HESI Mid Curricular Exam Study Guide ( 2025
Edition Questions With Correct Verified Answers
And Rationales ) 100% verified |Graded A+
The nurse assesses a client with the admitting diagnosis of bipolar affective disorder, mania.
Which client symptoms require the nurse's immediate action?
1-Incessant talking and sexual innuendos
2-Grandiose delusions and poor concentration
3-Outlandish behaviors and inappropriate dress
4-Nonstop physical activity and poor nutritional intake - ANSWER 4-Nonstop physical activity
and poor nutritional intake
Rationale:Mania is a mood characterized by excitement, euphoria, hyperactivity, excessive
energy, decreased need for sleep, and impaired ability to concentrate or complete a single train
of thought. The client's mood is predominantly elevated, expansive, or irritable. All of the
options reflect a client's possible symptoms. However, the correct option clearly presents a
problem that compromises physiological integrity and needs to be addressed immediately.
The nurse is caring for a client who was involuntarily hospitalized to a mental health unit and is
scheduled for electroconvulsive therapy. The nurse notes that an informed consent has not
been obtained for the procedure. Based on this information, what is the nurse's best
determination in planning care?
1-The informed consent does not need to be obtained.
2-The informed consent would be obtained from the family.
3-The informed consent needs to be obtained from the client.
4-The primary health care provider will provide the informed consent. - ANSWER 3-The
informed consent needs to be obtained from the client.
,Rationale: Clients who are admitted involuntarily to a mental health unit do not lose their right
to informed consent. Clients must be considered legally competent until they have been
declared incompetent through a legal proceeding. The best determination for the nurse to make
is to obtain the informed consent from the client.
A client presents to the emergency department with upper gastrointestinal bleeding and is in
moderate distress. In planning care, what is the priority nursing action for this client?
1-Assessment of vital signs
2-Completion of abdominal examination
3-Insertion of the prescribed nasogastric tube
4-Thorough investigation of precipitating events - ANSWER 1-Assessment of vital signs
Rationale:The priority nursing action is to assess the vital signs. This would provide information
about the amount of blood loss that has occurred and provide a baseline by which to monitor
the progress of treatment. The client may be unable to provide subjective data until the
immediate physical needs are met. Although an abdominal examination and an assessment of
the precipitating events may be necessary, these actions are not the priority. Insertion of a
nasogastric tube is not the priority and will require a primary health care provider's
prescription; in addition, the vital signs would be checked before performing this procedure.
The nurse provides instructions to a malnourished pregnant client regarding iron
supplementation. Which client statement indicates an understanding of the instructions?
1-"Iron supplements will give me diarrhea."
2-"Meat does not provide iron and should be avoided."
3-"The iron is best absorbed if taken on an empty stomach."
4-"On the days that I eat green leafy vegetables or calf liver I can omit taking the iron
supplement." - ANSWER 3-"The iron is best absorbed if taken on an empty stomach."
Rationale:Iron is needed to allow for transfer of adequate iron to the fetus and to permit
expansion of the maternal red blood cell mass. During pregnancy, the relative excess of plasma
,causes a decrease in the hemoglobin concentration and hematocrit, known as physiological
anemia of pregnancy. This is a normal adaptation during pregnancy. Iron is best absorbed if
taken on an empty stomach. Taking it with a fluid high in ascorbic acid such as tomato juice
enhances absorption. Iron supplements usually cause constipation. Meats are an excellent
source of iron. The client needs to take the iron supplements regardless of food intake.
The nurse is teaching a client with emphysema about positions that help breathing during
dyspneic episodes. The nurse instructs the client that which positions alleviate dyspnea? Select
all that apply.
1- Sitting up and leaning on a table
2-Standing and leaning against a wall
3-Lying supine with the feet elevated
4-Sitting up with the elbows resting on knees
5-Lying on the back in a low-Fowler's position - ANSWER 1- Sitting up and leaning on a table
2-Standing and leaning against a wall
4-Sitting up with the elbows resting on knees
Rationale:The client would use the positions outlined in options 1, 2, and 4. These allow for
maximal chest expansion. The client would not lie on the back because this reduces movement
of a large area of the client's chest wall. Sitting is better than standing, whenever possible. If no
chair is available, leaning against a wall while standing allows accessory muscles to be used for
breathing and not posture control.
A client is about to undergo a lumbar puncture. The nurse describes to the client that which
position will be used during the procedure?
1-Side-lying with a pillow under the hip
2-Prone with a pillow under the abdomen
3-Prone in slight Trendelenburg's position
4-Side-lying with the legs pulled up and the head bent down onto the chest - ANSWER 4-Side-
lying with the legs pulled up and the head bent down onto the chest
, Rationale:A client undergoing lumbar puncture is positioned lying on the side, with the legs
pulled up to the abdomen and the head bent down onto the chest. This position helps open the
spaces between the vertebrae and allows for easier needle insertion by the primary health care
provider. The nurse remains with the client during the procedure to help the client maintain this
position. The other options identify incorrect positions for this procedure.
The nurse recognizes that which interventions are likely to facilitate effective communication
between a dying client and family? Select all that apply.
1-The nurse encourages the client and family to identify and discuss feelings openly.
2-The nurse assists the client and family in carrying out spiritually meaningful practices.
3-The nurse removes autonomy from the client to alleviate any unnecessary stress for the
client.
4-The nurse makes decisions for the client and family to relieve them of unnecessary demands.
5-The nurse maintains a calm attitude and one of acceptance when the family or client
expresses anger. - ANSWER 1-The nurse encourages the client and family to identify and discuss
feelings openly.
2-The nurse assists the client and family in carrying out spiritually meaningful practices.5-The
nurse maintains a calm attitude and one of acceptance when the family or client expresses
anger.
Rationale: Maintaining effective and open communication among family members affected by
death and grief is of the greatest importance. Option 1 describes encouraging discussion of
feelings and is likely to enhance communication. Option 2 is also an effective intervention
because spiritual practices give meaning to life and have an impact on how people react to
crisis. Option 5 is also an effective technique because the client and family need to know that
someone will be there who is supportive and nonjudgmental. The remaining options describe
the nurse removing autonomy and decision making from the client and family, who are already
experiencing feelings of loss of control in that they cannot change the process of dying. These
are ineffective interventions that could impair communication further.
Edition Questions With Correct Verified Answers
And Rationales ) 100% verified |Graded A+
The nurse assesses a client with the admitting diagnosis of bipolar affective disorder, mania.
Which client symptoms require the nurse's immediate action?
1-Incessant talking and sexual innuendos
2-Grandiose delusions and poor concentration
3-Outlandish behaviors and inappropriate dress
4-Nonstop physical activity and poor nutritional intake - ANSWER 4-Nonstop physical activity
and poor nutritional intake
Rationale:Mania is a mood characterized by excitement, euphoria, hyperactivity, excessive
energy, decreased need for sleep, and impaired ability to concentrate or complete a single train
of thought. The client's mood is predominantly elevated, expansive, or irritable. All of the
options reflect a client's possible symptoms. However, the correct option clearly presents a
problem that compromises physiological integrity and needs to be addressed immediately.
The nurse is caring for a client who was involuntarily hospitalized to a mental health unit and is
scheduled for electroconvulsive therapy. The nurse notes that an informed consent has not
been obtained for the procedure. Based on this information, what is the nurse's best
determination in planning care?
1-The informed consent does not need to be obtained.
2-The informed consent would be obtained from the family.
3-The informed consent needs to be obtained from the client.
4-The primary health care provider will provide the informed consent. - ANSWER 3-The
informed consent needs to be obtained from the client.
,Rationale: Clients who are admitted involuntarily to a mental health unit do not lose their right
to informed consent. Clients must be considered legally competent until they have been
declared incompetent through a legal proceeding. The best determination for the nurse to make
is to obtain the informed consent from the client.
A client presents to the emergency department with upper gastrointestinal bleeding and is in
moderate distress. In planning care, what is the priority nursing action for this client?
1-Assessment of vital signs
2-Completion of abdominal examination
3-Insertion of the prescribed nasogastric tube
4-Thorough investigation of precipitating events - ANSWER 1-Assessment of vital signs
Rationale:The priority nursing action is to assess the vital signs. This would provide information
about the amount of blood loss that has occurred and provide a baseline by which to monitor
the progress of treatment. The client may be unable to provide subjective data until the
immediate physical needs are met. Although an abdominal examination and an assessment of
the precipitating events may be necessary, these actions are not the priority. Insertion of a
nasogastric tube is not the priority and will require a primary health care provider's
prescription; in addition, the vital signs would be checked before performing this procedure.
The nurse provides instructions to a malnourished pregnant client regarding iron
supplementation. Which client statement indicates an understanding of the instructions?
1-"Iron supplements will give me diarrhea."
2-"Meat does not provide iron and should be avoided."
3-"The iron is best absorbed if taken on an empty stomach."
4-"On the days that I eat green leafy vegetables or calf liver I can omit taking the iron
supplement." - ANSWER 3-"The iron is best absorbed if taken on an empty stomach."
Rationale:Iron is needed to allow for transfer of adequate iron to the fetus and to permit
expansion of the maternal red blood cell mass. During pregnancy, the relative excess of plasma
,causes a decrease in the hemoglobin concentration and hematocrit, known as physiological
anemia of pregnancy. This is a normal adaptation during pregnancy. Iron is best absorbed if
taken on an empty stomach. Taking it with a fluid high in ascorbic acid such as tomato juice
enhances absorption. Iron supplements usually cause constipation. Meats are an excellent
source of iron. The client needs to take the iron supplements regardless of food intake.
The nurse is teaching a client with emphysema about positions that help breathing during
dyspneic episodes. The nurse instructs the client that which positions alleviate dyspnea? Select
all that apply.
1- Sitting up and leaning on a table
2-Standing and leaning against a wall
3-Lying supine with the feet elevated
4-Sitting up with the elbows resting on knees
5-Lying on the back in a low-Fowler's position - ANSWER 1- Sitting up and leaning on a table
2-Standing and leaning against a wall
4-Sitting up with the elbows resting on knees
Rationale:The client would use the positions outlined in options 1, 2, and 4. These allow for
maximal chest expansion. The client would not lie on the back because this reduces movement
of a large area of the client's chest wall. Sitting is better than standing, whenever possible. If no
chair is available, leaning against a wall while standing allows accessory muscles to be used for
breathing and not posture control.
A client is about to undergo a lumbar puncture. The nurse describes to the client that which
position will be used during the procedure?
1-Side-lying with a pillow under the hip
2-Prone with a pillow under the abdomen
3-Prone in slight Trendelenburg's position
4-Side-lying with the legs pulled up and the head bent down onto the chest - ANSWER 4-Side-
lying with the legs pulled up and the head bent down onto the chest
, Rationale:A client undergoing lumbar puncture is positioned lying on the side, with the legs
pulled up to the abdomen and the head bent down onto the chest. This position helps open the
spaces between the vertebrae and allows for easier needle insertion by the primary health care
provider. The nurse remains with the client during the procedure to help the client maintain this
position. The other options identify incorrect positions for this procedure.
The nurse recognizes that which interventions are likely to facilitate effective communication
between a dying client and family? Select all that apply.
1-The nurse encourages the client and family to identify and discuss feelings openly.
2-The nurse assists the client and family in carrying out spiritually meaningful practices.
3-The nurse removes autonomy from the client to alleviate any unnecessary stress for the
client.
4-The nurse makes decisions for the client and family to relieve them of unnecessary demands.
5-The nurse maintains a calm attitude and one of acceptance when the family or client
expresses anger. - ANSWER 1-The nurse encourages the client and family to identify and discuss
feelings openly.
2-The nurse assists the client and family in carrying out spiritually meaningful practices.5-The
nurse maintains a calm attitude and one of acceptance when the family or client expresses
anger.
Rationale: Maintaining effective and open communication among family members affected by
death and grief is of the greatest importance. Option 1 describes encouraging discussion of
feelings and is likely to enhance communication. Option 2 is also an effective intervention
because spiritual practices give meaning to life and have an impact on how people react to
crisis. Option 5 is also an effective technique because the client and family need to know that
someone will be there who is supportive and nonjudgmental. The remaining options describe
the nurse removing autonomy and decision making from the client and family, who are already
experiencing feelings of loss of control in that they cannot change the process of dying. These
are ineffective interventions that could impair communication further.
