BSN HESI 266 Exam Questions and Answers (LATEST UPDATE)
d d d d d d d d
(VERIFIED ELABORATIONS) d d
Client is recovering from a transurethral prostatectomy. Which activity should be limited until after
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the first postoperative visit with the healthcare provider?
d d d d d d d d
Drink 3L d
A client with stage IV bone cancer is admitted to the hospital for a 1-10 scale. Which
d d d d d d d d d d d d d d d d
intervention should the nurse implement?
d d d d d
Administer opioid and non-opioid medications simultaneously
d d d d d
A client experiences an AOB incompatibility reaction after multiple blood transfusions. Which
d d d d d d d d d d d
finding should the nurse report immediately to the health care provider?
d d d d d d d d d d d
a. low back pain and hypotension
d d d d
b. rhinitis and nasal stuffiness d d d
c. delayed painful rash with urticarial d d d d
d. arthritic joint changes and chronic pain d d d d d
a. low back pain and hypotension
d d d d
ANSWER: (A) LOW BACK PAIN AND HYPOTENSTION d d d d d d
When conducting discharge teaching for a client
d d d d d d
diagnosed with diverticulosis, which diet instruction should the nurse include?
d d d d d d d d d
a. Have small frequent meals and sit up for at least two hours after meals.
d d d d d d d d d d d d d
b. Eat a bland diet and avoid spicy foods.
d d d d d d d
c. Eat a high fiber diet and increase fluid intake.
d d d d d d d d
d. Eat a soft diet with increased intake of milk and milk products
d d d d d d d d d d d
c. Eat a high fiber diet and increase fluid intake.
d d d d d d d d d
ANSWER (C) EAT A HIGH-FIBER DIET AND INCREASE FLUID INTAKE
d d d d d d d d d
,The nurse observes an increased number of blood clots in the drainage tubing of a client with
d d d d d d d d d d d d d d d d
continuous bladder irrigation following a transurethral resection of the prostate (TURP). What is
d d d d d d d d d d d d d
the best initial nursing action?
d d d d d
a. Provide additional oral fluid intake d d d d
b. Measure the client's intake and output. d d d d d
c. Increase the flow of the d d d d
bladder irrigation
d d
d. Administer a PRN dose of an antispasmodic agent d d d d d d d
c. Increase the flow of the bladder irrigation
d d d d d d d
ANSWER (C) Increase the flow of the bladder irrigation d d d d d d d d
dWe have an expert-written solution to this
d d d d d d
problem!
A client wit lung cancer who wears a subcutaneous morphine sulfate patch for pain is short of breath
d d d d d d d d d d d d d d d d d
and difficult to arouse. When performing a head
d d d d d d d d
-to-toe assessment, the nurse discovers four analgesic patches on
d d d d d d d d
Remove all morphine patches d d d
Coming down the basement steps, a client is brought to the emergency room X-ray ... cast, which
d d d d d d d d d d d d d d d d
assessment finding warrants immediate
d d d d
Intervention by the nurse? d d d
Right foot pale with sluggish capillary refill An
d d d d d d d
overweight, young adult who was
d d d d d
recently Check finger stick glucose diagnosed with type 2 diabetes mellitus is admitted for a hernia
d d d d d d d d d d d d d d d
repair. He tells the nurse that he is feeling very weak and jittery.
d d d d d d d d d d d d d
Which actions should the nurse implement?
d d d d d
(Select all that apply.)
d d d d
a. Check finger d
stick glucose
d d
b. Assess skin temperature d d
and moisture
d d
, c. Measure pulse and d d
blood pressure
d d
a. Check finger d
stick glucose
d d
b. Assess skin temperature d d
and moisture
d d
c. Measure pulse and d d
blood pressure
d d
ANSWER: (CAM) d
A client who underwent cardiac stent placement four days ago arrives to the
d d d d d d d d d d d d
emergency department reporting a sudden onset of chest pressure and shortness
d d d d d d d d d d d
of breath. Which action should the nurse take next?
d d d d d d d d d
a. Listen for extra heart sounds, murmurs, and r
d d d d d d d
hythm with the bell of
d d d d d
the stethoscope.
d
b. Evaluate upper and lower extremities for perfusion, pulse
d d d d d d d
volume, and pitting edema.
d d d d
c. Verify troponin level assessments are scheduled every 3-6 hours for a series of three.
d d d d d d d d d d d d d
d. Obtain a 12-lead electrocardiogram and begin continuous cardiac monitoring
d d d d d d d d
.
d. Obtain a 12-lead electrocardiogram and begin continuous cardiac monitoring
d d d d d d d d d
While completing a health assessment for a client with migraine headaches, the nurse assesses
d d d d d d d d d d d d d
bilateral weakness in the clients hand grips. The client reports joint pain and trouble twisting a door
d d d d d d d d d d d d d d d d d
knob due to weaknesses. Which action should the nurses take in response to these figures?
d d d d d d d d d d d d d d d
a. Implement fall precautions to reduce the clients risk of injury. d d d d d d d d d
b. Explain that relief of the migraine pain will reduce related symptoms.
d d d d d d d d d d
c. Gather additional assessment data about the pain and weakness.
d d d d d d d d
d. Consult with the occupational therapist for a functional assessment
d d d d d d d d
c. Gather additional assessment data about the pain and weakness.
d d d d d d d d d
d d d d d d d d
(VERIFIED ELABORATIONS) d d
Client is recovering from a transurethral prostatectomy. Which activity should be limited until after
d d d d d d d d d d d d d
the first postoperative visit with the healthcare provider?
d d d d d d d d
Drink 3L d
A client with stage IV bone cancer is admitted to the hospital for a 1-10 scale. Which
d d d d d d d d d d d d d d d d
intervention should the nurse implement?
d d d d d
Administer opioid and non-opioid medications simultaneously
d d d d d
A client experiences an AOB incompatibility reaction after multiple blood transfusions. Which
d d d d d d d d d d d
finding should the nurse report immediately to the health care provider?
d d d d d d d d d d d
a. low back pain and hypotension
d d d d
b. rhinitis and nasal stuffiness d d d
c. delayed painful rash with urticarial d d d d
d. arthritic joint changes and chronic pain d d d d d
a. low back pain and hypotension
d d d d
ANSWER: (A) LOW BACK PAIN AND HYPOTENSTION d d d d d d
When conducting discharge teaching for a client
d d d d d d
diagnosed with diverticulosis, which diet instruction should the nurse include?
d d d d d d d d d
a. Have small frequent meals and sit up for at least two hours after meals.
d d d d d d d d d d d d d
b. Eat a bland diet and avoid spicy foods.
d d d d d d d
c. Eat a high fiber diet and increase fluid intake.
d d d d d d d d
d. Eat a soft diet with increased intake of milk and milk products
d d d d d d d d d d d
c. Eat a high fiber diet and increase fluid intake.
d d d d d d d d d
ANSWER (C) EAT A HIGH-FIBER DIET AND INCREASE FLUID INTAKE
d d d d d d d d d
,The nurse observes an increased number of blood clots in the drainage tubing of a client with
d d d d d d d d d d d d d d d d
continuous bladder irrigation following a transurethral resection of the prostate (TURP). What is
d d d d d d d d d d d d d
the best initial nursing action?
d d d d d
a. Provide additional oral fluid intake d d d d
b. Measure the client's intake and output. d d d d d
c. Increase the flow of the d d d d
bladder irrigation
d d
d. Administer a PRN dose of an antispasmodic agent d d d d d d d
c. Increase the flow of the bladder irrigation
d d d d d d d
ANSWER (C) Increase the flow of the bladder irrigation d d d d d d d d
dWe have an expert-written solution to this
d d d d d d
problem!
A client wit lung cancer who wears a subcutaneous morphine sulfate patch for pain is short of breath
d d d d d d d d d d d d d d d d d
and difficult to arouse. When performing a head
d d d d d d d d
-to-toe assessment, the nurse discovers four analgesic patches on
d d d d d d d d
Remove all morphine patches d d d
Coming down the basement steps, a client is brought to the emergency room X-ray ... cast, which
d d d d d d d d d d d d d d d d
assessment finding warrants immediate
d d d d
Intervention by the nurse? d d d
Right foot pale with sluggish capillary refill An
d d d d d d d
overweight, young adult who was
d d d d d
recently Check finger stick glucose diagnosed with type 2 diabetes mellitus is admitted for a hernia
d d d d d d d d d d d d d d d
repair. He tells the nurse that he is feeling very weak and jittery.
d d d d d d d d d d d d d
Which actions should the nurse implement?
d d d d d
(Select all that apply.)
d d d d
a. Check finger d
stick glucose
d d
b. Assess skin temperature d d
and moisture
d d
, c. Measure pulse and d d
blood pressure
d d
a. Check finger d
stick glucose
d d
b. Assess skin temperature d d
and moisture
d d
c. Measure pulse and d d
blood pressure
d d
ANSWER: (CAM) d
A client who underwent cardiac stent placement four days ago arrives to the
d d d d d d d d d d d d
emergency department reporting a sudden onset of chest pressure and shortness
d d d d d d d d d d d
of breath. Which action should the nurse take next?
d d d d d d d d d
a. Listen for extra heart sounds, murmurs, and r
d d d d d d d
hythm with the bell of
d d d d d
the stethoscope.
d
b. Evaluate upper and lower extremities for perfusion, pulse
d d d d d d d
volume, and pitting edema.
d d d d
c. Verify troponin level assessments are scheduled every 3-6 hours for a series of three.
d d d d d d d d d d d d d
d. Obtain a 12-lead electrocardiogram and begin continuous cardiac monitoring
d d d d d d d d
.
d. Obtain a 12-lead electrocardiogram and begin continuous cardiac monitoring
d d d d d d d d d
While completing a health assessment for a client with migraine headaches, the nurse assesses
d d d d d d d d d d d d d
bilateral weakness in the clients hand grips. The client reports joint pain and trouble twisting a door
d d d d d d d d d d d d d d d d d
knob due to weaknesses. Which action should the nurses take in response to these figures?
d d d d d d d d d d d d d d d
a. Implement fall precautions to reduce the clients risk of injury. d d d d d d d d d
b. Explain that relief of the migraine pain will reduce related symptoms.
d d d d d d d d d d
c. Gather additional assessment data about the pain and weakness.
d d d d d d d d
d. Consult with the occupational therapist for a functional assessment
d d d d d d d d
c. Gather additional assessment data about the pain and weakness.
d d d d d d d d d
