HESI Fundamentals Practice Exam With Answers (73 Solved Questions)

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Hesi Fundamentals Practice TestQuestions (73Terms) All Correctly Answered and Explainedin Details,A+ Score Solution,Guaranteedpass.An elderly client with a fractured left hip is on strict bedrest. Which nursingmeasure is essential to the client's nursing care?A. Massage any reddened areas for at least five minutes.B. Encourage active range of motion exercises on extremities.C. Position the client laterally, prone, and dorsally in sequence.D. Gently lift the client when moving into a desired position.-DetailedExplanation:To avoid shearing forces when repositioning, the client should belifted gently across a surface (D). Reddened areas should not be massaged (A)since this may increase the damage to already traumatized skin. To control painand muscle spasms, active rangeof motion (B) may be limited on the affected leg.The position described in (C) is contraindicated for a client with a fractured lefthip.Exact Answer:DThe nurse is administering medications through a nasogastric tube (NGT) which isconnected to suction. After ensuring correct tube placement, what action shouldthe nurse take next?A. Clamp the tube for 20 minutes.B. Flush the tube with water.

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C. Administer the medications as prescribed.D. Crush the tablets and dissolve in sterile water.-Detailed Explanation:The NGTshould be flushed before, after and in between each medication administered (B).Once all medications are administered, the NGT should be clamped for 20 minutes(A). (C and D) may be implemented only after the tubing has been flushed.Exact Answer:BA client who is in hospice care complains of increasing amounts of pain. Thehealthcare provider prescribes an analgesic every four hours as needed. Whichaction should the nurse implement?A. Give an around-the-clock schedule for administration of analgesics.B. Administer analgesic medication as needed when the pain is severe.C. Provide medication to keep the client sedated and unaware of stimuli.D. Offer a medication-free period so that the client can do daily activities.-Detailed Explanation:The most effective management of pain is achieved usingan around-the-clock schedule that provides analgesic medications on a regularbasis (A) and in a timely manner. Analgesics are less effective if pain persists untilit is severe, so an analgesic medication should be administered before the client'spain peaks (B). Providing comfort is a priority for the client who is dying, but

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sedation that impairs the client's ability to interact and experience the time beforelife ends should be minimized (C). Offering a medication-free period allows theserum drug level to fall, which is not an effective method to manage chronic pain(D).Exact Answer:AWhen assessing a client with wrist restraints, the nurse observes that the fingerson the right hand are blue. What action should the nurse implement first?A. Loosen the right wrist restraint.B. Apply a pulse oximeter to the right hand.C. Compare hand color bilaterally.D. Palpate the right radial pulse.-Detailed Explanation:The priority nursingaction is to restore circulation by loosening the restraint (A), because blue fingers(cyanosis)indicatedecreased circulation. (C and D) are also important nursinginterventions, but do not have the priority of (A). Pulse oximetry (B) measures thesaturation of hemoglobin with oxygen and is not indicated in situations where thecyanosis is related to mechanical compression (the restraints).Exact Answer:A

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The nurse is assessing the nutritional status of several clients. Which client has thegreatest nutritional need for additional intake of protein?A. A college-age track runner with a sprained ankle.B. A lactating woman nursing her 3-day-old infant.C. A school-aged child with Type 2 diabetes.D. An elderly man being treated for a peptic ulcer.-Detailed Explanation:Alactating woman (B) has the greatest need for additional protein intake. (A, C, andD) are all conditions that require protein, but do not have the increased metabolicprotein demands of lactation.Exact Answer:BA client is in the radiology department at 0900 when the prescription levofloxacin(Levaquin) 500 mg IV q24h is scheduled to be administered. The client returns tothe unit at 1300. What is the best intervention for the nurse to implement?A. Contact the healthcare provider and complete a medication variance form.B. Administer the Levaquin at 1300 and resume the 0900 schedule in the morning.C. Notify the charge nurse and complete an incident report to explain the misseddose.

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D. Give the missed dose at 1300 and change the schedule to administer daily at1300.-Detailed Explanation:To ensure that a therapeutic level of medication ismaintained, the nurse should administer the missed dose as soon as possible, andrevise the administration schedule accordingly to prevent dangerously increasingthe level of the medication in the bloodstream (D). The nurse should documentthe reason for the late dose, but (A and C) are not warranted. (B) could result inincreased blood levels of the drug.Exact Answer:DWhile instructing a male client's wife in the performance of passive range-of-motion exercises to his contracted shoulder, the nurse observes that she is holdinghis arm above and below the elbow. What nursing action should the nurseimplement?A. Acknowledge that she is supporting the arm correctly.B. Encourage her to keep the joint covered to maintain warmth.C. Reinforce the need to grip directly under the joint for better support.D. Instruct her to grip directly over the joint for better motion.-DetailedExplanation:The wife is performing the passive ROM correctly, therefore thenurse should acknowledge this fact (A). The joint that is being exercised should beuncovered (B) while the rest of the body should remain covered for warmth and

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privacy. (C and D) do not provide adequate support to the joint while still allowingfor joint movement.Exact Answer:AWhat is the most important reason for starting intravenous infusions in the upperextremities rather than the lower extremities of adults?A. It is more difficult to find a superficial vein in the feet and ankles.B. A decreased flow rate could result in the formation of a thrombosis.C. A cannulated extremity is more difficult to move when the leg or foot is used.D. Veins are located deep in the feet and ankles, resulting in a more painfulprocedure.-Detailed Explanation:Venous return is usually better in the upperextremities. Cannulation of the veins in the lower extremities increases the risk ofthrombus formation (B) which, if dislodged, could be life-threatening. Superficialveins are often very easy (A) to find in the feet and legs. Handling a leg or footwith an IV (C) is probably not any more difficult than handling an arm or hand.Even if the nurse did believe moving a cannulated leg was more difficult, this is notthe most important reason for using the upper extremities. Pain (D) is not aconsideration.Exact Answer:B

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The nurse observes an unlicensed assistive personnel (UAP) taking a client's bloodpressure with a cuff that is too small, but the blood pressure reading obtained iswithin the client's usual range. What action is most important for the nurse toimplement?A. Tell the UAP to use a larger cuff at the next scheduled assessment.B. Reassess the client's blood pressure using a larger cuff.C. Have the unit educator review this procedure with the UAPs.D. Teach the UAP the correct technique for assessing blood pressure.-DetailedExplanation:The most important action is to ensure that an accurate BP reading isobtained. The nurse should reassess the BP with the correct size cuff (B).Reassessment should not be postponed (A). Though (C and D) are likely indicated,these actions do not have thepriority of (B).Exact Answer:BA client is to receive cimetidine (Tagamet) 300 mg q6h IVPB. The preparationarrives from the pharmacy diluted in 50 ml of 0.9% NaCl. The nurse plans toadminister the IVPB dose over 20 minutes. For how many ml/hr should theinfusion pump be set to deliverthe secondary infusion?-Detailed Explanation:

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The infusion rate is calculated as a ratio proportion problem, i.e., 50 ml/ 20 min : xml/ 60 min. Multiply extremes and means 50 × 60 /20x 1= 300/20=150Exact Answer:150Twenty minutes after beginning a heat application, the client states that theheating pad no longer feels warm enough. What is the best response by thenurse?A. That means you have derived the maximum benefit, and the heat can beremoved.B. Your blood vessels are becoming dilated and removing the heat from the site.C. We will increase the temperature 5 degrees when the pad no longer feelswarm.D. The body's receptors adapt over time as they are exposed to heat.-DetailedExplanation:(D) describes thermal adaptation, which occurs 20 to 30 minutesafter heat application. (A and B) provide false information. (C) is not based on aknowledge of physiology and is an unsafe action that may harm the client.Exact Answer:D

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The nurse is instructing a client with high cholesterol about diet and life stylemodification. What comment from the client indicates that the teaching has beeneffective?A. If I exercise at least two times weekly for one hour, I will lower my cholesterol.B. I need to avoid eating proteins, including red meat.C. I will limit my intake of beef to 4 ounces per week.D. My blood level of low density lipoproteins needs to increase.-DetailedExplanation:Limiting saturated fat from animal food sources to no more than 4ounces per week (C) is an important diet modification for lowering cholesterol. Tobe effective in reducing cholesterol, the client should exercise 30 minutes per day,or at least 4 to 6 times per week (A). Red meat and all proteins do not need to beeliminated (B) to lower cholesterol, but should be restricted to lean cuts of redmeat and smaller portions (2-ounce servings). The low density lipoproteins (D)need to decrease rather than increase.Exact Answer:CThe UAPs working on a chronic neuro unit ask the nurse to help them determinethe safest way to transfer an elderly client with left-sided weakness from the bedto the chair. What method describes the correct transfer procedure for this client?

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A. Place the chair at a right angle to the bed on the client's left side beforemoving.B. Assist the client to a standing position, then place the right hand on thearmrest.C. Have the client place the left foot next to the chair and pivot to the left beforesitting.D. Move the chair parallel to the right side of the bed, and stand the client on theright foot.-Detailed Explanation:(D) uses the client's stronger side, the right side,for weight-bearing during the transfer, and is the safest approach to take. (A, B,and C) are unsafe methods of transfer and include the use of poor bodymechanics by the caregiver.Exact Answer:DAn unlicensed assistive personnel (UAP) places a client in a left lateral positionprior to administering a soap suds enema. Which instruction should the nurseprovide the UAP?A. Position the client on the right side of the bed in reverse Trendelenburg.B. Fill the enema container with 1000 ml of warm water and 5 ml of castile soap.C. Reposition in a Sim's position with the client's weight on the anterior ilium.

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D. Raise the side rails on both sides of the bed and elevate the bed to waist level.-Detailed Explanation:The left sided Sims' position allows the enema solution tofollow the anatomical course of the intestines and allows the best overall results,so the UAP should reposition the client in the Sims' position, which distributes theclient's weight to the anterior ilium (C). (A) is inaccurate. (B and D) should beimplemented once the client is positioned.Exact Answer:CA client who is a Jehovah's Witness is admitted to the nursing unit. Which concernshould the nurse have for planning care in terms of the client's beliefs?A. Autopsy of the body is prohibited.B. Blood transfusions are forbidden.C. Alcohol use in any form is not allowed.D. A vegetarian diet must be followed.-Detailed Explanation:Blood transfusionsare forbidden (B) in the Jehovah's Witness religion. Judaism prohibits (A).Buddhism forbids the use of (C) and drugs. Many of these sects are vegetarian (D),but the direct impact on nursing care is (B).Exact Answer:B

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The nurse observes that a male client has removed the covering from an ice packapplied to his knee. What action should the nurse take first?A. Observe the appearance of the skin under the ice pack.B. Instruct the client regarding the need for the covering.C. Reapply the covering after filling with fresh ice.D. Ask the client how long the ice was applied to the skin.-Detailed Explanation:The first action taken by the nurse should be to assess the skin for any possiblethermal injury (A). If no injury to the skin has occurred, the nurse can take theother actions (B, C, and D) as needed.Exact Answer:AThe nurse mixes 50 mg of Nipride in 250 ml of D5W and plans to administer thesolution at a rate of 5 mcg/kg/min to a client weighing 182 pounds. Using a dripfactor of 60 gtt/ml, how many drops per minute should the client receive?A. 31 gtt/min.B. 62 gtt/min.C. 93 gtt/min.D. 124 gtt/min.-Detailed Explanation:(D) is the correct calculation: Convert lbsto kg: 182/2.2 = 82.73 kg. Determine the dosage for this client: 5 mcg × 82.73 =

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413.65 mcg/min. Determine how many mcg are contained in 1 ml: 250/50,000mcg = 200 mcg per ml. The client is to receive 413.65 mcg/min, and there are 200mcg/ml; so the client is to receive 2.07ml per minute. With a drip factor of 60gtt/ml, then 60 × 2.07= 124.28 gtt/min (D) OR, using dimensional analysis: gtt/min= 60 gtt/ml X 250 ml/50 mg X 1 mg/1,000 mcg X 5 mcg/kg/min X 1 kg/2.2 lbs X182 lbs.Exact Answer:DA hospitalized male client is receiving nasogastric tube feedings via a small-boretube and a continuous pump infusion. He reports that he had a bad bout of severecoughing a few minutes ago, but feels fine now. What action is best for the nurseto take?A. Record the coughing incident. No further action is required at this time.B. Stop the feeding, explain to the family why it is being stopped, and notify thehealthcare provider.C. After clearing the tube with 30 ml of air, check the pH of fluid withdrawn fromthe tube.D. Inject 30 ml of air into the tube while auscultating the epigastrium for gurgling.-Detailed Explanation:Coughing, vomiting, and suctioning can precipitatedisplacement of the tip of the small bore feeding tube upward into the esophagus,

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placing the client at increased risk for aspiration. Checking the sample of fluidwithdrawn from the tube (after clearing the tube with 30 ml of air) for acidic(stomach) or alkaline (intestine) values is a more sensitive method for these tubes,and the nurse should assess tube placement in this way prior to taking any otheraction (C). (A and B) are not indicated. The auscultating method (D) has beenfound to be unreliable for small-bore feeding tubes.Exact Answer:CA male client being discharged with a prescription for the bronchodilatortheophylline tells the nurse that he understands he is to take three doses of themedication each day. Since, at the time of discharge, timed-release capsules arenot available, which dosing schedule should the nurse advise the client to follow?A. 9 a.m., 1 p.m., and 5 p.m.B. 8 a.m., 4 p.m., and midnight.C. Before breakfast, before lunch and before dinner.D. With breakfast, with lunch, and with dinner.-Detailed Explanation:Theophylline should be administered on a regular around-the-clock schedule (B)to provide the best bronchodilating effect and reduce the potential for adverseeffects. (A, C, and D) do not provide around-the-clock dosing. Food may alterabsorption of themedication (D).

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Exact Answer:BA client is to receive 10 mEq of KCl diluted in 250 ml of normal saline over 4 hours.At what rate should the nurse set the client's intravenous infusion pump?A. 13 ml/hour.B. 63 ml/hour.C. 80 ml/hour.D. 125 ml/hour.-Detailed Explanation:(B) is the correct calculation: To calculatethis problem correctly, remember that the dose of KCl is not used in thecalculation. 250 ml/4 hours = 63 ml/hour.Exact Answer:BAn obese male client discusses with the nurse his plans to begin a long-termweight loss regimen. In addition to dietary changes, he plans to begin an intensiveaerobic exercise program 3 to 4 times a week and to take stress managementclasses. After praising the client for his decision, which instruction is mostimportant for the nurse to provide?A. Be sure to have a complete physical examination before beginning yourplanned exercise program.

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