HESI EXAM PRACTICE QUESTIONS AND ANSWERS

HESI EXAM PRACTICE QUESTIONS AND ANSWERS The nurse is reviewing a patient's list of nursing diagnoses in the medical record. The most recent nursing diagnosis is diarrhea related to intestinal colitis. Why is this an incorrectly stated diagnosis statement? It identifies the medical diagnosis instead of the patient's response to the diagnosis Nurses in the presurgical unit are preparing patients with different medical conditions for surgical procedures. The nurse knows to expect which type of medical condition to cause an increased risk of infection and delayed wound healing after surgery? Bone marrow depression -Immunological disorder, the nurse will expect an increased risk of infection and delayed wound healing after surgery. The nurse is given a form with preset standard findings for recording a progress note. The nurse reports the findings in the following way: "Physical Exam: All systems within normal except left lower extremity, casted d/t to heel fracture. Review of Systems: All normal except pain in the left foot." What kind of documentation and informatics is this? Charting by exception -uses forms that have predefined normal findings, the nurse only documents findings that are not standard. Unless documented, all other findings are assumed to be normal The nurse is interviewing a patient with cognitive impairment. Which strategy should the nurse avoid while communicating with this patient? Using detailed explanations while asking questions to help the patient understand The caregiver of a patient with terminal illness is receiving respite care. Which type of primary and preventive care services offers this kind of care? Block and parish nursing -a preventative and primary care service that provides services in respite care, homemaker aides, spiritual health, help with errands, and transportation -respite care provides short term relief or time off for people providing home care to an ill, disables, or frail older adult A patient is diagnosed with metabolic acidosis. Which physiological conditions can be identified as causes for the patient's condition? Ketoacidosis -may have increased metabolic acid Oliguric renal disease - may not be able to excrete al the acid from the body A patient visited the primary health care provider complaining of pain and tenderness in the joints of fingers of the left hand. The primary health care provider observed rheumatoid nodules. Which nursing interventions are beneficial? Administering ordered analgesics -arthritic joint pain is caused by inflammation (chronic) -analgesics relieve pain A surgeon obtains patient consent for an appendectomy. While operating, the surgeon also removes the patient's gallbladder. This mistake could be classified as which type of tort? Battery Torts are intentional or unintentional mistakes that are infringements of civil law surgeon did not get consent to remove bladder The nurse is attending to an elderly patient scheduled for a hernia operation. The nurse understands that due to aging, the patient may have rigidity of the blood vessel walls and a reduction in sympathetic and parasympathetic innervation to the heart. What risk would be increased I this patient following surgery? Hemorrhage Increased systolic blood pressure Increased diastolic blood pressure -blood vessel walls become rigid, causing a reduction in sympathetic and parasympathetic innervation to the heart Which are defining characteristics of constipation? Hard or dry stools pain or straining with defecation no bowel movement for four days Which type of loss does a toddler experience associated with separation anxiety from mom when starting preschool? Maturational loss The nurse is caring for a patient with cancer who was previously in a state of denial but has now accepted the illness. The patient asks the nurse questions about the illness and expresses emotions openly. What interventions should the nurse perform at this stage? Involve the family in teaching information for discharge Encourage the expression of feelings Set aside formal times for discussion The primary health care provider suggests discontinuing the peripheral intravenous access of a patient. Which nursing actions are beneficial to the patient? Inspecting catheter tip after removing it -catheter may break and cause embolization, which is an emergency situation The health care provider has asked for a postmortem examination on a patient. Under which circumstances can a health care provider make the decision to perform an autopsy? The patient's death occurred under suspicious circumstances The patient died within 1 hour of being admitted to the hospital - only to determine cause of death A patient was rushed to the emergency department and then to surgery to repair injuries sustained in a hit-and-run car accident. After surgery, the patient was transferred to the medical-surgical unit for postsurgical management. The healthcare provider informs the nurse that the patient has a durable power of attorney for health care (DPAHC). How should the nurse interpret this information? The patient has designated a person who makes health care decisions when the patient is not able to make decisions The patient has designated a person who is solely responsible for making health care decisions according to the patient's wishes During a home health visit, the nurse prepares to instruct a patient in how to perform range-of-motion exercises for an injured shoulder. The nurse verifies that the patient took an analgesic 30 minutes before the nurse arrived at the patient's home. After discussing the purpose for the exercises and demonstrating each one, the nurse has the patient perform them. After two attempts with only the second of three exercises, the patient stops and says, "This hurts too much. I don't see why I have to do the so many times." Which statement made by the nurse illustrates the critical thinking attitude of integrity? "I understand your reluctance, but the exercises are necessary for you to regain function in your shoulder. Let's go a bit more slowly and try to relax." In a health fair, a woman with diabetes was diagnosed with high blood pressure. She was advised to follow a low-salt diet. The woman followed the dietary restrictions and noted improvement in her blood pressure after 6 months. Which level of prevention does this case illustrate? Secondary prevention A patient with post traumatic stress disorder is admitted into a psychiatric unit. Which action performed by the nurse indicates the working phase of the helping relationship? Encouraging and helping patient set goals Which activities may weaken hearing ability? Woodworking Target shooting Listening to loud music A 43 year old female patient has come into the clinic for her annual physical examination. The patient has chronic arthritis, states that she feels incompetent doing simple tasks, and that she is a burden to others. Which techniques would the nurse perform to assess for low self-esteem? Observe patient's behavior Ask patient to explain thoughts and feelings about self Note clues about both stressful and supportive relationships The nursing student is preparing evidence-based practice project for which the student has posed a clear and concise clinical question. Which should the student do before incorporating the evidence into practice? Collect the most relevant and best evidence Critically appraise the evidence gathered Shared the outcome with others To enhance cultural awareness, which should the nursing students include in their self-examination? Background, personal biases, and prejudices During bathing, a patient who is in a supine position experiences shortness of breath and labored breathing with a respiration rate of 30. In which position should the bed be placed? Fowler's A nurse cares for a patient who has pancreatic cancer. Which stool finding is consistent with the patient's disorder? Oily stool The nurse is employed in a health care setting and is responsible for immunizations. In which healthcare setting is the nurse working? Preventive care The nurse is unable to form the PICOT question that addresses the effectiveness of chest physiotherapy in removing chest secretions in patients with cystic fibrosis. Which elements of the PICOT format are missing in this research question? Time Comparison of interest A patient is scheduled for surgery. The patient is being prepared to receive medication. Which action should the nurse perform before starting any treatment? Check consistent forms for accuracy The nurse is caring for an older-adult couple in a community-based assisted living facility. During the family assessment, the nurse notes that the couple has many expired medications and multiple medications for the respective chronic illness. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. This is an example of which competency for Quality and Safety Education for Nurses? Safety Which questions if asked by the nurse are useful for evaluating a patient's perception of safety? "Are you still afraid of falling?" "Do you feel safer as a result of the changes in home?" The nurse is caring for a patient who has a lack of coordination and weakness of both lower limbs. The patient is able to bear weight on both limbs but is unable to walk independently. Which gait does the nurse teach the patient? A four point gait The nurse is assigned to care for a patient who has low self esteem after undergoing a right leg amputation. The goal for the patient is that the patients self-esteem will improve in 2 weeks. What are the expected outcomes to achieve the goal? Patient will interact in a social setting Patient will talk about his or her feelings Patient will verbalize acceptance of the prosthetic leg The nurse is conducting research on the effect of imagery on pain perception. Which actions should the nurse perform when searching the scientific databases for evidence? Seek the assistance of a medical librarian Enter and manipulate different key words Be prepared for some confusion with the evidence obtained When comparing nasogastric tubes used for gastric decompression, what is the Salem sump specifically designed to do? Remove gastric secretions and provide an air vent A mother is unable to put her newborn baby to sleep. What measures should the nurse teach the mother to promote sleep in the newborn? Rock the baby gently Sing a lullaby to the baby Hold the baby snugly in a blanket Which nursing student statement regarding hormonal regulation during the different stages of general adaptation syndrome (GAS) indicate a need for further education? "During the resistance stage, hormone levels rise rapidly" The nurse is interviewing a 37 year old patient who is not coping well with a recent loss of employment. Which activities should the nurse perform to assess coping in the patient? Observe the patient's appearance Ask the patient about changes in eating patterns Ask the patient about changes in his or her sleeping pattern What is true about the general practice of advance practice registered nurses? Function independently The patient complains of difficulty passing stools, which are small, hard lumps. According to the Bristol stool form scale, what would be the classification of these stools? Type 1 A patient is experiencing the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). For which electrolyte disturbance should the nurse evaluate the patient? Hyponatremia -excess ADH secretion means excess retention of water from the kidney which is disproportionate to salt retention The nurse observes a student nurse caring for a patient with diarrhea. Which quality in the student nurse reflects cognitive maturity? Considering multiple solutions for the patients condition The nurse is positioning a quadriplegic patient to a supported fowlers position. While positioning, the nurse uses a pillow to help support the arms and hands of the patient. How will this help the patient? It prevents shoulder dislocation It prevents flexion contractors of the arm and wrist Which dietary practice is followed by a Hindu patient? Not eating any meat A 56 year old patient has a severe, productive cough. The patient is diagnosed with tuberculosis (TB) and is placed in an isolation room. What are the possible reasons for this action? To prevent the spread of infection To restrict the patients movements Which statement is true regarding respiratory changes due to immobility? Alveoli in the lung may collapse due to immobility The nurse is caring for an islamic patient who is recovering from a motor vehicle accident. The patient is observing Ramadan, the ninth lunar month, in which muslims fast during daylight for 28 days. The nurse understands that a good diet is important for the patient's wounds to heal. What should the nurse do when planning the patient's diet? Reschedule meal Respect cultural beliefs and assure the patient that medical needs will be taken care of What statement, if made by a nursing student, regarding glomerular filtration indicates a need for further education? "The glomerulus always filters large proteins and blood cells." The nurse is assessing a patient with acute pain. Which statements are true about acute pain? Acute pain is protective Acute pain is self limiting Acute pain has an identifiable cause A patient presents with decreased libido, depression, and ineffective coping. Which nursing interventions would be helpful for the patient? Help the patient set realistic goals Assess the causes of ineffective coping Encourage the patient to express feelings The nurse wants to experiment with a new interventions a patient. How should the nurse confirm the effectiveness of this intervention in an ethical manner? Focus on evidence based practice Focus on the patients values and beliefs related to the new intervention A patient with a sprained ankle is prescribed pain medications. The patient refuses to take the pain medications and insists on taking acupuncture treatment for pain relief. Which actions indicate open-mindedness on the nurses part? Respecting the patient's views Developing tolerance to differences of opinions The spouse of a patient who is terminally ill is in spiritual distress. What other situations adversely affect the spirituality of an individual? A diagnosis of diabetes A near death experience A major vehicle accident The senior nurse is teaching a group of nursing students about health care ethics. Which are examples of the nurse showing respect for a patients autonomy? Ensuring that the patient understands the risk of a medical procedure Asking the patient to read and sign an informed consent before surgery Receiving permission from the patient before performing a physical examination The nurse is conducting a psychosocial assessment of the patient to establish the patient's behavioral baseline. Which behaviors can be seen in a person with altered self-concept? The patient relies on others for making decisions and goes to extreme lengths to obtain support What should the nurse do while documenting and reporting the evaluation of interventions in the care of a patient? If the patient is not progressing, the nurse should report it to the primary health care provider The nurse has conducted field research and is now writing a manuscript about the study. Which information should the nurse include in the section following the conclusion? The explanation of the application of the results in clinical settings During a follow-up visit for a regular check-up, a patient who is on long-term antihypertensive medication exhibits a blood pressure of 180/100mmHg. The primary health care provider prescribes diuretics. Which teaching approach is most suitable to the patient? Participating A patient is diagnosed with a diabetic ulcer with gangrene to his foot. The primary health care provider advises surgery, but the patient refuses because removal of a body part is not permitted according his or her religious preference. Which concept justifies this scenario? Iceberg analogy Which priority nursing intervention does the nurse incorporate into a plan of care to promote sleep for a hospitalized patient? Avoid awakening patient for nonessential tasks A patient who is spiritually distressed comes for a follow-up. What observations by the nurse indicate positive outcomes in the patient? The patient is compliant with medication regimen The patients relationship with his partner is satisfactory The patient expresses increased hope of becoming healthy A student nurse who has not been trained to administer medications in assisting a registered nurse while caring for various patients in the general ward. Which intervention by the student nurse may result in a malpractice lawsuit? Administering a subcutaneous injection In the pyramid of mallows hierarchy of needs, which need of the patient is placed at the highest level? Self-actualization A patient with iron deficiency anemia reports rhythmical movement of the feet and legs and an itching sensation in the muscle before sleep. Which condition is likely to be found in the patient? Restless leg syndrome A patient expresses the desire to learn how to meditate. What does the nurse need to do first? Select a teaching environment that is free from distractions A patient complains of epigastric pain. The nurse assumes the problem is gastritis and educates the patient about the condition. The patient is later diagnosed with mild myocardial infarction. Which statements indicate appropriate management of the situation? The nurse should provide a straight forward explanation to the patient for why the confusion occurred The nurse should remember the need to be open-minded while looking at the patients information during the initial diagnosis The nurse should retroactively correlate the patients data to see what was missed The nurse is caring for a patient who is diagnosed with renal failure due to diabetes. The nurse must pass the patient care to another nurse during change of shift. Which information should the nurse include in the hand-off report? Nursing diagnosis of the patient Important information about family members Recent changes in objective measurements A patient is suspected to have dehydration. How should the nurse assess the elasticity of the skin? By folding the skin of the forearm with the fingertips and releasing it A patient has undergone throat surgery and is unable to speak. The following day while performing routine care, the nurse finds it difficult to interact with the patient. How should the nurse manage the situation? Use the message boards to communicate with the patient A patient is diagnosed with breast cancer. She is upset about the diagnosis. What questions should the nurse ask to assess the coping skills of the patient? "Has your caffeine intake increased?" "What is bothering you most right now?" "Have you started drinking and smoking?" The nurse is assessing a patient who developed post traumatic stress disorder (PTSD) after witnessing a plane crash. What would be the findings in this patient? Nightmares of the plane crash Flashbacks of the plane crash The nurse in the postoperative ward has two tasks at hand. A urine sample has to be dispatched, and a patient needs to ambulate down the hallway. Meanwhile another patient experiences a sudden drop in blood pressure associated with altered consciousness. Which nursing action is appropriate? Providing care to the patient who is experiencing falling blood pressure A primary healthcare provider is prescribing medications using an electronic health record. Suddenly an alert comes up stating that the patient is allergic to the prescribed medication and needs a change in medications. What kind of system gives such warnings? Clinical decision support system (CDSS) A 47 year old patient has arrived at the clinic after accidentally cutting his forearm with a pair of scissors. Which clinical manifestations would the nurse expect to indicate a local inflammation? Swelling Redness Pain The nurse is performing an assessment on a patient admitted to the emergency department with eye trauma. What do the nurses priority interventions include? Orienting the patient to the environment to reduce anxiety and prevent further injury to the eye Placing necessary objects such as the call light and water in front of the patient to prevent falls due to reaching The nursing assistive person asks for help to transfer a patient who is 125lb from the bed to a wheel chair. The patient is unable to assist. What is the nurses best response? "Call the lift-team for additional assistance" The nurse is caring for four different patients with immobility with different conditions. Which patient should the nurse place in the side-lying position? Patient with pressure ulcers How often should the nurse check gastric residuals for patients who are prescribed aspiration precautions? Every 4-6 hours Which actions are appropriate for a circulating nurse to perform during a surgical procedure? Calculating blood loss Counting surgical instruments Assisting the anesthesia care provider with endotracheal intubation A patient is learning crutch walking before starting to walk, the patient assumes a tripod position, extends the head and neck, straightens the vertebral column, extends the hips, and flexes the knees. What does the nurse tell the patient? "The vertebral column is in a correct position" "Keep the head and neck in an erect position" "Keep the hips in an extended position while crutch walking" As you are obtaining the oxygen saturation on a 19 year old college student with severe asthma, you note that she has black nail polish on her nails. You remove the polish from one nail and she asks you why her nail polish had to be removed. How should you respond? Nail polish interferes with sensor function A student nurse is reluctant to touch a patient who is suffering from a noncommunicable skin disorder. Which is the most appropriate action by the nurse? Inform the student that touch comforts the patient A patient who was on intravenous infusion therapy reports shortness of breath and an increase in the frequency of urination. Which nursing interventions would be beneficial? Placing patient in high fowlers position When teaching a group of patients with heart disease how to plan a mean, which teaching principles used by the nurse would be most appropriate? Simulating Maintaining learning attention and participation The nurse is referring to various research articles to acquire information about a PICOT question for which no pilot study has been done. After studying the references, the nurse finds that the evidence is not strong enough to apply in practice. What should the nurse do to investigate the PICOT question? Conduct a pilot study The nurse is caring for a terminally ill patient and advises the patients caregiver to increase fiber in the patients diet. Which symptoms is the nurse addressing with this instruction? Constipation While attending to a patient, the nurse finds that the patient is having difficulty in getting up to a sitting position. The nurse cares for this patient by applying the process of doing for. Which is the most appropriate action the nurse can take? Help the patient move into the sitting position The nurse is interviewing a 15 year old female patient and finds that the patient has an altered body image. Which factors can affect body image in this patient? Cultural and societal attitudes Cognitive and physical growth How much energy does 1g of carbohydrate produce? 4 k/cal In the general adaptation syndrome, what happens in the body because of increased epinephrine? The heart rate increases Oxygen intake increases Blood glucose levels increase Which body image stressor would likely damage the self concept of an individual? Amputation of the foot Alopecia due to chemotherapy The nurse tries to apply the concept of critical thinking in clinical practice. Which are characteristics of critical thinking? Open mindedness, continual inquiry, and perseverance Recognition of an issue, analysis of related information, and formation of conclusions Imagination and exploration of alternatives, consideration of ethical principles, and informed decision making During a history intake assessment, a patient describes stools as soft and smooth like sausage. According to the Bristol stool for scale, what would be the classification of these stools? Type 4 The nurse works in a sleep clinic. The nurse understands that sleep medicines should be administered with caution in some patients. In which patient can benzodiazepines be given safely? A 30 year old patient Which method should the student nurse use to reflect on and analyze the students own thoughts, actions, and knowledge? Reflective journaling The nurse understands that levels of preventive care include primary, secondary, and tertiary prevention. Which activities are included in primary prevention? Health education programs Immunizations Physical fitness activities A patient needs a blood transfusion but is apprehensive due to fear of developing sepsis. Which nursing intervention is helpful in preventing transfusion related sepsis? Follow blood banking standards Which action by the nursing assistant at bedtime requires the nurse to intervene? Giving a patient a cup of coffee A registered nurse is teaching a group of student nurses about the nursing documentation in a hospital. Which statement made by a student nurse indicates the need for additional teaching? "The subjective and objective data are included in PIE charting" A patient wants to know how exercise affects the body. What effects/changes does the nurse list? Increased joint mobility Increased cardiac output Increased basal metabolic rate The nurse is reviewing the reports of four patients scheduled for different programs. According to the chart, which patient requires secondary acute care? Patient scheduled for radiologic procedures such as a computed tomography (CT) scan Which nursing questions are concerned with the safety of a patient who is experiencing hallucinations? "How are you sleeping?" "Do you have any thoughts of harming yourself or others?" "Have you had any accidents at home, in the car, at school, or on the job?"