HESI MODULE 10 EXAM WITH WELL DETAILED QUESTION &
ANSWERS PERFECTLY A+ GRADED WITH RATIONALE
The nurse is assigned to care for four clients on the medical-surgical unit. Which client should
the nurse see first on the shift assessment?
A client admitted with pneumonia with a fever of 100° F (37.8°C) and some diaphoresis
A client with congestive heart failure with clear lung sounds on the previous shift
A client with new-onset of shortness of breath (SOB) and a history of pulmonary edema (PE)
A client undergoing long-term corticosteroid therapy with mild bruising on the anterior surfaces
of the arms CORRECT ANSWER>>>>A client with new-onset of shortness of breath
(SOB) and a history of pulmonary edema (PE)
A client with gastroenteritis who has been vomiting and has diarrhea is admitted to the hospital
with a diagnosis of dehydration. For which clinical manifestations that correlate with this fluid
imbalance would the nurse assess the client? Select all that apply.
Decreased pulse
Decreased urine output
Increased blood pressure
Increased respiratory rate
Decreased respiratory depth CORRECT ANSWER>>>>Decreased urine output
Increased respiratory rate
,The nurse is reviewing medical records to assigned clients on the 7 am to 7 pm shift. Which
client will the nurse monitor most closely for excessive fluid volume?
A 48-year-old client receiving diuretics to treat hypertension
A 35-year old client who is vomiting undigested food after eating
An 85-year-old client receiving intravenous (IV) therapy at a rate of 100 mL/hr
A 65-year-old client with a nasogastric tube attached to low suction following partial
gastrectomy CORRECT ANSWER>>>>An 85-year-old client receiving intravenous (IV)
therapy at a rate of 100 mL/hr
The nurse is caring for a client who is being treated for congestive heart failure related to
excessive fluid volume. Which assessment finding causes the nurse to determine that the
client's condition has improved?
Dyspnea
1+ edema in the legs
Moist crackles in the lower lobes of the lungs
Weight loss of 4 lb (1.8 kg) in 24 hours CORRECT ANSWER>>>>Weight loss of 4 lb (1.8
kg) in 24 hours
The nurse notes that a client has ST-segment depression on the electrocardiogram (ECG)
monitor. With which serum potassium reading does the nurse associate this finding?
3.1 mEq/L (3.1 mmol/L)
4.2 mEq/L (4.2 mmol/L)
4.5 mEq/L (4.5 mmol/L)
5.4 mEq/L (5.4 mmol/L) CORRECT ANSWER>>>>3.1
,The primary health care provider writes a prescription for the administration of intravenous (IV)
potassium chloride to a client with hypokalemia. What does the nurse plan to do when
preparing and administering this medication?
Insert a Foley catheter in the client
Prepare the client for insertion of a central IV line
Administer the medication with the use of a macrodrip IV tubing set
Ensure that the medication is diluted in an appropriate amount of normal saline solution
CORRECT ANSWER>>>>Ensure that the medication is diluted in an appropriate amount of
normal saline solution
The nurse notes that a client's serum potassium level is 5.8 mEq/L(5.8 mmol/L). What does the
nurse interpret this expected finding to be related to?
Diarrhea
Wound drainage
Addison disease
Heart failure being treated with loop diuretics CORRECT ANSWER>>>>Addison disease
The nurse is caring for a client experiencing hyponatremia who was admitted to the medical-
surgical unit with fluid-volume overload. For which clinical manifestations of this electrolyte
imbalance does the nurse monitor this client? Select all that apply.
Slow pulse
Decreased urine output
Skeletal muscle weakness
Hyperactive bowel sounds
Hyperactive deep tendon reflexes CORRECT ANSWER>>>>Skeletal muscle weakness
Hyperactive bowel sounds
, The nurse is monitoring a client with hyperparathyroidism for signs/symptoms of
hypercalcemia. For which clinical manifestations, associated with this electrolyte imbalance,
does the nurse assess the client? Select all that apply.
Paresthesias
Muscle weakness
Increased urine output
Chvostek sign
Hyperactive deep tendon reflexes CORRECT ANSWER>>>>Muscle weakness
Increased urine output
The nurse is caring for a client with Crohn's disease whose magnesium level is 1.0 mEq/L (0.5
mmol/L). Which assessment findings does the nurse expect to note? Select all that apply.
Hypotension
Abdominal distention
Trousseau sign
Skeletal muscle weakness
Decreased deep tendon reflexes CORRECT ANSWER>>>>Abdominal distention
Trousseau sign
The nurse enters a client's room and finds the client unconscious. The nurse quickly performs an
assessment and determines that the client is not breathing. Which action does the nurse take
first?
Beginning chest compressions
Checking the client's pulse oximetry reading
ANSWERS PERFECTLY A+ GRADED WITH RATIONALE
The nurse is assigned to care for four clients on the medical-surgical unit. Which client should
the nurse see first on the shift assessment?
A client admitted with pneumonia with a fever of 100° F (37.8°C) and some diaphoresis
A client with congestive heart failure with clear lung sounds on the previous shift
A client with new-onset of shortness of breath (SOB) and a history of pulmonary edema (PE)
A client undergoing long-term corticosteroid therapy with mild bruising on the anterior surfaces
of the arms CORRECT ANSWER>>>>A client with new-onset of shortness of breath
(SOB) and a history of pulmonary edema (PE)
A client with gastroenteritis who has been vomiting and has diarrhea is admitted to the hospital
with a diagnosis of dehydration. For which clinical manifestations that correlate with this fluid
imbalance would the nurse assess the client? Select all that apply.
Decreased pulse
Decreased urine output
Increased blood pressure
Increased respiratory rate
Decreased respiratory depth CORRECT ANSWER>>>>Decreased urine output
Increased respiratory rate
,The nurse is reviewing medical records to assigned clients on the 7 am to 7 pm shift. Which
client will the nurse monitor most closely for excessive fluid volume?
A 48-year-old client receiving diuretics to treat hypertension
A 35-year old client who is vomiting undigested food after eating
An 85-year-old client receiving intravenous (IV) therapy at a rate of 100 mL/hr
A 65-year-old client with a nasogastric tube attached to low suction following partial
gastrectomy CORRECT ANSWER>>>>An 85-year-old client receiving intravenous (IV)
therapy at a rate of 100 mL/hr
The nurse is caring for a client who is being treated for congestive heart failure related to
excessive fluid volume. Which assessment finding causes the nurse to determine that the
client's condition has improved?
Dyspnea
1+ edema in the legs
Moist crackles in the lower lobes of the lungs
Weight loss of 4 lb (1.8 kg) in 24 hours CORRECT ANSWER>>>>Weight loss of 4 lb (1.8
kg) in 24 hours
The nurse notes that a client has ST-segment depression on the electrocardiogram (ECG)
monitor. With which serum potassium reading does the nurse associate this finding?
3.1 mEq/L (3.1 mmol/L)
4.2 mEq/L (4.2 mmol/L)
4.5 mEq/L (4.5 mmol/L)
5.4 mEq/L (5.4 mmol/L) CORRECT ANSWER>>>>3.1
,The primary health care provider writes a prescription for the administration of intravenous (IV)
potassium chloride to a client with hypokalemia. What does the nurse plan to do when
preparing and administering this medication?
Insert a Foley catheter in the client
Prepare the client for insertion of a central IV line
Administer the medication with the use of a macrodrip IV tubing set
Ensure that the medication is diluted in an appropriate amount of normal saline solution
CORRECT ANSWER>>>>Ensure that the medication is diluted in an appropriate amount of
normal saline solution
The nurse notes that a client's serum potassium level is 5.8 mEq/L(5.8 mmol/L). What does the
nurse interpret this expected finding to be related to?
Diarrhea
Wound drainage
Addison disease
Heart failure being treated with loop diuretics CORRECT ANSWER>>>>Addison disease
The nurse is caring for a client experiencing hyponatremia who was admitted to the medical-
surgical unit with fluid-volume overload. For which clinical manifestations of this electrolyte
imbalance does the nurse monitor this client? Select all that apply.
Slow pulse
Decreased urine output
Skeletal muscle weakness
Hyperactive bowel sounds
Hyperactive deep tendon reflexes CORRECT ANSWER>>>>Skeletal muscle weakness
Hyperactive bowel sounds
, The nurse is monitoring a client with hyperparathyroidism for signs/symptoms of
hypercalcemia. For which clinical manifestations, associated with this electrolyte imbalance,
does the nurse assess the client? Select all that apply.
Paresthesias
Muscle weakness
Increased urine output
Chvostek sign
Hyperactive deep tendon reflexes CORRECT ANSWER>>>>Muscle weakness
Increased urine output
The nurse is caring for a client with Crohn's disease whose magnesium level is 1.0 mEq/L (0.5
mmol/L). Which assessment findings does the nurse expect to note? Select all that apply.
Hypotension
Abdominal distention
Trousseau sign
Skeletal muscle weakness
Decreased deep tendon reflexes CORRECT ANSWER>>>>Abdominal distention
Trousseau sign
The nurse enters a client's room and finds the client unconscious. The nurse quickly performs an
assessment and determines that the client is not breathing. Which action does the nurse take
first?
Beginning chest compressions
Checking the client's pulse oximetry reading
