HESI RN FUNDAMENTALS V1 AND V2 EXAM LATEST
UPDATE 2024 WITH 100% CORRET QUESTION AND
ANSWERS GRADED A+
The nurse is giving preop instructions to a 14 yr old scheduled to correct a spinal curvature. Which
statement best demonstrates that learning has taken place? - Correct Answer I understand I will be in a
body cast and I will show you hoy you taught me to turn
To take the vital signs of a 4 month old child which order will give the most accurate results? - Correct
Answer Respiratory rate, heart rate, rectal temperature
AN otoscope exam of a child's ear reveals a tympanic membrane that is pearly gray, slightly bulging and
not movable. What action should the nurse take next? - Correct Answer Ask the child if he has has a
cold, runny nose or any ear pain lately
Which restraint should be used for a toddler after a cleft palate repair? - Correct Answer elbow
What preoperative nursing intervention should be included in the plan of care for an infant with pyloric
stenosis? - Correct Answer Observe for projectile vomiting
A six month old returns from surgery with elbow restraints in place. What nursing intervention should
be included when caring for any restrained child? - Correct Answer remove restraints one at a time and
provide range of motion exercise
A two year old with Down Syndrome is brought to the clinic for his regular physical exam. The nurse
knows which problem is frequently associated with Down Syndrome? - Correct Answer Congenital
Heart Disease
When assessing a child with asthma the nurse should expect intercostal retractions during - Correct
Answer inspiration
When planning the care for a child who has had a cleft lip repair, the nurse knows that crying should be
minimized because it - Correct Answer stresses the suture line
,A client with a productive cough has obtained a sputum specimen for culture as instructed. What action
is the best initial nursing action? - Correct Answer Administer the first dose of prescribed antibiotic
therapy
A client is brought to the Emergency Department by ambulance in cardiac arrest with CPR in progress.
The client is intubated and receiving 100% O2 per ambu bag. The nurse determines the client is cyanotic,
cold, and diaphoretic. Which assessment is most important to obtain? - Correct Answer deep tendon
reflexes
After a hospitalization for Syndrome of Inappropriate Antidiuretic Hormone (SIADH), a client develops
pontine myselinolysis. Which intervention should the nurse implement first? - Correct Answer
Reorientate client to his room
A male client with heart failure (HF) calls the clinic and reports he cannot put his shoes on because they
are too tight. Which additional information should the nurse obtain? - Correct Answer Has his weight
changed in the last several days
An older adult with a long hx of COPD is admitted with progressive shortness of breath and a persistent
cough. She is anxious and is complaining of a dry mouth. Which intervention should the nurse
implement? - Correct Answer Apply a high flow venturi mask
A client with a hx of asthma and bronchitis arrives at the clinic with SOB, productive cough with
thickened tenacious mucous and the inability to walk up a flight of stairs without experiencing
breathlessness. Which action is important for the nurse to instruct the client about self care? - Correct
Answer Increase the daily intake of oral fluids to to liquefy secretions
A cardiac catherization of a client with heart disease indicates the following blockages 95% LAD 99%
proximal circumflex and 95% proximal RCA. The client later asks the nurse "what does all that mean for
me" - Correct Answer 3 main arteries have major blockages with only 1 to 5% of blood flow getting
through to the heart muscle
The nurse is caring for a client with a lower left pulmonary abscess which position should the nurse
instruct the client to maintain - Correct Answer left lateral
, A client with cholelithiasis has a gallstone lodged in the common bile duct and is unable to eat or drink
without nausea and vomiting. Which finding should the nurse report to the healthcare provider -
Correct Answer yellow sclera
While caring for a client with Amyotrophic Lateral Sclerosis (ALS), the nurse performs a neuro
assessment every 4 hours. which assessment finding warrants immediate intervention by the nurse? -
Correct Answer Increasing Anxiety
The nurse is providing preoperative education for a Jewish client scheduled to receive a xenograft to
promote burn healing. Which info should the nurse provide this client? - Correct Answer The xenograft
is taken from nonhuman sources
A male client who had colon surgery 3 days ago is anxious and requests assistance to reposition. The
wound dehiscences and eviscerates. The nurse moistens an available sterile dressing and places it over
the wound which intervention should the nurse implement next? - Correct Answer prepare the client to
return to the operating room
A client with carcinoma of the lung is complaining of weakness and has a serum sodium level of 117
mEq/L. Which nursing problem should the nurse include in this client's plan of care? - Correct Answer
Fluid volume excess
A female client enters the clinic and insists on being seen. She is weak, nervous, and reports a racing
heart beat and recent weight loss of 15 pounds. After ruling out substance withdrawal, the healthcare
provider suspects hyperthyroidism and admits her for further testing. Which action should the nurse
implement? - Correct Answer space the clients care to provide periods of rest
The nurse is teaching the client with glomerulonephritis about self care which dietary recommendations
should the nurse encourage the client to follow? - Correct Answer restrict intake by limiting meats and
other high protein foods
An overweight, young adult male who was recently diagnosed with type 2 diabetes mellitus is admitted
for a hernia repair. He tells the nurse that he is feeling very weak and jittery. Which actions should the
nurse implement? - Correct Answer - assess his skin temp and moisture
- document anxiety on the surgical checklist
-administer a PRN dose of regular insulin
UPDATE 2024 WITH 100% CORRET QUESTION AND
ANSWERS GRADED A+
The nurse is giving preop instructions to a 14 yr old scheduled to correct a spinal curvature. Which
statement best demonstrates that learning has taken place? - Correct Answer I understand I will be in a
body cast and I will show you hoy you taught me to turn
To take the vital signs of a 4 month old child which order will give the most accurate results? - Correct
Answer Respiratory rate, heart rate, rectal temperature
AN otoscope exam of a child's ear reveals a tympanic membrane that is pearly gray, slightly bulging and
not movable. What action should the nurse take next? - Correct Answer Ask the child if he has has a
cold, runny nose or any ear pain lately
Which restraint should be used for a toddler after a cleft palate repair? - Correct Answer elbow
What preoperative nursing intervention should be included in the plan of care for an infant with pyloric
stenosis? - Correct Answer Observe for projectile vomiting
A six month old returns from surgery with elbow restraints in place. What nursing intervention should
be included when caring for any restrained child? - Correct Answer remove restraints one at a time and
provide range of motion exercise
A two year old with Down Syndrome is brought to the clinic for his regular physical exam. The nurse
knows which problem is frequently associated with Down Syndrome? - Correct Answer Congenital
Heart Disease
When assessing a child with asthma the nurse should expect intercostal retractions during - Correct
Answer inspiration
When planning the care for a child who has had a cleft lip repair, the nurse knows that crying should be
minimized because it - Correct Answer stresses the suture line
,A client with a productive cough has obtained a sputum specimen for culture as instructed. What action
is the best initial nursing action? - Correct Answer Administer the first dose of prescribed antibiotic
therapy
A client is brought to the Emergency Department by ambulance in cardiac arrest with CPR in progress.
The client is intubated and receiving 100% O2 per ambu bag. The nurse determines the client is cyanotic,
cold, and diaphoretic. Which assessment is most important to obtain? - Correct Answer deep tendon
reflexes
After a hospitalization for Syndrome of Inappropriate Antidiuretic Hormone (SIADH), a client develops
pontine myselinolysis. Which intervention should the nurse implement first? - Correct Answer
Reorientate client to his room
A male client with heart failure (HF) calls the clinic and reports he cannot put his shoes on because they
are too tight. Which additional information should the nurse obtain? - Correct Answer Has his weight
changed in the last several days
An older adult with a long hx of COPD is admitted with progressive shortness of breath and a persistent
cough. She is anxious and is complaining of a dry mouth. Which intervention should the nurse
implement? - Correct Answer Apply a high flow venturi mask
A client with a hx of asthma and bronchitis arrives at the clinic with SOB, productive cough with
thickened tenacious mucous and the inability to walk up a flight of stairs without experiencing
breathlessness. Which action is important for the nurse to instruct the client about self care? - Correct
Answer Increase the daily intake of oral fluids to to liquefy secretions
A cardiac catherization of a client with heart disease indicates the following blockages 95% LAD 99%
proximal circumflex and 95% proximal RCA. The client later asks the nurse "what does all that mean for
me" - Correct Answer 3 main arteries have major blockages with only 1 to 5% of blood flow getting
through to the heart muscle
The nurse is caring for a client with a lower left pulmonary abscess which position should the nurse
instruct the client to maintain - Correct Answer left lateral
, A client with cholelithiasis has a gallstone lodged in the common bile duct and is unable to eat or drink
without nausea and vomiting. Which finding should the nurse report to the healthcare provider -
Correct Answer yellow sclera
While caring for a client with Amyotrophic Lateral Sclerosis (ALS), the nurse performs a neuro
assessment every 4 hours. which assessment finding warrants immediate intervention by the nurse? -
Correct Answer Increasing Anxiety
The nurse is providing preoperative education for a Jewish client scheduled to receive a xenograft to
promote burn healing. Which info should the nurse provide this client? - Correct Answer The xenograft
is taken from nonhuman sources
A male client who had colon surgery 3 days ago is anxious and requests assistance to reposition. The
wound dehiscences and eviscerates. The nurse moistens an available sterile dressing and places it over
the wound which intervention should the nurse implement next? - Correct Answer prepare the client to
return to the operating room
A client with carcinoma of the lung is complaining of weakness and has a serum sodium level of 117
mEq/L. Which nursing problem should the nurse include in this client's plan of care? - Correct Answer
Fluid volume excess
A female client enters the clinic and insists on being seen. She is weak, nervous, and reports a racing
heart beat and recent weight loss of 15 pounds. After ruling out substance withdrawal, the healthcare
provider suspects hyperthyroidism and admits her for further testing. Which action should the nurse
implement? - Correct Answer space the clients care to provide periods of rest
The nurse is teaching the client with glomerulonephritis about self care which dietary recommendations
should the nurse encourage the client to follow? - Correct Answer restrict intake by limiting meats and
other high protein foods
An overweight, young adult male who was recently diagnosed with type 2 diabetes mellitus is admitted
for a hernia repair. He tells the nurse that he is feeling very weak and jittery. Which actions should the
nurse implement? - Correct Answer - assess his skin temp and moisture
- document anxiety on the surgical checklist
-administer a PRN dose of regular insulin
