HESI FUNDAMENTALS PRACTICE
EXAM QUESTIONS WITH
ACCURATE ANSWERS
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."
correct answer B. "Place a pillow between your knees while lying in bed to
prevent hip dislocation."
(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.)
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. correct answer 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 dose as soon as possible, and revise the administration schedule
accordingly to prevent dangerously increasing the level of 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.)
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 HCP before administering the next dose.
D. Give the client a PRN dose of aspirin while the medication infuses. correct
answer B. Initiate an alternate site for the IV infusion of the medication.
(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
alternate IV site. Although aspirin has antiinflammatory actions, (D) is not
indicated.)
,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?
correct answer 63 mL/hr
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, BUN is 15 mg/dL, and the serum potassium is 3.7
mEq/L. Which action is most important for the nurse to implement?
A. Notify HCP and request to change the IV infusion to hypertonic D10W
B. Decrease in the infusion rate of the current IV and report to the HCP
C. Document in the medical record that these normal findings are expected
outcomes
D. Obtain potassium chloride 20 mEq in anticipation of prescription to to present
IV correct answer C. Document in the medical record that these normal findings
are expected outcomes..
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?" correct answer B. "What
vitamin and mineral supplements do you take?"
(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.)
, 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. Autopsy of the body is prohibited.
B. Blood transfusions are forbidden.
C. Alcohol use in any form is not allowed.
D. A vegetarian diet must be followed. correct answer B. Blood transfusions are
forbidden.
A client who is in hospice care complains of increasing amounts of pain. The
healthcare provider prescribes an analgesic every four hours as needed. Which
action should the nurse implement?
A. Give an around-the-clock schedule for administration of analgesics.
B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so that the client can do daily activities. correct
answer A. Give an around-the-clock schedule for administration of analgesics.
(The most effective management of pain is achieved using an around-the-clock
schedule that provides analgesic medications on a regular basis (A) and in a timely
manner. Analgesics are less effective if pain persists until it is severe, so an
analgesic medication should be administered before the client's pain peaks (B).
Providing comfort is a priority for the client who is dying, but sedation that
impairs the client's ability to interact and experience the time before life ends
should be minimized (C). Offering a medication-free period allows the serum drug
level to fall, which is not an effective method to manage chronic pain.)
A client with acute hemorrhagic anemia is to receive four units of packed RBCs as
rapidly as possible. Which intervention is most important for the nurse to
implement?
A. Obtain the pre-transfusion hemoglobin level.
EXAM QUESTIONS WITH
ACCURATE ANSWERS
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."
correct answer B. "Place a pillow between your knees while lying in bed to
prevent hip dislocation."
(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.)
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. correct answer 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 dose as soon as possible, and revise the administration schedule
accordingly to prevent dangerously increasing the level of 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.)
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 HCP before administering the next dose.
D. Give the client a PRN dose of aspirin while the medication infuses. correct
answer B. Initiate an alternate site for the IV infusion of the medication.
(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
alternate IV site. Although aspirin has antiinflammatory actions, (D) is not
indicated.)
,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?
correct answer 63 mL/hr
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, BUN is 15 mg/dL, and the serum potassium is 3.7
mEq/L. Which action is most important for the nurse to implement?
A. Notify HCP and request to change the IV infusion to hypertonic D10W
B. Decrease in the infusion rate of the current IV and report to the HCP
C. Document in the medical record that these normal findings are expected
outcomes
D. Obtain potassium chloride 20 mEq in anticipation of prescription to to present
IV correct answer C. Document in the medical record that these normal findings
are expected outcomes..
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?" correct answer B. "What
vitamin and mineral supplements do you take?"
(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.)
, 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. Autopsy of the body is prohibited.
B. Blood transfusions are forbidden.
C. Alcohol use in any form is not allowed.
D. A vegetarian diet must be followed. correct answer B. Blood transfusions are
forbidden.
A client who is in hospice care complains of increasing amounts of pain. The
healthcare provider prescribes an analgesic every four hours as needed. Which
action should the nurse implement?
A. Give an around-the-clock schedule for administration of analgesics.
B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so that the client can do daily activities. correct
answer A. Give an around-the-clock schedule for administration of analgesics.
(The most effective management of pain is achieved using an around-the-clock
schedule that provides analgesic medications on a regular basis (A) and in a timely
manner. Analgesics are less effective if pain persists until it is severe, so an
analgesic medication should be administered before the client's pain peaks (B).
Providing comfort is a priority for the client who is dying, but sedation that
impairs the client's ability to interact and experience the time before life ends
should be minimized (C). Offering a medication-free period allows the serum drug
level to fall, which is not an effective method to manage chronic pain.)
A client with acute hemorrhagic anemia is to receive four units of packed RBCs as
rapidly as possible. Which intervention is most important for the nurse to
implement?
A. Obtain the pre-transfusion hemoglobin level.
