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2023 HESI Fundamentals of Nursing Practice Exam With Answers (319 Solved Questions)

2023 HESI Fundamentals of Nursing Practice Exam With Answers ensures complete exam preparation with authentic past test questions.

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    1 the purpose of therapeutic interaction ANSWER : to allow the client to autonomy to make choices when appropriate. keep statements value - free, advice free, and reassurance - free what action should the nurse take in a psychiatric situation when the client describes a physical problem? ANSWER : assess. example: if a client has schizophrenia complains of chest pain take their blood pressure basic communication principles ANSWER : establish trust, nonjudgemental attitude,active listening, offer self, accept client's feelings, validate client's statements, matter of fact approach nausea is a common complaint after ECT ANSWER : vomiting by an unconscious can lead to aspiration. maintain a paten airway common physiological responses to anxiety ANSWER : increased heart rate, and blood pressure, rapid shallow respirations, dry mouth, tight feeling in throat, tremors, muscle twitching, anorexia, urinary frequency, palmar sweating nurse - client anxiety ANSWER : anxiety is contagious, nurse needs to asses on anxiety level and remain calm. it helps gain control, decrease anxiety, and increase feelings of security desensitization ANSWER : is the nursing intervention for phobia disorders. -- assess client to recognize the factors associated with feared stimuli. - teach and practice with client alternative coping strategies - expose client to feared stimuli - provide positive reinforcement the nurse should place an anxious client where there are red uced environmental stimuli HESI Fundamentals UPDATED VERSION 2023 GRADED A+

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    2 ANSWER : quiet area of the unit away from the nurse's station the best time for interaction with a client is at the completion of the performed ritual ANSWER : the client's anxiety is lowest at this time and its an optimal time for learning compulsive acts are used in response to anxiety, which may or may not be related to the obsession. its the nurse's responsibility help alleviate anxiety ANSWER : its the nurse's responsibility help alleviate anxiety, interfering will increase the anxiety as long as the client's acts are free of violence: nurse should.... ANSWER : - actively listen to the clients obsessive themes - acknowledge the effects that ritualistic acts have on the client - demonstrate empathy - avoid being judgmental ford clients with PTSD, the nurse should.... ANSWER : - actively listen to client's stories of experiences surrounding the traumatic event - assess suicide risk - assist client to develop objectivity about the event and problem solve regarding possible means of controlling anxiety related to the event - encourage group therapy with other clients who have experienced the same traumatic event be aware of your own feelings when dealing with this somatoform clients. ANSWER : the pa in is real to the person experiencing it theses disorders cannot be explained medically, it results from internal conflict. the nurse should...

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    3 ANSWER : - acknowledge the symptom or complaint - reaffirm that diagnostic test results reveal no organic pathology - determine the secondary gains acquired by the client avoid giving clients with dissociative disorders too much information about past events at one time ANSWER : the various types of amnestic that accompany dissociative disorders provide protection from pain and too much to soon can cause decompensation personality disorders are long standing behavioral traits that are maladaptive responses to anxiety and that cause difficulty in relating to and working with other individuals AN SWER : persons with personality disorders are usually comfortable with their disorders and believe that they are right and the world is wrong and have little motivation people with anorexia gain pleasure from providing others with food and watching them eat ANSWER : these behaviors reinforce their perception of self - control. don not allow these clients to plan or prepare food for unit - based activities individuals with Bulimia often use syrup of ipecac to induce vomiting. if ipecac is not vomited and is absorbed, cardiotoxicity may occur and cause conduction disturbances, cardiac dysrhythmias, fatal myocarditis, and circulatory failure ANSWER : because heart failure is not usually seen in this age group, it is often overlooked. assess for edema and l isten to breath sounds physical assessment and nutritional support are a priority, the physiological implication are great. nursing interventions should increase self - esteem and develop a positive body image. ANSWER : family therapy is most effective because issues of control are common in these (eating disorders.) therapy is usually long term the most important s/s of depression are a depressed mood with a loss of interest in the pleasures in life

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    4 ANSWER : the client has a sustained loss s/s of depression ANSWER : - significant change in appetite - insomnia - fatigue or lack of energy - feelings of hopelessness - loss of ability to concentrate - preoccupation with death or suicide depressed clients have difficulty hearing and accepting compliments because of their lowered self - concept ANSWER : comment on signs of improvement by noting behavior the nurse knows depressed clients are improving when they ANSWER : begin to take an interest in their appearance or begin to perform self - care activities the nurse should suspect an imminent suicide attempt if a depressed client becomes "better" ANSWER : be aware a happy affect may signify the the client feels relieved that a plan has been made and is prepared for the suicide attempt when dealing with a depressed client the nurse should assist with personal hygiene tasks and encourage the client to initiate grooming activities even when they dont feel like doing so ANSWER : this helps to promote self - esteem and a sense of control nursing intervention for depressed client

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    5 ANSWER : sit quietly with the client, offering your support with your presence side effects of antianxiety drugs ANSWER : sedation, drowsiness s/e of antidepressants drugs ANSWER : anticholinergic effects, postural hypotension s/e MAO inhibitors ANSWER : hypertensive crisis lithium requires renal function assessment and monitoring ANSWER : phenothiazines cause EPS (tardic dyskinesia can be permanent) phenothiazines cause photosensitivity so client must wear protective clothing and sunglasses ANSWER : MAO inhibitors require dietary restrictions to prevent hypertensive crisis atypical antipsychotics drugs are also indication for mania ANSWER : monitor serum lithium levels carefully. 0. - 1.5 is therapeutic level, blood should be drawn every 12 hours after last dose manic clients can be very caustic toward authority figures ANSWER : avoid arguing or becoming defensive what activities are appropriate for a manic client? ANSWER : noncompetitive physical activities that require the use of large muscle groups

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    6 where should a manic client be place on the unit ? ANSWER : make every attempt to reduce stimuli in the environment, place client in quiet part of the unit what intervention should the nurse use if the client becomes abusive ANSWER : - redirect negative behavior - suggest a walk - set limits on intrusive behavior - seclude or administer medication Bleuler's 4 A's for schizophrenia ANSWER : autism (preoccupied with self) affect (flat) associations (loose) ambivalence (difficulty making decisions) observe for increased motor activity and erratic response to staff and other clients ANSWER : client may experiencing an increase in command in hallucinations, when this occurs there is an increased potential for aggressive behavior don't argue with a client about the delusions. ANSWER : logic only increases a client's anxiety, so be matter of fact and divert delusional thought to reality what medication can the nurse expect to administer to chemically dependent clients? ANSWER : librium or ativan, antabuse for alcohol abuse

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    7 what type of therapy is used with chemically dependent clients? ANSWER : group therapy harm reduction is a community health strategy designed to reduce the harm of substance abuse to families, individuals, community, and society ANSWER : denial and rationalization are the two most common coping styles used for substance abuse what basic needs take priority when working with chemically dependent clients? ANSWER : nutrition is a priority, alcohol and drug intake has superseded the intake of food for these clients what behaviors are expected during withdrawal? ANSWER : in the alcoholic DT's occur 12 - 36 hours after the last intake of alcohol select only one nurse to care for an abused child ANSWER : abused children have difficulty establishing trust, and the child will be less anxious with one consistent caregiver women who are abused may rationalize the spouse's behavior and unnecessarily accept blame for his actions. ANSWER : the woman may or may not choose to press charges. be sure to give her the number of a shelter or help line it is difficult for an elderly person to admit abuse for fear of being placed in a nursing home or being abandoned ANSWER : it is imperative to establish a trusting relationship with elderly client rape victims are at high risk for PTSD. immediate intervention to diminish distress is vital.

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    8 ANSWER : the nurse should also assess for and intervene for sequelae such as unwanted pregnancy, STD's, and HIV in child abuse, the nurse is responsible for reporting all suspected cases of abuse ANSWER : in intimate abuse, its the adult's decision and the nurse should be supportive the basic difference between delirium and dementia is ... ANSWER : delirium is acute and reversible but dementia is gradual and permanent confusion in the elderly is often accepted as being part of growing old. ANSWER : however, the confusion may be caused from dehydration and is usually due to a specific stressor confabulation is not lying ANSWER : it is used by the client to decrease anxiety and protect the ego Alzheimer medication ANSWER : you can use atypical antipsychotics. Clozaril is not a front line agent because of side effects. one may also give mood stabilizers, and antianxiety medications nursing interventions for confused elderly ANSWER : - maintain client's health and safety - encourage self care - reinforce reality orientation - provide safe, consistent environment provide a consistent caregiver is priority in planning nursing care for the confused older client

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    9 ANSWER : change increases anxiety and confusion children experience depression, which presents as headaches, stomachaches, and other somatic complaints ANSWER : assess suicide risks, especially in the adolescent the child/adolescent's lack of remorse about antisocial behavior represents a malfunction of the superego ANSWER : the id functions on the basic instinct level and strives to meet immediate needs. the ego is in touch with external reality and is the part of personality that makes decisions provide consistent interventions for children ANSWER : this helps to prevent manipulation because inconsistency does not help the client develop self control What type of procedures should be assigned to professional nurses? ANSWER : Inform the health care provider or physician; record that the health care provider or physician was informed and the health care provider's or physician's response to such information; in form the nursing supervisor; refuse to carry out the prescription Describe the nurse's legal responsibility when asked to perform a task for which he or she is unprepared. ANSWER : Inform the health care provider or physician or person asking the nurse to perform the task that he or she is unprepared to carry out the task; refuse to perform the task Describe nursing care for a restrained client. ANSWER : Apply restraints properly; check restraints frequently to see that they are not causing injury and record such monitoring; remove restraints as soon as possible; use restraints only as a last resort. Describe six patient rights guaranteed under HIPAA regulations that nurses must be aware of in practice.

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    10 ANSWER : a. A patient must give written consent before health care providers can use or disclose personal health information b. Health care providers and physicians must give patients notice about providers' responsibilities regarding patient confidentiality c. Patient's must have acces s to their medication records; Providers who restrict access must explain why and must offer patients a description of the complaint process d. Patients have the right to request that changes be made in their medical records to correct inaccuracies e. Health care providers must follow specific tracking procedures for any disclosures made that ensure accountability for maintenance of patient confidentiality f. Patients have the right to request that health care providers and physicians restrict the use and disclosure of their personal health information, though the provider may decline to do so. A UAP may perform care that falls within which component of the nursing process? ANSWER : Implementation What are the five rights of delegation? ANSWER : A. Right task B. Right circumstance C. Right person D. Right direction or communication E. Right supervision Common causes of fluid volume deficit: ANSWER : a. Gastrointestinal causes b. Vomiting c. Diarrhea

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    11 d. GI suctioning e. Decrease in fluid intake f. Increase in fluid output such as sweating g. Massive edema h. Ascites Common causes of fluid volume overload: ANSWER : a. Heart failure b. Renal failure c. Cirrhosis d. Excess ingestion of table salt e. Overhydration with sodium containing fluids Identify two examples of isotonic IV fluids. ANSWER : a. Ringers lactate b. Normal saline List three systems that maintain acid base balance. ANSWER : a. Lungs b. Kidneys c. Chemical buffers normal ABGs ANSWER : a. pH: 7.35 - 7.45 b. PaCO2: 35 - 45

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    12 c. HCO3: 22 - 26 Variables that increase surgical risk. ANSWER : a. Age: very young and very old b. Obesity c. Malnutrition d. Preoperative dehydration/hypovolemia e. Preoperative infection f. Use of anticoagulants (aspirin) preoperatively Why is a client with liver disease at increased risk of operative complications? ANSWER : a. Impairs ability to detoxify medications used during surgery b. Impairs ability to produce prothrombin to reduce hemorrhage Preoperative teaching should include demonstration and explanation of expected postoperative client activities. What activities should be included? ANSWER : a. Respiratory activities: coughing, breathing, use of spirometer b. Exercises: range of motion, leg exercises, turning c. Pain Management: medications and splinting d. Dietary restrictions: NPO evolving to progressive diet e. Dressings and drains: orientation to recovery room environment What items should the nurse assist the client in removing before surgery? ANSWER : Contact lenses; Glasses; Dentures; Partial plates; Wigs; Jewelry; Prosthesis; Makeup; Nail polish. Nursing actions that prevent postoperative wound dehiscence and evisceration:

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    13 ANSWER : a. Teaching client to splint incision when coughing b. Encouraging coughing and deep breathing in early postoperative period when sutures are strong. c. Monitoring for signs of infection d. Malnutrition e. Dehydration f. Encouraging high - protein diet Identify three nursing interventions that prevent postoperative urinary tract infections. ANSWER : a. Avoiding postoperative catheterization b. Increasing oral fluid intake c. Emptying bladder every 4 to 6 hours d. Early ambulation Identify nursing/medical interventions that prevent postoperative paralytic ileus. ANSWER : a. Early ambulation b. Limiting use of narcotic analgesics c. NG tube decompression List four interventions that prevent postoperative thrombophlebitis. ANSWER : a. Teaching performance of in bed leg exercises b. Encouraging early ambulation c. Applying antiembolus stockings d. Teaching avoidance of positions and pressures that obstruct venous flow What six factors should the nurse include when assessing the pain experience?

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