HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+, Exams of Nursing

Download HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ and more Exams Nursing in PDF only on Docsity! HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI EXIT V2  The nurse is caring for a pre-adolescent client in skeletal Dunlop traction. Which nursing intervention is appropriate for this child? A) Make certain the child is maintained in correct body alignment. B) Be sure the traction weights touch the end of the bed. C)Adjust the head and foot of the bed for the child's comfort D) Release the traction for 15-20 minutes every 6 hours PRN.  The nurse is reassigned to work at the Poison Control Center telephone hotline. In which of these cases of childhood poisoning would the nurse suggest that parents have the child drink orange juice? A)An 18 month-old who ate an undetermined amount of crystal drain cleaner B)A 14 month-old who chewed 2 leaves of a philodendron plant C)A 20 month-old who is found sitting on the bathroom floor beside an empty bottle of diazepam (Valium) D)A 30 month-old who has swallowed a mouthful of charcoal lighter fluid HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  Which of these is an example of a variation in the newborn resulting from the presence of maternal hormones? A) Engorgement of the breasts B) Mongolian spots C) Edema of the scrotum D) Lanugo  A 2 month-old child has had a cleft lip repair. The selection of which restraint would require no further action by the charge nurse? A) Elbow B) Mummy C) Jacket D) Clove hitch  A client treated for depression tells the nurse at the mental health clinic that he recently purchased a handgun because he is thinking about suicide. The first nursing action should be to A) Notify the health care provider immediately B) Suggest in-patient psychiatric care HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ emphasize that A)The client should remain on bed rest in a semi-Fowler's position B) The client should alternate ambulation with bed rest with legs elevated C) The client may ambulate and sit in chair as tolerated D)The client may ambulate as tolerated and remain in semi-Fowler position in bed  The nurse is performing physical assessments on adolescents. When would the nurse anticipate that females experience growth spurts? A)About 2 years earlier than males B)About the same time as males C) Just prior to the onset of puberty D)That increase height by 4 inches each year  A client is admitted with low T3 and T4 levels and an elevated TSH level. On initial assessment, the nurse would anticipate which of the following assessment findings? A) Lethargy B) Heat intolerance C) Diarrhea HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ D) Skin eruptions  The emergency room nurse admits a child who experienced a seizure at school. The father comments that this is the first occurrence, and denies any family history of epilepsy. What is the best response by the nurse? A) "Do not worry. Epilepsy can be treated with medications." B) "The seizure may or may not mean your child has epilepsy." C) "Since this was the first convulsion, it may not happen again." D) "Long term treatment will prevent future seizures."  Alcohol and drug abuse impairs judgment and increases risk taking behavior. What nursing diagnosis best applies? A) Risk for injury B) Risk for knowledge deficit HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ C)Altered thought process D) Disturbance in self-esteem  The nurse is caring for a 10 month-old infant who is has oxygen via mask. It is important for the nurse to maintain patency of which of these areas? A) Mouth B) Nasal passages C) Back of throat D) Bronchials  The nurse is providing instructions for a client with pneumonia. What is the most important information to convey to the client? A) "Take at least 2 weeks off from work." B) "You will need another chest x-ray in 6 weeks." C) "Take your temperature every day." D) "Complete all of the antibiotic even if your findings decrease." HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  A recovering alcoholic asked the nurse, "Will it be ok for me to just drink at special family gatherings?" Which initial response by the nurse would be best? A) "A recovering person has to be very careful not to lose control, therefore, confine your drinking just at family gatherings." B) "At your next AA meeting discuss the possibility of limited drinking with your sponsor." C) "A recovering person needs to get in touch with their feelings. Do you want a drink?" D) "A recovering person cannot return to drinking without starting the addiction process over."  In taking the history of a pregnant woman, which of the following would the nurse recognize as the primary contraindication for breast feeding? A) Age 40 years B) Lactose intolerance HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ C) Family history of breast cancer D) Uses cocaine on weekends  A client is receiving nitroprusside IV for the treatment of acute heart failure with pulmonary edema. What diagnostic lab value should the nurse monitor in relation to this medication? A) Potassium B) Arterial blood gasses C) Blood urea nitrogen D) Thiocyanate  A victim of domestic violence tells the batterer she needs a little time away. How would the nurse expect that the batterer might respond? A)With acceptance and views the victim’s comment as an indication that their marriage is in trouble B) With fear of rejection causing increased rage toward the victim C) With a new commitment to seek counseling to assist with their marital HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ problems D)With relief, and welcomes the separation as a means to have some personal time  A postpartum mother is unwilling to allow the father to participate in the newborn's care, although he is interested in doing so. She states, "I am afraid the baby will be confused about who the mother is. Baby raising is for mothers, not fathers." The nurse's initial intervention should be what focus? A) Discuss with the mother sharing parenting responsibilities B) Set time aside to get the mother to express her feelings and concerns C)Arrange for the parents to attend infant care classes D)Talk with the father and help him accept the wife's decision  A client with emphysema visits the clinic. While teaching about proper nutrition, the nurse should emphasize that the client A) Eat foods high in sodium increases sputum liquefaction B) Use oxygen during meals improves gas exchange C) Perform exercise after respiratory therapy enhances appetite HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ C) High in carbohydrates, low in proteins D) Low in carbohydrates, high in proteins  In evaluating the growth of a 12 month-old child, which of these findings would the nurse expect to be present in the infant? A) Increased 10% in height B) 2 deciduous teeth C) Tripled the birth weight D) Head > chest circumference  A Hispanic client in the postpartum period refuses the hospital food because it is "cold." The best initial action by the nurse is to A) Have the unlicensed assistive personnel (UAP) reheat the food if the client wishes HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ B)Ask the client what foods are acceptable or bad C) Encourage her to eat for healing and strength D) Schedule the dietitian to meet with the client as soon as possible  The father of an 8 month-old infant asks the nurse if his infant's vocalizations are normal for his age. Which of the following would the nurse expect at this age? A) Cooing B) Imitation of sounds C) Throaty sounds D) Laughter  The nurse should recognize that physical dependence is accompanied by what findings when alcohol consumption is first reduced or ended? A) Seizures B) Withdrawal C) Craving D) Marked tolerance HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  Immediately following an acute battering incident in a violent relationship, the batterer may respond to the partner’s injuries by A) Seeking medical help for the victim's injuries B) Minimizing the episode and underestimating the victim’s injuries C) Contacting a close friend and asking for help D) Being very remorseful and assisting the victim with medical care  The nurse is planning to give a 3 year-old child oral digoxin. Which of the following is the best approach by the nurse? A) "Do you want to take this pretty red medicine?" B) "You will feel better if you take your medicine." C) "This is your medicine, and you must take it all right now." D) "Would you like to take your medicine from a spoon or a cup?" HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ memory? A) "Name the year." "What season is this?" (pause for answer after each question) B) "Subtract 7 from 100 and then subtract 7 from that." (pause for answer) "Now continue to subtract 7 from the new number." C) "I am going to say the names of three things and I want you to repeat them after me: blue, ball, pen." D) "What is this on my wrist?" (point to your watch) Then ask, "What is the purpose of it?"  In planning care for a 6 month-old infant, what must the nurse provide to assist in the development of trust? A) Food B) Warmt h C) Security D) Comfort  A nurse has just received a medication order which is not legible. Which statement best reflects assertive communication? HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ A) "I cannot give this medication as it is written. I have no idea of what you mean." B) "Would you please clarify what you have written so I am sure I am reading it correctly?" C) "I am having difficulty reading your handwriting. It would save me time if you would be more careful." D) "Please print in the future so I do not have to spend extra time attempting to read your writing."  What is the most important consideration when teaching parents how to reduce risks in the home? A) Age and knowledge level of the parents B) Proximity to emergency services C) Number of children in the home D) Age of children in the home HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  A 35 year-old client with sickle cell crisis is talking on the telephone but stops as the nurse enters the room to request something for pain. The nurse should A) Administer a placebo B) Encourage increased fluid intake C) Administer the prescribed analgesia D) Recommend relaxation exercises for pain control  While caring for a toddler with croup, which initial sign of croup requires the nurse's immediate attention? A) Respiratory rate of 42 B) Lethargy for the past hour C)Apical pulse of 54 D) Coughing up copious secretions  In planning care for a child diagnosed with minimal change nephrotic syndrome, the nurse should understand the relationship between edema HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  The nurse prepares for a Denver Screening test with a 3 year-old child in the clinic. HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ The mother asks the nurse to explain the purpose of the test. What is the nurse’s best response about the purpose of the Denver? A) It measures a child’s intelligence. B) It assesses a child's development. C) It evaluates psychological responses. D) It helps to determine problems.  The nurse is preparing a 5 year-old for a scheduled tonsillectomy and adenoidectomy. The parents are anxious and concerned about the child's reaction to impending surgery. Which nursing intervention would be best to prepare the child? A) Introduce the child to all staff the day before surgery B) Explain the surgery 1 week prior to the procedure C) Arrange a tour of the operating and recovery rooms D) Encourage the child to bring a favorite toy to the hospital  The nurse, assisting in applying a cast to a client with a broken arm, knows HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ that A)The cast material should be dipped several times into the warm water B) The cast should be covered until it dries C) The wet cast should be handled with the palms of hands D)The casted extremity should be placed on a cloth-covered surface  Based on principles of teaching and learning, what is the best initial approach to pre- op teaching for a client scheduled for coronary artery bypass? A) Touring the coronary intensive unit B) Mailing a video tape to the home C) Assessing the client's learning style D) Administering a written pre-test  A 4 year-old child is recovering from chicken pox (varicella). The parents would like to have the child return to day care as soon as possible. In order to ensure that the illness is no longer communicable, what should the nurse assess for in this child? A)All lesions crusted HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ T7 level. Which intervention should take priority in planning care? A) Increase fluid intake to prevent dehydration B) Place client on a pressure reducing support surface C) Use skin care products designed for use with incontinence D) Increase caloric intake to aid healing  A nurse is conducting a community wide seminar on childhood safety issues. Which of these children is at the highest risk for poisoning? A) 9 month-old who stays with a sitter 5 days a week B) 20 month-old who has just learned to climb stairs HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ C) 10 year-old who occasionally stays at home unattended D) 15 year-old who likes to repair bicycles  During an examination of a 2 year-old child with a tentative diagnosis of Wilm's tumor, the nurse would be most concerned about which statement by the mother? A) My child has lost 3 pounds in the last month. B) Urinary output seemed to be less over the past 2 days. C) All the pants have become tight around the waist. D) The child prefers some salty foods more than others.  What is the most important aspect to include when developing a home care plan for a client with severe arthritis? A) Maintaining and preserving function B)Anticipating side effects of therapy C) Supporting coping with limitations D) Ensuring compliance with medications HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  A mother asks the nurse if she should be concerned about the tendency of her child to stutter. What assessment data will be most useful in counseling the parent? A)Age of the child B) Sibling position in family C) Stressful family events D) Parental discipline strategies  A pre-term newborn is to be fed breast milk through nasogastric tube. Why is breast milk preferred over formula for premature infants? A) Contains less lactose B) Is higher in calories/ounce C) Provides antibodies D) Has less fatty acid  Which of the following nursing assessments in an infant is most valuable in identifying serious visual defects? HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ B) "Cystic fibrosis results in nutritional concerns that can be dealt with." C) "Thin, tenacious secretions from the lungs are a constant struggle in cystic fibrosis." D) "You will work with a team of experts and also have access to a support group that the family can attend."  Which type of accidental poisoning would the nurse expect to occur in children under age 6? A) Oral ingestion B) Topical contact C) Inhalation D) Eye splashes  A client was admitted to the psychiatric unit with a diagnosis of bipolar disorder. He constantly bothers other clients, tries to help the housekeeping staff, demonstrates pressured speech and demands constant attention from the staff. Which activity would be best for the client? A) Reading B) Checkers HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ C) Cards D) Ping-pong  The nurse is caring for a client who has developed cardiac tamponade. Which finding would the nurse anticipate? A) Widening pulse pressure B) Pleural friction rub C) Distended neck veins D) Bradycardia  Which nursing action is a priority as the plan of care is developed for a 7 year-old child hospitalized for acute glomerulonephritis? A) Assess for generalized edema B) Monitor for increased urinary output C) Encourage rest during hyperactive periods D) Note patterns of increased blood pressure HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  The nurse is caring for a child receiving chest physiotherapy (CPT). Which of the following actions by the nurse would be appropriate? A) Schedule the therapy thirty minutes after meals B) Teach the child not to cough during the treatment C) Confine the percussion to the rib cage area D) Place the child in a prone position for the therapy  A polydrug user has been in recovery for 8 months. The client has began skipping breakfast and not eating regular dinners. The client has also started frequenting bars to "see old buddies." The nurse understands that the client’s behavior is a warning sign to indicate that the client may be A) headed for relapse B) feeling hopeless C) approaching recovery D) in need of increased socialization  A client was admitted to the psychiatric unit with major depression after a suicide attempt. In addition to feeling sad and hopeless, the nurse would HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ A) Invite the client to join the exercise group B) Tell the client you will call someone to come for her C) Give the client simple information about what she will be doing D) Firmly direct the client to her assigned group activity  A victim of domestic violence states to the nurse, "If only I could change and be how my companion wants me to be, I know things would be different." Which would be the best response by the nurse? A) "The violence is temporarily caused by unusual circumstances, don’t stop hoping for a change." B) "Perhaps, if you understood the need to abuse, you could stop the violence." C) "No one deserves to be beaten. Are you doing anything to provoke your spouse into beating you?" D) "Batterers lose self-control because of their own internal reasons, not because of what their partner did or did not do." HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  A 38 year-old female client is admitted to the hospital with an acute exacerbation of asthma. This is her third admission for asthma in 7 months. She describes how she doesn't really like having to use her medications all the time. Which explanation by the nurse best describes the long-term consequence of uncontrolled airway inflammation? A) Degeneration of the alveoli B) Chronic broncho constriction of the large airways C) Lung remodeling and permanent changes in lung function D) Frequent pneumonia  A mother wants to switch her 9 month-old infant from an iron fortified formula to whole milk because of the expense. Upon further assessment, the nurse finds that the baby eats table foods well, but drinks less milk than before. What is the best advice by the nurse? A) Change the baby to whole milk B) Add chocolate syrup to the bottle C) Continue with the present formula D) Offer fruit juice frequently HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  Privacy and confidentiality of all client information is legally protected. In which of these situations would the nurse make an exception to this practice? A) When a family member offers information about their loved one B) When the client threatens self-harm and harm to others C) When the health care provider decides the family has a right to know the client's diagnosis D) When a visitor insists that the visitor has been given permission by the client  The nurse is caring for a client who is in the late stage of multiple myeloma. Which of the following should be included in the plan of care? A) Monitor for hyperkalemia B) Place in protective isolation C) Precautions with position changes D)Administer diuretics as ordered HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  The nurse assesses delayed gross motor development in a 3 year-old child. The inability of the child to do which action confirms this finding? A) Stand on 1 foot B) Catch a ball C) Skip on alternate feet D) Ride a bicycle .  The mother of a 15 month-old child asks the nurse to explain her child's lab results and how they show her child has iron deficiency anemia. The nurse's best response is A) "Although the results are here, your doctor will explain them later." B) "Your child has less red blood cells that carry oxygen." C) "The blood cells that carry nutrients to the cells are too large." D) "There are not enough blood cells in your child's circulation."  In a child with suspected coarctation of the aorta, the nurse would expect to find HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ A) Strong pedal pulses B) Diminishing carotid pulses C) Normal femoral pulses D) Bounding pulses in the arms  At the day treatment center a client diagnosed with Schizophrenia - Paranoid Type sits alone alertly watching the activities of clients and staff. The client is hostile when approached and asserts that the doctor gives her medication to control her mind. The client's behavior most likely indicates A) Feelings of increasing anxiety related to paranoia B) Social isolation related to altered thought processes C) Sensory perceptual alteration related to withdrawal from environment D) Impaired verbal communication related to impaired judgment  A 65-year-old Hispanic-Latino client with prostate cancer rates his pain as a 6 on a 0- to-10 scale. The client refuses all pain medication other than Motrin, which does not relieve his pain. The next action for the nurse to take is to A)Ask the client about the refusal of certain pain medications HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ B) Talk with the client's family about the situation C) Report the situation to the health care provider D) Document the situation in the notes  A client who has been drinking for five years states that he drinks when he gets upset about "things" such as being unemployed or feeling like life is not leading anywhere. The nurse understands that the client is using alcohol as a way to deal with A) Recreational and social needs B) Feelings of anger C) Life’s stressors D) Issues of guilt and disappointment  The nurse is monitoring the contractions of a woman in labor. A contraction is recorded as beginning at 10:00 A.M. and ending at 10:01 A.M. Another begins at 10:15 A.M. What is the frequency of the contractions? A) 14 minutes B) 10 HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ D) Compare the child's behavior with classic signs and symptoms  Which of the actions suggested to the RN by the PN during a planning conference for a 10 month-old infant admitted 2 hours ago with bacterial meningitis would be acceptable to add to the plan of care? A) Measure head circumference B) Place in airborne isolation C) Provide passive range of motion D) Provide an over-the-crib protective top  A client is admitted with a diagnosis of hepatitis B. In reviewing the initial laboratory results, the nurse would expect to find elevation in which of the following values? A) Blood urea nitrogen B) Acid phosphatase C) Bilirubin HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ D) Sedimentation rate  The nurse is discussing nutritional requirements with the parents of an 18 month-old child. Which of these statements about milk consumption is correct? A) May drink as much milk as desired B) Can have milk mixed with other foods C) Will benefit from fat-free cow's milk D) Should be limited to 3-4 cups of milk daily  The nurse is talking with a client. The client abruptly says to the nurse, "The moon is full. Astronauts walk on the moon. Walking is a good health habit." The client’s behavior most likely indicates A) Neologisms B) Dissociation C) Flight of ideas D) Word salad HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  A mother asks about expected motor skills for a 3 year-old child. Which of the following would the nurse emphasize as normal at this age? A) Jumping rope B) Tying shoelaces C) Riding a tricycle D) Playing hopscotch  A home health nurse is caring for a client with a pressure sore that is red, with serous drainage, is 2 inches in diameter with loss of subcutaneous tissue. The appropriate dressing for this wound is A) A transparent film dressing B) Wet dressing with debridement granules C) Wet to dry with hydrogen peroxide D) Moist saline dressing HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  When assessing a client who has just undergone a cardioversion, the nurse finds the respirations are 12. Which action should the nurse take first? A)Try to vigorously stimulate normal breathing B)Ask the RN to assess the vital signs C) Measure the pulse oximetry D) Continue to monitor respirations  A new nurse on the unit notes that the nurse manager seems to be highly respected by the nursing staff. The new nurse is surprised when one of the nurses states: "The manager makes all decisions and rarely asks for our input." The best description of the nurse manager's management style is A) Participative or democratic B) Ultraliberal or communicative C) Autocratic or authoritarian D) Laissez faire or permissive HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  A depressed client who has recently been acting suicidal is now more social and energetic than usual. Smilingly he tells the nurse "I’ve made some decisions about my life." What should be the nurse’s initial response? A) "You’ve made some decisions." B) "Are you thinking about killing yourself?" C) "I’m so glad to hear that you’ve made some decisions." D) "You need to discuss your decisions with your therapist."  The nurse caring for a 14 year-old boy with severe Hemophilia A, who was admitted after a fall while playing basketball. In understanding his behavior and in planning care for this client, what must the nurse understand about adolescents with hemophilia? A) Must have structured activities B) Often take part in active sports C) Explain limitations to peer groups D) Avoid risks after bleeding episodes HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  When an autistic client begins to eat with her hands, the nurse can best handle the problem by A) Placing the spoon in the client’s hand and stating, "Use the spoon to eat your food." B) Commenting "I believe you know better than to eat with your hand." C) Jokingly stating, "Well I guess fingers sometimes work better than spoons." D) Removing the food and stating "You can’t have anymore food until you use the spoon."  In assessing the healing of a client's wound during a home visit, which of the following is the best indicator of good healing? A) White patches B) Green drainage C) Reddened tissue D) Eschar development  Which therapeutic communication skill is most likely to encourage a depressed client to vent feelings? HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  What is the best way for the nurse to accomplish a health history on a 14 year-old client? A) Have the mother present to verify information B)Allow an opportunity for the teen to express feelings C) Use the same type of language as the adolescent D) Focus the discussion of risk factors in the peer group  What principle of HIV disease should the nurse keep in mind when planning care for a newborn who was infected in utero? A) The disease will incubate longer and progress more slowly in this infant B) The infant is very susceptible to infections C) Growth and development patterns will proceed at a normal rate D) Careful monitoring of renal function is indicated  While planning care for a preschool aged child, the nurse understands developmental needs. Which of the following would be of the most concern to the nurse? A) Playing HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ imaginatively B) Expressing shame C) Identifying with family D) Exploring the playroom  A client has been receiving lithium (Lithane) for the past two weeks for the treatment of bipolar illness. When planning client teaching, what is most important to emphasize to the client? A) Maintain a low sodium diet B) Take a diuretic with lithium C) Come in for evaluation of serum lithium levels every 1-3 months D) Have blood lithium levels drawn during the summer months  While teaching a client about their medications, the client asks how long it will take before the effects of lithium take place. What is the best response of the nurse? A) Immediately B) Several days HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ C) 2 weeks D) 1 month  The nursing intervention that best describes treatment to deal with the behaviors of clients with personality disorders include A) Pointing out inconsistencies in speech patterns to correct thought disorders B) Accepting client and the client's behavior unconditionally C) Encouraging dependency in order to develop ego controls D) Consistent limit-setting enforced 24 hours per day  Following a cocaine high, the user commonly experiences an extremely unpleasant feeling called A) Craving B) Crashing C) Outward bound D) Nodding out HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ the nurse do next? A) Give the medication as ordered B) Call the health care provider to clarify the dose C) Recognize that antibiotics are over-prescribed D) Hold the medication as the dosage is too low  The nurse is participating in a community health fair. As part of the assessments, the nurse should conduct a mental status examination when A) An individual displays restlessness B) There are obvious signs of depression C) Conducting any health assessment D) The resident reports memory lapses  The nurse is caring for a 12 year-old with an acute illness. Which of the following indicates the nurse understands common sibling reactions to hospitalization? A) Younger siblings adapt very well B) Visitation is helpful for HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ both C) The siblings may enjoy privacy HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ D) Those cared for at home cope better  Parents of a 7 year-old child call the clinic nurse because their daughter was sent home from school because of a rash. The child had been seen the day before by the health care provider and diagnosed with Fifth Disease (erythema infectiosum). What is the most appropriate action by the nurse? A) Tell the parents to bring the child to the clinic for further evaluation B) Refer the school officials to printed materials about this viral illness C) Inform the teacher that the child is receiving antibiotics for the rash D) Explain that this rash is not contagious and does not require isolation  When making a home visit to a client with chronic pyelonephritis, which nursing action has the highest priority? A) Follow-up on lab values before the visit B) Observe client findings for the effectiveness of antibiotics C) Ask for a log of urinary output D) As for the log of the oral intake HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ B) Acute extrapyramidal syndrome C) Glaucoma, prostatic hypertrophy D) Parkinson's disease, atypical tremors  The nurse is caring for a client in the coronary care unit. The display on the cardiac monitor indicates ventricular fibrillation. What should the nurse do first? A) Perform defibrillation B) Administer epinephrine as ordered C) Assess for presence of pulse D) Institute CPR  During the use of an interpreter to teach a client about a procedure to do in the home the nurse should take which approach? A) Speak directly to the interpreter while presenting information and use pauses for questions B) Talk to the interpreter in advance and leave the client and interpreter alone HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ C) Include a family member and direct communications to that person D) Face the client while presenting the information as the interpreter talks in the native language  A client is in her third month of her first pregnancy. During the interview, she tells the nurse that she has several sex partners and is unsure of the identity of the baby's father. Which of the following nursing interventions is a priority? A) Counsel the woman to consent to HIV screening B) Perform tests for sexually transmitted diseases C) Discuss her high risk for cervical cancer D) Refer the client to a family planning clinic  A client is discharged following hospitalization for congestive heart failure. The nurse teaching the family suggests they encourage the client to rest frequently in which of the following positions? A) High Fowler's B) Supine C) Left lateral HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ D) Low Fowler's  A nurse who is evaluating a mentally retarded 2 year-old in a clinic should stress which goal when talking to the child's mother? A)Teaching the child self-care skills B) Preparing for independent toileting C) Promoting the child's optimal development D) Helping the family decide on long term care  The nurse is caring for a client with trigeminal neuralgia (tic douloureaux). To assist the client with nutrition needs, the nurse should A) Offer small meals of high calorie soft food B)Assist the client to sit in a chair for meals C) Provide additional servings of fruits and raw vegetables D) Encourage the client to eat fish, liver and chicken HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ C) Folic acid D) Aspirin HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+  When a client is having a general tonic clonic seizure, the nurse should A) Hold the client's arms at their side B) Place the client on their side C) Insert a padded tongue blade in client's mouth D) Elevate the head of the bed 101 After talking with her partner, a client voluntarily admitted herself to the substance abuse unit. After the second day on the unit the client states to the nurse, "My husband told me to get treatment or he would divorce me. I don’t believe I really need treatment but I don’t want my husband to leave me." Which response by the nurse would assist the client? A) "In early recovery, it's quite common to have mixed feelings, but unmotivated people can’t get well." B) "In early recovery, it’s quite common to have mixed feelings, but I didn’t know you had been pressured to come." C) "In early recovery it’s quite common to have mixed feelings, perhaps it would be best to seek treatment on an out client bases." HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ HESI A2 EXIT V2 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+ D) "In early recovery, it’s quite common to have mixed feelings. Let’s discuss the benefits of sobriety for you."  A neonate born 12 hours ago to a methadone maintained woman is exhibiting a hyperactive MORO reflex and slight tremors. The newborn passes loose, watery stool. Which of these is a nursing priority? A) Hold the infant at frequent intervals. B)Assess for neonatal withdrawal syndrome C) Offer fluids to prevent dehydration D)Administer paregoric to stop diarrhea  The nurse is caring for a post myocardial infarction client in an intensive care unit. It is noted that urinary output has dropped from 60 -70 ml per hour to 30 ml per hour. This change is most likely due to A) Dehydration B) Diminished blood volume HESI A2 EXIT V2 160 QUESTIONS & ANSWERS LATEST UPDATE 2021/2022 DOWNLOAD A+