Exam (elaborations)
HESI Fundamentals V.2 WITH QUESTIONS AND ANSWERS.
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HESI Fundamentals V.2 WITH QUESTIONS AND ANSWERS.
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HESI Fundamentals V.2 WITH QUESTIONS ANDANSWERS
The .nurse .observes .a .newly .admitted .older .adult .female .take .short .steps .and .walk .very .slowly .whil
e .pushing .a .walker .in .front .of .her. .What .action .should .the .nurse .take .in .response .to .these .observa
tions?
A) .Complete .a .full .fall .risk .assessment .of .the .client.
B) .Teach .the .client .to .take .longer .steps .at .faster .pace.
C) .Suggest .that .the .the .client .use .a .wheelchair .instead .of .a .walker.
D) .Place .client .on .bedrest .until .the .healthcare .provider .is .notified. .- .(correct .answer) .-A) .Complete .a
.full .fall .risk .assessment .of .the .client.
While .suctioning .a .client's .nasopharynx, .the .nurse .observes .that .the .client's .oxygen .saturation .remai
ns .at .94%, .which .is .the .same .reading .obtained .prior .to .starting .the .procedure. .What .action .should .t
he .nurse .take .in .response .to .this .finding?
A) .Reposition .the .pulse .oximeter .clip .to .obtain .a .new .reading.
B) .Stop .suctioning .until .the .pulse .oximeter .reading .is .above .95%.
C) .Complete .the .intermittent .suction .of .the .nasopharynx.
D) .Apply .an .oxygen .mask .over .the .client's .nose .and .mouth. .- .(correct .answer) .-
C) .Complete .the .intermittent .suction .of .the .nasopharynx.
An .older .woman .with .end .stage .heart .disease .is .hospitalized .for .severe .heart .failure. .She .is .alert, .or
iented, .and .requests .that .no .heroic .measures .are .implemented .if .her .breathing .stops. .What .action .
should .the .nurse .take .first?
,A) .Discuss .with .the .client .her .meaning .of .heroic .measures.
B) .Obtain .a ."do .not .resuscitate" .(DNR) .prescription.
C) .Set .up .a .family .conference .to .discuss .the .client's.
D) .Consult .the .palliative .care .team .about .client's .care. .- .(correct .answer) .-
A) .Discuss .with .the .client .her .meaning .of .heroic .measures.
A .client .diagnosed .with .primary .open-
angle .glaucoma .received .a .prescription .for .biotic .eye .drops, .pilocarpine .HCl .
(Pilocarpine). .What .instruction .should .the .nurse .plan .to .include .in .this .client's .teaching?
A) ."Do .not .allow .the .dropper .bottle .to .touch .the .eye."
B) ."Administer .the .medication .directly .on .the .cornea."
C) ."Squeeze .your .eye .closed .after .administering .the .drops."
D) ."Wash .your .hands .after .each .administration .of .eye .drops." .- .(correct .answer) .-
A) ."Do .not .allow .the .dropper .bottle .to .touch .the .eye."
When .assessing .a .client .who .starts .to .wheeze .related .data .should .obtain?
A) .Presence .of .radiation.
B) .Heart .sounds.
C) .Body .temperature.
D) .Precipitating .factors. .- .(correct .answer) .-D) .Precipitating .factors.
The .home .health .nurse .is .reviewing .the .personal .care .of .an .elderly .client .who .lives .alone. .Which .cli
ent .assessment .findings .indicate .the .need .to .assign .unlicensed .assistive .personnel .
(UAP) .to .provide .routine .foot .care .and .file .the .client's .toenails? .Select .all .that .apply.
A) .Syncope .when .bending.
B) .Hand .tremors.
C) .Diminished .visual .acuity.
D) .Urinary .incontinence. .
,E) .Shuffling .gait. .- .(correct .answer) .-A) .Syncope .when .bending.
B) .Hand .tremors.
C) .Diminished .visual .acuity.
A .client .is .discharged .to .a .long-
term .care .facility .with .an .indwelling .urinary .catheter. .Which .nursing .action .should .be .included .in .th
e .plan .to .reduce .the .client's .risk .for .infection .related .to .the .catheter?
A) .Flush .the .catheter .daily .with .sterile .saline.
B) .Encourage .increased .intake .of .oral .fluids.
C) .Administer .a .PRN .antipyretic .if .a .fever .develops.
D) .Secure .the .drainage .bag .at .bladder .level .during .transport. .- .(correct .answer) .-
B) .Encourage .increased .intake .of .oral .fluids.
To .assess .the .quality .of .an .adult .client's .pain, .what .approach .should .the .nurse .use?
A) .Observe .body .language .and .movement.
B) .Provide .a .numeric .pain .scale.
C) .Ask .the .client .to .describe .the .pain.
D) .Identify .effective .pain .relief .measures. .- .(correct .answer) .-C) .Ask .the .client .to .describe .the .pain.
A .client .who .has .been .diagnosed .with .terminal .cancer .tells .the .nurse, ."The .doctor .told .me .I .have .c
ancer .and .do .not .have .long .to .live." .Which .response .is .best .for .the .nurse .to .provide?
A) ."That's .correct, .you .do .not .have .long .to .live."
B) ."Would .you .like .me .to .call .your .minister?"
C) ."Don't .give .up, .you .still .have .chemotherapy .to .try."
D) ."Yes, .your .condition .is .serious." .- .(correct .answer) .-D) ."Yes, .your .condition .is .serious."
When .performing .blood .pressure .measurement .to .assess .for .orthostatic .hypotension, .which .action .s
hould .the .nurse .implement .first?
, A) .Apply .the .blood .pressure .cuff .securely.
B) .Record .the .client's .pulse .rate .and .rhythm.
C) .Position .the .client .supine .for .a .few .minutes.
D) .Assist .the .client .to .stand .at .bedside. .- .(correct .answer) .-
C) .Position .the .client .supine .for .a .few .minutes.
The .nurse .is .providing .passive .range .of .motion .
(ROM) .exercises .to .the .hip .and .knee .for .a .client .who .is .unconscious. .After .supporting .the .client's .kn
ee .with .one .hand, .what .action .should .the .nurse .take .next?
A) .Raise .the .bed .to .a .comfortable .working .level.
B) .Bend .the .client's .knee.
C) .Move .the .knee .toward .the .chest .as .far .as .it .will .go.
D) .Cradle .the .client's .heel. .- .(correct .answer) .-D) .Cradle .the .client's .heel.
The .nurse .is .preparing .to .irrigate .a .client's .indwelling .urinary .catheter .using .an .open .technique. .Wh
at .action .should .the .nurse .take .after .applying .gloves?
A) .Empty .the .client's .urinary .drainage .bag.
B) .Draw .up .the .irrigating .solution .into .the .syringe.
C) .Secure .the .client's .catheter .to .the .drainage .tubing.
D) .Use .aseptic .technique .to .instill .the .irrigating .solution. .- .(correct .answer) .-
B) .Draw .up .the .irrigating .solution .into .the .syringe.
Which .client .care .requires .the .nurse .to .wear .barrier .gloves .as .required .by .the .protocol .for .Standard
.Precautions?
A) .Removing .the .empty .food .tray .from .a .client .with .a .urinary .catheter.
B) .Washing .and .combing .the .hair .of .a .client .with .a .fractured .leg .in .traction.
C) .Administering .oral .medications .to .a .cooperative .client .with .a .wound .infection.
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