HESI RN EXAM WITH 200+
QUESTIONS AND
ANSWERS WITH
RATIONALE [A+]
1. Question: Describe the pathophysiology of heart failure and its common
causes.
Answer: Heart failure occurs when the heart is unable to pump enough blood to meet the
body's needs. This can result from various factors, including:
● Ischemic heart disease: Damage from coronary artery disease or a heart attack.
● Hypertension: Chronic high blood pressure can lead to left ventricular hypertrophy and
ultimately heart failure.
● Cardiomyopathy: Diseases of the heart muscle can weaken its ability to contract.
● Valvular heart disease: Malfunctioning heart valves can increase the workload of the
heart.
● Arrhythmias: Irregular heart rhythms can impair the heart's efficiency.
The compensatory mechanisms that attempt to maintain cardiac output may initially help but
eventually lead to increased workload and further decline in heart function.
2. Question: Explain the nursing interventions for a patient experiencing a
stroke.
Answer: Nursing interventions for a stroke patient include:
● Assessment: Monitor vital signs, neurological status, and level of consciousness
frequently. Use the FAST (Face, Arms, Speech, Time) method to assess stroke
symptoms.
● Positioning: Place the patient in a safe position (e.g., side-lying) to maintain an open
airway and prevent aspiration.
● Oxygen therapy: Administer oxygen if the patient shows signs of hypoxia.
● IV access: Establish IV access for medications or fluids as prescribed.
, ● Communication: Use clear, simple language and allow extra time for the patient to
respond, especially if they have aphasia.
● Monitoring: Assess for complications such as increased intracranial pressure or
seizures.
● Education: Inform the patient and family about stroke risk factors, signs of stroke, and
the importance of adherence to prescribed therapies.
3. Question: Discuss the principles of medication administration for a
patient with renal impairment.
Answer: When administering medications to a patient with renal impairment, consider the
following principles:
● Dosage adjustment: Many medications require dosage modifications based on renal
function. Use the patient's creatinine clearance or estimated GFR to guide dosing.
● Monitoring: Regularly monitor kidney function and serum drug levels, especially for
medications with narrow therapeutic ranges.
● Renal-safe medications: Prefer medications that are less nephrotoxic or have minimal
renal clearance.
● Patient education: Instruct the patient to report any symptoms of adverse effects, such
as changes in urine output, swelling, or fatigue.
● Drug interactions: Be aware of potential interactions between medications that may
worsen renal function.
4. Question: What are the signs and symptoms of hyperglycemia, and how
should a nurse respond?
Answer: Signs and symptoms of hyperglycemia include:
● Increased thirst (polydipsia)
● Frequent urination (polyuria)
● Fatigue
● Blurred vision
● Headache
● Dry mouth and skin
Nursing Response:
1. Assessment: Measure blood glucose levels and assess for ketones in the urine if the
patient is diabetic.
2. Administer insulin: If prescribed, administer insulin as needed, following the facility's
protocol.
3. Encourage hydration: Advise the patient to drink plenty of fluids to help dilute the
glucose and prevent dehydration.
4. Monitor: Keep a close watch on the patient for any signs of diabetic ketoacidosis (DKA),
such as abdominal pain or altered mental status.
, 5. Educate: Teach the patient about lifestyle modifications, including diet and exercise, to
help manage blood glucose levels.
5. Question: Describe the nursing care plan for a patient undergoing
surgery.
Answer: A nursing care plan for a surgical patient should include:
● Preoperative care:
○ Conduct a thorough assessment, including medical history, allergies, and current
medications.
○ Educate the patient about the procedure, expected outcomes, and postoperative
care.
○ Ensure informed consent is obtained and documented.
○ Administer preoperative medications as ordered, such as anxiolytics or
antibiotics.
● Intraoperative care:
○ Assist the surgical team as needed.
○ Monitor vital signs and the patient's status throughout the procedure.
○ Maintain sterile technique to prevent infection.
● Postoperative care:
○ Assess the patient’s recovery from anesthesia, including airway patency and
level of consciousness.
○ Monitor surgical site for signs of bleeding or infection.
○ Manage pain effectively using prescribed medications.
○ Encourage early ambulation to prevent complications like deep vein thrombosis
(DVT).
○ Educate the patient about signs of complications to report before discharge.
:
6. Question: What are the risk factors for developing deep vein thrombosis
(DVT), and what nursing interventions can help prevent it?
Answer: Risk factors for developing DVT include:
● Immobility: Prolonged bed rest or sitting (e.g., long flights or car rides).
● Surgery: Especially orthopedic or pelvic surgeries.
● Obesity: Increased weight can put pressure on veins.
● Age: Risk increases with age.
● Hormonal factors: Use of oral contraceptives or hormone replacement therapy.
● History of DVT: Previous episodes increase the risk of recurrence.
● Chronic conditions: Such as heart failure or cancer.
Nursing Interventions:
1. Encourage mobility: Promote early ambulation post-surgery and encourage patients to
change positions frequently.
, 2. Leg exercises: Teach patients to perform ankle pumps and leg lifts while in bed.
3. Compression devices: Use graduated compression stockings or intermittent pneumatic
compression devices as ordered.
4. Hydration: Encourage adequate fluid intake to prevent dehydration, which can
contribute to clot formation.
5. Assessment: Monitor for signs of DVT, including swelling, pain, or redness in the
extremities.
6. Patient education: Instruct patients about the importance of mobility and recognizing
DVT symptoms.
7. Question: Explain the concept of patient-centered care and its
importance in nursing practice.
Answer: Patient-centered care is an approach that emphasizes the involvement of patients in
their own care and treatment decisions. It respects and responds to individual patient
preferences, needs, and values. Its importance in nursing practice includes:
● Improved outcomes: Studies show that patient-centered care leads to better health
outcomes, increased satisfaction, and adherence to treatment plans.
● Enhanced communication: Fosters a therapeutic nurse-patient relationship, promoting
open dialogue and trust.
● Empowerment: Encourages patients to take an active role in their health, leading to
increased engagement and self-management.
● Holistic care: Addresses the physical, emotional, social, and spiritual needs of patients,
providing a more comprehensive approach to health care.
● Cultural competence: Acknowledges and respects diverse backgrounds and values,
ensuring care is appropriate for each individual.
8. Question: What are the potential complications of uncontrolled
hypertension, and how can a nurse educate patients about management?
Answer: Potential complications of uncontrolled hypertension include:
● Heart disease: Increased risk of heart failure, coronary artery disease, and myocardial
infarction.
● Stroke: Hypertension is a significant risk factor for both ischemic and hemorrhagic
strokes.
● Kidney damage: Can lead to chronic kidney disease and eventual renal failure.
● Vision loss: Hypertensive retinopathy can result in vision impairment.
● Aneurysms: Weakened blood vessels can lead to the formation of aneurysms.
Patient Education on Management:
1. Lifestyle modifications: Discuss the importance of a heart-healthy diet (e.g., DASH
diet), regular exercise, and weight management.
QUESTIONS AND
ANSWERS WITH
RATIONALE [A+]
1. Question: Describe the pathophysiology of heart failure and its common
causes.
Answer: Heart failure occurs when the heart is unable to pump enough blood to meet the
body's needs. This can result from various factors, including:
● Ischemic heart disease: Damage from coronary artery disease or a heart attack.
● Hypertension: Chronic high blood pressure can lead to left ventricular hypertrophy and
ultimately heart failure.
● Cardiomyopathy: Diseases of the heart muscle can weaken its ability to contract.
● Valvular heart disease: Malfunctioning heart valves can increase the workload of the
heart.
● Arrhythmias: Irregular heart rhythms can impair the heart's efficiency.
The compensatory mechanisms that attempt to maintain cardiac output may initially help but
eventually lead to increased workload and further decline in heart function.
2. Question: Explain the nursing interventions for a patient experiencing a
stroke.
Answer: Nursing interventions for a stroke patient include:
● Assessment: Monitor vital signs, neurological status, and level of consciousness
frequently. Use the FAST (Face, Arms, Speech, Time) method to assess stroke
symptoms.
● Positioning: Place the patient in a safe position (e.g., side-lying) to maintain an open
airway and prevent aspiration.
● Oxygen therapy: Administer oxygen if the patient shows signs of hypoxia.
● IV access: Establish IV access for medications or fluids as prescribed.
, ● Communication: Use clear, simple language and allow extra time for the patient to
respond, especially if they have aphasia.
● Monitoring: Assess for complications such as increased intracranial pressure or
seizures.
● Education: Inform the patient and family about stroke risk factors, signs of stroke, and
the importance of adherence to prescribed therapies.
3. Question: Discuss the principles of medication administration for a
patient with renal impairment.
Answer: When administering medications to a patient with renal impairment, consider the
following principles:
● Dosage adjustment: Many medications require dosage modifications based on renal
function. Use the patient's creatinine clearance or estimated GFR to guide dosing.
● Monitoring: Regularly monitor kidney function and serum drug levels, especially for
medications with narrow therapeutic ranges.
● Renal-safe medications: Prefer medications that are less nephrotoxic or have minimal
renal clearance.
● Patient education: Instruct the patient to report any symptoms of adverse effects, such
as changes in urine output, swelling, or fatigue.
● Drug interactions: Be aware of potential interactions between medications that may
worsen renal function.
4. Question: What are the signs and symptoms of hyperglycemia, and how
should a nurse respond?
Answer: Signs and symptoms of hyperglycemia include:
● Increased thirst (polydipsia)
● Frequent urination (polyuria)
● Fatigue
● Blurred vision
● Headache
● Dry mouth and skin
Nursing Response:
1. Assessment: Measure blood glucose levels and assess for ketones in the urine if the
patient is diabetic.
2. Administer insulin: If prescribed, administer insulin as needed, following the facility's
protocol.
3. Encourage hydration: Advise the patient to drink plenty of fluids to help dilute the
glucose and prevent dehydration.
4. Monitor: Keep a close watch on the patient for any signs of diabetic ketoacidosis (DKA),
such as abdominal pain or altered mental status.
, 5. Educate: Teach the patient about lifestyle modifications, including diet and exercise, to
help manage blood glucose levels.
5. Question: Describe the nursing care plan for a patient undergoing
surgery.
Answer: A nursing care plan for a surgical patient should include:
● Preoperative care:
○ Conduct a thorough assessment, including medical history, allergies, and current
medications.
○ Educate the patient about the procedure, expected outcomes, and postoperative
care.
○ Ensure informed consent is obtained and documented.
○ Administer preoperative medications as ordered, such as anxiolytics or
antibiotics.
● Intraoperative care:
○ Assist the surgical team as needed.
○ Monitor vital signs and the patient's status throughout the procedure.
○ Maintain sterile technique to prevent infection.
● Postoperative care:
○ Assess the patient’s recovery from anesthesia, including airway patency and
level of consciousness.
○ Monitor surgical site for signs of bleeding or infection.
○ Manage pain effectively using prescribed medications.
○ Encourage early ambulation to prevent complications like deep vein thrombosis
(DVT).
○ Educate the patient about signs of complications to report before discharge.
:
6. Question: What are the risk factors for developing deep vein thrombosis
(DVT), and what nursing interventions can help prevent it?
Answer: Risk factors for developing DVT include:
● Immobility: Prolonged bed rest or sitting (e.g., long flights or car rides).
● Surgery: Especially orthopedic or pelvic surgeries.
● Obesity: Increased weight can put pressure on veins.
● Age: Risk increases with age.
● Hormonal factors: Use of oral contraceptives or hormone replacement therapy.
● History of DVT: Previous episodes increase the risk of recurrence.
● Chronic conditions: Such as heart failure or cancer.
Nursing Interventions:
1. Encourage mobility: Promote early ambulation post-surgery and encourage patients to
change positions frequently.
, 2. Leg exercises: Teach patients to perform ankle pumps and leg lifts while in bed.
3. Compression devices: Use graduated compression stockings or intermittent pneumatic
compression devices as ordered.
4. Hydration: Encourage adequate fluid intake to prevent dehydration, which can
contribute to clot formation.
5. Assessment: Monitor for signs of DVT, including swelling, pain, or redness in the
extremities.
6. Patient education: Instruct patients about the importance of mobility and recognizing
DVT symptoms.
7. Question: Explain the concept of patient-centered care and its
importance in nursing practice.
Answer: Patient-centered care is an approach that emphasizes the involvement of patients in
their own care and treatment decisions. It respects and responds to individual patient
preferences, needs, and values. Its importance in nursing practice includes:
● Improved outcomes: Studies show that patient-centered care leads to better health
outcomes, increased satisfaction, and adherence to treatment plans.
● Enhanced communication: Fosters a therapeutic nurse-patient relationship, promoting
open dialogue and trust.
● Empowerment: Encourages patients to take an active role in their health, leading to
increased engagement and self-management.
● Holistic care: Addresses the physical, emotional, social, and spiritual needs of patients,
providing a more comprehensive approach to health care.
● Cultural competence: Acknowledges and respects diverse backgrounds and values,
ensuring care is appropriate for each individual.
8. Question: What are the potential complications of uncontrolled
hypertension, and how can a nurse educate patients about management?
Answer: Potential complications of uncontrolled hypertension include:
● Heart disease: Increased risk of heart failure, coronary artery disease, and myocardial
infarction.
● Stroke: Hypertension is a significant risk factor for both ischemic and hemorrhagic
strokes.
● Kidney damage: Can lead to chronic kidney disease and eventual renal failure.
● Vision loss: Hypertensive retinopathy can result in vision impairment.
● Aneurysms: Weakened blood vessels can lead to the formation of aneurysms.
Patient Education on Management:
1. Lifestyle modifications: Discuss the importance of a heart-healthy diet (e.g., DASH
diet), regular exercise, and weight management.
