Mid-Curricular HESI Questions And Answers With
Complete Solutions Including Rationale For ANSWERS
A 6-year-old child has just been diagnosed with localized
Hodgkin's disease, and chemotherapy is planned to begin
immediately. The parent of the child asks the nurse why
radiation therapy was not prescribed as a part of the treatment.
The nurse would plan to make which best response?
1-"It's very costly, and chemotherapy works just as well."
2-"I'm not sure. I'll discuss it with the primary health care
provider."
3-"Sometimes age has to do with the decision for radiation
therapy."
4-"The primary health care provider would prefer that you
discuss treatment options with the oncologist." Correct Answer
3-"Sometimes age has to do with the decision for radiation
therapy."
Rationale:Radiation therapy is usually delayed, whenever
possible, until a child is 8 years old to prevent retardation of
bone growth and soft tissue development. Options 1, 2, and 4 are
inappropriate responses to the parent and place the parent's
question on hold.
A breast-feeding/chest-feeding parent of an infant with lactose
intolerance asks the nurse about dietary measures. What foods
would the nurse tell the parent are acceptable to consume while
breast-feeding/chest feeding? Select all that apply.
1-1% milk
2-Egg yolk
3-Dried beans
Rationale:Breast-feeding or chest-feeding parents with lactose-
intolerant infants need to be encouraged to limit dairy products.
Milk and cheese are dairy products. Alternative calcium sources
that can be consumed by the parent include egg yolk, dried
beans, green leafy vegetables, cauliflower, and molasses.
A client admitted to the hospital with chest pain and a history of
type 2 diabetes mellitus is scheduled for cardiac catheterization.
Which medication would need to be withheld for 24 hours
before the procedure and for 48 hours after the procedure?
1-Glipizide
2-Metformin
3-Repaglinide
4-Regular insulin Correct Answer 2-Metformin
Rationale:Metformin needs to be withheld 24 hours before and
for 48 hours after cardiac catheterization because of the injection
of a contrast medium during the procedure. Metformin is
excreted by the kidneys. If the contrast medium affects kidney
function, with metformin in the system the client would be at
increased risk for lactic acidosis. The medications in the
remaining options do not need to be withheld 24 hours before
and 48 hours after cardiac catheterization. Repaglinide is
metabolized by the liver and excreted in bile. Glipizide is
eliminated primarily by hepatic biotransformation.
,A client admitted to the hospital with coronary artery disease
complains of dyspnea at rest. The nurse caring for the client uses
which item as the best means to monitor respiratory status on an
ongoing basis?
1-Apnea monitor
2-Oxygen flowmeter
3-Telemetry cardiac monitor
4-Oxygen saturation monitor Correct Answer 4-Oxygen
saturation monitor
Rationale:Dyspnea in the cardiac client often is accompanied by
hypoxemia. Hypoxemia can be detected by an oxygen saturation
monitor, especially if it is used continuously. An apnea monitor
detects apnea episodes, such as when the client has stopped
breathing briefly. An oxygen flowmeter is part of the setup for
delivering oxygen therapy. Cardiac monitors detect
dysrhythmias.
A client arrives at the clinic complaining of fatigue, lack of
energy, constipation, and depression. Hypothyroidism is
diagnosed, and levothyroxine is prescribed. What is an expected
outcome of the medication?
1-Alleviates depression
2-Increases energy levels
3-Increases blood glucose levels
4-Achieves normal thyroid hormone levels Correct Answer 4-
Achieves normal thyroid hormone levels
Rationale:Laboratory determinations of the serum thyroid-
stimulating hormone (TSH) level are an important means of
evaluation. Successful therapy causes elevated TSH levels to
, decline. These levels begin their decline within hours of the
onset of therapy and continue to decrease as plasma levels of
thyroid hormone build up. If an adequate dosage is
administered, TSH levels remain suppressed for the duration of
therapy. Although energy levels may increase and the client's
mood may improve following effective treatment, these are not
noted until normal thyroid hormone levels are achieved with
medication therapy. An increase in the blood glucose level is not
associated with this condition.
A client comes to the emergency department after an assault and
is extremely agitated, trembling, and hyperventilating. What is
the priority nursing action for this client?
1-Begin to teach relaxation techniques.
2-Encourage the client to discuss the assault.
3-Remain with the client until the anxiety decreases.
4-Place the client in a quiet room alone to decrease stimulation.
Correct Answer 3-Remain with the client until the anxiety
decreases.
Rationale:This client is in a severe state of anxiety. When a
client is in a severe or panic state of anxiety, it is crucial for the
nurse to remain with the client. The client in a severe state of
anxiety would be unable to learn relaxation techniques.
Discussing the assault at this point would increase the client's
level of anxiety further. Placing the client in a quiet room alone
may also increase the anxiety level.
A client has experienced an episode of pulmonary edema. The
nurse determines that the client's respiratory status is improving
after this episode if which breath sounds are noted?
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