HESI Practice Exam
A 24-year-old female client diagnosed with a human papillomavirus infection (HPV) is angry at
her ex-boyfriend and says she is not going to tell him that he is infected. What response is best
for the nurse to provide?
"You do not have to tell him because this is not a reportable disease."
"Because there is no cure for this disease, telling him is of no benefit to him or to you."
"Even though you are angry, he should be told, so he can take precautions to prevent the
spread of infection."
"You should tell him, so he can feel as guilty and miserable as you do now, knowing that you
have this disease." - ANS-"Even though you are angry, he should be told, so he can take
precautions to prevent the spread of infection."
Anger is a common emotional reaction when confronted with the diagnosis of a STI, and often
lay blame and project this anger at the sexual partner. Although HPV is not a reportable disease
in many states, all contacts should be informed of the infection, treatment, transmission, and
precautions to minimize infecting others.
\A 40-year-old female client has a history of smoking. Which finding should the nurse identify as
a risk factor for myocardial infarction?
Oral contraceptives.
Senile osteopenia.
Levothyroxine therapy.
Pernicious anemia. - ANS-Oral contraceptives.
Women older than 35 years old who smoke and take oral contraceptives have an increased risk
of myocardial infarction or stroke.
\A 48-year-old client with endometrial cancer is being discharged after a total hysterectomy and
bilateral salpingo-oophorectomy. Which client statement indicates that further teaching is
needed?
"Well, I don't have to worry about getting pregnant anymore."
"I can't wait to go on the cruise that I have planned for this summer."
"I know I will miss having sexual intercourse with my husband."
"I have asked my daughter to stay with me next week after I am discharged." - ANS-"I know I
will miss having sexual intercourse with my husband."
Further teaching is needed in response to the client's misunderstanding of not being able to
have sexual intercourse after a hysterectomy.
,\A client asks the nurse about the purpose of beginning chemotherapy (CT) because the tumor
is still very small. Which information supports the explanation that the nurse should provide?
Side effects are less likely if therapy is started early.
Collateral circulation increases as the tumor grows.
Sensitivity of cancer cells to CT is based on cell cycle rate.
The cell count of the tumor reduces by half with each dose. - ANS-The cell count of the tumor
reduces by half with each dose.
Initiating chemotherapy while the tumor is small provides a better chance of eradicating all
cancer cells because 50% of cancer cells or tumor cells are killed with each dose.
\A client has been told that there is cataract formation over both eyes. Which finding should the
nurse expect when assessing the client?
Decreased color perception.
Presence of floaters.
Loss of central vision.
Reduced peripheral vision. - ANS-Decreased color perception.
Decreased color perception occurs with cataract formation. Cataract formation is also
associated with blurred vision and a global loss of vision so gradual that the client may not be
aware of it.
\A client in an ambulatory clinic describes awaking in the middle of the night with difficulty
breathing and shortness of breath related to paroxysmal nocturnal dyspnea. Which underlying
condition should the registered nurse (RN) identify in the client's history?
Chronic bronchitis.
Gastroesophageal reflux disease (GERD).
Heart failure (HF).
Chronic pancreatitis. - ANS-Heart failure (HF)
Paroxysmal nocturnal dyspnea is classic sign of heart failure and is secondary to fluid overload
associated with heart failure which causes pulmonary edema.
\A client in the preoperative holding area receives a prescription for midazolam IV. The nurse
determines that the surgical consent form needs to be signed by the client. Which action should
the nurse implement?
Give the drug and allow the client to read and sign the consent form.
Counter-sign the client's initials on the consent form after giving the drug.
Withhold the drug until the client validates understanding of the surgical procedure and signs
the consent form.
Call the healthcare provider to explain the surgical procedure before the client signs the
consent. - ANS-Withhold the drug until the client validates understanding of the surgical
procedure and signs the consent form.
,Midazolam, a benzodiazepine sedative, is commonly used for conscious-sedation
intraoperatively and interferes with the client's cognition and level of consciousness, so the
consent form should be signed before the drug is administered.
\A client is admitted after blunt abdominal injury. Which assessment finding requires immediate
action by the nurse?
Radiating abdominal pain with left lower quadrant palpation.
Grimacing after palpation of the right hypochondriac region.
Rebound tenderness with abdominal palpation.
Bluish periumbilical skin discoloration. - ANS-Bluish periumbilical skin discoloration.
Immediate action is indicated for intraperitoneal hemorrhage which causes periumbilical
discoloration and indicates the presence of a splenic rupture, a life-threatening complication of
blunt abdominal injury.
\A client is admitted for reports of chest pain and aching for the past 4 days. The results for
serum creatine kinase-MB (CK-MB) and troponin levels are obtained. What rationale should the
nurse use to evaluate the laboratory findings?
Serum myoglobin levels are needed to confirm myocardial damage.
The most reliable indicator of myocardial necrosis is serum CK-MB.
Serum cardiac markers are inconclusive in determining myocardial injury after waiting several
days.
Myocardial damage that occurred several days earlier is best validated by serum troponin
levels. - ANS-Myocardial damage that occurred several days earlier is best validated by serum
troponin levels.
An elevated serum troponin has become the cardiac marker of choice for diagnosing an acute
MI, according the American College of Cardiology (ACC) guidelines (2017) for NSTEMI. An
elevated troponin will become evident within 2 to 3 hours of an MI in comparison to the CK-MB
and other cardiac enzymes that can take up to 6 to 9 hours after the MI occurrence.
\A client is admitted to the emergency department after being lost for four days while hiking in a
national forest. Upon review of the laboratory results, the nurse determines the client's serum
level for thyroid-stimulating hormone (TSH) is elevated. Which additional assessment should the
nurse make?
Body mass index.
Skin elasticity and turgor.
Thought processes and speech.
Exposure to cold environmental temperatures. - ANS-Exposure to cold environmental
temperatures.
, TSH influences the amount of thyroxine secretion which increases the rate of metabolism to
maintain body temperature near normal. Prolonged exposure to cold environmental
temperatures stimulates the hypothalamus to secrete thyrotropin-releasing hormone, which
increases anterior pituitary serum release of TSH.
\A client is admitted to the hospital with a traumatic brain injury after his head violently struck a
brick wall during a gang fight. Which finding is most important for the nurse to assess further?
A scalp laceration oozing blood.
Serosanguineous nasal drainage.
Headache rated "10" on a 0-10 scale.
Dizziness, nausea and transient confusion. - ANS-Serosanguineous nasal drainage.
Any nasal discharge following a head injury should be evaluated to determine the presence of
cerebral spinal fluid which would indicate a tear in the dura making the client susceptible to
meningitis.
\A client is recently diagnosed with systemic lupus erythematosus (SLE) and the registered
nurse (RN) is assessing for common complications. Which symptom should the RN instruct the
client to report immediately?
Fever related to infection.
Weight loss and anorexia.
Depressed mood.
Break in tissue integrity. - ANS-Fever related to infection
Secondary infections are a major concern with SLE clients due to the use of corticosteroids and
chemotherapeutic agents, which suppresses the immune system, so reporting fever and
infections should be reported immediately.
\A client who had abdominal surgery two days ago has prescriptions for intravenous morphine
sulfate 4 mg every 2 hours and a clear liquid diet. The client describes feeling distended and
has sharp, cramping gas pains. What nursing intervention should be implemented?
Obtain a prescription for a laxative.
Withhold all oral fluid and food.
Assist the client to ambulate in the hall.
Administer the prescribed morphine sulfate. - ANS-Assist the client to ambulate in the hall.
Postoperative abdominal distention is caused by decreased peristalsis as a result of handling
the intestine during surgery, limited dietary intake before and after surgery, and anesthetic and
analgesic agents. Peristalsis is stimulated, flatus is passed, and distention is minimized by
implementing early and frequent ambulation.
A 24-year-old female client diagnosed with a human papillomavirus infection (HPV) is angry at
her ex-boyfriend and says she is not going to tell him that he is infected. What response is best
for the nurse to provide?
"You do not have to tell him because this is not a reportable disease."
"Because there is no cure for this disease, telling him is of no benefit to him or to you."
"Even though you are angry, he should be told, so he can take precautions to prevent the
spread of infection."
"You should tell him, so he can feel as guilty and miserable as you do now, knowing that you
have this disease." - ANS-"Even though you are angry, he should be told, so he can take
precautions to prevent the spread of infection."
Anger is a common emotional reaction when confronted with the diagnosis of a STI, and often
lay blame and project this anger at the sexual partner. Although HPV is not a reportable disease
in many states, all contacts should be informed of the infection, treatment, transmission, and
precautions to minimize infecting others.
\A 40-year-old female client has a history of smoking. Which finding should the nurse identify as
a risk factor for myocardial infarction?
Oral contraceptives.
Senile osteopenia.
Levothyroxine therapy.
Pernicious anemia. - ANS-Oral contraceptives.
Women older than 35 years old who smoke and take oral contraceptives have an increased risk
of myocardial infarction or stroke.
\A 48-year-old client with endometrial cancer is being discharged after a total hysterectomy and
bilateral salpingo-oophorectomy. Which client statement indicates that further teaching is
needed?
"Well, I don't have to worry about getting pregnant anymore."
"I can't wait to go on the cruise that I have planned for this summer."
"I know I will miss having sexual intercourse with my husband."
"I have asked my daughter to stay with me next week after I am discharged." - ANS-"I know I
will miss having sexual intercourse with my husband."
Further teaching is needed in response to the client's misunderstanding of not being able to
have sexual intercourse after a hysterectomy.
,\A client asks the nurse about the purpose of beginning chemotherapy (CT) because the tumor
is still very small. Which information supports the explanation that the nurse should provide?
Side effects are less likely if therapy is started early.
Collateral circulation increases as the tumor grows.
Sensitivity of cancer cells to CT is based on cell cycle rate.
The cell count of the tumor reduces by half with each dose. - ANS-The cell count of the tumor
reduces by half with each dose.
Initiating chemotherapy while the tumor is small provides a better chance of eradicating all
cancer cells because 50% of cancer cells or tumor cells are killed with each dose.
\A client has been told that there is cataract formation over both eyes. Which finding should the
nurse expect when assessing the client?
Decreased color perception.
Presence of floaters.
Loss of central vision.
Reduced peripheral vision. - ANS-Decreased color perception.
Decreased color perception occurs with cataract formation. Cataract formation is also
associated with blurred vision and a global loss of vision so gradual that the client may not be
aware of it.
\A client in an ambulatory clinic describes awaking in the middle of the night with difficulty
breathing and shortness of breath related to paroxysmal nocturnal dyspnea. Which underlying
condition should the registered nurse (RN) identify in the client's history?
Chronic bronchitis.
Gastroesophageal reflux disease (GERD).
Heart failure (HF).
Chronic pancreatitis. - ANS-Heart failure (HF)
Paroxysmal nocturnal dyspnea is classic sign of heart failure and is secondary to fluid overload
associated with heart failure which causes pulmonary edema.
\A client in the preoperative holding area receives a prescription for midazolam IV. The nurse
determines that the surgical consent form needs to be signed by the client. Which action should
the nurse implement?
Give the drug and allow the client to read and sign the consent form.
Counter-sign the client's initials on the consent form after giving the drug.
Withhold the drug until the client validates understanding of the surgical procedure and signs
the consent form.
Call the healthcare provider to explain the surgical procedure before the client signs the
consent. - ANS-Withhold the drug until the client validates understanding of the surgical
procedure and signs the consent form.
,Midazolam, a benzodiazepine sedative, is commonly used for conscious-sedation
intraoperatively and interferes with the client's cognition and level of consciousness, so the
consent form should be signed before the drug is administered.
\A client is admitted after blunt abdominal injury. Which assessment finding requires immediate
action by the nurse?
Radiating abdominal pain with left lower quadrant palpation.
Grimacing after palpation of the right hypochondriac region.
Rebound tenderness with abdominal palpation.
Bluish periumbilical skin discoloration. - ANS-Bluish periumbilical skin discoloration.
Immediate action is indicated for intraperitoneal hemorrhage which causes periumbilical
discoloration and indicates the presence of a splenic rupture, a life-threatening complication of
blunt abdominal injury.
\A client is admitted for reports of chest pain and aching for the past 4 days. The results for
serum creatine kinase-MB (CK-MB) and troponin levels are obtained. What rationale should the
nurse use to evaluate the laboratory findings?
Serum myoglobin levels are needed to confirm myocardial damage.
The most reliable indicator of myocardial necrosis is serum CK-MB.
Serum cardiac markers are inconclusive in determining myocardial injury after waiting several
days.
Myocardial damage that occurred several days earlier is best validated by serum troponin
levels. - ANS-Myocardial damage that occurred several days earlier is best validated by serum
troponin levels.
An elevated serum troponin has become the cardiac marker of choice for diagnosing an acute
MI, according the American College of Cardiology (ACC) guidelines (2017) for NSTEMI. An
elevated troponin will become evident within 2 to 3 hours of an MI in comparison to the CK-MB
and other cardiac enzymes that can take up to 6 to 9 hours after the MI occurrence.
\A client is admitted to the emergency department after being lost for four days while hiking in a
national forest. Upon review of the laboratory results, the nurse determines the client's serum
level for thyroid-stimulating hormone (TSH) is elevated. Which additional assessment should the
nurse make?
Body mass index.
Skin elasticity and turgor.
Thought processes and speech.
Exposure to cold environmental temperatures. - ANS-Exposure to cold environmental
temperatures.
, TSH influences the amount of thyroxine secretion which increases the rate of metabolism to
maintain body temperature near normal. Prolonged exposure to cold environmental
temperatures stimulates the hypothalamus to secrete thyrotropin-releasing hormone, which
increases anterior pituitary serum release of TSH.
\A client is admitted to the hospital with a traumatic brain injury after his head violently struck a
brick wall during a gang fight. Which finding is most important for the nurse to assess further?
A scalp laceration oozing blood.
Serosanguineous nasal drainage.
Headache rated "10" on a 0-10 scale.
Dizziness, nausea and transient confusion. - ANS-Serosanguineous nasal drainage.
Any nasal discharge following a head injury should be evaluated to determine the presence of
cerebral spinal fluid which would indicate a tear in the dura making the client susceptible to
meningitis.
\A client is recently diagnosed with systemic lupus erythematosus (SLE) and the registered
nurse (RN) is assessing for common complications. Which symptom should the RN instruct the
client to report immediately?
Fever related to infection.
Weight loss and anorexia.
Depressed mood.
Break in tissue integrity. - ANS-Fever related to infection
Secondary infections are a major concern with SLE clients due to the use of corticosteroids and
chemotherapeutic agents, which suppresses the immune system, so reporting fever and
infections should be reported immediately.
\A client who had abdominal surgery two days ago has prescriptions for intravenous morphine
sulfate 4 mg every 2 hours and a clear liquid diet. The client describes feeling distended and
has sharp, cramping gas pains. What nursing intervention should be implemented?
Obtain a prescription for a laxative.
Withhold all oral fluid and food.
Assist the client to ambulate in the hall.
Administer the prescribed morphine sulfate. - ANS-Assist the client to ambulate in the hall.
Postoperative abdominal distention is caused by decreased peristalsis as a result of handling
the intestine during surgery, limited dietary intake before and after surgery, and anesthetic and
analgesic agents. Peristalsis is stimulated, flatus is passed, and distention is minimized by
implementing early and frequent ambulation.
