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HESI/SAUNDERS ONLINE REVIEW FOR THE NCLEX-RN EXAMINATION (1 YEAR) QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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HESI/SAUNDERS ONLINE REVIEW FOR THE NCLEX-RN EXAMINATION (1 YEAR) QUESTIONS AND ANSWERS WITH SOLUTIONS 2024

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  • 12 september 2024
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HESI/SAUNDERS ONLINE REVIEW FOR
THE NCLEX-RN EXAMINATION (1 YEAR)
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
AWnurseWisWassignedWtoWcareWforWaWclientWwithWchronicWrenalWfailureWwhoWisWundergoingWhemodialysisWt
hroughWanWinternalWarteriovenousW(AV)WfistulaWinWtheWrightWarm.WWhichWofWtheWfollowingWinterventions
WshouldWtheWnurseWimplementWinWcaringWforWtheWclient?WSelectWallWthatWapply.W



A)WAssessingWtheWradialWpulseWinWtheWrightWextremity

B)WUsingWtheWleftWarmWtoWtakeWbloodWpressureWreadings

C)WDrawingWpredialysisWbloodWspecimensWfromWtheWleftWarmWD)WAssessingWtheWareaWoverWtheWAVWfistula
WforWaWbruitWandWthrillWeachWshiftW



E)WPlacingWaWpressureWdressingWoverWtheWsiteWafterWeachWdialysisWtreatment

F)WAdministeringWintravenousW(IV)WfluidsWthroughWtheWvenousWsiteWofWtheWAVWfistulaWasWneededW-
WANSWERWAnswer(s):WA,B,C,D



Rationale:WSeveralWprecautionsWmustWbeWobservedWtoWensureWtheWfunctionWofWanWinternalWAVWfistula.WT
heWnurseWassessesWtheWfistula,WandWtheWdistalWportionWofWtheWextremity,WforWadequateWcirculation;Wche
cksWforWaWbruitWandWaWthrillWbyWmeansWofWauscultationWorWpalpationWoverWtheWaccessWsite;WmonitorsWth
eWradialWpulseWinWtheWextremity;WandWavoidsWtakingWbloodWpressureWreadingsWorWdrawingWbloodWfromWt
heWarmWwithWtheWAVWfistula.WVenipunctureWisWavoidedWinWtheWextremityWbearingWtheWAVWfistula.WBloodW
isWneverWdrawnWfromWtheWAVWfistula,WandWtheWAVWfistulaWisWnotWusedWforWtheWadministrationWofWIVWflui
ds.WTheWAVWfistulaWsiteWisWnotWcoveredWwithWaWpressureWdressingWafterWdialysis.



AWnurseWisWevaluatingWoutcomesWforWaWclientWwithWGuillain-
BarréWsyndrome.WWhichWofWtheWfollowingWoutcomesWdoesWtheWnurseWrecognizeWasWoptimalWrespiratoryW
outcomesWforWtheWclient?WSelectWallWthatWapply.W

A)WNormalWdeepWtendonWreflexes

B)WImprovedWskeletalWmuscleWtone

C)WAbsenceWofWparesthesiasWinWtheWlowerWextremitiesW

D)WClearWsoundsWinWtheWlowerWlungWfieldsWbilaterallyW

E)WPo2WofW85%WandWPco2WofW40WmmWHgW-WANSWERWAnswer(s):WD,E

Rationale:WSatisfactoryWrespiratoryWoutcomesWincludeWclearWbreathWsoundsWonWauscultation,WclearWmen
tation,WspontaneousWbreathing,WnormalWvitalWcapacity,WandWnormalWarterialWbloodWgases.WTheWABGWres
ultsWlistedWhereW—WaWPo2WofW85%WandWaWPco2WofW40WmmWHgW—

,WareWnormal.WTheWpresenceWofWnormalWdeepWtendonWreflexes,WimprovedWskeletalWmuscleWtone,WandWab
senceWofWparesthesiasWinWtheWlowerWextremitiesWreflectWimprovementWinWtheWsymptomsWassociatedWwit
hWGuillain-BarréWbutWareWnotWspecificWtoWaWrespiratoryWoutcome.



AWnurseWonWtheWtelemetryWunitWisWcaringWforWaWclientWwhoWhasWhadWaWmyocardialWinfarctionWandWisWno
wWattachedWtoWaWcardiacWmonitor.WTheWnurse,WmonitoringWtheWclient'sWcardiacWrhythm,WnotesWtheWrhyt
hmWdepictedWinWtheWimage.WWhichWofWtheWfollowingWnursingWactionsWshouldWtheWnurseWtake?

(RhythmWisWcontinuousWupWandWdownWinWpic)

A)WCallingWtheWrapidWresponseWteamW

B)WPreparingWtheWclientWforWcardioversionW

C)WAskingWtheWclientWtoWbearWdownWandWcough

D)WPreparingWtoWadministerWdiltiazemW(Cardiazem)W-WANSWERWAnswer:WA

Rationale:WThisWpatternWindicatesWventricularWfibrillationW(VF).WClientsWwhoWhaveWsustainedWaWmyocardi
alWinfarctionWareWatWgreatWriskWforWVF.WWithWtheWonsetWofWVFWtheWclientWfeelsWfaint,WthenWimmediatelyWl
osesWconsciousnessWandWbecomesWpulselessWandWapneic.WThereWisWnoWbloodWpressure,WandWheartWsoun
dsWareWabsent.WTheWgoalsWofWtreatmentWareWtoWterminateWVFWpromptlyWandWconvertWitWtoWanWorganize
dWrhythm.WBecauseWdefibrillationWisWtheWimmediateWtreatment,WtheWnurseWmustWcallWtheWrapidWrespons
eWteamWandWinitiateWcardiopulmonaryWresuscitation.WTheWclientWwouldWnotWbeWableWtoWbearWdownWorWc
ough.WCardioversionWisWaWsynchronizedWcountershockWthatWmayWbeWperformedWinWemergenciesWforWuns
tableWventricularWorWsupraventricularWtachydysrhythmiasWorWelectivelyWforWstableWtachydysrhythmiasWth
atWareWresistantWtoWmedicalWtherapiesWsuchWasWtheWadministrationWofWdiltiazemW(Cardiazem).



AWnurseWdevelopingWaWplanWofWcareWforWaWclientWwithWaWspinalWcordWinjuryWincludesWmeasuresWtoWpreve
ntWautonomicWdysreflexiaW(hyperreflexia).WWhichWofWtheWfollowingWinterventionsWdoesWtheWnurseWincor
porateWintoWtheWplanWtoWpreventWthisWcomplication?

A)WKeepingWaWfanWrunningWinWtheWclient'sWroom

B)WKeepingWtheWlinensWwrinkle-freeWunderWtheWclientW

C)WLimitingWbladderWcatheterizationWtoWonceWeveryW12Whours

D)WAvoidingWtheWadministrationWofWenemasWandWrectalWsuppositoriesW-WANSWERWAnswer:WB

Rationale:WTheWmostWfrequentWcausesWofWautonomicWdysreflexiaWareWaWdistendedWbladderWandWimpacte
dWfecesWinWtheWrectum.WStraightWcatheterizationWshouldWbeWperformedWeveryW4WtoW6Whours,WandWtheWF
oleyWcatheterWshouldWbeWcheckedWfrequentlyWtoWpreventWkinksWinWtheWtubing.WConstipationWandWfecalWi
mpactionWareWotherWcauses,WsoWmaintainingWbowelWregularityWisWimportant.WOtherWcausesWincludeWstim
ulationWofWtheWskinWbyWtactile,Wthermal,WorWpainfulWstimuli.WTheWnurseWrendersWcareWinWsuchWaWwayWasW
toWminimizeWriskWinWtheseWareas.

,AWnurseWprovidesWhomeWcareWinstructionsWtoWaWclientWwhoWhasWbeenWfittedWwithWaWhaloWdeviceWtoWtre
atWaWcervicalWfracture.WWhichWstatementWbyWtheWclientWindicatesWtheWneedWforWfurtherWinstruction?

A)W"IWneedWtoWgetWmoreWfluidsWandWfiberWintoWmyWdiet."

B)W"IWshouldWcutWmyWfoodWintoWsmallWpiecesWbeforeWIWeat."

C)W"IWneedWtoWputWpowderWunderWtheWvestWtwiceWaWdayWtoWpreventWsweating."W

D)W"IWhaveWtoWcheckWtheWpinWsitesWeveryWdayWandWwatchWforWsignsWofWinfection."W-WANSWERWAnswer:WC

Rationale:WTheWclientWshouldWcleanseWtheWskinWunderWtheWlambs-
woolWlinerWeachWdayWtoWpreventWrashesWorWsores.WPowderWorWlotionsWshouldWbeWusedWonlyWsparinglyWo
rWnotWatWallWbecauseWtheyWmayWcake,WresultingWinWskinWirritation.WTheWclientWshouldWincreaseWintakeWofW
fluidWandWfiberWtoWhelpWpreventWconstipation.WFoodWshouldWbeWcutWintoWsmallWpiecesWtoWfacilitateWche
wingWandWswallowing.WTheWclientWshouldWalsoWuseWaWstrawWforWdrinking.WTheWpinWsitesWshouldWbeWchec
kedWdailyWforWsignsWofWinfection.



AWnurseWisWcaringWforWclientWwithWincreasedWintracranialWpressureW(ICP).WInWwhichWpositionWshouldWtheW
nurseWmaintainWtheWclient?

A)WSupine,WwithWtheWheadWextended

B)WSide-lying,WwithWtheWneckWflexed

C)WSupine,WwithWtheWheadWturnedWtoWtheWside

D)WHeadWmidlineWandWelevatedW30WtoW45WdegreesW-WANSWERWAnswer:WD

Rationale:WTheWclientWwithWincreasedWICPWshouldWbeWpositionedWwithWtheWheadWinWaWneutralWmidlineWp
osition.WItWisWtheWresponsibilityWofWtheWnurseWtoWensureWthatWallWthoseWdeliveringWcareWtoWtheWclientWm
aintainWtheWproperWpositioning.WTheWclientWshouldWavoidWflexingWorWextendingWtheWneckWorWturningWthe
WneckWsideWtoWside.WTheWheadWofWtheWbedWshouldWbeWraisedWtoW30WtoW45Wdegrees.WUseWofWproperWposi

tioningWpromotesWvenousWdrainageWfromWtheWcraniumWtoWkeepWICPWdown.



AWclientWwithWaWbasilarWskullWfractureWhasWclearWfluidWleakingWfromWtheWears.WTheWnurseWshould:

A)WAssessWtheWclearWfluidWforWprotein

B)WCheckWtheWclearWfluidWforWtheWpresenceWofWglucoseW

C)WPlaceWcottonWballsWorWdryWgauzeWlooselyWinWtheWears

D)WUseWanWotoscopeWtoWassessWtheWtympanicWmembraneWforWruptureW-WANSWERWAnswer:WB

Rationale:WLeakageWofWcerebrospinalWfluidW(CSF)WfromWtheWearsWorWnoseWmayWaccompanyWbasilarWskullW
fracture.WCSFWcanWbeWdistinguishedWfromWotherWbodyWfluidsWbecauseWitWwillWseparateWintoWbloodyWandW

, yellowWconcentricWringsWonWdressingWmaterial,WaWphenomenonWreferredWtoWasWtheWhaloWsign.WItWalsoWte
stsWpositiveWforWglucose.WCSFWdoesWnotWcontainWprotein.WTheWpresenceWofWCSFWindicatesWaWdisruptionWi
nWtheWintegrityWofWtheWcranium.WThereforeWinsertingWcottonWballs,Wgauze,WorWanWotoscopeWintoWtheWear
WputsWtheWclientWatWriskWforWinfection.




AWnurseWisWcaringWforWaWclientWwhoWhasWjustWundergoneWcardioversion.WWhichWofWtheWfollowingWinterve
ntionsWisWtheWnurse'sWpriorityWafterWthisWprocedure?

A)WAdministeringWoxygenW

B)WMonitoringWtheWbloodWpressure

C)WAdministeringWantidysrhythmicWmedicationsW

D)WMonitoringWtheWclient'sWlevelWofWconsciousnessW-WANSWERWAnswer:WA

Rationale:WNursingWresponsibilitiesWafterWcardioversionWincludeWmaintenanceWofWaWpatentWairway,Woxyg
enWadministration,WassessmentWofWvitalWsignsWandWlevelWofWconsciousness,WandWdetectionWofWdysrhythm
ias.WTheWpriorityWnursingWinterventionWhereWisWadministeringWoxygen.



AWclientWwithWdiabetesWmellitusWwhoWisWscheduledWtoWhaveWbloodWdrawnWforWdeterminationWofWtheWgly
cosylatedWhemoglobinW(HbA1C)WlevelWasksWtheWnurseWwhyWtheWtestWisWnecessaryWifWheWisWperformingWbl
oodWglucoseWmonitoringWatWhome.WTheWnurseWtellsWtheWclientWthatWthisWtestWisWusedWspecificallyWto:

A)WDetectWdiabeticWcomplications

B)WAssessWlong-termWglycemicWcontrolW

C)WDetermineWwhetherWtheWclientWisWatWriskWforWhypoglycemia

D)WDetermineWwhetherWtheWprescribedWinsulinWdosageWisWadequateW-WANSWERWAnswer:WB

Rationale:WTheWHbA1CWreadingWprovidesWanWindicationWofWglycemicWcontrolWoverWtheWprecedingW3Wmon
ths.WAnWHbA1CWvalueWofWlessWthanW7%WindicatesWgoodWglycemicWcontrol.WWhenWincreasesWinWtheWblood
WglucoseWoccur,WsomeWglucoseWmoleculesWattachWthemselvesWtoWredWbloodWcellsW(RBCs)WandWremainWth

ereWforWtheWlifeWofWtheWRBCs.WThereforeWaWhighWvalueWonWthisWtestWisWcorrelatedWwithWaWhighWbloodWglu
coseWlevel,WindicatingWpoorWlong-
termWcontrolWofWbloodWglucose,WwhichWoftenWleadsWtoWtheWdevelopmentWofWcomplicationsWinWtheWclient
WwithWdiabetesWmellitus.WTheWotherWoptionsWareWnotWpurposesWforWthisWtest.




AWnurseWcaringWforWaWclientWwithWAIDSWisWmonitoringWtheWclientWforWsignsWofWcomplications.WWhichWofWt
heWfollowingWfindingsWwouldWcauseWtheWnurseWtoWsuspectWinfectionWwithWPneumocystisWjiroveci?WSelect
WallWthatWapply.



A)WDiarrheaW

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