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To assess the quality of an adult client’s pain, what approach should the nurse use? C
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.
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?
A) “That’s correct, you do not have long to live”
D
B) “Would you like me to call your minister?”
C) “Don't give up, you still have chemotherapy to try.”
D) “Yes, your condition is serious.”
When performing blood pressure measurement to assess for
orthostatic hypotension, which action should the nurse implement
first? C
A) Apply the blood pressure cuff securely.
B) Record the client’s pulse
rate and rhythm. C) Position
the client supine for a few
minutes.
D) Assist the client to stand at bedside.
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Female unlicensed assistive personnel (UAP) are assigned to take the vital
signs of a client with pertussis for whom droplet precautions have been
implemented. The UAP request a change in assignment, stating she has not
yet been fitted for a particulate filter mask. What action should the nurse
take? D
When evaluating the effectiveness of a client’s nursing care, the nurse first
reviews the expected outcomes identified in the plan of care. What action
should the nurse take next?
A) Modify the nursing interventions to achieve the client’s goals.
B) Determine if the expected outcomes were realistic.
C) Review related professional standards of care.
D) Obtain current client data to compare with expected outcomes.
A policy requiring the removal of acrylic nails by all nursing personnel was
implemented six months ago. Which assessment measure best determines if
the intended outcome of the policy is being achieved?
A) Number of the staff-induced skin injuries.
B) Client satisfaction survey.
C) Rate of needlestick injuries by nurses.
D) Healthcare-associated infection rates.
A client with limited tolerance for activity needs to walk in the hallway
with assistance. Which instructions should the nurse give to the
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unlicensed assistive personnel (UAP) who assisting with client’s care?
(Select all that apply.)
A) Instruct the client about signs of orthostatic hypertension
B) Determine if the client needs to have a gait belt applied
C) Measure the clients vital signs before the
client walks.
D) Offer to assist the client to void prior to
walking in the hall.
E) Report the onset of any dizziness or light headedness.
A client has begun a long-term maintenance therapy with lithium,
which has a narrow therapeutic index. Which adverse effect is most
important for nurse to include in the teaching plan?
A) Dependence.
B) Toxicity.
C) Interaction.
D) Tolerance.
While interviewing a client, the nurse records the assessment in the
electronic health record. Which statement is most accurate regarding
electronic documentation during an interview?
A) The interview process is enhanced with electronic documentation and allows the
client to speak at a normal pace.
B) Completing the electronic record during an interview is a legal obligation of the
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To assess the quality of an adult client’s pain, what approach should the nurse use? C
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.
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?
A) “That’s correct, you do not have long to live”
D
B) “Would you like me to call your minister?”
C) “Don't give up, you still have chemotherapy to try.”
D) “Yes, your condition is serious.”
When performing blood pressure measurement to assess for
orthostatic hypotension, which action should the nurse implement
first? C
A) Apply the blood pressure cuff securely.
B) Record the client’s pulse
rate and rhythm. C) Position
the client supine for a few
minutes.
D) Assist the client to stand at bedside.
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Answers latest update 2022/2023
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HESI RN FUNDAMENTALS TESTBANK Exam Questions and
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Female unlicensed assistive personnel (UAP) are assigned to take the vital
signs of a client with pertussis for whom droplet precautions have been
implemented. The UAP request a change in assignment, stating she has not
yet been fitted for a particulate filter mask. What action should the nurse
take? D
When evaluating the effectiveness of a client’s nursing care, the nurse first
reviews the expected outcomes identified in the plan of care. What action
should the nurse take next?
A) Modify the nursing interventions to achieve the client’s goals.
B) Determine if the expected outcomes were realistic.
C) Review related professional standards of care.
D) Obtain current client data to compare with expected outcomes.
A policy requiring the removal of acrylic nails by all nursing personnel was
implemented six months ago. Which assessment measure best determines if
the intended outcome of the policy is being achieved?
A) Number of the staff-induced skin injuries.
B) Client satisfaction survey.
C) Rate of needlestick injuries by nurses.
D) Healthcare-associated infection rates.
A client with limited tolerance for activity needs to walk in the hallway
with assistance. Which instructions should the nurse give to the
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Answers latest update 2022/2023
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unlicensed assistive personnel (UAP) who assisting with client’s care?
(Select all that apply.)
A) Instruct the client about signs of orthostatic hypertension
B) Determine if the client needs to have a gait belt applied
C) Measure the clients vital signs before the
client walks.
D) Offer to assist the client to void prior to
walking in the hall.
E) Report the onset of any dizziness or light headedness.
A client has begun a long-term maintenance therapy with lithium,
which has a narrow therapeutic index. Which adverse effect is most
important for nurse to include in the teaching plan?
A) Dependence.
B) Toxicity.
C) Interaction.
D) Tolerance.
While interviewing a client, the nurse records the assessment in the
electronic health record. Which statement is most accurate regarding
electronic documentation during an interview?
A) The interview process is enhanced with electronic documentation and allows the
client to speak at a normal pace.
B) Completing the electronic record during an interview is a legal obligation of the
HESI RN FUNDAMENTALS TESTBANK Exam Questions and
Answers latest update 2022/2023
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