HESI Exam Prep Test Bank P a g e | 1
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Oral prednisone 10 mg/day is prescribed for a client with an acute exacerbation of rheumatoid arthritis.
The nurse is providing information to the client about the medication. What time of day does the
nurse tell the client is best to take the medication?
At bedtime
With lunch
In the evening, after 9 p.m.
In the morning, before 9:00 a.m. –
Correct Answer :In the morning, before 9:00 a.m.
Rationale: The nurse tells the client that it is best to take glucocorticoids before 9 a.m. This schedule
helps minimize adrenal insufficiency and mimics the burst of glucocorticoids released naturally by the
adrenals each morning. Prednisone, a glucocorticoid, may be prescribed to reduce inflammation and
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pain in acute exacerbations of rheumatoid arthritis. The time frames in the remaining options are
incorrect.
A child with growth hormone deficiency will be receiving somatropin. The nurse provides information
to the mother about the medication. Which of the following laboratory values does the nurse tell the
mother will require monitoring?
Creatinine
Hemoglobin
Blood urea nitrogen (BUN)
Thyroid-stimulating hormone (TSH) –
Correct Answer :Thyroid-stimulating hormone (TSH)
Rationale: TSH is the laboratory value the nurse tells the mother to monitor. Somatropin is a growth
hormone. One adverse reaction to somatropin is hypothyroidism. Thyroid function is assessed before
treatment and periodically thereafter. Creatinine and BUN are used to evaluate renal function, and
hemoglobin reflects hematologic activity.
Laboratory studies are performed on a client diagnosed with suspected sickle cell disease, and
electrophoresis reveals a large percentage of hemoglobin S (HbS). Which additional laboratory finding
will the nurse expect to note that is a characteristic of this disease?
Low reticulocyte count
Low total bilirubin level
Increased hematocrit count
Increased white blood cell (WBC) count –
Correct Answer :Increased white blood cell (WBC) count
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Rationale: Sickle cell disease is a genetic disorder that results in chronic anemia, pain, disability, organ
damage, increased risk for infection, and early death. The WBC count is usually higher than normal in
clients with sickle cell disease. Also, the red blood cells assume a sickle shape, become rigid, and clump
together. The main laboratory finding associated with sickle cell disease is the large percentage of HbS
present on electrophoresis. The reticulocyte count is increased, indicating anemia of long duration,
and the total bilirubin level is increased. The hematocrit level is low and decreases during crisis,
because the bone marrow fails to produce cells during stressful periods. It is believed that this
increase is related to chronic inflammation resulting from tissue hypoxia and ischemia.
A client being seen in the clinic complains of fatigue and weakness. Laboratory studies are performed
because the primary health care provider suspects iron-deficiency anemia. After reviewing the
laboratory results, which finding indicative of this type of anemia does the nurse expect to note?.
An increased RBC count
An increased hematocrit level
An increased hemoglobin level
Microcytic red blood cells (RBCs) –
Correct Answer :Microcytic red blood cells (RBCs)
Rationale: The nurse expects to note a low RBC count and microcytic (small) RBCs. In iron-deficiency
anemia, laboratory testing will reveal low hemoglobin and hematocrit levels. In iron-deficiency anemia,
iron stores are depleted first, followed by hemoglobin stores.
Alendronate is prescribed for a client with postmenopausal osteoporosis. The nurse provides
information on the medication to the client. When does the nurse tell the client to take the
alendronate?
At bedtime
With orange juice, to enhance absorption at night
Every morning before breakfast, with a full glass of water
Every morning after breakfast, after which the client should lie down for 30 minutes –
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Correct Answer :Every morning before breakfast, with a full glass of water
Rationale: Alendronate should be taken in the morning before breakfast with a full glass of water and
on an empty stomach to maximize its bioavailability. It is a medication used to treat postmenopausal
osteoporesis, glucocorticoid-induced osteoporosis, and Paget's disease of bone. Proper
administration is necessary to maximize bioavailability and minimize the risk of esophagitis. No food,
including orange juice or coffee, should be consumed for at least 30 minutes after alendronate is
taken. To minimize the risk of esophagitis, the client should take the medication with a full glass of
water and remain upright (seated or standing) for at least 30 minutes. Therefore taking the
medication at bedtime, with orange juice to help with absorption, and every morning after breakfast,
followed by a 30-minute period of lying down, are all incorrect.
Calcium carbonate is prescribed for a client with mild hypocalcemia. What food does the nurse instruct
the client to avoid consuming while taking this medication?
Fish
Milk
Spinach
Watermelon –
Correct Answer :Spinach
Rationale: The nurse instructs the client to avoid consuming spinach while taking calcium carbonate.
Oral calcium salts are used to treat mild hypocalcemia and to supplement dietary calcium. The client is
instructed to take oral calcium with a large glass of water with or after a meal to promote absorption.
The client is also instructed to avoid taking calcium with foods that can suppress calcium absorption.
Such foods include not only spinach, but Swiss chard, beets, bran, and whole-wheat cereals. The client
does not need to avoid fish, milk, or watermelon.
An emergency department nurse is caring for a client in hypovolemic shock, a result of external
hemorrhage caused by a gunshot wound. Which nursing interventions should the nurse take? Select
all that apply.
Maintaining the client in a high Fowler's position
P a g e 4 | 176
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Oral prednisone 10 mg/day is prescribed for a client with an acute exacerbation of rheumatoid arthritis.
The nurse is providing information to the client about the medication. What time of day does the
nurse tell the client is best to take the medication?
At bedtime
With lunch
In the evening, after 9 p.m.
In the morning, before 9:00 a.m. –
Correct Answer :In the morning, before 9:00 a.m.
Rationale: The nurse tells the client that it is best to take glucocorticoids before 9 a.m. This schedule
helps minimize adrenal insufficiency and mimics the burst of glucocorticoids released naturally by the
adrenals each morning. Prednisone, a glucocorticoid, may be prescribed to reduce inflammation and
P a g e 1 | 176
, HESI Exam Prep Test Bank P a g e | 2
pain in acute exacerbations of rheumatoid arthritis. The time frames in the remaining options are
incorrect.
A child with growth hormone deficiency will be receiving somatropin. The nurse provides information
to the mother about the medication. Which of the following laboratory values does the nurse tell the
mother will require monitoring?
Creatinine
Hemoglobin
Blood urea nitrogen (BUN)
Thyroid-stimulating hormone (TSH) –
Correct Answer :Thyroid-stimulating hormone (TSH)
Rationale: TSH is the laboratory value the nurse tells the mother to monitor. Somatropin is a growth
hormone. One adverse reaction to somatropin is hypothyroidism. Thyroid function is assessed before
treatment and periodically thereafter. Creatinine and BUN are used to evaluate renal function, and
hemoglobin reflects hematologic activity.
Laboratory studies are performed on a client diagnosed with suspected sickle cell disease, and
electrophoresis reveals a large percentage of hemoglobin S (HbS). Which additional laboratory finding
will the nurse expect to note that is a characteristic of this disease?
Low reticulocyte count
Low total bilirubin level
Increased hematocrit count
Increased white blood cell (WBC) count –
Correct Answer :Increased white blood cell (WBC) count
P a g e 2 | 176
, HESI Exam Prep Test Bank P a g e | 3
Rationale: Sickle cell disease is a genetic disorder that results in chronic anemia, pain, disability, organ
damage, increased risk for infection, and early death. The WBC count is usually higher than normal in
clients with sickle cell disease. Also, the red blood cells assume a sickle shape, become rigid, and clump
together. The main laboratory finding associated with sickle cell disease is the large percentage of HbS
present on electrophoresis. The reticulocyte count is increased, indicating anemia of long duration,
and the total bilirubin level is increased. The hematocrit level is low and decreases during crisis,
because the bone marrow fails to produce cells during stressful periods. It is believed that this
increase is related to chronic inflammation resulting from tissue hypoxia and ischemia.
A client being seen in the clinic complains of fatigue and weakness. Laboratory studies are performed
because the primary health care provider suspects iron-deficiency anemia. After reviewing the
laboratory results, which finding indicative of this type of anemia does the nurse expect to note?.
An increased RBC count
An increased hematocrit level
An increased hemoglobin level
Microcytic red blood cells (RBCs) –
Correct Answer :Microcytic red blood cells (RBCs)
Rationale: The nurse expects to note a low RBC count and microcytic (small) RBCs. In iron-deficiency
anemia, laboratory testing will reveal low hemoglobin and hematocrit levels. In iron-deficiency anemia,
iron stores are depleted first, followed by hemoglobin stores.
Alendronate is prescribed for a client with postmenopausal osteoporosis. The nurse provides
information on the medication to the client. When does the nurse tell the client to take the
alendronate?
At bedtime
With orange juice, to enhance absorption at night
Every morning before breakfast, with a full glass of water
Every morning after breakfast, after which the client should lie down for 30 minutes –
P a g e 3 | 176
, HESI Exam Prep Test Bank P a g e | 4
Correct Answer :Every morning before breakfast, with a full glass of water
Rationale: Alendronate should be taken in the morning before breakfast with a full glass of water and
on an empty stomach to maximize its bioavailability. It is a medication used to treat postmenopausal
osteoporesis, glucocorticoid-induced osteoporosis, and Paget's disease of bone. Proper
administration is necessary to maximize bioavailability and minimize the risk of esophagitis. No food,
including orange juice or coffee, should be consumed for at least 30 minutes after alendronate is
taken. To minimize the risk of esophagitis, the client should take the medication with a full glass of
water and remain upright (seated or standing) for at least 30 minutes. Therefore taking the
medication at bedtime, with orange juice to help with absorption, and every morning after breakfast,
followed by a 30-minute period of lying down, are all incorrect.
Calcium carbonate is prescribed for a client with mild hypocalcemia. What food does the nurse instruct
the client to avoid consuming while taking this medication?
Fish
Milk
Spinach
Watermelon –
Correct Answer :Spinach
Rationale: The nurse instructs the client to avoid consuming spinach while taking calcium carbonate.
Oral calcium salts are used to treat mild hypocalcemia and to supplement dietary calcium. The client is
instructed to take oral calcium with a large glass of water with or after a meal to promote absorption.
The client is also instructed to avoid taking calcium with foods that can suppress calcium absorption.
Such foods include not only spinach, but Swiss chard, beets, bran, and whole-wheat cereals. The client
does not need to avoid fish, milk, or watermelon.
An emergency department nurse is caring for a client in hypovolemic shock, a result of external
hemorrhage caused by a gunshot wound. Which nursing interventions should the nurse take? Select
all that apply.
Maintaining the client in a high Fowler's position
P a g e 4 | 176
