myocardial infarction.

💁‍♂️Angina occurs from temporary lack of oxygen without necrosis.

💊Early identification prevents progression to myocardial infarction through prompt management.

📌Core Message

ST depression with normal troponin represents angina, not myocardial infarction.

7 :
A nurse is caring for a client.

History and Physical
Nurses' Notes
Vital Signs
Orders
Imaging studies

The client denies previous episodes of similar pain.

Past medical History:

Hypertension

Obesity

20-year history of smoking (quit 5 years ago)

Current Medication:

Metoprolol succinate ER 25 mg PO daily

1230 hrs:

Emergency Department Presentation

Neurological:

Alert and oriented to person, place, time, and situation

Agitated

Denies headaches

Cardiovascular:

Chest pain: pressure and tightness, unrelieved by rest

Rapid, regular rhythm

Normal heart tones

Radial and pedal pulses: 2+

Capillary refill: 2 seconds

Respiratory:

Rapid, shallow respirations

Breath sounds clear bilaterally

Gastrointestinal:

Within normal limits (WNL)

Genitourinary:

Within normal limits (WNL)

Musculoskeletal:

Within normal limits (WNL)

Pain Assessment:

Pain score: 7/10

Quality: tightness and pressure

Duration: began approximately 2 hours ago, progressively worsening

Not relieved by rest

1230 hrs:

Temperature: 98.1°F (36.7°C) orally

Heart rate: 121 beats/minute

Respirations: 21 breaths/minute

Blood pressure: 162/98 mm Hg

Oxygen saturation: 92% on room air

Body mass index [BMI]: 32 kg/m² (normal 18 to 24.9 kg/m²)

Pain: 7 on a 0 to 10 scale, tightness and pressure in chest

1245 hrs:

12-lead electrocardiogram (ECG)

Laboratory tests:

Prothrombin time (PT)

International normalized ratio (INR)

Troponin T

Troponin I

C-reactive protein

Cholesterol panel: Total cholesterol, triglycerides, HDL, LDL

Titrate oxygen via nasal cannula to maintain SpO₂ > 94%

Insert peripheral IV (PIV) access device and maintain per protocol

1300:

12-lead electrocardiogram (ECG)

Sinus tachycardia (ST) with a

1st degree heart block PR interval (PRI) 0.22 seconds

ST depression.

The client was given oxygen, sublingual nitroglycerin, and aspirin. After one dose of nitroglycerin, the client's pain decreased to a reported 2 on a 0 to 10 scale with squeezing pain. The client was admitted for observation and percutaneous coronary intervention (PCI) to be completed later within the evening. The client asks the nurse to explain why a PCI is being completed. Drag and drop word choices to complete the sentence. If healthcare providers (HCPs) see a narrowed heart vessel while performing a percutaneous coronary intervention (PCI), they may perform a balloon angioplasty to compress the plaque against the vessel wall and secure it with a stent, which will lessenand.

Hint : ❤️Restoring coronary circulation helps relieve both pain and arterial constriction.

Correct Answers

Blank 1 Correct Option: pain
Blank 2 Correct Option: vasospasms

Rationale :

💁‍♂️Percutaneous coronary intervention (PCI) restores blood flow to ischemic myocardium by widening narrowed arteries.

💨Reducing vasospasm prevents sudden arterial constriction, maintaining oxygen supply.

💊By improving perfusion, chest pain decreases, enhancing cardiac output.

⚕️Thus, PCI minimizes angina and ischemia-related complications.

📌Core Message

PCI with stent placement reduces chest pain and prevents vasospasm by improving myocardial perfusion.

8 :
A nurse is caring for a client.

History and Physical
Nurses' Notes
Vital Signs
Orders
Imaging studies

The client denies previous episodes of similar pain.

Past medical History:

Hypertension

Obesity

20-year history of smoking (quit 5 years ago)

Current Medication:

Metoprolol succinate ER 25 mg PO daily

1230 hrs:

Emergency Department Presentation

Neurological:

Alert and oriented to person, place, time, and situation

Agitated

Denies headaches

Cardiovascular:

Chest pain: pressure and tightness, unrelieved by rest

Rapid, regular rhythm

Normal heart tones

Radial and pedal pulses: 2+

Capillary refill: 2 seconds

Respiratory:

Rapid, shallow respirations

Breath sounds clear bilaterally

Gastrointestinal:

Within normal limits (WNL)

Genitourinary:

Within normal limits (WNL)

Musculoskeletal:

Within normal limits (WNL)

Pain Assessment:

Pain score: 7/10

Quality: tightness and pressure

Duration: began approximately 2 hours ago, progressively worsening

Not relieved by rest

1230 hrs:

Temperature: 98.1°F (36.7°C) orally

Heart rate: 121 beats/minute

Respirations: 21 breaths/minute

Blood pressure: 162/98 mm Hg

Oxygen saturation: 92% on room air

Body mass index [BMI]: 32 kg/m² (normal 18 to 24.9 kg/m²)

Pain: 7 on a 0 to 10 scale, tightness and pressure in chest

1245 hrs:

12-lead electrocardiogram (ECG)

Laboratory tests:

Prothrombin time (PT)

International normalized ratio (INR)

Troponin T

Troponin I

C-reactive protein

Cholesterol panel: Total cholesterol, triglycerides, HDL, LDL

Titrate oxygen via nasal cannula to maintain SpO₂ > 94%

Insert peripheral IV (PIV) access device and maintain per protocol

1300:

12-lead electrocardiogram (ECG)

Sinus tachycardia (ST) with a

1st degree heart block PR interval (PRI) 0.22 seconds

ST depression.

The nurse has provided discharge teaching to the client to manage his chest pain at home. Which 2 statements from the client should the nurse recognize as a need for further education?

Answer Options

I will take the nitroglycerin 1 or 2 more times 10 minutes apart if pain does not get better.

I will chew my nitroglycerin tabs as soon as pain begins.

I will call 911 if there is no improvement in my chest pain after taking nitroglycerin.

I will wait 5 minutes after taking my nitroglycerin to see if the pain improves.

I will keep my nitroglycerin tablets with me all the time.

I will wear a medication alert bracelet to indicate my history of heart problems.

I will lie down or sit if I start to feel any chest discomfort.

Hint : 🤦‍♂️Timing and route of nitroglycerin are key; incorrect use can delay pain relief and worsen outcomes.

Correct Answers:

I will take the nitroglycerin 1 or 2 more times 10 minutes apart if pain does not get better.

Rationale :

💊Nitroglycerin should be taken every 5 minutes up to 3 doses, not every 10 minutes.

💁‍♂️It should be placed sublingually, not chewed, as chewing alters absorption rate.

📞If pain persists after 3 doses, the client should call emergency services.

📋Incorrect administration can delay relief and worsen ischemia.

📌Core Message

Proper timing and route of nitroglycerin are essential—chewing or incorrect intervals indicate poor understanding.

9 :
An adult client who had a gastric bypass two days ago reports to the nurse of feeling bloated. After verifying that the client's abdomen is distended, which intervention should the nurse implement?

Assess vital signs and report the finding to the healthcare provider immediately.

Assess hydration status and provide the client with a clear carbonated drink.

Measure the abdomen and review the client's dietary intake for the past 24 hours.

Reassure the client and encourage the client to walk more to decrease gas.

Hint : 💨Encouraging movement helps stimulate bowel activity and ease gas retention after abdominal surgery.

Correct Answers:

Reassure the client and encourage the client to walk more to decrease gas.

Rationale :

⌚Early ambulation after gastric bypass surgery promotes peristalsis and assists in expelling gas, thereby reducing abdominal distention and discomfort.

🚶‍♀️Walking stimulates intestinal movement and is a safe, non-invasive intervention that helps prevent complications such as paralytic ileus.

🩺The nurse should avoid carbonated drinks, as they can increase gas formation and worsen bloating.

📋Vital signs should be monitored but do not require immediate provider notification unless accompanied by severe pain, tachycardia, or other signs of complications.

📌Core Message

Encouraging ambulation after gastric bypass reduces abdominal distention by stimulating gas expulsion and peristalsis.

10 :
The healthcare provider prescribes a low-fiber diet for a client with ulcerative colitis. Which food selection indicates to the nurse that the client understands the prescribed diet?

Baked potato with skin, raw carrots.

Pancakes, whole-grain cereals.

Roasted turkey, canned vegetables.

Roast pork, fresh strawberries.

Hint : 🥫Focus on soft, easily digested foods that minimize intestinal stimulation.

Correct Answers:

Roasted turkey, canned vegetables.

Rationale :

🥣A low-fiber diet reduces bowel irritation by limiting foods that increase stool bulk or stimulate peristalsis.

🍗Canned vegetables are low in fiber and easily digestible, making them suitable for ulcerative colitis management.

🌾Whole grains and raw vegetables like carrots and potato skins are high in fiber and can aggravate the inflamed intestinal mucosa.

🥛The goal is to promote bowel rest and minimize mechanical irritation to allow intestinal healing.

📌Core Message

A low-fiber diet for ulcerative colitis includes cooked, refined foods like roasted turkey and canned vegetables to prevent irritation.

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Ans

1 : Fifteen minutes after receiving sulfamethoxazole-trimethoprim (SMZ-TMP), the client reports a burning sensation over the abdomen, chest, and groin. Which intervention is most important for the nurse to implement?

2 : The school nurse is implementing standards to manage students and provide a safe and healthy school setting. Which action is most important for the nurse to implement?

3 : Which environmental factor is most significant when planning care for a client with osteomalacia?

4 : A client receives a new prescription for zafirlukast. Prior to administering the medication, the nurse should review the electronic medical record for which condition?

5 : A nurse is caring for a client.

Correct Answers

6 : A nurse is caring for a client.

Correct Answers

7 : A nurse is caring for a client.

Correct Answers

8 : A nurse is caring for a client.

Answer Options

9 : An adult client who had a gastric bypass two days ago reports to the nurse of feeling bloated. After verifying that the client's abdomen is distended, which intervention should the nurse implement?

10 : The healthcare provider prescribes a low-fiber diet for a client with ulcerative colitis. Which food selection indicates to the nurse that the client understands the prescribed diet?

1 :
Fifteen minutes after receiving sulfamethoxazole-trimethoprim (SMZ-TMP), the client reports a burning sensation over the abdomen, chest, and groin. Which intervention is most important for the nurse to implement?

2 :
The school nurse is implementing standards to manage students and provide a safe and healthy school setting. Which action is most important for the nurse to implement?

3 :
Which environmental factor is most significant when planning care for a client with osteomalacia?

4 :
A client receives a new prescription for zafirlukast. Prior to administering the medication, the nurse should review the electronic medical record for which condition?

5 :
A nurse is caring for a client.

6 :
A nurse is caring for a client.

7 :
A nurse is caring for a client.

8 :
A nurse is caring for a client.

9 :
An adult client who had a gastric bypass two days ago reports to the nurse of feeling bloated. After verifying that the client's abdomen is distended, which intervention should the nurse implement?

10 :
The healthcare provider prescribes a low-fiber diet for a client with ulcerative colitis. Which food selection indicates to the nurse that the client understands the prescribed diet?