HESI ADULT HEALTH 1 NEWEST
ACTUAL EXAM 2025 QUESTIONS AND
DETAILED CORRECT ANSWERS WITH
RATIONALES | A+ GRADE
GUARANTEED PASS
The nurse is providing post-operative instructions for a
female client after a mastectomy. Which information
should the nurse include in the teaching plan?
A. avoid lifting more than 4.5 kg (10 lb) or reaching above
her head
B. empty surgical drains once a week using procedural
gloves
C. report inflammation of the incision site or the affected
arm
D. wearing clothing with snug sleeves over the arm on the
operative side Correct Answer A and D
Part of the client's teaching plan should include
reporting evidence of inflammation at the incision or
of the affected arm and to avoid lifting or reaching,
which places the client at risk for injury to the
extremity that may have compromised lymphatic
drainage. the client should be instructed to empty
surgical drains daily, no weekly. Activity that
decreases circulation in the affected arm, such as
carrying a handbag over the shoulder, wearing tight
clothing, or tight jewelry, should be avoided.
,the nurse directs an unlicensed assisstive personnel
(UAP) to obtain vital signs for a client who returns to the
unit after having a mastectomy for cancer. What
information should the nurse provide the UAP?
A. elevate the arm with an IV infusing on the operative
side with a pillow
B. apply the blood pressure cuff to the arm on the non-
operative side
C. position the arm on the operative side close to the body
D. collect a fingerstick blood specimen from the arm on
the operative side Correct Answer B.
Blood pressure reading should be obtained from the
arm on the unoperative side to reduce the risk of
injury of the extremity that may have compromised
lymphatic drainage postoperatively. The arm on the
operative side of the mastectomy should be elevated
on a pillow above the level of the right atrium to
facilitate lymphatic drainage, not close to the body. An
IV infusion or blood specimen collection should not
involve the use of the arm on the operative side.
Which client is at the highest risk for compromised
psychological adjustment after a hysterectomy?
A. a 62-year-old widow who has three friends who had
uncomplicated hysterectomies
B. A 29-year-old woman whose uterus ruptured after
giving birth to her first child
C. A 46-year-old woman with three children and a recent
promotion at work
,D. A 55-year-old woman with abnormal bleeding and pain
for 3 years Correct Answer B
The client who is a primipara and is still in her
childbearing years is at highest risk for unresolved
conflicts about the end of her childbearing
opportunities. The client with a family and positive life
events, the menopausal client with physical distress,
the post-menopausal client with support of peers with
similar positive outcomes are less likely to be
psychologically distressed.
A 48-year-old client with endometrial cancer is being
discharged after a total hysterectomy and bilateral
salpingo-oophorectomy. Which client statement indicates
that further teaching is needed?
A. "I have asked my daughter to stay with me next week
after I am discharged"
B. "Well, I don't have to worry about getting pregnant
anymore"
C. "I know I will miss having sexual intercourse with my
husband"
D. "I can't wait to go on the cruise that I have planned for
this summer" Correct Answer C
further teaching is needed in response to the client's
misunderstanding of sexuality after a hysterectomy
that is reflected in the statement. the client's
knowledge about reproduction, a positive outlook with
plans for the future, and her anticipated need for
, assistance and support during recovery indicate she
understands the present status of her recovery.
During the assessment of a client who is 24 hours post-
hemicolectomy with a temporary colostomy, the nurse
determines that the client's stoma is dry and dark red in
color. What action should the nurse implement?
A. place petrolatum gauze dressing over the stoma
B. document the assessment
C. notify the surgeon
D. secure a colostomy pouch over the stoma Correct
Answer C
The stoma should appear reddish pink and moist,
which indicates circulatory perfusion to the surgical
diversion of the intestine. If the stoma becomes dry,
firm, flaccid, or is dark red or purple, the stoma is
ischemic, and the surgeon should be notified
immediately.
The nurse is caring for a client with end stage liver disease
who is being assessed for the presence of asterixis. To
assess the client for asterixis, what position should the
nurse ask the client to demonstrate?
A. extend arms with both legs adducted to shoulder width
B. extend the left arm laterally with the left palm upward
C. extend the arms and hold this position for 30 seconds
D. extend the arm, dorsiflex the wrist, and extend the
fingers Correct Answer D
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