HESI FUNDAMENTALS EXAM QUESTIONS
& ANSWERS
A client has a paracentesis, and the health care provider removes 1500 mL of fluid. To monitor
for a serious postprocedure complication, the nurse should assess for:
1
Dry mouth
Correct 3
3
Hypertensive crisis
4
Increased abdominal distention
Fluid may shift from the intravascular space to the abdomen as fluid is removed, leading to
hypovolemia and compensatory tachycardia. Dry mouth may occur with dehydration, but it
is not as vital or immediate as signs of shock. Dry mouth is a subjective symptom that
cannot be measured objectively. The fluid shift can cause hypovolemia with resulting
hypotension, not hypertension. A paracentesis decreases the degree of abdominal
distention.
A client admitted to the hospital with a diagnosis of malabsorption syndrome exhibits signs of
tetany. The nurse concludes that the tetany was precipitated by the inadequate absorption of
which electrolyte?
1
Sodium
Correct 2
Calcium
3
Potassium
4
Phosphorus
The muscle contraction-relaxation cycle requires an adequate serum calcium-phosphorus
ratio; the reduction of the ionized serum calcium level associated with malabsorption
syndrome causes tetany (spastic muscle spasms). Sodium is the major extracellular cation.
Sodium's major route of excretion is the kidneys, under the control of aldosterone. Although
it plays a part in neuromuscular transmission, potassium is not related to the development
of tetany. Potassium is the major intracellular cation. Potassium is part of the sodium-
potassium pump and helps to balance the response of nerves to stimulation. Potassium is
not related to the development of tetany. Although phosphorus is closely related to calcium
because they exist in a specific ratio, phosphorus is not related to the development of
tetany.
,A client reports severe pain two days after surgery. After assessing the characteristics of the
pain, which initial action should the nurse take next?
1
Encourage rest.
Correct 2
Obtain the vital signs.
3
Administer the prescribed analgesic.
4
Document the client's pain response.
Immediately before administration of an analgesic, an assessment of vital signs is
necessary to determine whether any contraindications to the medication exist (e.g.,
hypotension, respirations ≤12 breaths/min). Pain prevents both psychological and
physiological rest. Before administration of an analgesic, the nurse must check the health
care provider's prescription, the time of the last administration, and the client's vital signs. A
complete assessment including vital signs should be done before documenting.
The health care provider orders 1000 mL normal saline to be infused over
8 hours for a client with a diagnosis of dehydration. The intravenous (IV)
tubing delivers 15 drops per milliliter (drop factor). The nurse should
administer the IV infusion at a rate of
gtts/minute. Record your answer using a whole number.
Administering 1,000 mL over 8 hours is equal to administering 125 mL over 1 hour (60
minutes). To find the number of milliliters per minute:
125/60 min = X/1 minute
60X = 125X = 2.1
mL/minute
To find the number of drops/minute:
2.1 mL/X gtts = 1 mL/15
gtts X = 31 gtts/minute
A health care provider prescribes simvastatin (Zocor) 20 mg daily for elevated cholesterol and
triglyceride levels for a female client. Which is most important for the nurse to teach when the
client initially takes the medication?
1
Take the medication with breakfast.
2
Have liver function tests every six months.
3
Wear sunscreen to prevent photosensitivity reactions.
, Correct 4
Inform the health care provider if the client wishes to become pregnant.
Simvastatin is contraindicated in pregnancy because it is capable of causing fetal damage
(teratogenic). It is a Pregnancy Category X teratogen. Simvastatin should be taken in the
evening because most cholesterol is synthesized between 12 midnight and 3:00 AM. Liver
function tests should be done at 6 to 12 weeks initially and only then every 6 months.
Although wearing sunscreen should be taught, sensitivity reactions are a rare occurrence; it
is not as important as an action in another option.
A client who weighs 176 pounds is receiving 8 mg/kg cyclosporine
(Sandimmune) each day to prevent organ transplant rejection. How many
milligrams should the nurse administer each day? Record your answer
using a whole number. mg
First compute the client's weight in kilograms and then compute the dosage. Solve the
problem using ratio and proportion.
Desired 176 pounds = x
kg Have 2.2 pounds = 1
kg
2.2 x = 176
x = 176 ÷ 2.2
x = 80 kg
Desired 80 kg X x
mg Have 1 kg 8 mg
1x = 80 X 8
x = 640 mg
A client is being treated for Influenza A (H1N1). The nurse has provided instructions to the
client about how to decrease the risk of transmission to others. Which patient statement
indicates a need for further instruction/clarification?
1
"I should practice respiratory hygiene/cough etiquette."
2
"I should avoid contact with the elderly or children."
Correct 3
"I should obtain a pneumococcal vaccination each year."
4
"I should allow visitors for short periods of time only."
The client should be encouraged to receive an influenza vaccine each year. Pneumococcal
vaccines will not prevent influenza. The nurse should stress the importance of practicing
respiratory hygiene/cough etiquette. The client should avoid contact with vulnerable
populations such as the elderly and children. Visitors for clients in isolation for influenza
& ANSWERS
A client has a paracentesis, and the health care provider removes 1500 mL of fluid. To monitor
for a serious postprocedure complication, the nurse should assess for:
1
Dry mouth
Correct 3
3
Hypertensive crisis
4
Increased abdominal distention
Fluid may shift from the intravascular space to the abdomen as fluid is removed, leading to
hypovolemia and compensatory tachycardia. Dry mouth may occur with dehydration, but it
is not as vital or immediate as signs of shock. Dry mouth is a subjective symptom that
cannot be measured objectively. The fluid shift can cause hypovolemia with resulting
hypotension, not hypertension. A paracentesis decreases the degree of abdominal
distention.
A client admitted to the hospital with a diagnosis of malabsorption syndrome exhibits signs of
tetany. The nurse concludes that the tetany was precipitated by the inadequate absorption of
which electrolyte?
1
Sodium
Correct 2
Calcium
3
Potassium
4
Phosphorus
The muscle contraction-relaxation cycle requires an adequate serum calcium-phosphorus
ratio; the reduction of the ionized serum calcium level associated with malabsorption
syndrome causes tetany (spastic muscle spasms). Sodium is the major extracellular cation.
Sodium's major route of excretion is the kidneys, under the control of aldosterone. Although
it plays a part in neuromuscular transmission, potassium is not related to the development
of tetany. Potassium is the major intracellular cation. Potassium is part of the sodium-
potassium pump and helps to balance the response of nerves to stimulation. Potassium is
not related to the development of tetany. Although phosphorus is closely related to calcium
because they exist in a specific ratio, phosphorus is not related to the development of
tetany.
,A client reports severe pain two days after surgery. After assessing the characteristics of the
pain, which initial action should the nurse take next?
1
Encourage rest.
Correct 2
Obtain the vital signs.
3
Administer the prescribed analgesic.
4
Document the client's pain response.
Immediately before administration of an analgesic, an assessment of vital signs is
necessary to determine whether any contraindications to the medication exist (e.g.,
hypotension, respirations ≤12 breaths/min). Pain prevents both psychological and
physiological rest. Before administration of an analgesic, the nurse must check the health
care provider's prescription, the time of the last administration, and the client's vital signs. A
complete assessment including vital signs should be done before documenting.
The health care provider orders 1000 mL normal saline to be infused over
8 hours for a client with a diagnosis of dehydration. The intravenous (IV)
tubing delivers 15 drops per milliliter (drop factor). The nurse should
administer the IV infusion at a rate of
gtts/minute. Record your answer using a whole number.
Administering 1,000 mL over 8 hours is equal to administering 125 mL over 1 hour (60
minutes). To find the number of milliliters per minute:
125/60 min = X/1 minute
60X = 125X = 2.1
mL/minute
To find the number of drops/minute:
2.1 mL/X gtts = 1 mL/15
gtts X = 31 gtts/minute
A health care provider prescribes simvastatin (Zocor) 20 mg daily for elevated cholesterol and
triglyceride levels for a female client. Which is most important for the nurse to teach when the
client initially takes the medication?
1
Take the medication with breakfast.
2
Have liver function tests every six months.
3
Wear sunscreen to prevent photosensitivity reactions.
, Correct 4
Inform the health care provider if the client wishes to become pregnant.
Simvastatin is contraindicated in pregnancy because it is capable of causing fetal damage
(teratogenic). It is a Pregnancy Category X teratogen. Simvastatin should be taken in the
evening because most cholesterol is synthesized between 12 midnight and 3:00 AM. Liver
function tests should be done at 6 to 12 weeks initially and only then every 6 months.
Although wearing sunscreen should be taught, sensitivity reactions are a rare occurrence; it
is not as important as an action in another option.
A client who weighs 176 pounds is receiving 8 mg/kg cyclosporine
(Sandimmune) each day to prevent organ transplant rejection. How many
milligrams should the nurse administer each day? Record your answer
using a whole number. mg
First compute the client's weight in kilograms and then compute the dosage. Solve the
problem using ratio and proportion.
Desired 176 pounds = x
kg Have 2.2 pounds = 1
kg
2.2 x = 176
x = 176 ÷ 2.2
x = 80 kg
Desired 80 kg X x
mg Have 1 kg 8 mg
1x = 80 X 8
x = 640 mg
A client is being treated for Influenza A (H1N1). The nurse has provided instructions to the
client about how to decrease the risk of transmission to others. Which patient statement
indicates a need for further instruction/clarification?
1
"I should practice respiratory hygiene/cough etiquette."
2
"I should avoid contact with the elderly or children."
Correct 3
"I should obtain a pneumococcal vaccination each year."
4
"I should allow visitors for short periods of time only."
The client should be encouraged to receive an influenza vaccine each year. Pneumococcal
vaccines will not prevent influenza. The nurse should stress the importance of practicing
respiratory hygiene/cough etiquette. The client should avoid contact with vulnerable
populations such as the elderly and children. Visitors for clients in isolation for influenza
