HESI EXIT TEST BANK EXAM 2020 160 QUESTIONS WITH UPDATED 100% CORRECT ANSWERs with rationaleS ALREADY GRADED A+

HESI EXIT TEST
BANK EXAM 2020
160 QUESTIONS WITH
UPDATED 100%
CORRECT ANSWERs
with rationaleS
ALREADY GRADED
A+
A charge nurse is observing a newly licensed nurse
apply sterile gloves. Which of the following actions
by the newly licensed nurse demonstrates sterile
technique?
-Placing the glove package just below their waist
level
-Putting a glove on their dominant hand first
-Unrolling the cuff of the glove up their wrist
-Holding both gloved hands close to their body -
ANSWER-Putting a glove on their dominant hand
first
RAT:
The nurse is demonstrating sterile technique when
they put a glove on their dominant hand first. Using
the dominant hand to apply the second glove helps
prevent contamination because the nurse's
dominant hand is more likely to have better
dexterity than their nondominant hand.
INCORRECT:
The nurse should keep objects above the level of
their waist to maintain sterility.
The nurse should leave the cuff folded and make
sure it does not roll up their wrist. If the outer
surface of the glove touches the hand or wrist, it is
considered contaminated.
The nurse should hold their hands away from their
body to minimize the risk of contamination.
A nurse is assisting with the plan of care for a client
following a transurethral resection of the prostate.
Which of the following interventions should the
nurse include in the plan of care?
- Discontinue the urinary catheter 24 hr after
surgery.
- Adjust the bladder irrigation to keep the urine a
bright yellow color.
- Use 50 mL of sterile water to clear the urinary
catheter of obstruction.
- Irrigate the bladder using sterile technique. -
ANSWER-Irrigate the bladder using sterile
technique.
RAT: The nurse should irrigate the bladder using
strict sterile technique and maintain closed catheter
drainage system to minimize the risk of infection.
INCORRECT:
The nurse should discontinue the urinary catheter 2
to 3 days following surgery when continuous
irrigation is complete.
The nurse should adjust the bladder irrigation to
dilute the urine to a reddish-pink color to prevent
clot formation.
The nurse should use 20 to 30 mL of 0.9% sodium
chloride irrigation solution to clear the urinary
catheter of any obstruction.
A nurse is performing postmortem care for a client
prior to the arrivals of the client's family for viewing
of the body. Which of the following actions should
the nurse take?
- Remove the client's dentures and place them in a
container.
- Perform a complete bath for the client.
- Gently close the client's eyelids.
- Remove the pillow from under the client's head. -
ANSWER-Gently close the client's eyelids.
RAT:
The nurse should hold the client's eyelids closed for
a few seconds to ensure that they remain closed.
INCORRECT:
-The nurse should keep the dentures in the client's
mouth to maintain their facial shape.
-The nurse should clean the soiled areas of the
client's body prior to viewing by the family.
However, a complete bath is not necessary at this
time.
-The nurse should elevate the client's head on a
pillow to prevent pooling of blood in dependent
areas of the body, which can cause discoloration of
the client's face.