HESI with Rationale 12 366 rn exit Hesi Questions With
Complete Solutions
A 13-year-old client with non-union of a comminuted fracture of
the tibia is admitted with osteomyelitis. The healthcare provider
collects bone aspirate specimens for culture and sensitivity and
applies a cast to the adolescent's lower leg. What action should
the nurse implement next?
A. Administer antiemetic agents.
D. Bivalve the cast for distal compromise.
C. Provide high- calorie, high-protein diet.
D. Begin parenteral antibiotic therapy. Correct Answers
Answer
D. Begin parenteral antibiotic therapy.
Rationale
The standard of treatment for osteomyelitis is antibiotic therapy
and immobilization. After blood and bone aspirate specimens
are obtained for culture and sensitivity, the nurse should initiate
parenteral antibiotics (D) as prescribed. Antiemetics (A) should
be administered to manage anorexia, nausea, and vomiting upon
onset, but first the nurse should initiate antibiotic therapy. If the
healthcare provider is unable to cut the cast, the nurse must be
able to bivalve the cast (B) should compartment syndrome occur
when the cast has dried. (C) should be implemented when the
child can tolerate oral intake.
A 16-year-old adolescent with meningococcal meningitis is
receiving a continuous IV infusion of penicillin G, which is
prescribed as 20 million units in a total volume of 2 liters of
,normal saline every 24 hours. The pharmacy delivers 10 million
units/ liter of normal saline. How many ml/hr should the nurse
program the infusion pump? (Enter numeric value only. If
rounding is required, round to the nearest whole number.)
Correct Answers Rationale
To deliver the prescribed dose of 20 million units/2 liters q24
hours, the available solution, 10 million units/liter, should be
delivered in 12 hours.
1000 ml : 12 hours :: X ml : 1 hour
12X = 1000
X = 83.33 = 83 ml/hour
A 26-year-old female client is admitted to the hospital for
treatment of a simple goiter, and levothyroxine sodium
(Synthroid) is prescribed. Which symptoms indicate to the nurse
that the prescribed dosage is too high for this client? The client
experiences
A. palpitations and shortness of breath.
B. bradycardia and constipation.
C. lethargy and lack of appetite.
D. muscle cramping and dry, flushed skin. Correct Answers
Answer
A. palpitations and shortness of breath.
Rationale
An overdose of thyroid preparation generally manifests
symptoms of an agitated state such as tremors, palpitations,
shortness of breath, tachycardia, increased appetite, agitation,
sweating and diarrhea (A). (B, C, and D) are not related to
overdosage of thyroid preparations.
,A 3-year-old boy is brought to the emergency department after
the mother found the child in the back yard holding a piece of a
toy in his hand and in respiratory distress. The child is dusky
with a loud, inspiratory stridor and weak attempts to cough.
Which actions should the nurse implement?
A. Obtain a pulse oximetry reading and arterial blood gases.
B. Auscultate all pulmonary lung fields and attempt a Heimlich
maneuver.
C. Request a stat chest x-ray and prepare medications for an
asthmatic episode.
D. Determine if the child ingested a toxic substance and if
vomiting occurred. Correct Answers Answer
B. Auscultate all pulmonary lung fields and attempt a Heimlich
maneuver.
Rationale
Sudden onset of strider, dusky color, and weak ineffective cough
strongly suggest that the child aspirated a foreign body. After
auscultation of lung fields to determine the quality of air
exchange, a Heimlich maneuver (B) is indicated to release the
obstruction. After effective breathing is restored, the child may
be assessed for complications (A). A history of asthma with
symptoms of wheezing (C) is not a part of this child's clinical
findings. Although respiratory distress may occur with laryngeal
chemical exposure, oral facial burns and systemic manifestations
are more likely indications of toxic substance ingestion (D).
A 350-bed acute care hospital declares an internal disaster
because the emergency generators malfunctioned during a city-
, wide power failure. The Unlicensed Assistive Personnel (UAP)s
working on a general medical unit ask the charge nurse what
they should do first. What instruction should the charge nurse
provide to these UAPs?
A. Go to the emergency department and complete assigned
tasks.
B. Shut all doors to client rooms on the unit in case a fire erupts.
C. Offer to assist in ICU with a ventilator-dependent clients.
D. Tell all their assigned clients to stay in their rooms. Correct
Answers Rationale
D. Tell all their assigned clients to stay in their rooms.
Rationale
A power failure leaves a unit in total darkness except for battery
operated lighting. The top priority should be ensuring client
safety by having clients stay in the rooms, and an unlicensed
person can implement this (D). (A) is of higher priority in an
external disaster. (B) would further compound the lighting
problems, and has not indicated unless fire or smoke is visible.
(C) is contraindicated until client safety is insured on the
assigned unit.
A 56-year-old man shares with the nurse that he is having
difficulty making a decision about terminating life support for
his wife. What is the best initial action by the nurse?
A. Provide an opportunity for him to clarify his values related to
the decision.
B. Encourage him to share memories about his life with his wife
and family.
Complete Solutions
A 13-year-old client with non-union of a comminuted fracture of
the tibia is admitted with osteomyelitis. The healthcare provider
collects bone aspirate specimens for culture and sensitivity and
applies a cast to the adolescent's lower leg. What action should
the nurse implement next?
A. Administer antiemetic agents.
D. Bivalve the cast for distal compromise.
C. Provide high- calorie, high-protein diet.
D. Begin parenteral antibiotic therapy. Correct Answers
Answer
D. Begin parenteral antibiotic therapy.
Rationale
The standard of treatment for osteomyelitis is antibiotic therapy
and immobilization. After blood and bone aspirate specimens
are obtained for culture and sensitivity, the nurse should initiate
parenteral antibiotics (D) as prescribed. Antiemetics (A) should
be administered to manage anorexia, nausea, and vomiting upon
onset, but first the nurse should initiate antibiotic therapy. If the
healthcare provider is unable to cut the cast, the nurse must be
able to bivalve the cast (B) should compartment syndrome occur
when the cast has dried. (C) should be implemented when the
child can tolerate oral intake.
A 16-year-old adolescent with meningococcal meningitis is
receiving a continuous IV infusion of penicillin G, which is
prescribed as 20 million units in a total volume of 2 liters of
,normal saline every 24 hours. The pharmacy delivers 10 million
units/ liter of normal saline. How many ml/hr should the nurse
program the infusion pump? (Enter numeric value only. If
rounding is required, round to the nearest whole number.)
Correct Answers Rationale
To deliver the prescribed dose of 20 million units/2 liters q24
hours, the available solution, 10 million units/liter, should be
delivered in 12 hours.
1000 ml : 12 hours :: X ml : 1 hour
12X = 1000
X = 83.33 = 83 ml/hour
A 26-year-old female client is admitted to the hospital for
treatment of a simple goiter, and levothyroxine sodium
(Synthroid) is prescribed. Which symptoms indicate to the nurse
that the prescribed dosage is too high for this client? The client
experiences
A. palpitations and shortness of breath.
B. bradycardia and constipation.
C. lethargy and lack of appetite.
D. muscle cramping and dry, flushed skin. Correct Answers
Answer
A. palpitations and shortness of breath.
Rationale
An overdose of thyroid preparation generally manifests
symptoms of an agitated state such as tremors, palpitations,
shortness of breath, tachycardia, increased appetite, agitation,
sweating and diarrhea (A). (B, C, and D) are not related to
overdosage of thyroid preparations.
,A 3-year-old boy is brought to the emergency department after
the mother found the child in the back yard holding a piece of a
toy in his hand and in respiratory distress. The child is dusky
with a loud, inspiratory stridor and weak attempts to cough.
Which actions should the nurse implement?
A. Obtain a pulse oximetry reading and arterial blood gases.
B. Auscultate all pulmonary lung fields and attempt a Heimlich
maneuver.
C. Request a stat chest x-ray and prepare medications for an
asthmatic episode.
D. Determine if the child ingested a toxic substance and if
vomiting occurred. Correct Answers Answer
B. Auscultate all pulmonary lung fields and attempt a Heimlich
maneuver.
Rationale
Sudden onset of strider, dusky color, and weak ineffective cough
strongly suggest that the child aspirated a foreign body. After
auscultation of lung fields to determine the quality of air
exchange, a Heimlich maneuver (B) is indicated to release the
obstruction. After effective breathing is restored, the child may
be assessed for complications (A). A history of asthma with
symptoms of wheezing (C) is not a part of this child's clinical
findings. Although respiratory distress may occur with laryngeal
chemical exposure, oral facial burns and systemic manifestations
are more likely indications of toxic substance ingestion (D).
A 350-bed acute care hospital declares an internal disaster
because the emergency generators malfunctioned during a city-
, wide power failure. The Unlicensed Assistive Personnel (UAP)s
working on a general medical unit ask the charge nurse what
they should do first. What instruction should the charge nurse
provide to these UAPs?
A. Go to the emergency department and complete assigned
tasks.
B. Shut all doors to client rooms on the unit in case a fire erupts.
C. Offer to assist in ICU with a ventilator-dependent clients.
D. Tell all their assigned clients to stay in their rooms. Correct
Answers Rationale
D. Tell all their assigned clients to stay in their rooms.
Rationale
A power failure leaves a unit in total darkness except for battery
operated lighting. The top priority should be ensuring client
safety by having clients stay in the rooms, and an unlicensed
person can implement this (D). (A) is of higher priority in an
external disaster. (B) would further compound the lighting
problems, and has not indicated unless fire or smoke is visible.
(C) is contraindicated until client safety is insured on the
assigned unit.
A 56-year-old man shares with the nurse that he is having
difficulty making a decision about terminating life support for
his wife. What is the best initial action by the nurse?
A. Provide an opportunity for him to clarify his values related to
the decision.
B. Encourage him to share memories about his life with his wife
and family.
