HESI study questions (adaptive
quizzing) exam questions and
answers
Which information about skin care would the nurse include in the teaching
plan for a client who is receiving radiation therapy?
1: "Cover the area with a sterile gauze dressing"
2: "Put warm compresses on the site once a day"
3: "Limit lying on the back and unaffected side when sleeping"
4: "Avoid applying lotions and powders over the area" - answer 4: Lotions
and powders can cause a skin reaction on irradiated areas and should be
avoided. Gauze and tape may irritate the skin further and should be
avoided. Warm compresses are contraindicated because they may
precipitate skin breakdown. The client can assume a position of comfort.
Which statement made by the parent of an infant receiving phototherapy
for jaundice would cause concern?
1: "I keep track of the number of wet diapers."
2: "My baby's skin is dry, so I applied a little lotion"
3: "I placed my baby under the lights dressed only in a diaper"
4: "I closed my baby's eyes before placing the mask over them" - answer
2: Lotions, creams, and ointments should not be applied to an infant's skin
during phototherapy because it can absorb heat and cause burns. The
infant should be placed under the phototherapy lights dressed only in a
diaper. The number of wet or soiled diapers is monitored because it is an
indicator of hydration status. The eyes of the infant should be closed
before placing the mask over the eyes to prevent scratching of the cornea.
A client has an abdominal cholecystectomy for treatment of a gangreous
gallbladder. Consider the location of the surgical site, the nurse would
assess the client for which postoperative complication?
1 Atelectasis
2 Hemorrhage
,3 Paralytic ileus
4 Wound infection - answer 1: Subcostal incisional pain causes the client
to splint and avoid deep breathing, which impedes air exchange in the
alveoli. The location of the incision does not increase risk of hemorrhage.
Paralytic ileus can be a postoperative problem, but is unrelated to the site
of incision. The subcostal incision site is not specifically vulnerable to
infection.
Which synovial movement is decribed as turning the sole away from the
midline of the body?
1: Pronation
2: Eversion
3: Adduction
4: Supination - answer 2. Eversion is a synovial joint movement that
describes turning the sole outward away from the midline of the body.
Pronation is a synovial joint movement that describes turning the palm
downward. Adduction is a movement toward midline. Supination is turning
the palm upward.
A client's IV cannula insertion site has become red, swollen, and warm to
the touch. Purulent drainage is also noted. Which intervention would be
implemented?
1: Temporarily slow the infusion rate to a "keep vein open" rate
2 Elevate the extremity slightly above the level of the client's heart
3 Frequently apply cold and warm compresses to the site
4 Clean the site with alcohol, remove the cannula, and save for culture. -
answer 4. A client with redness, swelling, and warmth with purulent
drainage at the insertion site may have an infection. The nurse should
clean the site immediately with alcohol and remove the catheter (if
vesicant medications were not infusing) because of the obvious
development of an infection. The nurse would also save the catheter for
obtaining a culture of the organism. Temporarily slowing the infusion is
not recommended because doing so may lead to a systemic spread of the
infection. Elevating the extremity may help with phlebitis, with
thrombosis, or with ecchymosis and hematoma. Application of cold and
warm compresses may reduce the pain in a client with thrombophlebitis.
However, the comprehensive initial reaction is to clean the site with
alcohol, remove the cannula, and save for culture. The nurse would then
insert another intravenous cannula at a different location.
,Which parts of a client's body would the nurse assess for the presence of
tophi (urate deposits)? Select all that apply. One, some, or all responses
may be correct
1 Feet
2 Ears
3 Chin
4 Buttocks
5 Abdomen - answer Feet and ears. Clients with gout may develop
deposits of monosodium urate in their tissues (tophi). Also, urate crystals
form in the synovial tissue, typically the metatarsophalangeal joint of the
great toe. Uric acid tends to precipitate and form deposits at various sites,
including cartilaginous tissue such as the ears. Urate deposits will not
form at the chin, buttocks, and abdomen because the blood flow is ample,
and it is not cartilaginous tissue.
The nurse prepares to instruct a client experiencing decreased and
difficult urination about an ordered cystoscopy. Identify the primary
purpose of the ordered diagnostic.
1 To ascertain the size of the kidneys
2 To ascertain the protein content in urine
3 To ascertain the presence of urethral wall abnormalities
4 To ascertain the total amount of catecholamines excreted - answer 3.
Cystoscopy is a procedure in which a diagnostician uses a cystoscope to
visualize and examine the inner walls of the urinary bladder and ureter.
The health care provider introduces the cystoscope into the client's ureter
to detect the presence of urethral wall abnormalities or occlusions.
Radiography or ultrasonography of the kidneys enables visualization of
the kidneys to determine their size. A 24-hour urine test analyzes the
levels of various components in the urine and is recommended to
ascertain the protein content in urine. The total amount of catecholamines
excreted in urine can also be measured through 24-hour urine sample
testing.
A client reports diminished sensations of pain, touch, and temperature on
the skin. The nurse touches the skin and finds it cool. Which skin changes
would the nurse relate to the client's findings?
1 Degenerated elastic fibers
, 2 Decreased blood flow to the skin
3 Increased melanocytes in basal layer
4 Decreased activity of the apocrine glands - answer 2. Decreased blood
flow to the skin may cause diminished sensations of pain, touch, and
temperature. The skin may also feel cold. Degeneration of elastic fibers
may cause increased wrinkling and sagging of the breasts. Increased
melanocytes in the basal layers may cause solar lentigines. Decreased
activity of the apocrine glands may be related to uneven skin color and
dry skin.
Which topical agent would be beneficial in preventing new lesions and
treating preexisting acne?
1 Doxycycline
2 Azelaic acid
3 Isotretinoin
4 Azithromycin - answer 2. Azelaic acid, a topical antibacterial, is used to
prevent new lesions and treat existing acne. Doxycycline and isotretinoin
may both be used to treat acne, but these are administered orally, not
topically. Azithromycin is not a medication of choice for treating acne.
The nurse is educating adolescents on using sunscreen to reduce skin
cancer risk. Which statement by an adolescent requires correction by the
nurse?
1 "I'll use sunscreen without lanolin."
2 "Sunscreen will be applied every 2 hours."
3 "I can use sunscreen with an alcohol-free base."
4 "I will use sunscreen with a sun protective factor (SPF) of 10." - answer
4. The nurse will recommend using sunscreen with an SPF of at least 15,
not 10. Adolescents using sunscreen without lanolin, with an alcohol-free
base, and applying it every 2 hours do not need correction by the nurse.
While assessing a client's skin, the nurse notices that the client's skin is
dry. Which is the probable cause of this condition? Select all that apply.
One, some, or all responses may be correct.
1 Use of hard soap
2 Frequent bathing
quizzing) exam questions and
answers
Which information about skin care would the nurse include in the teaching
plan for a client who is receiving radiation therapy?
1: "Cover the area with a sterile gauze dressing"
2: "Put warm compresses on the site once a day"
3: "Limit lying on the back and unaffected side when sleeping"
4: "Avoid applying lotions and powders over the area" - answer 4: Lotions
and powders can cause a skin reaction on irradiated areas and should be
avoided. Gauze and tape may irritate the skin further and should be
avoided. Warm compresses are contraindicated because they may
precipitate skin breakdown. The client can assume a position of comfort.
Which statement made by the parent of an infant receiving phototherapy
for jaundice would cause concern?
1: "I keep track of the number of wet diapers."
2: "My baby's skin is dry, so I applied a little lotion"
3: "I placed my baby under the lights dressed only in a diaper"
4: "I closed my baby's eyes before placing the mask over them" - answer
2: Lotions, creams, and ointments should not be applied to an infant's skin
during phototherapy because it can absorb heat and cause burns. The
infant should be placed under the phototherapy lights dressed only in a
diaper. The number of wet or soiled diapers is monitored because it is an
indicator of hydration status. The eyes of the infant should be closed
before placing the mask over the eyes to prevent scratching of the cornea.
A client has an abdominal cholecystectomy for treatment of a gangreous
gallbladder. Consider the location of the surgical site, the nurse would
assess the client for which postoperative complication?
1 Atelectasis
2 Hemorrhage
,3 Paralytic ileus
4 Wound infection - answer 1: Subcostal incisional pain causes the client
to splint and avoid deep breathing, which impedes air exchange in the
alveoli. The location of the incision does not increase risk of hemorrhage.
Paralytic ileus can be a postoperative problem, but is unrelated to the site
of incision. The subcostal incision site is not specifically vulnerable to
infection.
Which synovial movement is decribed as turning the sole away from the
midline of the body?
1: Pronation
2: Eversion
3: Adduction
4: Supination - answer 2. Eversion is a synovial joint movement that
describes turning the sole outward away from the midline of the body.
Pronation is a synovial joint movement that describes turning the palm
downward. Adduction is a movement toward midline. Supination is turning
the palm upward.
A client's IV cannula insertion site has become red, swollen, and warm to
the touch. Purulent drainage is also noted. Which intervention would be
implemented?
1: Temporarily slow the infusion rate to a "keep vein open" rate
2 Elevate the extremity slightly above the level of the client's heart
3 Frequently apply cold and warm compresses to the site
4 Clean the site with alcohol, remove the cannula, and save for culture. -
answer 4. A client with redness, swelling, and warmth with purulent
drainage at the insertion site may have an infection. The nurse should
clean the site immediately with alcohol and remove the catheter (if
vesicant medications were not infusing) because of the obvious
development of an infection. The nurse would also save the catheter for
obtaining a culture of the organism. Temporarily slowing the infusion is
not recommended because doing so may lead to a systemic spread of the
infection. Elevating the extremity may help with phlebitis, with
thrombosis, or with ecchymosis and hematoma. Application of cold and
warm compresses may reduce the pain in a client with thrombophlebitis.
However, the comprehensive initial reaction is to clean the site with
alcohol, remove the cannula, and save for culture. The nurse would then
insert another intravenous cannula at a different location.
,Which parts of a client's body would the nurse assess for the presence of
tophi (urate deposits)? Select all that apply. One, some, or all responses
may be correct
1 Feet
2 Ears
3 Chin
4 Buttocks
5 Abdomen - answer Feet and ears. Clients with gout may develop
deposits of monosodium urate in their tissues (tophi). Also, urate crystals
form in the synovial tissue, typically the metatarsophalangeal joint of the
great toe. Uric acid tends to precipitate and form deposits at various sites,
including cartilaginous tissue such as the ears. Urate deposits will not
form at the chin, buttocks, and abdomen because the blood flow is ample,
and it is not cartilaginous tissue.
The nurse prepares to instruct a client experiencing decreased and
difficult urination about an ordered cystoscopy. Identify the primary
purpose of the ordered diagnostic.
1 To ascertain the size of the kidneys
2 To ascertain the protein content in urine
3 To ascertain the presence of urethral wall abnormalities
4 To ascertain the total amount of catecholamines excreted - answer 3.
Cystoscopy is a procedure in which a diagnostician uses a cystoscope to
visualize and examine the inner walls of the urinary bladder and ureter.
The health care provider introduces the cystoscope into the client's ureter
to detect the presence of urethral wall abnormalities or occlusions.
Radiography or ultrasonography of the kidneys enables visualization of
the kidneys to determine their size. A 24-hour urine test analyzes the
levels of various components in the urine and is recommended to
ascertain the protein content in urine. The total amount of catecholamines
excreted in urine can also be measured through 24-hour urine sample
testing.
A client reports diminished sensations of pain, touch, and temperature on
the skin. The nurse touches the skin and finds it cool. Which skin changes
would the nurse relate to the client's findings?
1 Degenerated elastic fibers
, 2 Decreased blood flow to the skin
3 Increased melanocytes in basal layer
4 Decreased activity of the apocrine glands - answer 2. Decreased blood
flow to the skin may cause diminished sensations of pain, touch, and
temperature. The skin may also feel cold. Degeneration of elastic fibers
may cause increased wrinkling and sagging of the breasts. Increased
melanocytes in the basal layers may cause solar lentigines. Decreased
activity of the apocrine glands may be related to uneven skin color and
dry skin.
Which topical agent would be beneficial in preventing new lesions and
treating preexisting acne?
1 Doxycycline
2 Azelaic acid
3 Isotretinoin
4 Azithromycin - answer 2. Azelaic acid, a topical antibacterial, is used to
prevent new lesions and treat existing acne. Doxycycline and isotretinoin
may both be used to treat acne, but these are administered orally, not
topically. Azithromycin is not a medication of choice for treating acne.
The nurse is educating adolescents on using sunscreen to reduce skin
cancer risk. Which statement by an adolescent requires correction by the
nurse?
1 "I'll use sunscreen without lanolin."
2 "Sunscreen will be applied every 2 hours."
3 "I can use sunscreen with an alcohol-free base."
4 "I will use sunscreen with a sun protective factor (SPF) of 10." - answer
4. The nurse will recommend using sunscreen with an SPF of at least 15,
not 10. Adolescents using sunscreen without lanolin, with an alcohol-free
base, and applying it every 2 hours do not need correction by the nurse.
While assessing a client's skin, the nurse notices that the client's skin is
dry. Which is the probable cause of this condition? Select all that apply.
One, some, or all responses may be correct.
1 Use of hard soap
2 Frequent bathing
