HESI Fun dam en tals V.2 Exam Questions w ith
100% Verified Cor rect Answ er s
1. The nurse observes a newly admitted older adult female take short steps
and walk very slowly while pushing a walker in front of her. What action
should the nurse take in response to these observations?
A) Complete a full fall risk assessment of the client.
B) Teach the client to take longer steps at faster pace.
C) Suggest that the client use a wheelchair instead of a walker.
D) Place client on bedrest until the healthcare provider is notified.
Correct A) Complete a full fall risk assessment of the client.
2. While suctioning a client's nasopharynx, the nurse observes that the client's
oxygen saturation remains at 94%, which is the same reading obtained prior to
starting the procedure. What action should the nurse take in response to this
finding?
A) Reposition the pulse oximeter clip to obtain a new reading.
B) Stop suctioning until the pulse oximeter reading is above 95%.
C) Complete the intermittent suction of the nasopharynx.
D)Apply an oxygen mask over the client's nose and mouth.
,Correct C) Complete the intermittent suction of the nasopharynx.
3. An older woman with end stage heart disease is hospitalized for severe
heart failure. She is alert, oriented, and requests that no heroic measures are
implemented if her breathing stops. What action should the nurse take
first?
A) Discuss with the client her meaning of heroic measures.
B) Obtain a "do not resuscitate" (DNR) prescription.
C) Set up a family conference to discuss the client's.
D)Consult the palliative care team about client's care.
Correct A) Discuss with the client her meaning of heroic measures.
4. A client diagnosed with primary open-angle glaucoma received a prescription
for biotic eye drops, pilocarpine HCl (Pilocarpine). What instruction should the
nurse plan to include in this client's teaching?
A) "Do not allow the dropper bottle to touch the eye."
B) "Administer the medication directly on the cornea."
C) "Squeeze your eye closed after administering the drops."
D) "Wash your hands after each administration of eye drops."
Correct A) "Do not allow the dropper bottle to touch the eye."
,5. When assessing a client who starts to wheeze related data should obtain?
A) Presence of radiation.
B) Heart sounds.
C) Body temperature.
D) Precipitating factors.
Correct D) Precipitating factors.
6. The home health nurse is reviewing the personal care of an elderly client
who lives alone. Which client assessment findings indicate the need to assign
unlicensed assistive personnel (UAP) to provide routine foot care and file the
client's toenails? Select all that apply.
A) Syncope when bending.
B) Hand tremors.
C) Diminished visual acuity.
D) Urinary incontinence.
E)Shuffling gait.
Correct A) Syncope when bending.
B) Hand tremors.
C) Diminished visual acuity.
, 7. A client is discharged to a long-term care facility with an indwelling
urinary catheter. Which nursing action should be included in the plan to
reduce the client's risk for infection related to the catheter?
A) Flush the catheter daily with sterile saline.
B) Encourage increased intake of oral fluids.
C) Administer a PRN antipyretic if a fever develops.
D) Secure the drainage bag at bladder level during transport.
Correct B) Encourage increased intake of oral fluids.
8. To assess the quality of an adult client's pain, what approach should the nurse
use?
A) Observe body language and movement.
B) Provide a numeric pain scale.
C) Ask the client to describe the pain.
D) Identify effective pain relief measures.
Correct C) Ask the client to describe the pain.
9. A client who has been diagnosed with terminal cancer tells the nurse,
"The doctor told me I have cancer and do not have long to live." Which
response is best for the nurse to provide?
100% Verified Cor rect Answ er s
1. The nurse observes a newly admitted older adult female take short steps
and walk very slowly while pushing a walker in front of her. What action
should the nurse take in response to these observations?
A) Complete a full fall risk assessment of the client.
B) Teach the client to take longer steps at faster pace.
C) Suggest that the client use a wheelchair instead of a walker.
D) Place client on bedrest until the healthcare provider is notified.
Correct A) Complete a full fall risk assessment of the client.
2. While suctioning a client's nasopharynx, the nurse observes that the client's
oxygen saturation remains at 94%, which is the same reading obtained prior to
starting the procedure. What action should the nurse take in response to this
finding?
A) Reposition the pulse oximeter clip to obtain a new reading.
B) Stop suctioning until the pulse oximeter reading is above 95%.
C) Complete the intermittent suction of the nasopharynx.
D)Apply an oxygen mask over the client's nose and mouth.
,Correct C) Complete the intermittent suction of the nasopharynx.
3. An older woman with end stage heart disease is hospitalized for severe
heart failure. She is alert, oriented, and requests that no heroic measures are
implemented if her breathing stops. What action should the nurse take
first?
A) Discuss with the client her meaning of heroic measures.
B) Obtain a "do not resuscitate" (DNR) prescription.
C) Set up a family conference to discuss the client's.
D)Consult the palliative care team about client's care.
Correct A) Discuss with the client her meaning of heroic measures.
4. A client diagnosed with primary open-angle glaucoma received a prescription
for biotic eye drops, pilocarpine HCl (Pilocarpine). What instruction should the
nurse plan to include in this client's teaching?
A) "Do not allow the dropper bottle to touch the eye."
B) "Administer the medication directly on the cornea."
C) "Squeeze your eye closed after administering the drops."
D) "Wash your hands after each administration of eye drops."
Correct A) "Do not allow the dropper bottle to touch the eye."
,5. When assessing a client who starts to wheeze related data should obtain?
A) Presence of radiation.
B) Heart sounds.
C) Body temperature.
D) Precipitating factors.
Correct D) Precipitating factors.
6. The home health nurse is reviewing the personal care of an elderly client
who lives alone. Which client assessment findings indicate the need to assign
unlicensed assistive personnel (UAP) to provide routine foot care and file the
client's toenails? Select all that apply.
A) Syncope when bending.
B) Hand tremors.
C) Diminished visual acuity.
D) Urinary incontinence.
E)Shuffling gait.
Correct A) Syncope when bending.
B) Hand tremors.
C) Diminished visual acuity.
, 7. A client is discharged to a long-term care facility with an indwelling
urinary catheter. Which nursing action should be included in the plan to
reduce the client's risk for infection related to the catheter?
A) Flush the catheter daily with sterile saline.
B) Encourage increased intake of oral fluids.
C) Administer a PRN antipyretic if a fever develops.
D) Secure the drainage bag at bladder level during transport.
Correct B) Encourage increased intake of oral fluids.
8. To assess the quality of an adult client's pain, what approach should the nurse
use?
A) Observe body language and movement.
B) Provide a numeric pain scale.
C) Ask the client to describe the pain.
D) Identify effective pain relief measures.
Correct C) Ask the client to describe the pain.
9. A client who has been diagnosed with terminal cancer tells the nurse,
"The doctor told me I have cancer and do not have long to live." Which
response is best for the nurse to provide?
