N220 HESI EXAM COMPLETE QUESTIONS WITH 100%
VERIFIED ANSWERS AND DETAILED RATIONALE
1. Which information about mammograms is most important to
provide a post-menopausal female client?
A. Breast self-examinations are not needed if annual mammograms are
obtained.
B. Radiation exposure is minimized by shielding the abdomen with a
lead-lined apron.
C. Yearly mammograms should be done regardless of previous normal x-
rays.
D. Women at high risk should have annual routine and ultrasound
mammograms.
Correct Answer: C. Yearly mammograms should be done regardless of
previous normal x-rays.
Explanation: Post-menopausal women should continue annual
mammograms because breast cancer risk increases with age. Previous
normal results do not eliminate the need for ongoing screening, as new
cancers can develop between examinations. The American Cancer
Society recommends yearly mammograms for women aged 45-54 and
every 2 years for those 55 and older who are in good health.
,2. Which client should the nurse recognize as most likely to experience
sleep apnea?
A. Middle-aged female who takes a diuretic nightly.
B. Obese older male client with a short, thick neck.
C. Adolescent female with a history of tonsillectomy.
D. School-aged male with a history of hyperactivity disorder.
Correct Answer: B. Obese older male client with a short, thick neck.
Explanation: Obstructive sleep apnea is most commonly associated with
obesity, male gender, older age, and anatomic features such as a short,
thick neck. Excess adipose tissue in the upper airway narrows the
pharyngeal lumen, increasing the risk of airway collapse during sleep.
Classic signs include loud snoring, witnessed apneas, and excessive
daytime sleepiness.
3. A client is admitted to the hospital with a diagnosis of severe acute
diverticulitis. Which assessment finding should the nurse expect this
client to exhibit?
A. Lower left quadrant pain and a low-grade fever.
B. Severe pain at McBurney's point and nausea.
C. Abdominal pain and intermittent tenesmus.
D. Exacerbations of severe diarrhea.
Correct Answer: A. Lower left quadrant pain and a low-grade fever.
Explanation: Acute diverticulitis typically presents with localized pain in
the lower left quadrant (sigmoid colon area) accompanied by fever,
nausea, and changes in bowel habits. McBurney's point pain is
,characteristic of appendicitis, not diverticulitis. Tenesmus and severe
diarrhea are less specific findings.
4. A client taking a thiazide diuretic for the past six months has a
serum potassium level of 3. The nurse anticipates which change in
prescription for the client?
A. The dosage of the diuretic will be decreased.
B. The diuretic will be discontinued.
C. A potassium supplement will be prescribed.
D. The dosage of the diuretic will be increased.
Correct Answer: C. A potassium supplement will be prescribed.
Explanation: Thiazide diuretics can cause hypokalemia (serum
potassium <3.5 mEq/L) by increasing potassium excretion in the distal
tubule. A potassium level of 3 is significantly low and requires
potassium supplementation. The diuretic may be continued with
monitoring rather than discontinued, as the benefits of blood pressure
control often outweigh the risk of electrolyte imbalance when properly
managed.
5. A client who is receiving chemotherapy asks the nurse, "Why is so
much of my hair falling out each day?" Which response by the nurse
best explains the reason for alopecia?
A. "Chemotherapy affects the cells of the body that grow rapidly, both
normal and malignant."
B. "Alopecia is a common side effect you will experience during long-
term steroid therapy."
, C. "Your hair will grow back completely after your course of
chemotherapy is completed."
D. "The chemotherapy causes permanent alterations in your hair
follicles that lead to hair loss."
Correct Answer: A. "Chemotherapy affects the cells of the body that
grow rapidly, both normal and malignant."
Explanation: Chemotherapeutic agents target rapidly dividing cells,
which includes both cancer cells and normal cells such as hair follicles,
bone marrow cells, and gastrointestinal epithelial cells. This explains
why alopecia occurs. While hair typically regrows after treatment, it
may not grow back completely or with the same texture, making option
C an inaccurate guarantee.
6. A client who was in a motor vehicle collision was admitted to the
hospital and the right knee was placed in skeletal traction. The nurse
has documented this nursing diagnosis in the client's medical record:
"Potential for impairment of skin integrity related to immobility from
traction." Which nursing intervention is indicated based on this
diagnosis statement?
A. Release the traction q4h to provide skin care.
B. Turn the client for back care while suspending traction.
C. Provide back and skin care while maintaining the traction.
D. Give back care after the client is released from traction.
Correct Answer: C. Provide back and skin care while maintaining the
traction.
VERIFIED ANSWERS AND DETAILED RATIONALE
1. Which information about mammograms is most important to
provide a post-menopausal female client?
A. Breast self-examinations are not needed if annual mammograms are
obtained.
B. Radiation exposure is minimized by shielding the abdomen with a
lead-lined apron.
C. Yearly mammograms should be done regardless of previous normal x-
rays.
D. Women at high risk should have annual routine and ultrasound
mammograms.
Correct Answer: C. Yearly mammograms should be done regardless of
previous normal x-rays.
Explanation: Post-menopausal women should continue annual
mammograms because breast cancer risk increases with age. Previous
normal results do not eliminate the need for ongoing screening, as new
cancers can develop between examinations. The American Cancer
Society recommends yearly mammograms for women aged 45-54 and
every 2 years for those 55 and older who are in good health.
,2. Which client should the nurse recognize as most likely to experience
sleep apnea?
A. Middle-aged female who takes a diuretic nightly.
B. Obese older male client with a short, thick neck.
C. Adolescent female with a history of tonsillectomy.
D. School-aged male with a history of hyperactivity disorder.
Correct Answer: B. Obese older male client with a short, thick neck.
Explanation: Obstructive sleep apnea is most commonly associated with
obesity, male gender, older age, and anatomic features such as a short,
thick neck. Excess adipose tissue in the upper airway narrows the
pharyngeal lumen, increasing the risk of airway collapse during sleep.
Classic signs include loud snoring, witnessed apneas, and excessive
daytime sleepiness.
3. A client is admitted to the hospital with a diagnosis of severe acute
diverticulitis. Which assessment finding should the nurse expect this
client to exhibit?
A. Lower left quadrant pain and a low-grade fever.
B. Severe pain at McBurney's point and nausea.
C. Abdominal pain and intermittent tenesmus.
D. Exacerbations of severe diarrhea.
Correct Answer: A. Lower left quadrant pain and a low-grade fever.
Explanation: Acute diverticulitis typically presents with localized pain in
the lower left quadrant (sigmoid colon area) accompanied by fever,
nausea, and changes in bowel habits. McBurney's point pain is
,characteristic of appendicitis, not diverticulitis. Tenesmus and severe
diarrhea are less specific findings.
4. A client taking a thiazide diuretic for the past six months has a
serum potassium level of 3. The nurse anticipates which change in
prescription for the client?
A. The dosage of the diuretic will be decreased.
B. The diuretic will be discontinued.
C. A potassium supplement will be prescribed.
D. The dosage of the diuretic will be increased.
Correct Answer: C. A potassium supplement will be prescribed.
Explanation: Thiazide diuretics can cause hypokalemia (serum
potassium <3.5 mEq/L) by increasing potassium excretion in the distal
tubule. A potassium level of 3 is significantly low and requires
potassium supplementation. The diuretic may be continued with
monitoring rather than discontinued, as the benefits of blood pressure
control often outweigh the risk of electrolyte imbalance when properly
managed.
5. A client who is receiving chemotherapy asks the nurse, "Why is so
much of my hair falling out each day?" Which response by the nurse
best explains the reason for alopecia?
A. "Chemotherapy affects the cells of the body that grow rapidly, both
normal and malignant."
B. "Alopecia is a common side effect you will experience during long-
term steroid therapy."
, C. "Your hair will grow back completely after your course of
chemotherapy is completed."
D. "The chemotherapy causes permanent alterations in your hair
follicles that lead to hair loss."
Correct Answer: A. "Chemotherapy affects the cells of the body that
grow rapidly, both normal and malignant."
Explanation: Chemotherapeutic agents target rapidly dividing cells,
which includes both cancer cells and normal cells such as hair follicles,
bone marrow cells, and gastrointestinal epithelial cells. This explains
why alopecia occurs. While hair typically regrows after treatment, it
may not grow back completely or with the same texture, making option
C an inaccurate guarantee.
6. A client who was in a motor vehicle collision was admitted to the
hospital and the right knee was placed in skeletal traction. The nurse
has documented this nursing diagnosis in the client's medical record:
"Potential for impairment of skin integrity related to immobility from
traction." Which nursing intervention is indicated based on this
diagnosis statement?
A. Release the traction q4h to provide skin care.
B. Turn the client for back care while suspending traction.
C. Provide back and skin care while maintaining the traction.
D. Give back care after the client is released from traction.
Correct Answer: C. Provide back and skin care while maintaining the
traction.
