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HESI-RN COMPREHENSIVE EXAM A QUESTIONS WITH COMPLETE ANSWERS
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HESI-RN COMPREHENSIVE EXAM A QUESTIONS WITH COMPLETE ANSWERS
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HESI-RN COMPREHENSIVE EXAM AQUESTIONS WITH COMPLETE
ANSWERS
The nurse is providing care to an 86-year-old admitted with generalized weakness.
Dietary modifications and levothyroxine are prescribed. Which physiologic finding in an
older adult could precipitate an adverse reaction to the medication?
A.
Reduced renal excretion
B.
Reduced gastrointestinal motility
C.
Increased hepatic metabolism
D.
Increased risk of autoimmune disorders - Answer-A
Rationale: During the aging process, reduced renal function is common and contributes
to drug accumulation that contributes to adverse reactions. Reduced hepatic function,
not option C, predisposes an older adult to an increase in adverse drug reactions.
Option B may occur frequently in an older client but does not impact the bioavailability
of drugs. Although an older adult may have a decreased immune response, the aging
client's risk for autoimmune disorders is not increased, nor does it affect drug
pharmacotherapeutics
The charge nurse of a 16-bed medical unit is making 0700 to 1900 shift assignments.
The team consists of two RNs, two PN/VNs, and two UAP. Which assignment is the
most effective use of the available team members?
A.
Assign the PNs to perform am care and assist with feeding the clients.
B.
Assign the UAPs to take vital signs and obtain daily weights.
C.
Assign the RNs to answer the call lights and administer all medications.
D.
Assign the PN/VNs to assist health care providers on rounds and perform glucometer
checks. - Answer-B
Rationale: A UAP can take vital signs and daily weights on stable clients. UAPs can
perform am care and feed clients, which is a better use of personnel than assigning the
task to the PN. All team members can answer call lights, and PNs can administer some
of the medications, so assigning the RN these tasks is not an effective use of the
available personnel. The RN is the best team member to assist on rounds, and the UAP
can perform glucometer checks, so assigning the PN these tasks is not an effective use
of available personnel.
,A client is admitted to the mental health unit with a chief complaint of crying, depressed
mood, and sleeping difficulties. While talking about the death of a friend, the client
states, "I can't believe this happened." Which statement by the nurse is most
therapeutic?
A.
"It sounds like you're feeling very sad."
B.
"Tell me more about how you're feeling."
C.
"How often do you have crying spells?"
D.
"Do you want to talk about these feelings?" - Answer-B
Rationale: It is most therapeutic to ask an open-ended question and encourage the
client to explore his or her feelings. Option A is a leading response, and the client may
not be feeling sad. Options C and D are closed-ended questions that do not facilitate
communication.
When the nurse manager posts a schedule for volunteers to be on call, one staff
member immediately signs up for all available 7-to-3 day shifts. Other staff members
complain to the charge nurse that they were not permitted the opportunity to be on call
for the day shift. What action should the nurse manager implement?
A.
Speak privately with the nurse.
B.
Hold a staff meeting to discuss this issue.
C.
Review the nurse's current salary.
D.
Nominate the nurse for employee of the month. - Answer-A
Rationale: The nurse manager should speak privately with the nurse to assess the
nurse's motives and to discuss allowing other team members the opportunity to be on
call for the day shift. Option B might become confrontational. Option C is irrelevant.
Option D is not warranted.
At 0800 the nurse placed a 1 inch/2.54 cm of 2% nitroglycerin paste to a client's right
thigh. The nurse placed the time, date and initials on the patch when it was applied. An
hour later the client was complaining of a sudden onset of dizziness; the blood pressure
was 90/50 mm Hg. Upon further assessment, a nitroglycerine patch was noted on the
client's back with the same date, and the time was 0830. What are the nurse's next
actions? (Select all that apply.)
A.
Take the clients vital signs every 15 minutes.
B.
Find out who applied the second dose of ointment.
C.
Have the client stay in bed.
, D.
Complete an occurrence/incident report.
E.
Notify the health care provider.
F.
Chart, occurrence report complete. - Answer-A, C, D, E
Rationale: The nurse's priority is the safety of the client who is going to require frequent
vital signs. The client's blood pressure is low and is at risk for falling. Notify the health
care provider of the event for any alternative prescriptions that may be necessary.
Complete the occurrence report to document the objective findings. Do not place in the
client's chart "occurrence report completed." Only chart the findings and the client's
physiologic responses to the treatments. The manager will complete the investigation.
A registered nurse (RN) delivers telehealth services to clients via electronic
communication. Which nursing action creates the greatest risk for professional liability
and has the potential for a malpractice lawsuit?
A.
Participating in telephone consultations with clients
B.
Identifying oneself by name and title to clients in telehealth communications
C.
Sending medical records to health care providers via the Internet
D.
Answering a client-initiated health question via electronic mail - Answer-C
Rationale: Sending medical records over the Internet, even with the latest security
protection, creates the greatest risk for liability because of the high potential of
breaching client confidentiality and the amount of information being transferred. Client
confidentiality is protected by federal wiretapping laws making telephone consultation a
private and protected form of communication. By stating one's name and credentials in
telehealth communication, one is taking responsibility for the encounter. E-mail initiated
by the client poses less risk than sending records via the Internet.
A client with arterial peripheral vascular disease (PVD) complains of pain in the feet.
Which instruction should the nurse give to the UAP to relieve the client's pain quickly?
A.
Help the client dangle legs.
B.
Apply compression stockings.
C.
Assist with passive leg exercises.
D.
Ambulate three times a day. - Answer-A
Rationale: The client who has arterial PVD may benefit from dependent positioning, and
this can be achieved with bedside dangling, which will promote gravitation of blood to
the feet, improve blood flow, and relieve pain. Option B is indicated for venous
, insufficiency and indicated for bed rest. Ambulation is indicated to facilitate collateral
circulation and may improve long-term complaints of pain.
The nurse is preparing assignments for the day shift. Which client should be assigned to
the staff RN rather than a PN?
A.
A client with an admitting diagnosis of menorrhagia who is now 24 hours' post-vaginal
hysterectomy
B.
A client admitted with a myocardial infarction 4 days ago who was transferred from the
intensive care unit (ICU) the previous day
C.
A client admitted during the night with depression following a suicide attempt with an
overdose of acetaminophen (Tylenol)
D.
A 4-year-old admitted the previous evening with gastrointestinal rotavirus who is
receiving IV fluids and a clear liquid diet - Answer-C
Rationale: Option C requires communication skills and assessment skills beyond the
educational level of a PN or UAP. Establishing a therapeutic, one-on-one relationship
with a depressed client is beyond the scope of practice for a PN. In addition, Tylenol is
extremely hepatotoxic, and careful assessment is essential. Options A, B, and D could
all be cared for by a PN under the supervision of the RN.
The nurse is preparing for discharge teaching for the client who had open abdominal
surgery. The client is a 46-year-old, Hispanic male client; weight 220 pounds/100 kg;
food preferences include beans, rice and fresh fruit; smokes ½ pack cigarettes daily;
and large extended family. Which factors place the client at risk for wound evisceration?
(Select all that apply.)
A.
Large extended family
B.
Dietary preferences
C.
Smoker
D.
Weight
E.
Abdominal surgery
F.
46 years old - Answer-C, D, E
Rationale: Risks for evisceration include abdominal surgery, poor wound healing
secondary to smoking, and obesity. The family offers social support; the diet is balanced
with protein, carbohydrates, vitamins and minerals; age is not a factor.
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