HESI BSN 366 EAQ P a g e | 1
HESI BSN 366 EAQ Practice Test A Results -
Questions and 100% Correct Answers With
Rationales/ Nightingale BSN 366 Concepts of
Nursing IV HESI Practice Exam Latest (New!)
graded A+ GUARANTEED PASS– Correctly
Answers Questions with Rationales
Which data obtained during a respiratory assessment for a 78-year-old client is most important to
report to the primary health care provider?
A.Auscultation of vesicular breath sounds
B.Pulse oximetry reading of 89%
C.Arterial Pao2 of 86%
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, HESI BSN 366 EAQ P a g e | 2
D.Resonance on percussion of the lungs
B
Rationale:
The nurse may delegate obtaining vital signs and O2 saturation; however, the nurse is responsible for
following up on any reported data (B). (A, C, and D) are all part of the nursing process and should not
be delegated under the nurse's scope of practice.
When caring for a client with a tracheostomy, which intervention should the nurse delegate to the
unlicensed assistive personnel (UAP)?
A.Teach the family about signs and symptoms of hypoxia.
B.Take the vital signs and obtain an O2 saturation level.
C.Evaluate the need for tracheal suctioning.
D.Revise the plan of care to include tracheostomy care.
B
Rationale:
Defibrillation is the first and most effective emergency treatment for ventricular fibrillation (B). The
others may follow the first action (A, C, and D)
The nurse who is preparing to give a 14-year-old client a prescribed antipsychotic medication notes
that parental consent has not been obtained. Which action should the nurse take?
A.
Review the chart for a signed consent for hospitalization.
B.
Get the health care provider's permission to give the medication.
C.
Do not give the medication and document the reason.
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, HESI BSN 366 EAQ P a g e | 3
D.
Complete an incident report and notify the parents. –
Correct Answer :C
Rationale:
The nurse should not give the medication and should document the reason because the client is a
minor and needs a guardian's permission to receive medications. Permission to give medications is not
granted by a signed hospital consent or a health care provider's permission, unless conditions are met
to justify coerced treatment. Option D is not necessary unless the medication had previously been
administered.
After the nurse tells an older client that an IV line needs to be inserted, the client becomes very
apprehensive, loudly verbalizing a dislike for all health care providers and nurses. How should the
nurse respond?
A.
Ask the client to remain quiet so the procedure can be performed safely.
B.
Concentrate on completing the insertion as efficiently as possible.
C.
Calmly reassure the client that the discomfort will be temporary.
D.
Tell the client a joke as a means of distraction from the procedure –
Correct Answer :C
Rationale:
The nurse should respond with a calm demeanor to help reduce the client's apprehension. After
responding calmly to the client's apprehension, the nurse may implement to ensure safe completion
of the procedure.
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, HESI BSN 366 EAQ P a g e | 4
The nurse worked with a client to alleviate pain with aroma and relaxation therapy. Twenty minutes
after working with the client, the nurse returns to the room and finds the client's eyes are closed and
breathing deeply. What is the best entry for the nurse to document this finding?
A.
Client sleeping
B.
Pain medication working
C.
Eyes closed, deeply breathing
D.
Effective use of alternative therapy –
Correct Answer :C
Rationale:
The purpose of charting is to document the client's response to care. Charting must be objective. The
client could still be awake, and in a calm state. Clients can sleep through pain, especially if the client
has chronic pain. There is no mention of pain medication in the questions. Chart the client's response
to the care; while the method of achieving relaxation is important, it is not the most important.
The postoperative nurse is reviewing the use of an incentive spirometer. Which instructions will the
nurse include in the client's teaching plan? (Select all that apply.)
A.
Sit in an upright position.
B.
Cough deeply three times.
C.
Hold breath for 5 seconds after inhaling on the spirometer.
D.
Place mouth securely around the mouthpiece of the spirometer.
P a g e 4 | 139
HESI BSN 366 EAQ Practice Test A Results -
Questions and 100% Correct Answers With
Rationales/ Nightingale BSN 366 Concepts of
Nursing IV HESI Practice Exam Latest (New!)
graded A+ GUARANTEED PASS– Correctly
Answers Questions with Rationales
Which data obtained during a respiratory assessment for a 78-year-old client is most important to
report to the primary health care provider?
A.Auscultation of vesicular breath sounds
B.Pulse oximetry reading of 89%
C.Arterial Pao2 of 86%
P a g e 1 | 139
, HESI BSN 366 EAQ P a g e | 2
D.Resonance on percussion of the lungs
B
Rationale:
The nurse may delegate obtaining vital signs and O2 saturation; however, the nurse is responsible for
following up on any reported data (B). (A, C, and D) are all part of the nursing process and should not
be delegated under the nurse's scope of practice.
When caring for a client with a tracheostomy, which intervention should the nurse delegate to the
unlicensed assistive personnel (UAP)?
A.Teach the family about signs and symptoms of hypoxia.
B.Take the vital signs and obtain an O2 saturation level.
C.Evaluate the need for tracheal suctioning.
D.Revise the plan of care to include tracheostomy care.
B
Rationale:
Defibrillation is the first and most effective emergency treatment for ventricular fibrillation (B). The
others may follow the first action (A, C, and D)
The nurse who is preparing to give a 14-year-old client a prescribed antipsychotic medication notes
that parental consent has not been obtained. Which action should the nurse take?
A.
Review the chart for a signed consent for hospitalization.
B.
Get the health care provider's permission to give the medication.
C.
Do not give the medication and document the reason.
P a g e 2 | 139
, HESI BSN 366 EAQ P a g e | 3
D.
Complete an incident report and notify the parents. –
Correct Answer :C
Rationale:
The nurse should not give the medication and should document the reason because the client is a
minor and needs a guardian's permission to receive medications. Permission to give medications is not
granted by a signed hospital consent or a health care provider's permission, unless conditions are met
to justify coerced treatment. Option D is not necessary unless the medication had previously been
administered.
After the nurse tells an older client that an IV line needs to be inserted, the client becomes very
apprehensive, loudly verbalizing a dislike for all health care providers and nurses. How should the
nurse respond?
A.
Ask the client to remain quiet so the procedure can be performed safely.
B.
Concentrate on completing the insertion as efficiently as possible.
C.
Calmly reassure the client that the discomfort will be temporary.
D.
Tell the client a joke as a means of distraction from the procedure –
Correct Answer :C
Rationale:
The nurse should respond with a calm demeanor to help reduce the client's apprehension. After
responding calmly to the client's apprehension, the nurse may implement to ensure safe completion
of the procedure.
P a g e 3 | 139
, HESI BSN 366 EAQ P a g e | 4
The nurse worked with a client to alleviate pain with aroma and relaxation therapy. Twenty minutes
after working with the client, the nurse returns to the room and finds the client's eyes are closed and
breathing deeply. What is the best entry for the nurse to document this finding?
A.
Client sleeping
B.
Pain medication working
C.
Eyes closed, deeply breathing
D.
Effective use of alternative therapy –
Correct Answer :C
Rationale:
The purpose of charting is to document the client's response to care. Charting must be objective. The
client could still be awake, and in a calm state. Clients can sleep through pain, especially if the client
has chronic pain. There is no mention of pain medication in the questions. Chart the client's response
to the care; while the method of achieving relaxation is important, it is not the most important.
The postoperative nurse is reviewing the use of an incentive spirometer. Which instructions will the
nurse include in the client's teaching plan? (Select all that apply.)
A.
Sit in an upright position.
B.
Cough deeply three times.
C.
Hold breath for 5 seconds after inhaling on the spirometer.
D.
Place mouth securely around the mouthpiece of the spirometer.
P a g e 4 | 139
