NUTRITION HESI EXAMINATION TEST 2025/2026
QUESTIONS AND SOLUTIONS RANKED A+
✔✔The nurse is preparing to hang fat emulsion (lipids) and notes that fat globules are
visible at the top of the solution. The nurse should take which action?
1. Roll the bottle of solution gently.
2. Obtain a different bottle of solution.
3. Shake the bottle of solution vigorously.
4. Run the bottle of solution under warm water. - ✔✔2Rationale: Fat emulsion (lipids) is
a white, opaque solution administered intravenously during parenteral nutrition therapy
to prevent fatty acid deficiency. The nurse should examine the bottle of fat emulsion for
separation of emulsion into layers of fat globules or for the accumulation of froth. The
nurse should not hang a fat emulsion if any of these are observed and should return the
solution to the pharmacy. Therefore, the remaining options are inappropriate actions.
✔✔A client receiving parenteral nutrition (PN) suddenly develops a fever. The nurse
notifies the health care provider (HCP), and the HCP initially prescribes that the solution
and tubing be changed. What should the nurse do with the discontinued materials?
1. Discard them in the unit trash.
2. Return them to the hospital pharmacy.
3. Save them for return to the manufacturer.
4. Prepare to send them to the laboratory for culture. - ✔✔4Rationale: When the client
who is receiving PN develops a fever, a catheter-related infection should be suspected.
The solution and tubing should be changed, and the discontinued materials should be
cultured for infectious organisms per HCP prescription. The other options are incorrect.
Because culture for infectious organisms is necessary, the discontinued materials are
not discarded or returned to the pharmacy or manufacturer.
✔✔A client has been discharged to home on parenteral nutrition (PN). With each visit,
the home care nurse should assess which parameter most closely in monitoring this
therapy?
1. Pulse and weight
2. Temperature and weight
3. Pulse and blood pressure
4. Temperature and blood pressure - ✔✔2Rationale: The client receiving PN at home
should have her or his temperature monitored as a means of detecting infection, which
is a potential complication of this therapy. An infection also could result in sepsis
because the catheter is in a blood vessel. The client's weight is monitored as a measure
of the effectiveness of this nutritional therapy and to detect hypervolemia. The pulse and
blood pressure are important parameters to assess, but they do not relate specifically to
the effects of PN.
✔✔96. The nurse, caring for a group of adult clients on an acute care medical-surgical
nursing unit, determines that which clients would be the most likelycandidates for
parenteral nutrition (PN)? Select all that apply.
,1. A client with extensive burns
2. A client with cancer who is septic
3. A client who has had an open cholecystectomy
4. A client with severe exacerbation of Crohn's disease
5. A client with persistent nausea and vomiting from chemotherapy - ✔✔1, 2, 4,
5Rationale: PN is indicated in clients whose gastrointestinal tracts are not functional or
must be rested, cannot take in a diet enterally for extended periods, or have increased
metabolic need. Examples of these conditions include those clients with burns,
exacerbation of Crohn's disease, and persistent nausea and vomiting due to
chemotherapy. Other clients would be those who have had extensive surgery, have
multiple fractures, are septic, or have advanced cancer or acquired immunodeficiency
syndrome. The client with the open cholecystectomy is not a candidate because this
client would resume a regular diet within a few days following surgery.
✔✔The nurse is preparing to hang the first bag of parenteral nutrition (PN) solution via
the central line of an assigned client. The nurse should obtain which most essential
piece of equipment before hanging the solution?
1. Urine test strips
2. Blood glucose meter
3. Electronic infusion pump
4. Noninvasive blood pressure monitor - ✔✔3Rationale: The nurse obtains an electronic
infusion pump before hanging a PN solution. Because of the high glucose content, use
of an infusion pump is necessary to ensure that the solution does not infuse too rapidly
or fall behind. Because the client's blood glucose level is monitored every 4 to 6 hours
during administration of PN, a blood glucose meter also will be needed, but this is not
the most essential item needed before hanging the solution because it is not directly
related to administering the PN. Urine test strips (to measure glucose) rarely are used
because of the advent of blood glucose monitoring. Although the blood pressure will be
monitored, a noninvasive blood pressure monitor is not the most essential piece of
equipment needed for this procedure.
✔✔The nurse is making initial rounds at the beginning of the shift and notes that the
parenteral nutrition (PN) bag of an assigned client is empty. Which solution should the
nurse hang until another PN solution is mixed and delivered to the nursing unit?
1. 5% dextrose in water
2. 10% dextrose in water
3. 5% dextrose in Ringer's lactate
4. 5% dextrose in 0.9% sodium chloride - ✔✔2Rationale: The client is at risk for
hypoglycemia; therefore, the solution containing the highest amount of glucose should
be hung until the new PN solution becomes available. Because PN solutions contain
high glucose concentrations, the 10% dextrose in water solution is the best of the
choices presented. The solution selected should be one that minimizes the risk of
hypoglycemia. The remaining options will not be as effective in minimizing the risk of
hypoglycemia.
, ✔✔The nurse is monitoring the status of a client's fat emulsion (lipid) infusion and notes
that the infusion is 1 hour behind. Which action should the nurse take?
1. Adjust the infusion rate to catch up over the next hour.
2. Increase the infusion rate to catch up over the next 2 hours.
3. Ensure that the fat emulsion infusion rate is infusing at the prescribed rate.
4. Adjust the infusion rate to run wide open until the solution is back on time. -
✔✔3Rationale: The nurse should not increase the rate of a fat emulsion to make up the
difference if the infusion timing falls behind. Doing so could place the client at risk for fat
overload. In addition, increasing the rate suddenly can cause fluid overload. The same
principle (not increasing the rate) applies to parenteral nutrition or any intravenous
infusion. Therefore, the remaining options are incorrect.
✔✔A client receiving parenteral nutrition (PN) in the home setting has a weight gain of 5
lb in 1 week. The nurse should next assess the client for the presence of which
condition?
1. Thirst
2. Polyuria
3. Decreased blood pressure
4. Crackles on auscultation of the lungs - ✔✔4Rationale: Optimal weight gain when the
client is receiving PN is 1 to 2 lb/week. The client who has a weight gain of 5 lb/week
while receiving PN is likely to have fluid retention. This can result in hypervolemia. Signs
of hypervolemia include increased blood pressure, crackles on lung auscultation, a
bounding pulse, jugular vein distention, headache, peripheral edema, and weight gain
more than desired. Thirst and polyuria are associated with hyperglycemia. A decreased
blood pressure is likely to be noted in deficient fluid volume.
✔✔The nurse is caring for a restless client who is beginning nutritional therapy with
parenteral nutrition (PN). The nurse should plan to ensure that which action is taken to
prevent the client from sustaining injury?
1. Calculate daily intake and output.
2. Monitor the temperature once daily.
3. Secure all connections in the PN system.
4. Monitor blood glucose levels every 12 hours. - ✔✔3Rationale: The nurse should plan
to secure all connections in the tubing (connections are used per agency protocol). This
helps to prevent the restless client from pulling the connections apart accidentally. The
nurse should also monitor intake and output, but this does not relate specifically to a risk
for injury as presented in the question. Also, monitoring the temperature and blood
glucose levels does not relate to a risk for injury as presented in the question. In
addition, the client's temperature and blood glucose levels are monitored more
frequently than the time frames identified in the options to detect signs of infection and
hyperglycemia, respectively.
✔✔A client receiving parenteral nutrition (PN) complains of a headache. The nurse
notes that the client has an increased blood pressure, bounding pulse, jugular vein
QUESTIONS AND SOLUTIONS RANKED A+
✔✔The nurse is preparing to hang fat emulsion (lipids) and notes that fat globules are
visible at the top of the solution. The nurse should take which action?
1. Roll the bottle of solution gently.
2. Obtain a different bottle of solution.
3. Shake the bottle of solution vigorously.
4. Run the bottle of solution under warm water. - ✔✔2Rationale: Fat emulsion (lipids) is
a white, opaque solution administered intravenously during parenteral nutrition therapy
to prevent fatty acid deficiency. The nurse should examine the bottle of fat emulsion for
separation of emulsion into layers of fat globules or for the accumulation of froth. The
nurse should not hang a fat emulsion if any of these are observed and should return the
solution to the pharmacy. Therefore, the remaining options are inappropriate actions.
✔✔A client receiving parenteral nutrition (PN) suddenly develops a fever. The nurse
notifies the health care provider (HCP), and the HCP initially prescribes that the solution
and tubing be changed. What should the nurse do with the discontinued materials?
1. Discard them in the unit trash.
2. Return them to the hospital pharmacy.
3. Save them for return to the manufacturer.
4. Prepare to send them to the laboratory for culture. - ✔✔4Rationale: When the client
who is receiving PN develops a fever, a catheter-related infection should be suspected.
The solution and tubing should be changed, and the discontinued materials should be
cultured for infectious organisms per HCP prescription. The other options are incorrect.
Because culture for infectious organisms is necessary, the discontinued materials are
not discarded or returned to the pharmacy or manufacturer.
✔✔A client has been discharged to home on parenteral nutrition (PN). With each visit,
the home care nurse should assess which parameter most closely in monitoring this
therapy?
1. Pulse and weight
2. Temperature and weight
3. Pulse and blood pressure
4. Temperature and blood pressure - ✔✔2Rationale: The client receiving PN at home
should have her or his temperature monitored as a means of detecting infection, which
is a potential complication of this therapy. An infection also could result in sepsis
because the catheter is in a blood vessel. The client's weight is monitored as a measure
of the effectiveness of this nutritional therapy and to detect hypervolemia. The pulse and
blood pressure are important parameters to assess, but they do not relate specifically to
the effects of PN.
✔✔96. The nurse, caring for a group of adult clients on an acute care medical-surgical
nursing unit, determines that which clients would be the most likelycandidates for
parenteral nutrition (PN)? Select all that apply.
,1. A client with extensive burns
2. A client with cancer who is septic
3. A client who has had an open cholecystectomy
4. A client with severe exacerbation of Crohn's disease
5. A client with persistent nausea and vomiting from chemotherapy - ✔✔1, 2, 4,
5Rationale: PN is indicated in clients whose gastrointestinal tracts are not functional or
must be rested, cannot take in a diet enterally for extended periods, or have increased
metabolic need. Examples of these conditions include those clients with burns,
exacerbation of Crohn's disease, and persistent nausea and vomiting due to
chemotherapy. Other clients would be those who have had extensive surgery, have
multiple fractures, are septic, or have advanced cancer or acquired immunodeficiency
syndrome. The client with the open cholecystectomy is not a candidate because this
client would resume a regular diet within a few days following surgery.
✔✔The nurse is preparing to hang the first bag of parenteral nutrition (PN) solution via
the central line of an assigned client. The nurse should obtain which most essential
piece of equipment before hanging the solution?
1. Urine test strips
2. Blood glucose meter
3. Electronic infusion pump
4. Noninvasive blood pressure monitor - ✔✔3Rationale: The nurse obtains an electronic
infusion pump before hanging a PN solution. Because of the high glucose content, use
of an infusion pump is necessary to ensure that the solution does not infuse too rapidly
or fall behind. Because the client's blood glucose level is monitored every 4 to 6 hours
during administration of PN, a blood glucose meter also will be needed, but this is not
the most essential item needed before hanging the solution because it is not directly
related to administering the PN. Urine test strips (to measure glucose) rarely are used
because of the advent of blood glucose monitoring. Although the blood pressure will be
monitored, a noninvasive blood pressure monitor is not the most essential piece of
equipment needed for this procedure.
✔✔The nurse is making initial rounds at the beginning of the shift and notes that the
parenteral nutrition (PN) bag of an assigned client is empty. Which solution should the
nurse hang until another PN solution is mixed and delivered to the nursing unit?
1. 5% dextrose in water
2. 10% dextrose in water
3. 5% dextrose in Ringer's lactate
4. 5% dextrose in 0.9% sodium chloride - ✔✔2Rationale: The client is at risk for
hypoglycemia; therefore, the solution containing the highest amount of glucose should
be hung until the new PN solution becomes available. Because PN solutions contain
high glucose concentrations, the 10% dextrose in water solution is the best of the
choices presented. The solution selected should be one that minimizes the risk of
hypoglycemia. The remaining options will not be as effective in minimizing the risk of
hypoglycemia.
, ✔✔The nurse is monitoring the status of a client's fat emulsion (lipid) infusion and notes
that the infusion is 1 hour behind. Which action should the nurse take?
1. Adjust the infusion rate to catch up over the next hour.
2. Increase the infusion rate to catch up over the next 2 hours.
3. Ensure that the fat emulsion infusion rate is infusing at the prescribed rate.
4. Adjust the infusion rate to run wide open until the solution is back on time. -
✔✔3Rationale: The nurse should not increase the rate of a fat emulsion to make up the
difference if the infusion timing falls behind. Doing so could place the client at risk for fat
overload. In addition, increasing the rate suddenly can cause fluid overload. The same
principle (not increasing the rate) applies to parenteral nutrition or any intravenous
infusion. Therefore, the remaining options are incorrect.
✔✔A client receiving parenteral nutrition (PN) in the home setting has a weight gain of 5
lb in 1 week. The nurse should next assess the client for the presence of which
condition?
1. Thirst
2. Polyuria
3. Decreased blood pressure
4. Crackles on auscultation of the lungs - ✔✔4Rationale: Optimal weight gain when the
client is receiving PN is 1 to 2 lb/week. The client who has a weight gain of 5 lb/week
while receiving PN is likely to have fluid retention. This can result in hypervolemia. Signs
of hypervolemia include increased blood pressure, crackles on lung auscultation, a
bounding pulse, jugular vein distention, headache, peripheral edema, and weight gain
more than desired. Thirst and polyuria are associated with hyperglycemia. A decreased
blood pressure is likely to be noted in deficient fluid volume.
✔✔The nurse is caring for a restless client who is beginning nutritional therapy with
parenteral nutrition (PN). The nurse should plan to ensure that which action is taken to
prevent the client from sustaining injury?
1. Calculate daily intake and output.
2. Monitor the temperature once daily.
3. Secure all connections in the PN system.
4. Monitor blood glucose levels every 12 hours. - ✔✔3Rationale: The nurse should plan
to secure all connections in the tubing (connections are used per agency protocol). This
helps to prevent the restless client from pulling the connections apart accidentally. The
nurse should also monitor intake and output, but this does not relate specifically to a risk
for injury as presented in the question. Also, monitoring the temperature and blood
glucose levels does not relate to a risk for injury as presented in the question. In
addition, the client's temperature and blood glucose levels are monitored more
frequently than the time frames identified in the options to detect signs of infection and
hyperglycemia, respectively.
✔✔A client receiving parenteral nutrition (PN) complains of a headache. The nurse
notes that the client has an increased blood pressure, bounding pulse, jugular vein
