HESI 799 RN ACTUAL EXAM PAPER 2026
QUESTIONS WITH SOLUTIONS GRADED A+
◉ A vacuum-assistive closure (VAC) device is being use to provide
wound care for a client who has stage III pressure ulcer on a below-the-
knee (BKA) residual limb. Which intervention should the nurse
implement to ensure maximum effectiveness of the device?
a. Empty the device every 8 hours and change the dressing daily ensure
sterility
b. Extended the transparent film dressing only to edge of wound to
prevent tension.
c. Ensure the transparent dressing has no tears that might create vacuum
leaks
d. Use an adhesive remover when changing the dressing to promote
comfort. Answer: Ensure the transparent dressing has no tears that might
create vacuum leak
Rationale: The nurse should ensure that the VAC transparent film is
intact, without tears or loose edges C) because a break in the seal
resulting in drying the wound and decreasing the vacuum. The vacuum-
assisted closure (VAC) device uses an open sponge in the wound bed,
sealed with a transparent film dressing and tube extrudes to a suction
device that exert negative pressure to remove excess wound fluid, reduce
the bacterial count and stimulate granulation. The VAC is changed every
other day or third day, not (A) depending on the stage of wound healing
,and emptied when full or weekly. The transparent wound dressing
should extend 3 to 5 cm beyond the wound edges, not (B) to ensure and
airtight seal. Adhesive removers leave a reduce that binder transparent
film adherence (D)
◉ The nurse is developing the plan of care for a client with pneumonia
and includes the nursing diagnosis of "Ineffective airway clearance
related to thick pulmonary secretions." Which intervention is most
important for the nurse to include in the client's plan of care?
a. Increase fluid intake to 3,000 ml/daily
b. Administer O2 at 5L/mint per nasal cannula
c. Maintain the client in a semi Fowler's position
d. Provide frequent rest period. Answer: Increase fluid intake to 3,000
ml/daily
Rationale: The plan of care should include an increase in fluid intake (A)
to liquefy and thin secretions for easier removal of thick pulmonary
secretion which facilitates airway clearance. (B) should be implemented
for signs of hypoxia (C) implemented to facilitate lung expansion, and
(D) implemented for activity intolerance, but these interventions do not
have the priority of (A)
◉ The nurse plans to collect a 24- hour urine specimen for a creatinine
clearance test. Which instruction should the nurse provide to the adult
male client?
,a. Clearance around the meatus, discard first portion of voiding, and
collect the rest in a sterile bottle
b. Urinate at specific time, discard the urine, and collect all subsequent
urine during the next 24 hours.
c. For the next 24 hours, notify the nurse when the bladder is full, and
the nurse will collect catheterized specimens.
d. Urinate immediately into a urinal, and the lab will collect specimen
every 6 hours, for the next 24 hours. Answer: Urinate at specific time,
discard the urine, and collect all subsequent urine during the next 24
hours.
Rationale: Urinate at specific time, discard the urine, and collect all
subsequent urine during the next 24 hours is the correct procedure for
collecting 24-hour urine specimen. Discarding even one voided
specimen invalidate the test.
◉ The nurse is preparing to administer a histamine 2-receptor antagonist
to a client with peptic ulcer disease. What is the primary purpose of this
drug classification?
a. Neutralize hydrochloric (HCI) acid in the stomach
b. Decreases the amount of HCL secretion by the parietal cells in the
stomach
c. Inhibit action of acetylcholine by blocking parasympathetic nerve
endings.
, d. Destroys microorganisms causing stomach inflammation. Answer:
Decreases the amount of HCL secretion by the parietal cells in the
stomach
Rationale: B correctly describe the action of histamine 2 receptor
antagonist in helping to prevent peptic ulcer disease.
◉ The healthcare provider prescribes acarbose (Precose), an alpha-
glucosidase inhibitor, for a client with Type 2 diabetes mellitus. Which
information provides the best indicator of the drug's effectiveness?
a. Body max index (BMI) between 20 and 24
b. Blood pressure reading less than 120/80 mm Hg
c. Hemoglobin A1C (HbA1C) reading less than 7%
d. Self-reported glucose levels of 120-150 mg/dl. Answer: Hemoglobin
A1C (HbA1C) reading less than 7%
Rationale: Acarbose (Precose) delays carbohydrate absorption in the GI
tract and causes the blood glucose to rise slowly after a meal. The best
indicator of acarbose effectiveness is a serum hemoglobin A1 no greater
than 7%, an indication of glucose level over time. Acarbose has no effect
on pain or blood pressure. Self-reported glucose levels of 120-150
reflect the blood sugar at the time taken and are not the best indicator of
drug effectiveness.
QUESTIONS WITH SOLUTIONS GRADED A+
◉ A vacuum-assistive closure (VAC) device is being use to provide
wound care for a client who has stage III pressure ulcer on a below-the-
knee (BKA) residual limb. Which intervention should the nurse
implement to ensure maximum effectiveness of the device?
a. Empty the device every 8 hours and change the dressing daily ensure
sterility
b. Extended the transparent film dressing only to edge of wound to
prevent tension.
c. Ensure the transparent dressing has no tears that might create vacuum
leaks
d. Use an adhesive remover when changing the dressing to promote
comfort. Answer: Ensure the transparent dressing has no tears that might
create vacuum leak
Rationale: The nurse should ensure that the VAC transparent film is
intact, without tears or loose edges C) because a break in the seal
resulting in drying the wound and decreasing the vacuum. The vacuum-
assisted closure (VAC) device uses an open sponge in the wound bed,
sealed with a transparent film dressing and tube extrudes to a suction
device that exert negative pressure to remove excess wound fluid, reduce
the bacterial count and stimulate granulation. The VAC is changed every
other day or third day, not (A) depending on the stage of wound healing
,and emptied when full or weekly. The transparent wound dressing
should extend 3 to 5 cm beyond the wound edges, not (B) to ensure and
airtight seal. Adhesive removers leave a reduce that binder transparent
film adherence (D)
◉ The nurse is developing the plan of care for a client with pneumonia
and includes the nursing diagnosis of "Ineffective airway clearance
related to thick pulmonary secretions." Which intervention is most
important for the nurse to include in the client's plan of care?
a. Increase fluid intake to 3,000 ml/daily
b. Administer O2 at 5L/mint per nasal cannula
c. Maintain the client in a semi Fowler's position
d. Provide frequent rest period. Answer: Increase fluid intake to 3,000
ml/daily
Rationale: The plan of care should include an increase in fluid intake (A)
to liquefy and thin secretions for easier removal of thick pulmonary
secretion which facilitates airway clearance. (B) should be implemented
for signs of hypoxia (C) implemented to facilitate lung expansion, and
(D) implemented for activity intolerance, but these interventions do not
have the priority of (A)
◉ The nurse plans to collect a 24- hour urine specimen for a creatinine
clearance test. Which instruction should the nurse provide to the adult
male client?
,a. Clearance around the meatus, discard first portion of voiding, and
collect the rest in a sterile bottle
b. Urinate at specific time, discard the urine, and collect all subsequent
urine during the next 24 hours.
c. For the next 24 hours, notify the nurse when the bladder is full, and
the nurse will collect catheterized specimens.
d. Urinate immediately into a urinal, and the lab will collect specimen
every 6 hours, for the next 24 hours. Answer: Urinate at specific time,
discard the urine, and collect all subsequent urine during the next 24
hours.
Rationale: Urinate at specific time, discard the urine, and collect all
subsequent urine during the next 24 hours is the correct procedure for
collecting 24-hour urine specimen. Discarding even one voided
specimen invalidate the test.
◉ The nurse is preparing to administer a histamine 2-receptor antagonist
to a client with peptic ulcer disease. What is the primary purpose of this
drug classification?
a. Neutralize hydrochloric (HCI) acid in the stomach
b. Decreases the amount of HCL secretion by the parietal cells in the
stomach
c. Inhibit action of acetylcholine by blocking parasympathetic nerve
endings.
, d. Destroys microorganisms causing stomach inflammation. Answer:
Decreases the amount of HCL secretion by the parietal cells in the
stomach
Rationale: B correctly describe the action of histamine 2 receptor
antagonist in helping to prevent peptic ulcer disease.
◉ The healthcare provider prescribes acarbose (Precose), an alpha-
glucosidase inhibitor, for a client with Type 2 diabetes mellitus. Which
information provides the best indicator of the drug's effectiveness?
a. Body max index (BMI) between 20 and 24
b. Blood pressure reading less than 120/80 mm Hg
c. Hemoglobin A1C (HbA1C) reading less than 7%
d. Self-reported glucose levels of 120-150 mg/dl. Answer: Hemoglobin
A1C (HbA1C) reading less than 7%
Rationale: Acarbose (Precose) delays carbohydrate absorption in the GI
tract and causes the blood glucose to rise slowly after a meal. The best
indicator of acarbose effectiveness is a serum hemoglobin A1 no greater
than 7%, an indication of glucose level over time. Acarbose has no effect
on pain or blood pressure. Self-reported glucose levels of 120-150
reflect the blood sugar at the time taken and are not the best indicator of
drug effectiveness.
