HESI Milestone Exam Study Guide With Multiple
Choice Questions And Rationalized Answers
Graded A+ 2025
1. Two hours after taking the first dose of penicillin, a client arrives at the
emergency department complaining of feeling ill, exhibiting hives, having difficulty
breathing, and experiencing hypotension. The nurse will develop an immediate plan
of care based on which finding?
A. Severe acute anaphylactic response
B.Side reaction that should resolve
C.Idiosyncratic reaction
D.Cumulative drug response
A: Rationale: Anaphylaxis related to penicillin can cause a life-threatening allergic
response characterized by bronchospasm, laryngeal edema, and a precipitous drop in
blood pressure. This client's ingestion of penicillin and presenting clinical picture
indicate the client is having an acute reaction with respiratory difficulty. Options B,
1/
20
,C, and D are other physiologic responses to medications, but immediate action is
required for a potential loss of airway, breathing, and circulation.
2. Which response best supports the observations that the nurse identifies in a client
who is experiencing a placebo effect?
A.Beneficial response or cure for disease B.Behavioral or
psychotropic responses C.Malingering or drug-seeking
behaviors D.Psychological response to inert medication
D: Rationale:The placebo effect is a response in the client that is caused by the
psychological impact of taking an inert drug that has no biochemical properties. A
placebo effect can be therapeutic, negative, or ineffective but provides no cure or
benefit to the client's progress. The placebo effect may evoke behavioral changes but
does not affect neurochemical psychotropic changes. Malingering and drug seeking ar
behaviors that a client exhibits to obtain treatment for nonexistent disorders or
obtain prescription medications.
3. A mother brings her 18-month-old child to the community health center because
the child has had "bad diarrhea" for the last 3 days. She states, "I bought some of
this liquid at the pharmacy and gave my child a half-ounce." The nurse sees that the
bottle contains loperamide. What is the next nursing action?
A. Tell the mother never to give this drug to her toddler.
2/
20
, B. Ask if any other siblings have experienced diarrhea.
C. Take the child's oral and tympanic temperatures.
D. Ask the mother when the child last voided.
D: Rationale: Determining when the child last voided is most important because
urine output is decreased with dehydration and an 18-month-old with a 3-day history
3/
20
Choice Questions And Rationalized Answers
Graded A+ 2025
1. Two hours after taking the first dose of penicillin, a client arrives at the
emergency department complaining of feeling ill, exhibiting hives, having difficulty
breathing, and experiencing hypotension. The nurse will develop an immediate plan
of care based on which finding?
A. Severe acute anaphylactic response
B.Side reaction that should resolve
C.Idiosyncratic reaction
D.Cumulative drug response
A: Rationale: Anaphylaxis related to penicillin can cause a life-threatening allergic
response characterized by bronchospasm, laryngeal edema, and a precipitous drop in
blood pressure. This client's ingestion of penicillin and presenting clinical picture
indicate the client is having an acute reaction with respiratory difficulty. Options B,
1/
20
,C, and D are other physiologic responses to medications, but immediate action is
required for a potential loss of airway, breathing, and circulation.
2. Which response best supports the observations that the nurse identifies in a client
who is experiencing a placebo effect?
A.Beneficial response or cure for disease B.Behavioral or
psychotropic responses C.Malingering or drug-seeking
behaviors D.Psychological response to inert medication
D: Rationale:The placebo effect is a response in the client that is caused by the
psychological impact of taking an inert drug that has no biochemical properties. A
placebo effect can be therapeutic, negative, or ineffective but provides no cure or
benefit to the client's progress. The placebo effect may evoke behavioral changes but
does not affect neurochemical psychotropic changes. Malingering and drug seeking ar
behaviors that a client exhibits to obtain treatment for nonexistent disorders or
obtain prescription medications.
3. A mother brings her 18-month-old child to the community health center because
the child has had "bad diarrhea" for the last 3 days. She states, "I bought some of
this liquid at the pharmacy and gave my child a half-ounce." The nurse sees that the
bottle contains loperamide. What is the next nursing action?
A. Tell the mother never to give this drug to her toddler.
2/
20
, B. Ask if any other siblings have experienced diarrhea.
C. Take the child's oral and tympanic temperatures.
D. Ask the mother when the child last voided.
D: Rationale: Determining when the child last voided is most important because
urine output is decreased with dehydration and an 18-month-old with a 3-day history
3/
20
