HESI level 2 (NSG 170) Exam Test Questions and Answers Graded A+
A client with acute appendicitis is experiencing anxiety
and loss of sleep about missing final examination week at B. Achieve a sense of control.
college. Which outcome is most important for the nurse
to include in the plan of care? The experience of psychological discomfort may be as real
as physical pain for the client and
A. Sleeping six to eight hours. should be seen as a priority in care. Because the client is
B. Achieve a sense of control. experiencing anxiety, achieving a sense of control is a key
C. Utilize problem solving skills. need (B) before (A, C and D) are addressed.
D. Increased focus of attention.
A 57-year-old male client is scheduled to have a
stress-thallium test the following morning and is NPO
after midnight. At 0130, he is agitated because he cannot
eat and is demanding food. Which response is best for D. "The test you are having tomorrow requires that you
the nurse to provide to this client? have nothing by mouth tonight."
A) I'm sorry sir, you have a prescription for nothing by
mouth from midnight tonight. Being direct and explaining to the client that the test
B) I will let you have one cracker, but that is all you can requires him to be NPO, is the most therapeutic statement
have for the rest of tonight. because the nurse is responding to the client's question
C) What did the healthcare provider tell you about the test and providing him the reason why.
you are having tomorrow?
D) The test you are having tomorrow requires that you
have nothing by mouth tonight.
A male client who smokes two packs of cigarettes a day
states he understands that smoking cigarettes is con-
tributing to the diflculty that he and his wife are having in B, C, D
getting pregnant and wants to know if other factors could
be contributing to their diflculty. What information is best Use of tobacco, alcohol, and marijuana may attect sperm
for the nurse to provide? (Select all that apply.) counts. Sperm count is also negatively attected by low
A.Marijuana cigarettes do not attect sperm count. testosterone levels and obesity.
B.Alcohol consumption can cause erectile dysfunction.
C.Low testosterone levels attect sperm production.
,HESI level 2 (NSG 170) Exam Test Questions and Answers Graded A+
D.Cessation of smoking improves general health and
fertility.
E.Obesity has no ettect on sperm production.
Which response by a client with a nursing diagnosis of
Spiritual distress indicates to the nurse that a desired
outcome measure has been met?
C.Accepts that punishment from God is not related to
A.Expresses concern about the meaning and importance
illness
of life.
B.Remains angry at God for the continuation of the ill-
Acceptance that her illness is not God punishing her, indi-
ness.
cates a desired outcome for some degree of resolution of
C.Accepts that punishment from God is not related to
spiritual distress
illness.
D.Refuses to participate in religious rituals that have no
meaning.
A mother brings her 4-month-old infant to the clinic for a
well-child checkup. She asks if she should go back to work
now or stay at home with the baby. How should the nurse C.Ask the mother to talk about the options she has been
respond to the mother? considering.
A.Mothers can promote healthy bonding by staying at
home during the child's first years. It is common for mothers to feel ambivalent about return-
B.Determine if other family relatives can stay at home with ing to work and caring full time for children at home. The
the baby. nurse should assist the mother to explore her feelings on
C.Ask the mother to talk about the options she has been the subject while focusing on the optimal, appropriate,
considering. safe, and available options for her child
D.Returning to work when an infant is young helps the
baby to adjust to other children.
A 4-year-old boy who is scheduled for a tonsillectomy and
adenoidectomy asks the nurse, "Will it hurt to have my D. "It may hurt but we'll give you medicine to help you feel
tonsils and adenoids taken out?" Which response is best better."
for the nurse to provide?
A. "It may hurt a little because of the incision made in your
,HESI level 2 (NSG 170) Exam Test Questions and Answers Graded A+
throat."
B. "It won't hurt because you're such a big boy." Answering questions simply and directly provides comfort
C. "It won't hurt because we put you to sleep." for the preschool-age child and builds confidence in the
D. "It may hurt but we'll give you medicine to help you feel healthcare team.
better."
A postoperative client has been receiving a continuous
IV infusion of meperidine (Demerol) 35 mg/hr for four
days. The client has a PRN prescription for Demerol 100
C. Decrease the IV infusion rate of the meperidine (De-
mg PO q3h. The nurse notes that the client has become
merol) per protocol.
increasingly restless, irritable and confused, stating that
there are bugs all over the walls. What action should the
The client is exhibiting symptoms of Demerol toxicity which
nurse take first?
is consistent with the large doses of Demerol received over
A. .Administer a PRN dose of the PO meperidine (De-
four days. Decreasing the infusion rate of the Demerol as
merol).
per protocol is the most ettective action to immediately
B. Administer naloxone (Narcan) IV per PRN protocol.
decrease the amount of serum Demerol. The next nursing
C.Decrease the IV infusion rate of the meperidine (De-
action is for the nurse to notify the healthcare provider.
merol) per protocol.
D.Notify the healthcare provider of the client's confusion
and hallucinations.
A couple trying to cope with an infertility problem wants
to know what can be done to preserve emotional equilib-
B: "Get involved with a support group. I will give you some
rium. What is the best response for the nurse to provide?
names."
A. "Tell your friends and family so that they can help you."
B. "Get involved with a support group. I will give you some
A support group provides a safe haven for the couple
names."
to share their feelings and experience, gain insight from
C. "Talk only to other friends who are infertile since only
others dealing with the same experience, and assure the
they can help."
couple that they are not alone in their situation.
D. "Start adoption proceedings immediately since obtain-
ing an infant is very diflcult."
A 17-year-old unmarried, pregnant client with drug ad-
diction is a high school dropout, homeless, and has a
, history of past abuse arrives at the clinic for her first A, B, C, D, E
prenatal visit. Which findings should the nurse document
as health risk factors for the client? (Select all that apply.) Health risk factors for this client include age, drug ad-
A.Age. diction, pregnancy, history of abuse and homelessness.
B.Drug addiction. Each factor should be considered individually. The client,
C.History of abuse. as an adolescent mother, is at high risk for nutritional
D.Pregnancy. deficits, anemia, gestational diabetes and hypertension,
E. Homelessness. which also impact the fetus' risk for small for gestational
F.Unmarried. age, fetal anomalies, and fetal demise.
Which nursing intervention should the nurse implement D. Keep the body available for a few hours in case they
with parents who experience a fetal demise and express change their minds.
the wish not to see the baby?
A. Tell them there is nothing to fear. Grieving parents should be encouraged to hold their in-
B. Insist that they hold infant so they can grieve. fant after death to facilitate closure. If parents are hesitant
C. Respect their wishes and release the body to the about seeing or holding their dead infant, the fetus should
morgue. be available for a few hours in the event they change
D. Keep the body available for a few hours in case they their mind after the initial shock. The other actions are not
change their minds. indicated.
A. Ask the family if they would like to see and hold the infant
A client is told that her infant will be stillborn. What is the
after birth.
most important action for the nurse to implement after
the birth?
Interventions and support from the nursing statt during a
A. Ask the family if they would like to see and hold the
prenatal loss are extremely important in the grief process
infant after birth.
and healing of the parents. Research had shown it is most
B. Inquire if the parents want a picture taken after the
helpful for a mother and father to see and hold their
infant is born.
deceased infant after delivery, so the parents should be
C. Discuss with the parents which funeral home should be
given this opportunity initially after birth. The other actions
notified.
should be done after determining the parents' wishes and
D. Find out if the client has a special outfit for the infant
providing the opportunity for bonding and closure with
after the birth.
their infant.
A client with acute appendicitis is experiencing anxiety
and loss of sleep about missing final examination week at B. Achieve a sense of control.
college. Which outcome is most important for the nurse
to include in the plan of care? The experience of psychological discomfort may be as real
as physical pain for the client and
A. Sleeping six to eight hours. should be seen as a priority in care. Because the client is
B. Achieve a sense of control. experiencing anxiety, achieving a sense of control is a key
C. Utilize problem solving skills. need (B) before (A, C and D) are addressed.
D. Increased focus of attention.
A 57-year-old male client is scheduled to have a
stress-thallium test the following morning and is NPO
after midnight. At 0130, he is agitated because he cannot
eat and is demanding food. Which response is best for D. "The test you are having tomorrow requires that you
the nurse to provide to this client? have nothing by mouth tonight."
A) I'm sorry sir, you have a prescription for nothing by
mouth from midnight tonight. Being direct and explaining to the client that the test
B) I will let you have one cracker, but that is all you can requires him to be NPO, is the most therapeutic statement
have for the rest of tonight. because the nurse is responding to the client's question
C) What did the healthcare provider tell you about the test and providing him the reason why.
you are having tomorrow?
D) The test you are having tomorrow requires that you
have nothing by mouth tonight.
A male client who smokes two packs of cigarettes a day
states he understands that smoking cigarettes is con-
tributing to the diflculty that he and his wife are having in B, C, D
getting pregnant and wants to know if other factors could
be contributing to their diflculty. What information is best Use of tobacco, alcohol, and marijuana may attect sperm
for the nurse to provide? (Select all that apply.) counts. Sperm count is also negatively attected by low
A.Marijuana cigarettes do not attect sperm count. testosterone levels and obesity.
B.Alcohol consumption can cause erectile dysfunction.
C.Low testosterone levels attect sperm production.
,HESI level 2 (NSG 170) Exam Test Questions and Answers Graded A+
D.Cessation of smoking improves general health and
fertility.
E.Obesity has no ettect on sperm production.
Which response by a client with a nursing diagnosis of
Spiritual distress indicates to the nurse that a desired
outcome measure has been met?
C.Accepts that punishment from God is not related to
A.Expresses concern about the meaning and importance
illness
of life.
B.Remains angry at God for the continuation of the ill-
Acceptance that her illness is not God punishing her, indi-
ness.
cates a desired outcome for some degree of resolution of
C.Accepts that punishment from God is not related to
spiritual distress
illness.
D.Refuses to participate in religious rituals that have no
meaning.
A mother brings her 4-month-old infant to the clinic for a
well-child checkup. She asks if she should go back to work
now or stay at home with the baby. How should the nurse C.Ask the mother to talk about the options she has been
respond to the mother? considering.
A.Mothers can promote healthy bonding by staying at
home during the child's first years. It is common for mothers to feel ambivalent about return-
B.Determine if other family relatives can stay at home with ing to work and caring full time for children at home. The
the baby. nurse should assist the mother to explore her feelings on
C.Ask the mother to talk about the options she has been the subject while focusing on the optimal, appropriate,
considering. safe, and available options for her child
D.Returning to work when an infant is young helps the
baby to adjust to other children.
A 4-year-old boy who is scheduled for a tonsillectomy and
adenoidectomy asks the nurse, "Will it hurt to have my D. "It may hurt but we'll give you medicine to help you feel
tonsils and adenoids taken out?" Which response is best better."
for the nurse to provide?
A. "It may hurt a little because of the incision made in your
,HESI level 2 (NSG 170) Exam Test Questions and Answers Graded A+
throat."
B. "It won't hurt because you're such a big boy." Answering questions simply and directly provides comfort
C. "It won't hurt because we put you to sleep." for the preschool-age child and builds confidence in the
D. "It may hurt but we'll give you medicine to help you feel healthcare team.
better."
A postoperative client has been receiving a continuous
IV infusion of meperidine (Demerol) 35 mg/hr for four
days. The client has a PRN prescription for Demerol 100
C. Decrease the IV infusion rate of the meperidine (De-
mg PO q3h. The nurse notes that the client has become
merol) per protocol.
increasingly restless, irritable and confused, stating that
there are bugs all over the walls. What action should the
The client is exhibiting symptoms of Demerol toxicity which
nurse take first?
is consistent with the large doses of Demerol received over
A. .Administer a PRN dose of the PO meperidine (De-
four days. Decreasing the infusion rate of the Demerol as
merol).
per protocol is the most ettective action to immediately
B. Administer naloxone (Narcan) IV per PRN protocol.
decrease the amount of serum Demerol. The next nursing
C.Decrease the IV infusion rate of the meperidine (De-
action is for the nurse to notify the healthcare provider.
merol) per protocol.
D.Notify the healthcare provider of the client's confusion
and hallucinations.
A couple trying to cope with an infertility problem wants
to know what can be done to preserve emotional equilib-
B: "Get involved with a support group. I will give you some
rium. What is the best response for the nurse to provide?
names."
A. "Tell your friends and family so that they can help you."
B. "Get involved with a support group. I will give you some
A support group provides a safe haven for the couple
names."
to share their feelings and experience, gain insight from
C. "Talk only to other friends who are infertile since only
others dealing with the same experience, and assure the
they can help."
couple that they are not alone in their situation.
D. "Start adoption proceedings immediately since obtain-
ing an infant is very diflcult."
A 17-year-old unmarried, pregnant client with drug ad-
diction is a high school dropout, homeless, and has a
, history of past abuse arrives at the clinic for her first A, B, C, D, E
prenatal visit. Which findings should the nurse document
as health risk factors for the client? (Select all that apply.) Health risk factors for this client include age, drug ad-
A.Age. diction, pregnancy, history of abuse and homelessness.
B.Drug addiction. Each factor should be considered individually. The client,
C.History of abuse. as an adolescent mother, is at high risk for nutritional
D.Pregnancy. deficits, anemia, gestational diabetes and hypertension,
E. Homelessness. which also impact the fetus' risk for small for gestational
F.Unmarried. age, fetal anomalies, and fetal demise.
Which nursing intervention should the nurse implement D. Keep the body available for a few hours in case they
with parents who experience a fetal demise and express change their minds.
the wish not to see the baby?
A. Tell them there is nothing to fear. Grieving parents should be encouraged to hold their in-
B. Insist that they hold infant so they can grieve. fant after death to facilitate closure. If parents are hesitant
C. Respect their wishes and release the body to the about seeing or holding their dead infant, the fetus should
morgue. be available for a few hours in the event they change
D. Keep the body available for a few hours in case they their mind after the initial shock. The other actions are not
change their minds. indicated.
A. Ask the family if they would like to see and hold the infant
A client is told that her infant will be stillborn. What is the
after birth.
most important action for the nurse to implement after
the birth?
Interventions and support from the nursing statt during a
A. Ask the family if they would like to see and hold the
prenatal loss are extremely important in the grief process
infant after birth.
and healing of the parents. Research had shown it is most
B. Inquire if the parents want a picture taken after the
helpful for a mother and father to see and hold their
infant is born.
deceased infant after delivery, so the parents should be
C. Discuss with the parents which funeral home should be
given this opportunity initially after birth. The other actions
notified.
should be done after determining the parents' wishes and
D. Find out if the client has a special outfit for the infant
providing the opportunity for bonding and closure with
after the birth.
their infant.
