HESI LEVEL 1 PRACTICE EXAM
1. The nurse is caring for a client who is receiving 24-hour total parenteral
nutrition (TPN) via a central line at 54 ml/hr. When initially assessing the
client, the nurse notes that the TPN solution has run out and the next TPN
solution is not available. What immediate action should the nurse take?
A. Infuse normal saline at a keep vein open rate.
B. Discontinue the IV and flush the port with heparin.
C. Infuse 10% dextrose and water at 54 ml/hour.
D. Obtain a stat blood glucose level and notify the healthcare provider.: C
2. A crying toddler has a blood pressure measurement of 120/70 mm Hg.
What action should the nurse implement?
A. Notify the healthcare provider of the measurement.
B. Quiet the child and retake the blood pressure.
C. Ask the parent if the child has a history of hypertension.
,D. Document the finding and recheck in 4 hours.: B
3. The mother of a neonate asks the nurse why it is so important to keep
the infant warm. What information should the nurse provide?
A. The kidneys and renal function are not fully developed.
B. Warmth promotes sleep so the infant will grow quickly.
C. A large body surface area favors heat loss to the environment.
D. The thick layer of subcutaneous fat is inadequate for insulation.: C
4. What action by the nurse demonstrates culturally sensitive care?
A. Asks permission before touching a client.
B. Avoids questions about male-female relationships.
C. Explains the differences between Western medical care and cultural folk
remedies.
D. Applies knowledge of a cultural group unless a client embraces Western
customs.: A
5. A client has a nursing diagnosis of, "Spiritual distress related to a loss
,of hope, secondary to impending death." What intervention is best for the
nurse to implement when caring for this client?
A. Help the client to accept the final stage of life.
B. Assist and support the client in establishing short-term goals.
C. Encourage the client to make future plans, even if they are unrealistic.
D. Instruct the client's family to focus on positive aspects of the client's life.:
B
6. A client who is 5 foot 5 inches tall and weighs 200 pounds is
scheduled for surgery the next day. Which 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?": B
7. The nurse working in the emergency department is assessing four
clients' ability to tolerate pain. Which client is likely to tolerate a higher level
of pain?
A. A 10-year-old who was burned by a camp fire earlier today.
B. A 70-year-old who has a postoperative infection from a surgery one
week ago.
C. A 23-year-old woman who sprained her knee while bicycling.
D. A 55-year-old woman who has had moderate low back pain for
three months.: D
8. A hospitalized male client is receiving nasogastric tube feedings via a
small-bore tube and a continuous pump infusion. He reports that he had a
bad bout of severe coughing a few minutes ago, but feels fine now. What
action is best for the nurse to take?
1. The nurse is caring for a client who is receiving 24-hour total parenteral
nutrition (TPN) via a central line at 54 ml/hr. When initially assessing the
client, the nurse notes that the TPN solution has run out and the next TPN
solution is not available. What immediate action should the nurse take?
A. Infuse normal saline at a keep vein open rate.
B. Discontinue the IV and flush the port with heparin.
C. Infuse 10% dextrose and water at 54 ml/hour.
D. Obtain a stat blood glucose level and notify the healthcare provider.: C
2. A crying toddler has a blood pressure measurement of 120/70 mm Hg.
What action should the nurse implement?
A. Notify the healthcare provider of the measurement.
B. Quiet the child and retake the blood pressure.
C. Ask the parent if the child has a history of hypertension.
,D. Document the finding and recheck in 4 hours.: B
3. The mother of a neonate asks the nurse why it is so important to keep
the infant warm. What information should the nurse provide?
A. The kidneys and renal function are not fully developed.
B. Warmth promotes sleep so the infant will grow quickly.
C. A large body surface area favors heat loss to the environment.
D. The thick layer of subcutaneous fat is inadequate for insulation.: C
4. What action by the nurse demonstrates culturally sensitive care?
A. Asks permission before touching a client.
B. Avoids questions about male-female relationships.
C. Explains the differences between Western medical care and cultural folk
remedies.
D. Applies knowledge of a cultural group unless a client embraces Western
customs.: A
5. A client has a nursing diagnosis of, "Spiritual distress related to a loss
,of hope, secondary to impending death." What intervention is best for the
nurse to implement when caring for this client?
A. Help the client to accept the final stage of life.
B. Assist and support the client in establishing short-term goals.
C. Encourage the client to make future plans, even if they are unrealistic.
D. Instruct the client's family to focus on positive aspects of the client's life.:
B
6. A client who is 5 foot 5 inches tall and weighs 200 pounds is
scheduled for surgery the next day. Which 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?": B
7. The nurse working in the emergency department is assessing four
clients' ability to tolerate pain. Which client is likely to tolerate a higher level
of pain?
A. A 10-year-old who was burned by a camp fire earlier today.
B. A 70-year-old who has a postoperative infection from a surgery one
week ago.
C. A 23-year-old woman who sprained her knee while bicycling.
D. A 55-year-old woman who has had moderate low back pain for
three months.: D
8. A hospitalized male client is receiving nasogastric tube feedings via a
small-bore tube and a continuous pump infusion. He reports that he had a
bad bout of severe coughing a few minutes ago, but feels fine now. What
action is best for the nurse to take?
