Hesi Fundamentals Exam Fall 2024
A 73-year-old female client had a hemiarthroplasty of the left
hip yesterday due to a fracture resulting from a fall. In reviewing
hip precautions with the client, which instruction should the
nurse include in this client's teaching plan?
A. In 8 weeks you will be able to bend at the waist to reach
items on the floor.
B. Place a pillow between your knees while lying in bed to
prevent hip dislocation.
C. It is safe to use a walker to get out of bed, but you need
assistance when walking.
D. Take pain medication 30 minutes after your physical therapy
sessions. - The client's affected hip joint following a
hemiarthroplasty (partial hip replacement) is at risk of
dislocation for 6 months to a year following the procedure. Hip
precautions to prevent dislocation include placing a pillow
between the knees to maintain abduction of the hips (B). Clients
should be instructed to avoid bending at the waist (A), to seek
assistance for both standing and walking until they are stable on
a walker or cane (C), and to take pain medication 20 to 30
minutes prior to physical therapy sessions, rather than waiting
until the pain level is high after their therapy.
Correct Answer: B
A client is in the radiology department at 0900 when the
prescription levofloxacin (Levaquin) 500 mg IV q24h is
scheduled to be administered. The client returns to the unit at
1300. What is the best intervention for the nurse to implement?
,A. Contact the healthcare provider and complete a medication
variance form.
B. Administer the Levaquin at 1300 and resume the 0900
schedule in the morning.
C. Notify the charge nurse and complete an incident report to
explain the missed dose.
D. Give the missed dose at 1300 and change the schedule to
administer daily at 1300. - To ensure that a therapeutic level of
medication is maintained, the nurse should administer the
missed dose as soon as possible, and revise the administration
schedule accordingly to prevent dangerously increasing the level
of the medication in the bloodstream (D). The nurse should
document the reason for the late dose, but (A and C) are not
warranted. (B) could result in increased blood levels of the drug.
Correct Answer: D
A client is receiving a cephalosporin antibiotic IV and
complains of pain and irritation at the infusion site. The nurse
observes erythema, swelling, and a red streak along the vessel
above the IV access site. Which action should the nurse take at
this time?
A. Administer the medication more rapidly using the same IV
site.
B. Initiate an alternate site for the IV infusion of the medication.
C. Notify the healthcare provider before administering the next
dose.
D. Give the client a PRN dose of aspirin while the medication
infuses. - A cephalosporin antibiotic that is administered IV may
cause vessel irritation. Rotating the infusion site minimizes the
risk of thrombophlebitis, so an alternate infusion site should be
initiated (B) before administering the next dose. Rapid
,administration (A) of intravenous cephalosporins can potentiate
vessel irritation and increase the risk of thrombophlebitis. (C) is
not necessary to initiate an alternative IV site. Although aspirin
has antiinflammatory actions, (D) is not indicated.
Correct Answer: B
A client is to receive 10 mEq of KCl diluted in 250 ml of normal
saline over 4 hours. At what rate should the nurse set the client's
intravenous infusion pump?
A. 13 ml/hour.
B. 63 ml/hour.
C. 80 ml/hour.
D. 125 ml/hour. - (B) is the correct calculation: To calculate this
problem correctly, remember that the dose of KCl is not used in
the calculation. 250 ml/4 hours = 63 ml/hour.
Correct Answer: B
A client is to receive cimetidine (Tagamet) 300 mg q6h IVPB.
The preparation arrives from the pharmacy diluted in 50 ml of
0.9% NaCl. The nurse plans to administer the IVPB dose over
20 minutes. For how many ml/hr should the infusion pump be
set to deliver the secondary infusion? - The infusion rate is
calculated as a ratio proportion problem, i.e., 50 ml/ 20 min : x
ml/ 60 min. Multiply extremes and means 50 × 60 /20x 1=
300/20=150
Correct Answer: 150
A client who has been NPO for 3 days is receiving an infusion
of D5W 0.45 normal saline (NS) with potassium chloride (KCl)
20 mEq at 83 ml/hour. The client's eight-hour urine output is
400 ml, blood urea nitrogen (BUN) is 15 mg/dl, lungs are clear
, bilaterally, serum glucose is 120 mg/dl, and the serum potassium
is 3.7 mEq/L. Which action is most important for the nurse to
implement?
A. Notify healthcare provider and request to change the IV
infusion to hypertonic D10W.
B. Decrease in the infusion rate of the current IV and report to
the healthcare provider.
C. Document in the medical record that these normal findings
are expected outcomes.
C. Obtain potassium chloride 20 mEq in anticipation of a
prescription to add to present IV. - The results are all within
normal range (C). No changes are needed (A, B, and D).
Correct Answer: C
A client who is 5' 5" tall and weighs 200 pounds is scheduled for
surgery the next day. What question is most important for the
nurse to include during the preoperative assessment?
A. What is your daily calorie consumption?
B. What vitamin and mineral supplements do you take?
C. Do you feel that you are overweight?
D. Will a clear liquid diet be okay after surgery? - Vitamin and
mineral supplements (B) may impact medications used during
the operative period. (A and C) are appropriate questions for
long-term dietary counseling. The nature of the surgery and
anesthesia will determine the need for a clear liquid diet (D),
rather than the client's preference.
Correct Answer: B
A client who is a Jehovah's Witness is admitted to the nursing
unit. Which concern should the nurse have for planning care in
terms of the client's beliefs?
A 73-year-old female client had a hemiarthroplasty of the left
hip yesterday due to a fracture resulting from a fall. In reviewing
hip precautions with the client, which instruction should the
nurse include in this client's teaching plan?
A. In 8 weeks you will be able to bend at the waist to reach
items on the floor.
B. Place a pillow between your knees while lying in bed to
prevent hip dislocation.
C. It is safe to use a walker to get out of bed, but you need
assistance when walking.
D. Take pain medication 30 minutes after your physical therapy
sessions. - The client's affected hip joint following a
hemiarthroplasty (partial hip replacement) is at risk of
dislocation for 6 months to a year following the procedure. Hip
precautions to prevent dislocation include placing a pillow
between the knees to maintain abduction of the hips (B). Clients
should be instructed to avoid bending at the waist (A), to seek
assistance for both standing and walking until they are stable on
a walker or cane (C), and to take pain medication 20 to 30
minutes prior to physical therapy sessions, rather than waiting
until the pain level is high after their therapy.
Correct Answer: B
A client is in the radiology department at 0900 when the
prescription levofloxacin (Levaquin) 500 mg IV q24h is
scheduled to be administered. The client returns to the unit at
1300. What is the best intervention for the nurse to implement?
,A. Contact the healthcare provider and complete a medication
variance form.
B. Administer the Levaquin at 1300 and resume the 0900
schedule in the morning.
C. Notify the charge nurse and complete an incident report to
explain the missed dose.
D. Give the missed dose at 1300 and change the schedule to
administer daily at 1300. - To ensure that a therapeutic level of
medication is maintained, the nurse should administer the
missed dose as soon as possible, and revise the administration
schedule accordingly to prevent dangerously increasing the level
of the medication in the bloodstream (D). The nurse should
document the reason for the late dose, but (A and C) are not
warranted. (B) could result in increased blood levels of the drug.
Correct Answer: D
A client is receiving a cephalosporin antibiotic IV and
complains of pain and irritation at the infusion site. The nurse
observes erythema, swelling, and a red streak along the vessel
above the IV access site. Which action should the nurse take at
this time?
A. Administer the medication more rapidly using the same IV
site.
B. Initiate an alternate site for the IV infusion of the medication.
C. Notify the healthcare provider before administering the next
dose.
D. Give the client a PRN dose of aspirin while the medication
infuses. - A cephalosporin antibiotic that is administered IV may
cause vessel irritation. Rotating the infusion site minimizes the
risk of thrombophlebitis, so an alternate infusion site should be
initiated (B) before administering the next dose. Rapid
,administration (A) of intravenous cephalosporins can potentiate
vessel irritation and increase the risk of thrombophlebitis. (C) is
not necessary to initiate an alternative IV site. Although aspirin
has antiinflammatory actions, (D) is not indicated.
Correct Answer: B
A client is to receive 10 mEq of KCl diluted in 250 ml of normal
saline over 4 hours. At what rate should the nurse set the client's
intravenous infusion pump?
A. 13 ml/hour.
B. 63 ml/hour.
C. 80 ml/hour.
D. 125 ml/hour. - (B) is the correct calculation: To calculate this
problem correctly, remember that the dose of KCl is not used in
the calculation. 250 ml/4 hours = 63 ml/hour.
Correct Answer: B
A client is to receive cimetidine (Tagamet) 300 mg q6h IVPB.
The preparation arrives from the pharmacy diluted in 50 ml of
0.9% NaCl. The nurse plans to administer the IVPB dose over
20 minutes. For how many ml/hr should the infusion pump be
set to deliver the secondary infusion? - The infusion rate is
calculated as a ratio proportion problem, i.e., 50 ml/ 20 min : x
ml/ 60 min. Multiply extremes and means 50 × 60 /20x 1=
300/20=150
Correct Answer: 150
A client who has been NPO for 3 days is receiving an infusion
of D5W 0.45 normal saline (NS) with potassium chloride (KCl)
20 mEq at 83 ml/hour. The client's eight-hour urine output is
400 ml, blood urea nitrogen (BUN) is 15 mg/dl, lungs are clear
, bilaterally, serum glucose is 120 mg/dl, and the serum potassium
is 3.7 mEq/L. Which action is most important for the nurse to
implement?
A. Notify healthcare provider and request to change the IV
infusion to hypertonic D10W.
B. Decrease in the infusion rate of the current IV and report to
the healthcare provider.
C. Document in the medical record that these normal findings
are expected outcomes.
C. Obtain potassium chloride 20 mEq in anticipation of a
prescription to add to present IV. - The results are all within
normal range (C). No changes are needed (A, B, and D).
Correct Answer: C
A client who is 5' 5" tall and weighs 200 pounds is scheduled for
surgery the next day. What question is most important for the
nurse to include during the preoperative assessment?
A. What is your daily calorie consumption?
B. What vitamin and mineral supplements do you take?
C. Do you feel that you are overweight?
D. Will a clear liquid diet be okay after surgery? - Vitamin and
mineral supplements (B) may impact medications used during
the operative period. (A and C) are appropriate questions for
long-term dietary counseling. The nature of the surgery and
anesthesia will determine the need for a clear liquid diet (D),
rather than the client's preference.
Correct Answer: B
A client who is a Jehovah's Witness is admitted to the nursing
unit. Which concern should the nurse have for planning care in
terms of the client's beliefs?
