HESI FUNDAMENTALS PRACTICE EXAM Western
Governors University |D 236| QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
The nurse is assessing the nutritional status of several clients. Which client has the greatest nutritional
need for additional intake of protein?
A. A college-age track runner with a sprained ankle.
B. A lactating woman nursing her 3-day-old infant.
C. A school-aged child with Type 2 diabetes.
D. An elderly man being treated for a peptic ulcer. - answer :B. A lactating woman nursing her 3-day-
old infant.
(A lactating woman (B) has the greatest need for additional protein intake. (A, C, and D) are all
conditions that require protein but do NOT have the increased metabolic protein demands of
lactation.)
A client who is a Jehovah's Witness is admitted to the nursing unit. Which concern should the nurse
have for planning care in terms of the client's beliefs?
A. Autopsy of the body is prohibited.
B. Blood transfusions are forbidden.
C. Alcohol use in any form is not allowed.
D. A vegetarian diet must be followed. - answer :B. Blood transfusions are forbidden.
When conducting an admission assessment, the nurse should ask the client about the use of
complimentary healing practices. Which statement is accurate regarding the use of these practices?
,A. Complimentary healing practices interfere with the efficacy of the medical model of treatment.
B. Conventional medications are likely to interact with folk remedies and cause adverse effects.
C. Many complimentary healing practices can be used in conjunction with conventional practices.
D. Conventional medical practices will ultimately replace the use of complimentary healing practices. -
answer :C. Many complimentary healing practices can be used in conjunction with conventional
practices. (Conventional approaches to health care can be depersonalizing and often fail to take into
consideration all aspects of an individual, including body, mind, and spirit. Often complimentary
healing practices can be used in conjunction with conventional medical practices (C), rather than
interfering (A) with conventional practices, causing adverse effects (B), or replacing conventional
medical care (D). )
A client who is in hospice care complains of increasing amounts of pain. The healthcare provider
prescribes an analgesic every four hours as needed. Which action should the nurse implement?
A. Give an around-the-clock schedule for administration of analgesics.
B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so that the client can do daily activities. - answer :A. Give an around-
the-clock schedule for administration of analgesics.
(The most effective management of pain is achieved using an around-the-clock schedule that provides
analgesic medications on a regular basis (A) and in a timely manner. Analgesics are less effective if
pain persists until it is severe, so an analgesic medication should be administered before the client's
pain peaks (B). Providing comfort is a priority for the client who is dying, but sedation that impairs the
client's ability to interact and experience the time before life ends should be minimized (C). Offering a
medication-free period allows the serum drug level to fall, which is not an effective method to
manage chronic pain.)
A client with pneumonia has a decrease in oxygen saturation from 94% to 88% while ambulating.
Based on these findings, which intervention should the nurse implement first?
A. Assist the ambulating client back to the bed
B. Encourage the client to ambulate to resolve pneumonia.
C. Obtain a prescription for portable oxygen while ambulating.
D. Move the oximetry probe from the finger to the earlobe. - answer :A. Assist the ambulating client
back to the bed.
(An oxygen saturation below 90% indicates inadequate oxygen. First, the client should be assisted to
return to bed (A) to minimize oxygen demands. Ambulation increases aeration of the lungs to prevent
, pooling of respiratory secretions, but the client's activity at this time is depleting oxygen saturation of
the blood, so (B) is contraindicated. Increased activity increases respiratory effort, and oxygen may be
necessary to continue ambulation (C), but first the client should return to the bed to rest. Oxygen
saturation levels at different sites should be evaluated AFTER the client returns to bed (D). )
A female client asks the nurse to find someone who can translate into her native language her
concerns about a treatment. Which action should the nurse take?
A. Explain that anyone who speaks her language can answer her questions.
B. Provide a translator only in an emergency situation.
C. Ask a family member or friend of the client to translate.
D. Request and document the name of the certified translator. - answer :D. Request and document
the name of the certified translator. (A certified translator should be requested to ensure the
exchanged information is reliable and unaltered. To adhere to legal requirements in some states, the
name of the translator should be documented (D). Client information that is translated is private and
protected under HIPAA rules, so (A) is not the best action. Although an emergency situation may
require extenuating circumstances (B), a translator should be provided in most situations. Family
members may skew info and not translate the exact information, so (C) is not preferred.)
An African-American grandmother tells the nurse that her 4-year-old grandson is suffering with
"miseries." Based on this statement, which focused assessment should the nurse conduct?
A. Inquire about the source and type of pain.
B. Examine the nose for congestion and discharge.
C. Take vital signs for temperature elevation.
D. Explore the abdominal area for distention. - answer :A. Inquire about the source and type of pain
(Different cultural groups often have their own terms for health conditions. African-Americans clients
may refer to pain as "the miseries." Based on understanding this term, the nurse should conduct a
focused assessment on the source and type of pain (A). (B, C, and D) are important, but do not focus
on "miseries" (pain).)
The nurse notices that the mother a 9-year-old Vietnamese child always looks at the floor when she
talks to the nurse. What action should the nurse take?
A. Talk directly to the child instead of the mother.
B. Continue asking the mother questions about the child.
C. Ask another nurse to interview the mother now.
Governors University |D 236| QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
The nurse is assessing the nutritional status of several clients. Which client has the greatest nutritional
need for additional intake of protein?
A. A college-age track runner with a sprained ankle.
B. A lactating woman nursing her 3-day-old infant.
C. A school-aged child with Type 2 diabetes.
D. An elderly man being treated for a peptic ulcer. - answer :B. A lactating woman nursing her 3-day-
old infant.
(A lactating woman (B) has the greatest need for additional protein intake. (A, C, and D) are all
conditions that require protein but do NOT have the increased metabolic protein demands of
lactation.)
A client who is a Jehovah's Witness is admitted to the nursing unit. Which concern should the nurse
have for planning care in terms of the client's beliefs?
A. Autopsy of the body is prohibited.
B. Blood transfusions are forbidden.
C. Alcohol use in any form is not allowed.
D. A vegetarian diet must be followed. - answer :B. Blood transfusions are forbidden.
When conducting an admission assessment, the nurse should ask the client about the use of
complimentary healing practices. Which statement is accurate regarding the use of these practices?
,A. Complimentary healing practices interfere with the efficacy of the medical model of treatment.
B. Conventional medications are likely to interact with folk remedies and cause adverse effects.
C. Many complimentary healing practices can be used in conjunction with conventional practices.
D. Conventional medical practices will ultimately replace the use of complimentary healing practices. -
answer :C. Many complimentary healing practices can be used in conjunction with conventional
practices. (Conventional approaches to health care can be depersonalizing and often fail to take into
consideration all aspects of an individual, including body, mind, and spirit. Often complimentary
healing practices can be used in conjunction with conventional medical practices (C), rather than
interfering (A) with conventional practices, causing adverse effects (B), or replacing conventional
medical care (D). )
A client who is in hospice care complains of increasing amounts of pain. The healthcare provider
prescribes an analgesic every four hours as needed. Which action should the nurse implement?
A. Give an around-the-clock schedule for administration of analgesics.
B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so that the client can do daily activities. - answer :A. Give an around-
the-clock schedule for administration of analgesics.
(The most effective management of pain is achieved using an around-the-clock schedule that provides
analgesic medications on a regular basis (A) and in a timely manner. Analgesics are less effective if
pain persists until it is severe, so an analgesic medication should be administered before the client's
pain peaks (B). Providing comfort is a priority for the client who is dying, but sedation that impairs the
client's ability to interact and experience the time before life ends should be minimized (C). Offering a
medication-free period allows the serum drug level to fall, which is not an effective method to
manage chronic pain.)
A client with pneumonia has a decrease in oxygen saturation from 94% to 88% while ambulating.
Based on these findings, which intervention should the nurse implement first?
A. Assist the ambulating client back to the bed
B. Encourage the client to ambulate to resolve pneumonia.
C. Obtain a prescription for portable oxygen while ambulating.
D. Move the oximetry probe from the finger to the earlobe. - answer :A. Assist the ambulating client
back to the bed.
(An oxygen saturation below 90% indicates inadequate oxygen. First, the client should be assisted to
return to bed (A) to minimize oxygen demands. Ambulation increases aeration of the lungs to prevent
, pooling of respiratory secretions, but the client's activity at this time is depleting oxygen saturation of
the blood, so (B) is contraindicated. Increased activity increases respiratory effort, and oxygen may be
necessary to continue ambulation (C), but first the client should return to the bed to rest. Oxygen
saturation levels at different sites should be evaluated AFTER the client returns to bed (D). )
A female client asks the nurse to find someone who can translate into her native language her
concerns about a treatment. Which action should the nurse take?
A. Explain that anyone who speaks her language can answer her questions.
B. Provide a translator only in an emergency situation.
C. Ask a family member or friend of the client to translate.
D. Request and document the name of the certified translator. - answer :D. Request and document
the name of the certified translator. (A certified translator should be requested to ensure the
exchanged information is reliable and unaltered. To adhere to legal requirements in some states, the
name of the translator should be documented (D). Client information that is translated is private and
protected under HIPAA rules, so (A) is not the best action. Although an emergency situation may
require extenuating circumstances (B), a translator should be provided in most situations. Family
members may skew info and not translate the exact information, so (C) is not preferred.)
An African-American grandmother tells the nurse that her 4-year-old grandson is suffering with
"miseries." Based on this statement, which focused assessment should the nurse conduct?
A. Inquire about the source and type of pain.
B. Examine the nose for congestion and discharge.
C. Take vital signs for temperature elevation.
D. Explore the abdominal area for distention. - answer :A. Inquire about the source and type of pain
(Different cultural groups often have their own terms for health conditions. African-Americans clients
may refer to pain as "the miseries." Based on understanding this term, the nurse should conduct a
focused assessment on the source and type of pain (A). (B, C, and D) are important, but do not focus
on "miseries" (pain).)
The nurse notices that the mother a 9-year-old Vietnamese child always looks at the floor when she
talks to the nurse. What action should the nurse take?
A. Talk directly to the child instead of the mother.
B. Continue asking the mother questions about the child.
C. Ask another nurse to interview the mother now.
