HESI Fundamentals Guide 12 Latest VersionsVerified Questions and Answers latest Updated 2022
HESI FUNDAMENTALS
A policy requiring the removal of acrylic nails by all nursing personnel was implemented 6 months ago. Which assessment measure best determines if the intended outcome of the policy...
A policy requiring the removal of acrylic nails by all nursing personnel was implemented 6
months ago. Which assessment measure best determines if the intended outcome of the
policy is being achieved.
Number of staff induced injury
Client satisfaction survey
Health care-associated infectionrate.
Rate of needle-stick injuries bynurse.
The nurse is preparing to assist a newly admitted client with personal hygiene measures. The
client...the client’s gag reflex. Which action should the nurse include?
Offer smalls sips of water through astraw
Place tongue blade on back half oftongue
Use a penlight to observe back of oral cavity
Auscultate breath sounds after client swallows
The nurse explains to an older adult male the procedure for collecting a 24-hour urine
specimen for creatinine clearance.
Assess the client for confusion and reteach the procedure
Check the urine for color and texture
Empty the urinal contents into the 24-hour collection container
Discard the contents of the urinal
A 54-year-old male client and his wife were informed this morning that he has terminal cancer.
Which nursing intervention is likely to be most
Ask her how she would like to participate in the client’s care
Provide the wife with information about hospice
Encourage the wife to visit after painful treatments are completed
Refer her to support group for family members of those dying of cancer
A client who has a body mass index (BMI) of 30 is requesting information on the initial
approach to a weight loss plan. Which action should the nurse recommend?
Plan low carbohydrate and high proteinmeals
Engage in strenuous activity for an hourdaily
Keep a record of food and drinks consumed daily
Participated in a group exercise class 3 times a week
The nurse assesses a client who has a nasal cannula delivering oxygen at 2 L/min. To assess for
skin damage related to the cannula, which areas should the nurse observe?
Tops of the ear
Bridge of the nose
Around the nostrils
Over the cheeks
Across the forehead
The nurse observes an unlicensed assistive personnel (UAP) who is providing a total bed bath
for a confused and lethargic client. The UAP is soaking the client’s foot in a basin of warm
water placed on the bed. What action should the nurse take?
Remove the basin of water from the client’s bed immediately
Remind the UAP to dry between the client’s toes completely
Advise the UAP that this procedure is damaging to the skin
Add skin cream to the basin of water while the foot is soaking
The nurse in the emergency department observes a colleague viewing the electronic health
,record (EHR) of a client who holds an elected position in the community. The client is not a part
of the colleague’s assignment. Which action should the nurseimplement?
Communicate the colleague’s actions to the unit charge nurse
Send an email to facility administration reporting the action
Write an anonymous complaint to a professional website
Post a comment about the action on a staff discussion board
At 0100 on a male client’s second postoperative night, the client states he is unstable to sleep
and plans to read until feeling sleepy. What action should the nurse implement?
Leave the room and close the door to the client’s room
Assess the appearance of the client’s surgical dressing
Bring the client a prescribed PRN sedative-hypnotic
Discuss symptoms of sleep deprivation with the client
The nursing staff in the cardiovascular intensive care unit are creating a continuous quality
improvement project on social media that addresses coronary artery disease (CAD). Which action
should the nurse implement to protect client privacy?
Remove identifying information of the clients who participated
Recall that authored content may be legally discoverable
Share material from credible, peer reviewed sources only
Respect all copyright laws when adding website content
A male client with unstable angina needs a cardiac catheterization, so the healthcare provider
explains the risks and benefits of the procedure, and then leaves to set up for the procedure.
When the nurse presents the consent form for signature, the client hesitates and asks how the
wires will keep his heart going. Which action should the nurse take?
Answer the client’s specific questions with a short understandable explanation
Postpone the procedure until the client understands the risks and benefits
Call the client’s next of kin and ask them to provide verbal consent
Page the healthcare provider to return and provide additional explanation
The nurse is teaching a client how to do active range of motion (ROM) exercises. To exercise
the hinge joints, which action should the nurse instruct the client to perform?
Tilt the pelvis forwards and backwards
,bend the arm by flexing the ulnar to the humerus
Turn the head to the right and left
Extend the arm at the ide and rotate in circles
A postoperative client has three different PRN analgesics prescribed for different levels of
pain. The nurse inadvertently administers a dose that is not within the prescribed parameters.
What actions should the nurse take first?
Access for side effects of the medication.
Document the client’s responses.
complete a medication error report.
Determine if the pain was relieved.
When assessing a male client, the nurse finds that he is fatigue, and is experiencing muscle
weakness, leg cramps, and cardiac dysrhythmias. Based on these findings, the nurse plans to
check the client’s laboratory values to validate the existence of which?
Hyperphosphatemia
Hypocalcemia
Hypermagnesemia
Hypokalemia
A female client’s significant other has been at her bedside providing reassurances and support
for the past 3days, as desired by the client. The client’s estranged husband arrives and
demands that the significant other not be allowed to visit or be given condition updates.
Which intervention should the nurse implement?
Obtain a perception from the healthcare provider regarding visitation privileges
Request a consultation with the ethics committee for resolution of the situation
Encourage the client to speak with her husband regarding his disruptive behavior
Communicate the client’s wishes to all members of the multidisciplinary team
When measuring vital signs, the nurse observes that a client is using accessory neck muscles
during respirations. What follow-up action should the nurse take first?
Determine pulse pressure
Auscultate heart sounds
Measure oxygen saturation
Check for neck vein distention
To avoid nerve injury, what location should the nurse select to administer a 3 mL IM injection?
Ventrogluteal
outer upper quadrant of the buttock
Two inches below the acromion process
Vastus lateralis
Which instruction should the nurse include in the discharge teaching plan for an adult client
with hypernatremia?
Monitor daily urine output volume
Drink plenty of water whenever thirsty
Use salt tablets for sodium content
Review food labels for sodium content
While changing a client’s post operative dressing, the nurse observes a red and swollen wound
with a moderate amount of yellow and green drainage and a foul odor. Given there is a
positive MRSA, which is the most important action for the nurse totake?
Force oral fluids
Request a nutrition consult
Initiate contact precautions
Limit visitors to immediate family only
To prepare a client for the potential side effects of a newly prescribed medication, what action
should the nurse implement?
, Assess the client for health alterations that may be impacted by the effects of the medication
Teach the client how to administer the medication to promote the best absorption
Administer a half dose and observe the client for side effects before administering a full
dosage
Encourage the client to drink plenty of fluids to promote effective drug distribution
A client is 2 days post-op from a thoracic surgery and is complaining of incisional pain. The
client last received pain medication 2 hours ago. He is rating his pain a 5 on a 1-10 scale. After
calling the provider, what is the nurse's next action?
instruct the client to use guided imagery and slow rhythmic breathing
Provide at least 20 minutes of back massage and gentle effleurage
Encourage the client to watch TV.
Place a hot water circulation device, such as an Aqua K pad, to operative site
A client with cirrhosis and ascites is receiving furosemide 40 mg BID. The pharmacy provides
20 mg tablets. How many tablets should the client receive each day? [Enter numeric value
only]
4 tablets
An older adult male client is admitted to the medical unit following a fall at home. When
undressing him, the nurse notes that he is wearing an adult diaper and skin breakdown is
obvious over his sacral area. What action should the nurse implement first?
Establish a toileting schedule to decrease episodes of incontinence
Complete a functional assessment of the client’s self-care abilities
Apply a barrier ointment to intact areas that may be exposed to moisture
Determine the size and depth of skin breakdown over the sacral area
While interviewing a client, the nurse records the assessment in the electronic health record.
Which statement is most accurate regarding electronic documentation during an interview?
The client’s comfort level is increased when the nurse breaks eye contact to type notes into
the record
The interview process is enhanced with electronic documentation and allows the client to
speak at a normal pace
The nurse has limited ability to observe nonverbal communication while entering the
assessment electronically
Completing the electronic record during an interview is a legal obligation of the examining
nurse
A female client with chronic back pain has been taking muscle relaxants and analgesics to
manage the discomfort, but is now experiencing an acute episode of pain that is not relieved
by this medication regime. The client tells the nurse that she does not want to have
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