BSN 246 HESI COMPLETE EXAM QUESTIONS
AND CORRECT ANSWERS | Nightingale
College | Pass Guaranteed - A+ Graded
Question 1
The registered nurse (RN) is caring for a client who developed oliguria and was
diagnosed with sepsis and dehydration 48 hours ago. Which assessment finding
indicates to the RN that the client is stabilizing?
-Urine output of 40 mL/hour.
-Apical pulse 100 and blood pressure 76/42.
-Urine specific gravity 1.001.
-Tented skin on dorsal surface of hands.
Correct Answer
Urine output of 40 mL/hour.
Rationale
A decrease in urinary output is a sign of dehydration. When the urine output returns
to a normal range, 40 mL/hour, the client's kidneys are perfusing adequately and
indicates the client's status is stablizing.
Page 1 of 223
,Question 2
A client with cirrhosis of the liver asks the registered nurse (RN) to explain how
varicose veins can occur in the esophagus. Which statement should the RN provide to
teach the client about the physiological etiology?
-The enlarged liver presses on the lower half of the esophagus which weakens blood
vessel walls.
-Abnormal vessels form as a result of liver damage that causes chronic low serum
protein levels.
-Esophageal swelling and tissue damage causes blood to circulate blood back
through the stomach.
-Increased portal pressure causes blood flow through liver to be shunted to the
esophageal vessels.
Correct Answer
Increased portal pressure causes blood flow through liver to be shunted to the
esophageal vessels.
Rationale
Cirrhotic and fibrosed liver damage causes obstructed blood flow through portal
vessels to the liver which increases the portal pressurecausing the blood flow
through the liver to be shunted to the esophageal vessels. The result of this
shunting of blood causes the esophageal vessels (veins) to balloon out and weaken.
As the portal hypertension increases, these esophageal varices can rupture and
cause bleeding resulting in bloody emesis and black tarry stools.
Question 3
While caring for a client who has esophageal varices, which nursing intervention is
most important for the registered nurse (RN) to implement?
-Monitor infusing IV fluids and any replacement blood products.
-Prepare for esophagogastroduodenoscopy (EGD).
-Maintain the client on strict bedrest.
-Insert a nasogastric tube (NGT) for intermittent suction.
Correct Answer
Monitor infusing IV fluids and any replacement blood products.
Rationale
Maintaining hemodynamic stability in a client with esophageal varicescan
precipitatea life-threatening crisis if esophageal varies leak or rupture and can result
in hemorrhage. The priority is assessing and monitoring infusions of IV fluids and
any replacement blood products.
Page 2 of 223
,Question 4
An older client is admitted to the hospital with severe diarrhea. The registered nurse
(RN) is completing an assessment and notes the client has dry mucous membranes
and poor skin turgor. Which assessment data should the RN gather to determine if
the client has a fluid volume deficit?
-Lower extremity edema.
-Orthostatic hypotension.
-Elevated blood pressure.
-Cheyne-Stokes respirations.
Correct Answer
Orthostatic hypotension.
Rationale
Orthostatic hypotension can be a sign of fluid volume deficit in an older client who
has experienced severe diarrhea.
Question 5
The registered nurse (RN) recognizes which client group is at the greatest risk for
developing a urinary tract infection (UTI)? (Rank from highest risk to lowest risk.)
1.Older males.
2.School-age female.
3.Older females.
4.Adolescent males.
Correct Answer
orrect Answer:
1.Older females.
2.School-age female.
3.Older males.
4.Adolescent males.
Rationale
Hypoestrogenism and alkalotic urine are other age-related factors put older women
at the highest risk for UTIs. School age girls (6 to 12 years) are at risk for UTIs due to
a higher prevalence to taking baths instead of showers, but these risks can be
controlled in this population as well as hypoestrogenism and alkalotic urine. Older
men are at risk due to possible obstruction of the bladder due to benign prostatic
hypertrophy (BPH). Adolescent males (12 to 19 years) are the lowest at risk for a UTI.
All individuals regardless of gender and/or age are at risk if the following conditions
exist: vesicoureteral reflux, neuromuscular conditions, like Parkinson's disease,
previous brain attacks, or the use of anticholinergic medications can all cause
incomplete bladder emptying which can create bacterial overgrowth. Fecal and
urinary incontinence contributes to poor perineal hygiene and bacterial growth.
Page 3 of 223
, Question 6
The registered nurse (RN) is assessing a client who was discharged home after
management of chronic hypertension. Which equipment should the RN instruct the
client to use at home?
-Exercise bicycle.
-Sphygmomanometer.
-Blood glucose monitor.
-Weekly medication box.
Correct Answer
Sphygmomanometer.
Rationale
Self-awareness is the best way for a client to manage chronic hypertension, so the
client should obtain a sphygmomanometer and learn how to monitor blood
pressure daily and maintain a record.
Question 7
A client with progressive hearing loss appears distressed when the registered nurse
(RN) asks open-ended questions about the client's health history. Which forms of
communication should the RN use?
Select all that apply
-Face the client so the client can see the RN's mouth.
-Increase one's speech volume when interacting with the client.
-Repeat information to the client if misunderstood.
-Check if the client's hearing aides are working properly.
-Reduce environmental noise surrounding the client.
Correct Answer
-Face the client so the client can see the RN's mouth.
-Check if the client's hearing aides are working properly.
-Reduce environmental noise surrounding the client.
Rationale
A client with hearing loss can develop the ability to read "lips," so facing the client
during conversation allows visualization of the lips and directs the sound towards
the client. Inspection of the hearing aide device's functionality is a vital step in
communication. Hearing aides magnify all surrounding noise, so it is imperative to
reduce outside environmental noise during the interview process. Speaking clearly
with enunciation and in a regular tone is easier for a client to understand than
increasing the volume of speech. If a client shows signs of confusion, rephrasing the
question, instead of repeating, should be done to decrease client anxiety and
facilitate understanding.
Page 4 of 223
AND CORRECT ANSWERS | Nightingale
College | Pass Guaranteed - A+ Graded
Question 1
The registered nurse (RN) is caring for a client who developed oliguria and was
diagnosed with sepsis and dehydration 48 hours ago. Which assessment finding
indicates to the RN that the client is stabilizing?
-Urine output of 40 mL/hour.
-Apical pulse 100 and blood pressure 76/42.
-Urine specific gravity 1.001.
-Tented skin on dorsal surface of hands.
Correct Answer
Urine output of 40 mL/hour.
Rationale
A decrease in urinary output is a sign of dehydration. When the urine output returns
to a normal range, 40 mL/hour, the client's kidneys are perfusing adequately and
indicates the client's status is stablizing.
Page 1 of 223
,Question 2
A client with cirrhosis of the liver asks the registered nurse (RN) to explain how
varicose veins can occur in the esophagus. Which statement should the RN provide to
teach the client about the physiological etiology?
-The enlarged liver presses on the lower half of the esophagus which weakens blood
vessel walls.
-Abnormal vessels form as a result of liver damage that causes chronic low serum
protein levels.
-Esophageal swelling and tissue damage causes blood to circulate blood back
through the stomach.
-Increased portal pressure causes blood flow through liver to be shunted to the
esophageal vessels.
Correct Answer
Increased portal pressure causes blood flow through liver to be shunted to the
esophageal vessels.
Rationale
Cirrhotic and fibrosed liver damage causes obstructed blood flow through portal
vessels to the liver which increases the portal pressurecausing the blood flow
through the liver to be shunted to the esophageal vessels. The result of this
shunting of blood causes the esophageal vessels (veins) to balloon out and weaken.
As the portal hypertension increases, these esophageal varices can rupture and
cause bleeding resulting in bloody emesis and black tarry stools.
Question 3
While caring for a client who has esophageal varices, which nursing intervention is
most important for the registered nurse (RN) to implement?
-Monitor infusing IV fluids and any replacement blood products.
-Prepare for esophagogastroduodenoscopy (EGD).
-Maintain the client on strict bedrest.
-Insert a nasogastric tube (NGT) for intermittent suction.
Correct Answer
Monitor infusing IV fluids and any replacement blood products.
Rationale
Maintaining hemodynamic stability in a client with esophageal varicescan
precipitatea life-threatening crisis if esophageal varies leak or rupture and can result
in hemorrhage. The priority is assessing and monitoring infusions of IV fluids and
any replacement blood products.
Page 2 of 223
,Question 4
An older client is admitted to the hospital with severe diarrhea. The registered nurse
(RN) is completing an assessment and notes the client has dry mucous membranes
and poor skin turgor. Which assessment data should the RN gather to determine if
the client has a fluid volume deficit?
-Lower extremity edema.
-Orthostatic hypotension.
-Elevated blood pressure.
-Cheyne-Stokes respirations.
Correct Answer
Orthostatic hypotension.
Rationale
Orthostatic hypotension can be a sign of fluid volume deficit in an older client who
has experienced severe diarrhea.
Question 5
The registered nurse (RN) recognizes which client group is at the greatest risk for
developing a urinary tract infection (UTI)? (Rank from highest risk to lowest risk.)
1.Older males.
2.School-age female.
3.Older females.
4.Adolescent males.
Correct Answer
orrect Answer:
1.Older females.
2.School-age female.
3.Older males.
4.Adolescent males.
Rationale
Hypoestrogenism and alkalotic urine are other age-related factors put older women
at the highest risk for UTIs. School age girls (6 to 12 years) are at risk for UTIs due to
a higher prevalence to taking baths instead of showers, but these risks can be
controlled in this population as well as hypoestrogenism and alkalotic urine. Older
men are at risk due to possible obstruction of the bladder due to benign prostatic
hypertrophy (BPH). Adolescent males (12 to 19 years) are the lowest at risk for a UTI.
All individuals regardless of gender and/or age are at risk if the following conditions
exist: vesicoureteral reflux, neuromuscular conditions, like Parkinson's disease,
previous brain attacks, or the use of anticholinergic medications can all cause
incomplete bladder emptying which can create bacterial overgrowth. Fecal and
urinary incontinence contributes to poor perineal hygiene and bacterial growth.
Page 3 of 223
, Question 6
The registered nurse (RN) is assessing a client who was discharged home after
management of chronic hypertension. Which equipment should the RN instruct the
client to use at home?
-Exercise bicycle.
-Sphygmomanometer.
-Blood glucose monitor.
-Weekly medication box.
Correct Answer
Sphygmomanometer.
Rationale
Self-awareness is the best way for a client to manage chronic hypertension, so the
client should obtain a sphygmomanometer and learn how to monitor blood
pressure daily and maintain a record.
Question 7
A client with progressive hearing loss appears distressed when the registered nurse
(RN) asks open-ended questions about the client's health history. Which forms of
communication should the RN use?
Select all that apply
-Face the client so the client can see the RN's mouth.
-Increase one's speech volume when interacting with the client.
-Repeat information to the client if misunderstood.
-Check if the client's hearing aides are working properly.
-Reduce environmental noise surrounding the client.
Correct Answer
-Face the client so the client can see the RN's mouth.
-Check if the client's hearing aides are working properly.
-Reduce environmental noise surrounding the client.
Rationale
A client with hearing loss can develop the ability to read "lips," so facing the client
during conversation allows visualization of the lips and directs the sound towards
the client. Inspection of the hearing aide device's functionality is a vital step in
communication. Hearing aides magnify all surrounding noise, so it is imperative to
reduce outside environmental noise during the interview process. Speaking clearly
with enunciation and in a regular tone is easier for a client to understand than
increasing the volume of speech. If a client shows signs of confusion, rephrasing the
question, instead of repeating, should be done to decrease client anxiety and
facilitate understanding.
Page 4 of 223
