HESI Exit RN Practice Questions

A nurse receives a client from the PACU following an appendectomy. During the initial assessment, the nurse finds a blood pressure of 88/54 mmHg, heart rate of 118 bpm, respiratory rate of 22, and the surgical dressing is saturated with dark red blood. Which action should the nurse take first?

A nurse is caring for a client taking digoxin 0.125 mg daily for heart failure. The client reports nausea, anorexia, and seeing yellow-green halos around lights. The apical pulse is 52 bpm. The nurse reviews the serum digoxin level: 2.4 ng/mL. Which action has the highest priority?

A nurse is monitoring an electronic fetal monitor (EFM) strip for a client in active labor. The baseline fetal heart rate is 150 bpm with good variability. With each contraction, the FHR drops to 110 bpm and returns to baseline within 30 seconds of the contraction ending. How should the nurse interpret this pattern?

A nurse is caring for a client taking lithium carbonate for bipolar disorder. Which assessment finding requires the nurse to hold the medication and contact the provider?

A nurse is triaging a 4-year-old child with high fever, drooling, difficulty swallowing, muffled voice, and the child is leaning forward in a tripod position. Which action is the highest priority?