HESI FUNDAMENTALS PRACTICE TEST,
FUNDAMENTALS HESI EXAM, FUNDAMENTALS-
FOUNDATIONS-H.A. HESI, HESI
FUNDAMENTALS PRACTICE TEST, NURSING
FUNDAMENTALS HESI PREP
64.A,low-sodium,,low-protein,diet,is,prescribed,for,a,45-year-
old,client,with,renal,insufficiency,and,hypertension,,who,gained,3,pounds,in,the,last,month.,The,nurse,
determines,that,the,client,has,been,noncompliant,with,the,diet,,based,on,which,report,from,the,24-
hour,dietary,recall?,(Select,all,that,apply.)
A.,Snack,of,potato,chips,,and,diet,soda.
B.,Lunch,of,tuna,fish,sandwich,,carrot,sticks,,fresh,fruit,,and,coffee.
C.,Breakfast,of,eggs,,bacon,,toast,,and,coffee.
D.,Dinner,of,vegetable,lasagna,,tossed,salad,,sherbet,,and,iced,tea.
E.,Bedtime,snack,of,crackers,and,milk.,,,ANS,-
Potato,chips,(A),are,high,in,sodium.,Tuna,(B),is,high,in,protein.,Bacon,(C),and,crackers,(E),are,high,in,so
dium.,Only,(D),is,a,meal,that,is,in,compliance,with,a,low,sodium,,low,protein,diet.
Correct,Answer:,A,,B,,C,,E
65.What,intervention,should,the,nurse,include,in,the,plan,of,care,for,a,client,who,is,being,treated,with,
an,Unna's,paste,boot,for,leg,ulcers,due,to,chronic,venous,insufficiency?
A.,Check,capillary,refill,of,toes,on,lower,extremity,with,Unna's,paste,boot.
B.,Apply,dressing,to,wound,area,before,applying,the,Unna's,paste,boot.
C.,Wrap,the,leg,from,the,knee,down,towards,the,foot.
D.,Remove,the,Unna's,paste,boot,q8h,to,assess,wound,healing.,,,ANS,-
The,Unna's,paste,boot,becomes,rigid,after,it,dries,,so,it,is,important,to,check,distally,for,adequate,circu
lation,(A).,Kerlix,is,often,wrapped,around,the,outside,of,the,boot,and,an,ace,bandage,may,be,used,to,c
over,both,,but,no,bandage,should,be,put,under,it,(B).,The,Unna's,paste,boot,should,be,applied,from,th
e,foot,and,wrapped,towards,the,knee,(C).,The,Unna's,paste,boot,acts,as,a,sterile,dressing,,and,should,n
ot,be,removed,q8h.,Weekly,removal,is,reasonable,(D).
Correct,Answer:,A
,66.A,75-year-
old,client,who,has,a,history,of,end,stage,renal,failure,and,advanced,lung,cancer,,recently,had,a,stroke.,
Two,days,ago,the,healthcare,provider,discontinued,the,client's,dialysis,treatments,,stating,that,death,is
,inevitable,,but,the,client,is,disoriented,and,will,not,sign,a,DNR,directive.,What,is,the,priority,nursing,in
tervention?
A.,Review,the,client's,most,recent,laboratory,reports.
B.,Refer,the,client,and,family,members,for,hospice,care.
C.,Notify,the,hospital,ethics,committee,of,the,client,situation.
D.,Determine,who,is,legally,empowered,to,make,decisions.,,,ANS,-
When,death,is,impending,,it,is,essential,for,the,nurse,to,determine,who,is,legally,empowered,to,make,
decisions,regarding,the,use,of,life-
saving,measures,for,the,client,(D).,(A),will,be,abnormal,and,will,worsen,without,dialysis,,so,are,not,of,i
mmediate,concern.,(B),may,help,improve,the,client's,quality,of,life,prior,to,death,,but,is,of,less,immedi
acy,than,determining,whether,actions,should,be,taken,to,save,a,client's,life.,If,the,nurse,remains,unabl
e,to,determine,who,is,empowered,to,make,decisions,in,this,situation,,the,nurse,may,choose,to,contact,
the,ethics,committee,(C),for,a,resolution.
Correct,Answer:,D
67.The,charge,nurse,assigns,a,nursing,procedure,to,a,new,staff,nurse,who,has,not,previously,performe
d,the,procedure.,What,action,is,most,important,for,the,new,staff,nurse,to,take?
A.,Review,the,steps,in,the,procedure,manual.
B.,Ask,another,nurse,to,assist,while,implementing,the,procedure.
C.,Follow,the,agency's,policy,and,procedure.
D.,Refuse,to,perform,the,task,that,is,beyond,the,nurse's,experience.,,,ANS,-
According,to,states',nurse,practice,acts,,it,is,the,responsibility,of,the,nurse,to,function,within,the,scope,
of,competency,(D),,and,in,this,case,safe,nursing,practice,constitutes,refusal,to,perform,the,procedure,b
ecause,of,a,lack,of,experience.,Although,state,mandates,,agency,policies,,and,continued,education,and,
experience,identify,tasks,that,are,within,the,scope,of,nursing,practice,,nurses,should,first,refuse,to,perf
orm,tasks,that,are,beyond,their,proficiency,,and,then,pursue,opportunities,to,enhance,their,competenc
y,(A,,B,,and,C).
Correct,Answer:,D
68.Before,administering,a,client's,medication,,the,nurse,assesses,a,change,in,the,client's,condition,and,
decides,to,withhold,the,medication,until,consulting,with,the,healthcare,provider.,After,consultation,wit
h,the,healthcare,provider,,the,dose,of,the,medication,is,changed,and,the,nurse,administers,the,newly,p
rescribed,dose,an,hour,later,than,the,originally,scheduled,time.,What,action,should,the,nurse,impleme
nt,in,response,to,this,situation?
,A.,Notify,the,charge,nurse,that,a,medication,error,occurred.
B.,Submit,a,medication,variance,report,to,the,supervisor.
C.,Document,the,events,that,occurred,in,the,nurses',notes.
D.,Discard,the,original,medication,administration,record.,,,ANS,-
The,nurse,took,the,correct,action,and,should,document,the,events,that,occurred,in,the,nurses',notes,(
C).,(A),did,not,occur,and,(B),is,not,indicated.,The,medication,administration,record,is,part,of,the,client's
,medical,record,and,should,be,placed,in,the,chart,,(D),when,no,longer,current.
Correct,Answer:,C
69.On,the,third,postoperative,day,following,thoracic,surgery,,a,client,reports,feeling,constipated.,Whic
h,intervention,should,the,nurse,implement,to,promote,bowel,elimination?
A.,Remind,the,client,to,turn,every,two,hours,while,lying,in,bed.
B.,Provide,warm,prune,juice,before,the,client,goes,to,bed,at,night.
C.,Teach,the,client,to,splint,the,incision,while,walking,to,the,bathroom.
D.,Administer,an,analgesic,before,the,client,attempts,to,defecate.,,,ANS,-
Prune,juice,is,a,natural,laxative,that,stimulates,peristalsis,,and,warming,the,prune,juice,(B),facilitates,p
eristalsis.,(A),is,also,helpful,in,promoting,peristalsis,but,is,less,likely,to,relieve,the,client's,constipation.,(
C),reduces,discomfort,during,ambulation,,but,will,not,help,relieve,the,client's,constipation.,Defecation,i
s,not,painful,following,most,surgeries,,and,many,analgesics,used,postoperatively,cause,constipation,,so
,(D),is,contraindicated.
Correct,Answer:,B
70.The,home,health,nurse,visits,an,elderly,client,who,lives,at,home,with,her,husband.,The,client,is,expe
riencing,frequent,episodes,of,diarrhea,and,bowel,incontinence.,Which,problem,,for,which,the,client,is,a
t,risk,,has,the,greatest,priority,when,planning,the,client's,care?
A.,Disturbed,sleep,pattern.
B.,Caregiver,role,strain.
C.,Impaired,skin,integrity.
D.,Fluid,volume,imbalance.,,,ANS,-Diarrhea,can,lead,to,fluid,volume,loss,,which,is,potentially,life-
threatening,,so,the,highest,priority,is,to,prevent,a,fluid,volume,imbalance,(D).,Diarrhea,and,bowel,inco
ntinence,can,also,lead,to,(A,,B,,and,C),,but,these,are,of,less,potential,harm,than,a,fluid,volume,deficit.
Correct,Answer:,D
, 71.After,a,client,has,been,premedicated,for,surgery,with,an,opioid,analgesic,,the,nurse,discovers,that,t
he,operative,permit,has,not,been,signed.,What,action,should,the,nurse,implement?
A.,Notify,the,surgeon,that,the,consent,form,has,not,been,signed.
B.,Read,the,consent,form,to,the,client,before,witnessing,the,client's,signature.
C.,Determine,if,the,client's,spouse,is,willing,to,sign,the,consent,form.
D.,Administer,an,opioid,antagonist,prior,to,obtaining,the,client's,signature.,,,ANS,-
Once,a,client,has,been,premedicated,for,surgery,with,any,type,of,sedative,,legal,informed,consent,is,no
t,possible,,so,the,nurse,must,notify,the,surgeon,(A).,(B,,C,,and,D),are,not,legally,viable,options,for,ensur
ing,informed,consent.
Correct,Answer:,A
72.A,client,who,has,been,on,bedrest,for,several,days,now,has,a,prescription,to,progress,activity,as,toler
ated.,When,the,nurse,assists,the,client,out,of,bed,for,the,first,time,,the,client,becomes,dizzy.,What,acti
on,should,the,nurse,implement?
A.,Encourage,the,client,to,take,several,slow,,deep,breaths,while,ambulating.
B.,Help,the,client,to,remain,standing,by,the,bedside,until,the,dizziness,is,relieved.
C.,Instruct,the,client,to,remain,on,bedrest,until,the,healthcare,provider,is,contacted.
D.,Advise,the,client,to,sit,on,the,side,of,the,bed,for,a,few,minutes,before,standing,again.,,,ANS,-
The,nurse,should,implement,(D),,because,orthostatic,hypotension,is,a,common,result,of,immobilization
,,causing,the,client,to,feel,dizzy,when,first,getting,out,of,bed,following,a,period,of,bedrest.,To,prevent,t
his,problem,,it,is,helpful,to,have,the,body,acclimate,to,a,standing,position,by,sitting,upright,for,a,short,
period,(D),before,rising,to,a,standing,position.,(A),is,unlikely,to,alleviate,the,dizziness.,(B),may,result,in,
a,loss,of,consciousness.,(C),is,not,indicated,and,will,increase,the,potential,for,complications,associated,
with,prolonged,immobility.
Correct,Answer:,D
74.A,client,is,admitted,to,the,hospital,with,intractable,pain.,What,instruction,should,the,nurse,provide,t
he,unlicensed,assistive,personnel,(UAP),who,is,preparing,to,assist,this,client,with,a,bed,bath?
A.,Take,measures,to,promote,as,much,comfort,as,possible.
B.,Report,any,signs,of,drug,addiction,to,the,nurse,immediately.
C.,Wait,until,the,client's,pain,is,gone,before,assisting,with,personal,care.
D.,This,client's,pain,will,be,difficult,to,manage,,since,the,cause,is,unknown.,,,ANS,-
Intractable,pain,is,highly,resistant,to,pain,relief,measures,,so,it,is,important,to,promote,comfort,(A),dur
ing,all,activities.,A,client,with,intractable,pain,may,develop,drug,tolerance,and,dependence,,but,(B),is,in
FUNDAMENTALS HESI EXAM, FUNDAMENTALS-
FOUNDATIONS-H.A. HESI, HESI
FUNDAMENTALS PRACTICE TEST, NURSING
FUNDAMENTALS HESI PREP
64.A,low-sodium,,low-protein,diet,is,prescribed,for,a,45-year-
old,client,with,renal,insufficiency,and,hypertension,,who,gained,3,pounds,in,the,last,month.,The,nurse,
determines,that,the,client,has,been,noncompliant,with,the,diet,,based,on,which,report,from,the,24-
hour,dietary,recall?,(Select,all,that,apply.)
A.,Snack,of,potato,chips,,and,diet,soda.
B.,Lunch,of,tuna,fish,sandwich,,carrot,sticks,,fresh,fruit,,and,coffee.
C.,Breakfast,of,eggs,,bacon,,toast,,and,coffee.
D.,Dinner,of,vegetable,lasagna,,tossed,salad,,sherbet,,and,iced,tea.
E.,Bedtime,snack,of,crackers,and,milk.,,,ANS,-
Potato,chips,(A),are,high,in,sodium.,Tuna,(B),is,high,in,protein.,Bacon,(C),and,crackers,(E),are,high,in,so
dium.,Only,(D),is,a,meal,that,is,in,compliance,with,a,low,sodium,,low,protein,diet.
Correct,Answer:,A,,B,,C,,E
65.What,intervention,should,the,nurse,include,in,the,plan,of,care,for,a,client,who,is,being,treated,with,
an,Unna's,paste,boot,for,leg,ulcers,due,to,chronic,venous,insufficiency?
A.,Check,capillary,refill,of,toes,on,lower,extremity,with,Unna's,paste,boot.
B.,Apply,dressing,to,wound,area,before,applying,the,Unna's,paste,boot.
C.,Wrap,the,leg,from,the,knee,down,towards,the,foot.
D.,Remove,the,Unna's,paste,boot,q8h,to,assess,wound,healing.,,,ANS,-
The,Unna's,paste,boot,becomes,rigid,after,it,dries,,so,it,is,important,to,check,distally,for,adequate,circu
lation,(A).,Kerlix,is,often,wrapped,around,the,outside,of,the,boot,and,an,ace,bandage,may,be,used,to,c
over,both,,but,no,bandage,should,be,put,under,it,(B).,The,Unna's,paste,boot,should,be,applied,from,th
e,foot,and,wrapped,towards,the,knee,(C).,The,Unna's,paste,boot,acts,as,a,sterile,dressing,,and,should,n
ot,be,removed,q8h.,Weekly,removal,is,reasonable,(D).
Correct,Answer:,A
,66.A,75-year-
old,client,who,has,a,history,of,end,stage,renal,failure,and,advanced,lung,cancer,,recently,had,a,stroke.,
Two,days,ago,the,healthcare,provider,discontinued,the,client's,dialysis,treatments,,stating,that,death,is
,inevitable,,but,the,client,is,disoriented,and,will,not,sign,a,DNR,directive.,What,is,the,priority,nursing,in
tervention?
A.,Review,the,client's,most,recent,laboratory,reports.
B.,Refer,the,client,and,family,members,for,hospice,care.
C.,Notify,the,hospital,ethics,committee,of,the,client,situation.
D.,Determine,who,is,legally,empowered,to,make,decisions.,,,ANS,-
When,death,is,impending,,it,is,essential,for,the,nurse,to,determine,who,is,legally,empowered,to,make,
decisions,regarding,the,use,of,life-
saving,measures,for,the,client,(D).,(A),will,be,abnormal,and,will,worsen,without,dialysis,,so,are,not,of,i
mmediate,concern.,(B),may,help,improve,the,client's,quality,of,life,prior,to,death,,but,is,of,less,immedi
acy,than,determining,whether,actions,should,be,taken,to,save,a,client's,life.,If,the,nurse,remains,unabl
e,to,determine,who,is,empowered,to,make,decisions,in,this,situation,,the,nurse,may,choose,to,contact,
the,ethics,committee,(C),for,a,resolution.
Correct,Answer:,D
67.The,charge,nurse,assigns,a,nursing,procedure,to,a,new,staff,nurse,who,has,not,previously,performe
d,the,procedure.,What,action,is,most,important,for,the,new,staff,nurse,to,take?
A.,Review,the,steps,in,the,procedure,manual.
B.,Ask,another,nurse,to,assist,while,implementing,the,procedure.
C.,Follow,the,agency's,policy,and,procedure.
D.,Refuse,to,perform,the,task,that,is,beyond,the,nurse's,experience.,,,ANS,-
According,to,states',nurse,practice,acts,,it,is,the,responsibility,of,the,nurse,to,function,within,the,scope,
of,competency,(D),,and,in,this,case,safe,nursing,practice,constitutes,refusal,to,perform,the,procedure,b
ecause,of,a,lack,of,experience.,Although,state,mandates,,agency,policies,,and,continued,education,and,
experience,identify,tasks,that,are,within,the,scope,of,nursing,practice,,nurses,should,first,refuse,to,perf
orm,tasks,that,are,beyond,their,proficiency,,and,then,pursue,opportunities,to,enhance,their,competenc
y,(A,,B,,and,C).
Correct,Answer:,D
68.Before,administering,a,client's,medication,,the,nurse,assesses,a,change,in,the,client's,condition,and,
decides,to,withhold,the,medication,until,consulting,with,the,healthcare,provider.,After,consultation,wit
h,the,healthcare,provider,,the,dose,of,the,medication,is,changed,and,the,nurse,administers,the,newly,p
rescribed,dose,an,hour,later,than,the,originally,scheduled,time.,What,action,should,the,nurse,impleme
nt,in,response,to,this,situation?
,A.,Notify,the,charge,nurse,that,a,medication,error,occurred.
B.,Submit,a,medication,variance,report,to,the,supervisor.
C.,Document,the,events,that,occurred,in,the,nurses',notes.
D.,Discard,the,original,medication,administration,record.,,,ANS,-
The,nurse,took,the,correct,action,and,should,document,the,events,that,occurred,in,the,nurses',notes,(
C).,(A),did,not,occur,and,(B),is,not,indicated.,The,medication,administration,record,is,part,of,the,client's
,medical,record,and,should,be,placed,in,the,chart,,(D),when,no,longer,current.
Correct,Answer:,C
69.On,the,third,postoperative,day,following,thoracic,surgery,,a,client,reports,feeling,constipated.,Whic
h,intervention,should,the,nurse,implement,to,promote,bowel,elimination?
A.,Remind,the,client,to,turn,every,two,hours,while,lying,in,bed.
B.,Provide,warm,prune,juice,before,the,client,goes,to,bed,at,night.
C.,Teach,the,client,to,splint,the,incision,while,walking,to,the,bathroom.
D.,Administer,an,analgesic,before,the,client,attempts,to,defecate.,,,ANS,-
Prune,juice,is,a,natural,laxative,that,stimulates,peristalsis,,and,warming,the,prune,juice,(B),facilitates,p
eristalsis.,(A),is,also,helpful,in,promoting,peristalsis,but,is,less,likely,to,relieve,the,client's,constipation.,(
C),reduces,discomfort,during,ambulation,,but,will,not,help,relieve,the,client's,constipation.,Defecation,i
s,not,painful,following,most,surgeries,,and,many,analgesics,used,postoperatively,cause,constipation,,so
,(D),is,contraindicated.
Correct,Answer:,B
70.The,home,health,nurse,visits,an,elderly,client,who,lives,at,home,with,her,husband.,The,client,is,expe
riencing,frequent,episodes,of,diarrhea,and,bowel,incontinence.,Which,problem,,for,which,the,client,is,a
t,risk,,has,the,greatest,priority,when,planning,the,client's,care?
A.,Disturbed,sleep,pattern.
B.,Caregiver,role,strain.
C.,Impaired,skin,integrity.
D.,Fluid,volume,imbalance.,,,ANS,-Diarrhea,can,lead,to,fluid,volume,loss,,which,is,potentially,life-
threatening,,so,the,highest,priority,is,to,prevent,a,fluid,volume,imbalance,(D).,Diarrhea,and,bowel,inco
ntinence,can,also,lead,to,(A,,B,,and,C),,but,these,are,of,less,potential,harm,than,a,fluid,volume,deficit.
Correct,Answer:,D
, 71.After,a,client,has,been,premedicated,for,surgery,with,an,opioid,analgesic,,the,nurse,discovers,that,t
he,operative,permit,has,not,been,signed.,What,action,should,the,nurse,implement?
A.,Notify,the,surgeon,that,the,consent,form,has,not,been,signed.
B.,Read,the,consent,form,to,the,client,before,witnessing,the,client's,signature.
C.,Determine,if,the,client's,spouse,is,willing,to,sign,the,consent,form.
D.,Administer,an,opioid,antagonist,prior,to,obtaining,the,client's,signature.,,,ANS,-
Once,a,client,has,been,premedicated,for,surgery,with,any,type,of,sedative,,legal,informed,consent,is,no
t,possible,,so,the,nurse,must,notify,the,surgeon,(A).,(B,,C,,and,D),are,not,legally,viable,options,for,ensur
ing,informed,consent.
Correct,Answer:,A
72.A,client,who,has,been,on,bedrest,for,several,days,now,has,a,prescription,to,progress,activity,as,toler
ated.,When,the,nurse,assists,the,client,out,of,bed,for,the,first,time,,the,client,becomes,dizzy.,What,acti
on,should,the,nurse,implement?
A.,Encourage,the,client,to,take,several,slow,,deep,breaths,while,ambulating.
B.,Help,the,client,to,remain,standing,by,the,bedside,until,the,dizziness,is,relieved.
C.,Instruct,the,client,to,remain,on,bedrest,until,the,healthcare,provider,is,contacted.
D.,Advise,the,client,to,sit,on,the,side,of,the,bed,for,a,few,minutes,before,standing,again.,,,ANS,-
The,nurse,should,implement,(D),,because,orthostatic,hypotension,is,a,common,result,of,immobilization
,,causing,the,client,to,feel,dizzy,when,first,getting,out,of,bed,following,a,period,of,bedrest.,To,prevent,t
his,problem,,it,is,helpful,to,have,the,body,acclimate,to,a,standing,position,by,sitting,upright,for,a,short,
period,(D),before,rising,to,a,standing,position.,(A),is,unlikely,to,alleviate,the,dizziness.,(B),may,result,in,
a,loss,of,consciousness.,(C),is,not,indicated,and,will,increase,the,potential,for,complications,associated,
with,prolonged,immobility.
Correct,Answer:,D
74.A,client,is,admitted,to,the,hospital,with,intractable,pain.,What,instruction,should,the,nurse,provide,t
he,unlicensed,assistive,personnel,(UAP),who,is,preparing,to,assist,this,client,with,a,bed,bath?
A.,Take,measures,to,promote,as,much,comfort,as,possible.
B.,Report,any,signs,of,drug,addiction,to,the,nurse,immediately.
C.,Wait,until,the,client's,pain,is,gone,before,assisting,with,personal,care.
D.,This,client's,pain,will,be,difficult,to,manage,,since,the,cause,is,unknown.,,,ANS,-
Intractable,pain,is,highly,resistant,to,pain,relief,measures,,so,it,is,important,to,promote,comfort,(A),dur
ing,all,activities.,A,client,with,intractable,pain,may,develop,drug,tolerance,and,dependence,,but,(B),is,in
