HESI: Practice Test Assessment Performance
Questions and Verified Answers
The nurse hears short, high-pitched sounds just before the end of inspiration in the right and left lower
lobes when auscultating a client's lungs. How should this finding be recorded?
A. Inspiratory wheezes in both lungs
B. Crackles in the right and left lower lobes
C. Abdominal lung sounds in the bases of both lungs
D. Pleural friction rub in the right and left lower lobes Correct Answer: B
Fine crackles are short, high pitched sounds heard just before the end of inspiration that are the result of
rapid equalization of pressure when collapsed alveoli or terminal bronchioles suddenly snap open.
Wheezing (A) is a continuous high pitched squeaking or musical sound caused by rapid vibration of
bronchial walls that are first evident on expiration and may be audible. Although (C) describes an
adventitious lung sound, the documentation is vague. (D) is a creaking or grating sound from roughened,
inflamed surfaces of the pleura rubbing together heard during inspiration, expiration, and with no
change during coughing.
The nurse is assessing an older client and determines that the client's left upper eyelid droops, covering
more of the iris than the right eyelid. Which description should the nurse use to document this finding?
A. Ptosis on the left eyelid
B. A nystagmus on the left
C. Astigmatism on the right
D. Exophthalmos on the right Correct Answer: A
Ptosis is the term used to describe an eyelid droop that covers a large portion of the iris, which may
result from oculomotor nerve or eyelid muscle disorder. (B) is characterized by rapid, rhythmic
movement of both eyes. (C) is a distortion of the lens of the eye, causing decreased visual acuity. (D) is a
term used to describe a protrusion of the eyeballs that occurs with hyperthyroidism
A client's family asks why their mother with heart failure needs a pulmonary artery catheter now that
she is in the ICU. What information should the nurse include in the explanation to the family?
,A. A central monitoring system reduces the risk of complications undetected by observation
B. A pulmonary artery catheter measures central pressure for monitoring fluid replacement
C. Pulmonary artery catheters allow for early detection of lung problems
D. The healthcare provider should explain the many reasons for its use. Correct Answer: B
Pulmonary artery catheters are used to measure central pressures and fluid balance. Even though all
clients in the ICU require close monitoring, they do not all need a PA catheter (A). PA lines do not
detect pulmonary problems (C). (D) avoids the family's question.
Several hours after surgical repair of an abdominal aortic aneurysm, the client develops left flank pain.
The nurse determines the client's urinary output is 20 mL/hr for the past 2 hours. The nurse should
conclude that these findings support which complication?
A. Infection
B. Hypovolemia
C. Intestinal ischemia
D. Renal artery embolization Correct Answer: D
Postoperative complications of surgical repair of AAA are related to the location of resection, graft, or
stent placement along the abdominal aorta. Embolization of a fragment of thrombus or plaque from the
aorta into a renal artery can compromise blood flow in one of the renal arteries, resulting in renal
ischemia that precipitates unilateral flank pain. Intraoperative blood loss or rupture of the aorta
anastomosis can cause acute renal failure related to hypovolemia (B), which involves both kidneys and
causing bilateral flank pain. (A) and (C) are not associated with these symptoms
The nurse is assessing a postmenopausal woman who is complaining of urinary urgency and frequency
and stress incontinence. She also reports difficulty emptying her bladder. These complaints are most
likely due to which condition?
A. Cystocele
B. Bladder infection
C. Pyelonephritis
, D. Irritable bladder Correct Answer: A
This constellation of signs in a postmenopausal woman are characteristic of cystocele. These symptoms
are not characteristic of (B), (C), or (D)
A male client who has never smoked by has had COPD is now being assessed for cancer of the lung. The
nurse knows that he is most likely to develop which type of lung cancer?
A. Adenocarcinoma
B. Oat-cell carcinoma
C. Malignant melanoma
D. Squamous cell carcinoma Correct Answer: A
Adenocarcinoma is the only lung cancer not related to cigarette smoking. It has been found to be
directly related to lung scarring and fibrosis from preexisting pulmonary disease such as TB or COPD.
Both (B) and (D) are malignant lung cancers related to cigarette smoking. (C) is a skin cancer and is
related to sunlight, not to lung problems
Muscular Dystrophy is characterized by which pathophysiological condition?
A. Stressed induced tremor and trembling
B. Cardiac damage
C. Seizure activity
D. Skeletal muscle degeneration Correct Answer: D
Skeletal muscle degeneration is a classic symptom of muscular dystrophy. Tremors and trembling (A) of
hands, particularly when stressed are symptoms of Parkinson's. Cardiac damage (B) and seizures (C) are
not exclusive to muscular dystrophy
The nurse is preparing to administer atropine, an anticholinergic, to a client who is scheduled for a
cholecystectomy. The client asks the nurse to explain the reason for the prescribed medication. What is
the best response for the nurse to provide?
A. Provide a more rapid induction of anesthesia
Questions and Verified Answers
The nurse hears short, high-pitched sounds just before the end of inspiration in the right and left lower
lobes when auscultating a client's lungs. How should this finding be recorded?
A. Inspiratory wheezes in both lungs
B. Crackles in the right and left lower lobes
C. Abdominal lung sounds in the bases of both lungs
D. Pleural friction rub in the right and left lower lobes Correct Answer: B
Fine crackles are short, high pitched sounds heard just before the end of inspiration that are the result of
rapid equalization of pressure when collapsed alveoli or terminal bronchioles suddenly snap open.
Wheezing (A) is a continuous high pitched squeaking or musical sound caused by rapid vibration of
bronchial walls that are first evident on expiration and may be audible. Although (C) describes an
adventitious lung sound, the documentation is vague. (D) is a creaking or grating sound from roughened,
inflamed surfaces of the pleura rubbing together heard during inspiration, expiration, and with no
change during coughing.
The nurse is assessing an older client and determines that the client's left upper eyelid droops, covering
more of the iris than the right eyelid. Which description should the nurse use to document this finding?
A. Ptosis on the left eyelid
B. A nystagmus on the left
C. Astigmatism on the right
D. Exophthalmos on the right Correct Answer: A
Ptosis is the term used to describe an eyelid droop that covers a large portion of the iris, which may
result from oculomotor nerve or eyelid muscle disorder. (B) is characterized by rapid, rhythmic
movement of both eyes. (C) is a distortion of the lens of the eye, causing decreased visual acuity. (D) is a
term used to describe a protrusion of the eyeballs that occurs with hyperthyroidism
A client's family asks why their mother with heart failure needs a pulmonary artery catheter now that
she is in the ICU. What information should the nurse include in the explanation to the family?
,A. A central monitoring system reduces the risk of complications undetected by observation
B. A pulmonary artery catheter measures central pressure for monitoring fluid replacement
C. Pulmonary artery catheters allow for early detection of lung problems
D. The healthcare provider should explain the many reasons for its use. Correct Answer: B
Pulmonary artery catheters are used to measure central pressures and fluid balance. Even though all
clients in the ICU require close monitoring, they do not all need a PA catheter (A). PA lines do not
detect pulmonary problems (C). (D) avoids the family's question.
Several hours after surgical repair of an abdominal aortic aneurysm, the client develops left flank pain.
The nurse determines the client's urinary output is 20 mL/hr for the past 2 hours. The nurse should
conclude that these findings support which complication?
A. Infection
B. Hypovolemia
C. Intestinal ischemia
D. Renal artery embolization Correct Answer: D
Postoperative complications of surgical repair of AAA are related to the location of resection, graft, or
stent placement along the abdominal aorta. Embolization of a fragment of thrombus or plaque from the
aorta into a renal artery can compromise blood flow in one of the renal arteries, resulting in renal
ischemia that precipitates unilateral flank pain. Intraoperative blood loss or rupture of the aorta
anastomosis can cause acute renal failure related to hypovolemia (B), which involves both kidneys and
causing bilateral flank pain. (A) and (C) are not associated with these symptoms
The nurse is assessing a postmenopausal woman who is complaining of urinary urgency and frequency
and stress incontinence. She also reports difficulty emptying her bladder. These complaints are most
likely due to which condition?
A. Cystocele
B. Bladder infection
C. Pyelonephritis
, D. Irritable bladder Correct Answer: A
This constellation of signs in a postmenopausal woman are characteristic of cystocele. These symptoms
are not characteristic of (B), (C), or (D)
A male client who has never smoked by has had COPD is now being assessed for cancer of the lung. The
nurse knows that he is most likely to develop which type of lung cancer?
A. Adenocarcinoma
B. Oat-cell carcinoma
C. Malignant melanoma
D. Squamous cell carcinoma Correct Answer: A
Adenocarcinoma is the only lung cancer not related to cigarette smoking. It has been found to be
directly related to lung scarring and fibrosis from preexisting pulmonary disease such as TB or COPD.
Both (B) and (D) are malignant lung cancers related to cigarette smoking. (C) is a skin cancer and is
related to sunlight, not to lung problems
Muscular Dystrophy is characterized by which pathophysiological condition?
A. Stressed induced tremor and trembling
B. Cardiac damage
C. Seizure activity
D. Skeletal muscle degeneration Correct Answer: D
Skeletal muscle degeneration is a classic symptom of muscular dystrophy. Tremors and trembling (A) of
hands, particularly when stressed are symptoms of Parkinson's. Cardiac damage (B) and seizures (C) are
not exclusive to muscular dystrophy
The nurse is preparing to administer atropine, an anticholinergic, to a client who is scheduled for a
cholecystectomy. The client asks the nurse to explain the reason for the prescribed medication. What is
the best response for the nurse to provide?
A. Provide a more rapid induction of anesthesia
