Exam (elaborations)
BSN 246 HESI Health Assessment Exam Versions 3 (New 2024/ 2025 Update) Questions and Verified Answers |100% Correct| A Grade - Nightingale
BSN 246 HESI Health Assessment Exam
Versions 3 (New 2024/ 2025 Update)
Questions and Verified Answers |100%
Correct| A Grade - Nightingale
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BSNI246IHESIIHealthIAssessmentIExamI
VersionsI3I(NewI2024/I2025IUpdate)I
QuestionsIandIVerifiedIAnswersI|100%I
Correct|IAIGradeI-INightingale
QUESTION
ITheIregisteredInurseI(RN)IisIevaluatingIaIclientIwhoIpresentsIwithIsymp-
ItomsIofIviralIgastroenteritis.IWhichIassessmentIfindingIshouldItheIRNIreportItoItheIhealthcare
Iprovider?
DryImucousImembranesIandIlips.
ReboundIabdominalItendernessIoverIrightIlowerIquadrant.IDizzinessIwhenIclientIambulatesIfro
mIaIsittingIposition.
PoorIskinIturgorIoverIclient'sIwrist.
Answer:
IReboundIabdominalItendernessIoverIrightIlowerIquadrant.
Rationale
RLQIreboundIabdominalItendernessImayIbeIrelatedItoIacuteIappendicitisIandIshouldIbeIreport
edItoItheIhealthcareIprovider.
QUESTION
ITheIregisteredInurseI(RN)IisIcaringIforIanIolderIclientIwhoIhasIbeenIbedriddenIforItwoIweek
s.IWhichIassessmentIfindingsIindicateItoItheIRNIthatItheIclientIisIdevelopingIaIcomplicationIr
elatedItoIimmobility?
I
DecreasedIpedalIpulses.IEdemaIinIupperIextremities.ILossIofIappetiteIforIfood.
StiffnessIinIrightIankleIjoint.
Answer:
IStiffnessIinIrightIankleIjoint.
Rationale
StiffnessIinIjointsIisIanIearlyIsignIofIcontracturesIandImuscleIatrophyIrelatedItoIinactivityIandI
immobility
QUESTION
,IAfterIaIliverIbiopsyIisIperformedIatItheIbedside,ItheIregisteredInurseI(RN)IisIassignedItheIcar
eIofItheIclient.IWhichInursingIinterventionIisImostIimportantIforItheIRNItoIimplement?
PositionIclientIonIleftIsideIwithIpillowIplacedIunderItheIcostalImargin.IAssistItheIclientIwithIv
oidingIimmediatelyIafterItheIprocedure.IEvaluateIvitalIsignsIq10ItoI20IminutesIforI2IhoursIaft
erIprocedure.
AmbulateIclientI3ItimesIinIfirstIhourIwithIpillowIheldIatIabdomen.
Answer:
IEvaluateIvitalIsignsIq10ItoI20IminutesIforI2IhoursIafterIprocedure.
Rationale
VitalIsignsIshouldIbeIcheckedIeveryI10ItoI20IminutesItoIassessIforIbleedingIafterIbiopsyIofIth
eIliver,IwhichIisIhighlyIvascular.ITheIclientIshouldIbeIpositionedIonItheIrightIsideIwithIaIpillo
wIorIsandbagIunderItheIcostalImarginIandIsupportingItheIbiopsyIsite.ITheIclientIshouldIbeImai
ntainedIonIbedrestIforIseveralIhoursItoIdecreaseItheIriskIofIbleedingIfromItheIbiopsyIsite.
QUESTION
ITheIregisteredInurseI(RN)IisIcaringIforIaIclientIwithIaInewlyIplacedInaso-
IgastricItubeI(NGT).IOnceItheIplacementIofItheINGItubeIisIverifiedIbyIx-
ray,IwhichItechniqueIshouldItheIRNIuseIasIaIreliableImethodItoIensureItheINGTIisInotIdisplac
ed?
CheckIpHIofIaspiratedIstomachIcontentsIobtainedIfromItheINGT.IAuscultateIoverItheIepigastri
umIwhileIinjectingIairIintoItheINGT.IDisconnectIandIplaceItheIendIofINGTIinIwaterItoIseeIifI
bubblesIappear.
ListenIforIhyperactiveIbowelIsoundsIinIallIfourIquadrantsIofIabdomen.
Answer:
ICheckIpHIofIaspiratedIstomachIcontentsIobtainedIfromItheINGT.
Rationale
CheckingItheIpHIofItheIaspirateIisItheIbestImethodItoIvalidateIthatItheINGTIisInotIdisplacedIa
ndIshouldIrevealIanIacidicIpHIofI1.5ItoI3.5IdueItoIpresenceIofIgastricIacid.
QUESTION
IAIclientIinIanIambulatoryIclinicIdescribesIawakingIinItheImiddleIofItheInightIwithIdifficultyI
breathingIandIshortnessIofIbreathIrelatedItoIparoxysmal
I
nocturnalIdyspnea.IWhichIunderlyingIconditionIshouldItheIregisteredInurse
(RN)IidentifyIinItheIclient'sIhistory?
ChronicIbronchitis.
GastroesophagealIrefluxIdiseaseI(GERD).IHeartIfailureI(HF).
ChronicIpancreatitis.
, Answer:
IHeartIfailureI(HF)
Rationale
ParoxysmalInocturnalIdyspneaIisIclassicIsignIofIheartIfailureIandIisIsecondaryItoIfluidIoverloa
dIassociatedIwithIheartIfailureIwhichIcausesIpulmonaryIedema.
QUESTION
ITheIregisteredInurseI(RN)IusesItheImini-
mentalIstateIexaminationI(MMSE)IwhenIassessingIaIclientIforIadmissionItoIanIassistedIlivingI
facility.IWhichIfindingIisItheIRNIassessingIwhenIrequestingItheIclientItoIcountIbyI7s?
RecallIofIinformation.IOrientationItoIsurroundings.IAttentionItoIdetails.
AbilityItoIfollowIcomplexIcommands.
Answer:
IAttentionItoIdetails.
Rationale
WhenIconductingItheIMMSEIandIhavingItheIclientIcountIbackwardsIbyI7s;IthisIevaluatesItheir
IabilityItoIdoIsimpleIcalculationsIandIisIspecificItoItheIclient'sIattentionItoIdetailIandIstayingIf
ocusIandInotIgettingIdistractedIbyIexternalIstimuli.
QUESTION
ITheIregisteredInurseI(RN)IisIassistingItheIhealthcareIproviderI(HCP)IwithItheIremovalIofIaIc
hestItube.IWhichIinterventionIhasItheIhighestIpriorityIandIshouldIbeIanticipatedIbyItheIRNIaft
erItheIremovalIofItheIchestItube?
PrepareItheIclientIforIchestIx-
rayIatItheIbedside.IReviewIarterialIbloodIgasesIafterIremoval.IElevateItheIheadIofIbedItoI45Ide
grees.
AssistIwithIdisassemblingItheIdrainageIsystem.
Answer:
IPrepareItheIclientIforIchestIx-rayIatItheIbedside
Rationale
AIchestIx-
rayIshouldIbeIperformedIimmediatelyIafterItheIremovalIofIaIchestItubeItoIensureIlungIexpansi
onIhasIbeenImaintainedIafterIitsIremoval.
QUESTION
IAnIinfantIwithIheartIfailureIreceivesIaIprescription,IdigoxinI35ImcgIPO.ITheIregisteredInurse
I(RN)IcalcuateItheIdesiredIdoseIforIadministrationIusingIthe