HESI COMPREHENSIVE REVIEW FOR
THE NCLEX-RN EXAMINATION
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
WhatYtypesYofYproceduresYshouldYbeYassignedYtoYprofessionalYnurses?Y-
YANSWERYSterileYorYinvasiveYprocedures.
NegligenceYisYmeasuredYbyYreasonableness.YWhatYquestionYmightYtheYnurseYaskYwhenYdeterminingYsuchYr
easonableness?Y-
YANSWERYWouldYaYreasonableYandYprudentYnurseYactYinYtheYsameYmannerYunderYtheYsameYcircumstances
?
ListYtheY4YelementsYthatYareYnecessaryYtoYproveYnegligence.Y-
YANSWERYDuty.YFailureYtoYprotectYclientYagainYunreasonableYrisk.YBreachYofYduty.YFailureYtoYperformYaccor
dingYtoYestablishedYstandards.YCausation.YAYconnectionYexistsYbetweenYconductYofYtheYnurseYandYtheYresul
tingYdamage.YDamages.YDamageYisYdoneYtoYtheYclient,YphysicalYorYmental.
DefineYanYintentionalYtortYandYfiveYoneYexample.Y-
YANSWERYConductYcausingYdamageYtoYanotherYpersonYinYaYwillfulYorYintentionalYwayYwithoutYjustYcause.YE
xampleYHittingYaYclientYoutYofYanger,YnotYinYaYmannerYofYselfYprotection.
VoluntaryYadmissionY-
YANSWERYClientYadmitsYselfYtoYanYinstitutionYforYtreatmentYandYrestrainsYhisYorYherYcivilYrights.YHeYorYsheY
mayYleaveYatYanyYtime.
InvoluntaryYadmissionY-
YANSWERYSomeoneYotherYthanYclientYappliesYforYtheYclient'sYadmissionYtoYanYinstitutionYrequiresYcertificat
ionYbyY1YorY2YhealthYcareYprovidersYthatYtheYpersonYisYaYdangerYtoYselfYorYothers.
ListY5YactivitiesYaYpersonYwhoYisYdeclaredYincompetentYcannotYperform.Y-
YANSWERYVote,YmakeYcontractsYorYwills,YdriveYaYcare,YsueYorYbeYsued,YholdYaYprofessionalYlicense.
NameY3YlegalYrequirementsYofYaYsurgicalYpermitY-YANSWERYVoluntary,Yinformed,YandYwritten.
,WhoYmayYgiveYconsentYforYmedicalYtreatment?Y-
YANSWERYAlert,Ycoherent,YorYotherwiseYcompetentYadults,YaYparentYorYlegalYguardian,YaYpersonYinYlocoYpar
entisYofYminorsYorYincompetentYadults.
WhatYlawYprotectsYtheYnurseYwhoYprovidesYcareYorYgivesYaidYinYanYemergencyYsituation?Y-
YANSWERYTheYGoodYSamaritanYAct.
WhatYactionYshouldYtheYnurseYtakeYifYheYorYsheYquestionsYaYhealthYcareYprovider'sYprescriptionYthatYtheyYb
elieveYisYwrong?Y-
YANSWERYInformYtheYhealthYcareYprovider.YRecordYthatYtheYhealthYcareYproviderYwasYinformedYandYtheYhe
althYcareYprovider'sYresponseYtoYsuchYinformation.YInformYtheYnursingYsupervisor.YRefuseYtoYcarryYoutYtheY
prescription.
DescribeYtheYnurse'sYlegalYresponsibilityYwhenYaskedYtoYperformYaYtaskYforYwhichYheYorYsheYisYunprepared.Y
-
YANSWERYInformYtheYhealthYcareYproviderYorYpersonYaskingYtheYnurseYtoYperformYtheYtaskYthatYheYorYsheYis
YunpreparedYtoYcarryYoutYtheYtask.YRefuseYtoYperformYtheYtask.
DescribeYnursingYcareYofYtheYrestrainedYclient.Y-
YANSWERYApplyYrestraintsYproperly.YCheckYrestraintsYfrequentlyYtoYseeYthatYtheyYareYnotYcausingYinjuryYan
dYrecordYsuchYmonitoring.YRemoveYrestraintsYasYsoonYasYpossible.YUseYrestraintsYasYaYlastYresort.
ByYwhatYauthorityYmayYRNsYdelegateYnursingYcareYtoYothers?Y-YANSWERYStateYNurseYPracticeYAct
AYUAPYmayYperformYcareYthatYfallsYwithinYwhichYcomponentsYofYtheYnursingYprocess?Y-
YANSWERYImplementation
WhichYtypeYofYcommunicationYisYnecessaryYtoYimplementYaYdemocraticYleadershipYstyle?Y-
YANSWERYAssertiveYcommunicationYskills
WhatYareYtheY4YrightsYofYcommunication?Y-
YANSWERYRightYtask,YrightYcircumstance,YrightYperson,YrightYdirectionYorYcommunication,YandYrightYsupervi
sion.
,WhichYtasksYcanYbeYdelegatedYtoYaYUAP?YA.YInsertingYaYFoleyYcatheter.YB.YMeasuringYandYrecordingYtheYclie
nt'sYoutputYthroughYaYFoleyYcatheter.YC.YTeachingYaYclientYhowYtoYcareYforYaYcatheterYafterYdischarge.YD.YAs
sessingYforYsymptomsYofYaYurinaryYtractYinfection.Y-
YANSWERYA.YisYaYsterileYinvasiveYprocedureYandYshouldYnotYbeYdelegatedYtoYaYUAP.YB.YFallsYwithinYtheYimple
mentationYphase,YdoesYnotYinvolveYnursingYjudgement.YEvaluationYofYtheYIY&YOYmustYbeYdoneYbyYtheYnurse
.YC.YClientYteachingYrequiresYtheYabilitiesYofYaYnurseYshouldYnotYbeYdelegated.YD.YAssessmentYmustYbeYperfo
rmedYbyYtheYnurseYandYshouldYnotYbeYdelegated.
WhatYareYtheYessentialYstepsYofYeffectiveYsupervision?Y-YANSWERYDirection,Yevaluation,YandYfollow-up.
WhichYofYtheYfollowingYisYanYexampleYofYassertiveYcommunication?YA.YYouYneedYtoYimproveYtheYwayYyouYs
pendYyourYtimeYsoYthatYallYofYyourYcareYgetsYperformed.YB.YI'veYnoticedYthatYmanyYofYyourYclientsYdidYnotYg
etYtheirYcareYtoday.Y-
YANSWERYA.YThisYisYanYaggressiveYcommunication,YwhichYcausesYanger,Yhostility,YandYaYdefensiveYattitude.Y
B.YAssertiveYcommunicationYbeginsYwithYIYratherYthanYyouYandYclearlyYstatesYtheYproblem.
ListYtheYthreeYlevelsYofYdisasterYmanagementY-
YANSWERYDisasterYpreparedness,YdisasterYresponse,YandYdisasterYrecovery.
ListYexamplesYofYtheYthreeYlevelsYofYpreventionYinYdisasterYmanagement.Y-
YANSWERYPrimary:YdevelopYplan,YtrainYandYeducateYpersonnelYandYpublic.YSecondary:Ytriage,YtreatmentYsh
elter,Ysupervision.YTertiary:Yfollow-up,YrecoveryYassistance,YpreventionYofYfutureYdisasters.
TriageY-YANSWERYToYsortYorYcategorize
IdentifyYthreeYbio-terrorismYagents.Y-
YANSWERYAnthrax,YpneumonicYplague,Ybotulism,Ysmallpox,YinhalationYtularemia,YviralYhemorrhage,Yfever,Y
ricin,Ysarin,Yradiation.
WhatYPo2YvalueYindicatesYrespiratoryYfailureYinYadults?Y-YANSWERYPo2YbelowY60YmmHg
WhatYbloodYvalueYindicatesYhypercapnia?Y-YANSWERYPco2YaboveY45YmmYHg
, IdentifyYtheYconditionYthatYexitsYwhenYtheYPo2YisYlessYthanY50YmmHgYandYFio2YisYgreaterYthanY60%.Y-
YANSWERYHypoxemia
ListYthreeYsymptomsYofYrespiratoryYfailureYinYadults.Y-
YANSWERYDyspneaYtachypnea,YintercostalYandYsternalYretractionsYcyanosis.
ListYfourYcommonYcausesYofYrespiratoryYfailureYinYchildren.Y-
YANSWERYCongenitalYheartYdisease,YinfectionYorYsepsis,YrespiratoryYdistressYsyndrome,Yaspiration,YfluidYov
erloadYorYdehydration.
WhatYpercentageYofYO2YshouldYaYchildYinYsevereYrespiratoryYdistressYreceive?Y-YANSWERY100%
AcuteYRespiratoryYDistressYSyndromeY-
YANSWERYIsYanYunexpected,YcatastrophicYpulmonaryYcomplicationYoccurringYaYpersonYwithYnoYpreviousYpu
lmonaryYproblem.YMortalityYrateY50%.
InterventionsYtoYpreventYcomplicationsYofYclientsYonYmechanicalYventilationYwithYARDSY-
YANSWERYElevateYheadYofYbedYatYleastY30Ydegrees.YAssistYwithYdailyYawakening.YImplementYaYcomprehensi
veYoralYhygieneYprogram.YImplementYaYcomprehensiveYmobilizationYprogram.
SuctionY-YANSWERYOnlyYwhenYsecretionsYareYpresent.
AllenYTestY-
YANSWERYPerformYpriorYtoYdrawingYABGs.YEnsuresYcollateralYcirculationYotYtheYhandYifYthrombosisYofYtheYr
adialYarteryYshouldYfollowYtheYpuncture.
PositiveYAllenYtestY-
YANSWERYMakeYtheYclientsYhandYblanchYbyYobliterationYbothYtheYradialYandYtheYulnarYpulses.YThenYrelease
YtheYpressureYoverYtheYulnarYarteryYonly.YIfYflowYthroughYtheYulnarYarteryYisYgood,YflushingYwillYbeYseeYimm
ediately.
NegativeYAllenYTestY-
YANSWERYRepeatYonYtheYotherYarm.YIfYthisYtestYisYalsoYnegative,YseekYanotherYsiteYforYarterialYpuncture.