BSN 246 PRACTICE HESI (1 & 2) EXAM QUESTIONS AND ANSWERS
1. The registered nurse (RN) is caring for a young adult who is
having an oral glucose tolerance tests (OGTT). Which laboratory
result should the RN assess as a normal value for the two hour
postprandial result?
140 mg/dl.
160 mg/dl.
180 mg/dl.
200 mg/dl.: 140 mg/dl.
Rationale
The two hour postprandial level should be less 140 mg/dl for a young adult client.
2. The registered nurse (RN) is caring for a client who has a
closed head injury from a motor vehicle collision. Which finding
should the RN assess the client for the risk of diabetes insipidus
(DI)?
High fever.
Low blood
pressure. Muscle
rigidity.
,Polydipsia.: Polydipsia.
Rationale
A characteristic finding of DI is excretion of large quantities of urine (5 to 20L/day),
and most clients compensate for fluid loss by drinking large amounts of water
(polydipsia). DI can occur when there has been damage or injury to the pituitary
gland or hypothalamus as a result of head trauma, tumor or an illness such as
meningitis. This damage interrupts the ADH production, storage and release causing
the excessive urination and thirst.
3. The registered nurse (RN) is caring for a client who developed
oliguria and was diagnosed with sepsis and dehydration 48 hours
ago. Which assessment finding indicates to the RN that the client
is stabilizing?
Urine output of 40 mL/hour.
Apical pulse 100 and blood pressure
76/42. Urine specific gravity 1.001.
Tented skin on dorsal surface of hands.: Urine output of 40 mL/hour.
,Rationale
A decrease in urinary output is a sign of dehydration. When the urine output returns
to a normal range, 40 mL/hour, the client's kidneys are perfusing adequately and
indicates the client's status is stablizing.
4. A client who is uses ipratropium reports having nausea,
blurred vision, headaches, and insomnia after using the
inhaler. Which action should the registered nurse (RN)
implement first?
Withhold medication and report symptoms and vital signs to
healthcare provider.
Give PRN medication for nausea and vomiting and evaluate
client in 30 min-utes.
Reassure client that the ipratropium given will alleviate the
symptoms.
Delay administration of ipratropium until next maintenance
medication is scheduled.: Withhold medication and report symptoms and
vital signs to healthcare provider.
Rationale
Headache, nausea, blurred vision and insomnia are symptoms of excessive use of
ipratropium, so withholding the medication until the healthcare provider is notified
should be initiated to maintain client safety.
, 5. The registered nurse (RN) is assessing a client who was
discharged home after management of chronic hypertension.
Which equipment should the RN instruct the client to use at
home?
Exercise bicycle.
Sphygmomanomet
er. Blood glucose
monitor.
Weekly medication box.: Sphygmomanometer.
Rationale
Self-awareness is the best way for a client to manage chronic hypertension, so the
client should obtain a sphygmo-manometer and learn how to monitor blood
pressure daily and maintain a record.
1. The registered nurse (RN) is caring for a young adult who is
having an oral glucose tolerance tests (OGTT). Which laboratory
result should the RN assess as a normal value for the two hour
postprandial result?
140 mg/dl.
160 mg/dl.
180 mg/dl.
200 mg/dl.: 140 mg/dl.
Rationale
The two hour postprandial level should be less 140 mg/dl for a young adult client.
2. The registered nurse (RN) is caring for a client who has a
closed head injury from a motor vehicle collision. Which finding
should the RN assess the client for the risk of diabetes insipidus
(DI)?
High fever.
Low blood
pressure. Muscle
rigidity.
,Polydipsia.: Polydipsia.
Rationale
A characteristic finding of DI is excretion of large quantities of urine (5 to 20L/day),
and most clients compensate for fluid loss by drinking large amounts of water
(polydipsia). DI can occur when there has been damage or injury to the pituitary
gland or hypothalamus as a result of head trauma, tumor or an illness such as
meningitis. This damage interrupts the ADH production, storage and release causing
the excessive urination and thirst.
3. The registered nurse (RN) is caring for a client who developed
oliguria and was diagnosed with sepsis and dehydration 48 hours
ago. Which assessment finding indicates to the RN that the client
is stabilizing?
Urine output of 40 mL/hour.
Apical pulse 100 and blood pressure
76/42. Urine specific gravity 1.001.
Tented skin on dorsal surface of hands.: Urine output of 40 mL/hour.
,Rationale
A decrease in urinary output is a sign of dehydration. When the urine output returns
to a normal range, 40 mL/hour, the client's kidneys are perfusing adequately and
indicates the client's status is stablizing.
4. A client who is uses ipratropium reports having nausea,
blurred vision, headaches, and insomnia after using the
inhaler. Which action should the registered nurse (RN)
implement first?
Withhold medication and report symptoms and vital signs to
healthcare provider.
Give PRN medication for nausea and vomiting and evaluate
client in 30 min-utes.
Reassure client that the ipratropium given will alleviate the
symptoms.
Delay administration of ipratropium until next maintenance
medication is scheduled.: Withhold medication and report symptoms and
vital signs to healthcare provider.
Rationale
Headache, nausea, blurred vision and insomnia are symptoms of excessive use of
ipratropium, so withholding the medication until the healthcare provider is notified
should be initiated to maintain client safety.
, 5. The registered nurse (RN) is assessing a client who was
discharged home after management of chronic hypertension.
Which equipment should the RN instruct the client to use at
home?
Exercise bicycle.
Sphygmomanomet
er. Blood glucose
monitor.
Weekly medication box.: Sphygmomanometer.
Rationale
Self-awareness is the best way for a client to manage chronic hypertension, so the
client should obtain a sphygmo-manometer and learn how to monitor blood
pressure daily and maintain a record.
