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Exam (elaborations)

HESI V2 EXAM WITH CORRECT QUESTIONS AND ANSWERS 2025

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HESI V2 EXAM WITH CORRECT QUESTIONS AND ANSWERS 2025

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Institution
HESI V2
Course
HESI V2

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Uploaded on
May 8, 2025
Number of pages
36
Written in
2024/2025
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HESI V2 EXAM WITH CORRECT
QUESTIONS AND ANSWERS 2025
The nurse knows that which statement by the mother indicates that the mother understands safety

precautions with her four month-old infant and her 4 year-old child? A) "I strap the infant car

seat on the front seat to face backwards." B) "I place my infant in the middle of the living room

floor on a blanket to play with my 4 year old while I make supper in the kitchen." C) "My

sleeping baby lies so cute in the crib with the little buttocks stuck up in the air while the four year

old naps on the sofa." D) "I have the 4 year-old hold and help feed the four month-old a bottle in

the kitchen while I make supper." - CORRECT-ANSWERS-"I have the four year-old hold and

help feed the four month-old a bottle in the kitchen

Upon completing the admission documents, the nurse learns that the 87 year-old client does not

have an advance directive. What action should the nurse take? A) Record the information on the

chart B) Give information about advance directives C) Assume that this client wishes a full code

D) Refer this issue to the unit secretary - CORRECT-ANSWERS-Give information about

advance directives

A nurse administers the influenza vaccine to a client in a clinic. Within 15 minutes after the

immunization was given, the client complains of itchy and watery eyes, increased anxiety, and

difficulty breathing. The nurse expects that the first action in the sequence of care for this client

will be to A) Maintain the airway B) Administer epinephrine 1:1000 as ordered C) Monitor for

hypotension with shock D) Administer diphenhydramine as ordered - CORRECT-ANSWERS-

Administer epinephrine 1:1000 as ordered .

,Which of these children at the site of a disaster at a child day care center would the triage nurse

put in the "treat last" category? A) An infant with intermittent bulging anterior fontanel between

crying episodes B) A toddler with severe deep abrasions over 98% of the body C) A preschooler

with 1 lower leg fracture and the other leg with an upper leg fracture D) A school-age child with

singed eyebrows and hair on the arms - CORRECT-ANSWERS-A toddler with severe deep

abrasions over 98% of the body .

When admitting a client to an acute care facility, an identification bracelet is sent up with the

admission form. In the event these do not match, the nurse's best action is to A) Change

whichever item is incorrect to the correct information B) Use the bracelet and admission form

until a replacement is supplied C) Notify the admissions office and wait to apply the bracelet D)

Make a corrected identification bracelet for the client - CORRECT-ANSWERS-notify the

admissions office and wait to apply the bracelet

The nurse is having difficulty reading the health care provider's written order that was written

right before the shift change. What action should be taken? A) Leave the order for the oncoming

staff to follow-up B) Contact the charge nurse for an interpretation C) Ask the pharmacy for

assistance in the interpretation D) Call the provider for clarification - CORRECT-ANSWERS-

Call the provider for clarification

An adult client is found to be unresponsive on morning rounds. After checking for

responsiveness and calling for help, the next action that should be taken by the nurse is to: A)

check the carotid pulse B) deliver 5 abdominal thrusts C) give 2 rescue breaths D) open the

client's airway - CORRECT-ANSWERS-open the client''s airway

A client has an order for 1000 ml of D5W over an 8 hour period. The nurse discovers that 800 ml

has been infused after 4 hours. What is the priority nursing action? A) Ask the client if there are

,any breathing problems B) Have the client void as much as possible C) Check the vital signs D)

Auscultate the lungs - CORRECT-ANSWERS-Auscultate the lungs

Following change-of-shift report on an orthopedic unit, which client should the nurse see first?

A) 16 year-old who had an open reduction of a fractured wrist 10 hours ago B) 20 year-old in

skeletal traction for 2 weeks since a motor cycle accident C) 72 year-old recovering from surgery

after a hip replacement 2 hours ago D) 75 year-old who is in skin traction prior to planned hip

pinning surgery. - CORRECT-ANSWERS-72 year-old recovering from surgery after a hip

replacement 2 hours ago

A nurse observes a family member administer a rectal suppository by having the client lie on the

left side for the administration. The family member pushed the suppository until the finger went

up to the second knuckle. After 10 minutes the client was told by the family member to turn to

the right side and the client did this. What is the appropriate comment for the nurse to make? A)

Why don't we now have the client turn back to the left side. B) That was done correctly. Did you

have any problems with the insertion? C) Let's check to see if the suppository is in far enough.

D) Did you feel any stool in the intestinal tract? - CORRECT-ANSWERS-That was done

correctly. Did you have any problems with the insertion?

A client with a diagnosis of Methicillin resistant Staphylococcus aureus (MRSA) has died.

Which type of precautions is the appropriate type to use when performing postmortem care? A)

airborne precautions B) droplet precautions C) contact precautions D) compromised host

precautions - CORRECT-ANSWERS-contact precautions

The nurse is reviewing with a client how to collect a clean catch urine specimen. Which

sequence is appropriate teaching? A) Void a little, clean the meatus, then collect specimen B)

clean the meatus, begin voiding, then catch urine stream C) Clean the meatus, then urinate into

, container D) Void continuously and catch some of the urine - CORRECT-ANSWERS-clean the

meatus, begin voiding, then catch urine stream

The provider orders Lanoxin (digoxin) 0.125 mg PO and furosomide 40 mg every day. Which of

these foods would the nurse reinforce for the client to eat at least daily? A) spaghetti B)

watermelon C) chicken D) tomatoes - CORRECT-ANSWERS-watermelon

A nurse is stuck in the hand by an exposed needle. What immediate action should the nurse take?

A) Look up the policy on needle sticks B) Contact employee health services C) Immediately

wash the hands with vigor D) Notify the supervisor and risk management - CORRECT-

ANSWERS-Immediately wash the hands with vigor

As the nurse observes the student nurse during the administration of a narcotic analgesic IM

injection, the nurse notes that the student begins to give the medication without first aspirating.

What should the nurse do? A) Ask the student: "What did you forget to do?" B) Stop. Tell me

why aspiration is needed. C) Loudly state: "You forgot to aspirate." D) Walk up and whisper in

the student's ear "Stop. Aspirate. Then inject." - CORRECT-ANSWERS-Walk up and whisper

in the student's ear "Stop. Aspirate. Then inject."

A client with Guillain Barre is in a non responsive state, yet vital signs are stable and breathing is

independent. What should the nurse document to most accurately describe the client's condition?

A) Comatose, breathing unlabored B) Glascow Coma Scale 8, respirations regular C) Appears to

be sleeping, vital signs stable D) Glascow Coma Scale 13, no ventilator required - CORRECT-

ANSWERS-Glascow Coma Scale 8, respirations regular

A client enters the emergency department unconscious via ambulance from the client's work

place. What document should be given priority to guide the direction of care for this client? A)

The statement of client rights and the client self determination act B) Orders written by the health
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