HESI Fundamentals Practice Test/Final 2 (NCLEX) questions and answers well illustrated.

HESI Fundamentals Practice Test/Final 2 (NCLEX) questions and answers well illustrated. An adult is now alert and oriented following abdominal surgery. What position is most appropriate for the client? A. Semi-Fowler's B. Prone C. Supine D. Sim's - correct answers.A This position allows for greater thoracic expansion and puts less pressure on the suture line Following a craniotomy, the nurse positioned a client in low fowler's for which reason? A. To promote comfort B. To promote drainage from operation site C. To promote thoracic expansion D. To prevent circulatory overload - correct answers.B The nurse is caring for a woman who had a CVA and has right-sided hemiplegia. Which action is least appropriate? a. Performing ROM exercise when bathing her b. Changing her position every two hours c. Suctioning the client supine and pulling the bed sheets tightly across her feet d. Placing her in the prone position for one hour three times a day - correct answers.C The sheets should not be drawn tightly across the feet as this may cause foot drop The nurse is to help their client with right-sided hemiplegia get up into the wheelchair. How should the nurse place the wheelchair? a. On the left side of the bed facing the foot of the bed b. On the right side of the bed facing the head of the bed c. Perpendicular to the bed on the right side d. Facing the bed in the left side of the bed - correct answers.A The client can then stand on the unaffected foot and pivot to sit down When caring for a client in hemorrhagic shock, how should the nurse position the client? a. Flat in bed with legs elevated b. Flat in bed c. Trendelenburg position d. Semi-Fowler's position - correct answers.A Mr. Landon is to have a tracheostomy performed. What is the top nursing priority? a. Shave the neck b. Establish a means of communication c. Insert a Foley catheter d. Start an IV - correct answers.B Mr. Landon is to have a tracheostomy performed. Which nursing action is essential during tracheal suctioning? a. Using a lubricant such as petroleum jelly b. Administering 100% oxygen before and after suctioning c. Making sure that the suction catheter is open or on during insertion d. Assisting the client to assume a supine position during suctioning - correct answers.B--To prevent hypoxia Mr. Landon is to have a tracheostomy performed. Which of the following actions is most appropriate for the nurse to take when suctioning the tracheostomy? a. Use sterile tube each time and suction for 30 seconds b. Use sterile technique and turn the suction off as the catheter is introduced c. Use clean technique and suction for 10 seconds d. Discard the catheter at the end of every shift - correct answers.B Mr. Landon is to have a tracheostomy performed. While the nurse is suctioning a tracheostomy tube, the client starts to cough. What is the best action for the nurse to take? a. Suction deeper to pick up secretions b. Gently withdraw suction tubing to allow suction or coughing out of mucous c. Remove the suction as quickly as possible d. Put the suction in and out several times to pick up secretions - correct answers.D During the suctioning of a tracheostomy tube, the catheter appears to attach to the tracheal walls and creates a pulling sensation. What is the best action for the nurse to take? a. Release the suction by opening the vent b. Continue suctioning to remove obstruction c. Increase the pressure d. Suction deeper - correct answers.A Warm compresses are ordered for an open wound. Which action is appropriate for the nurse? a. Use sterile technique when applying the dressing b. Leave the compresses on the area continuously, pouring warm solution on the area when it cools down c. Alternate warm compressed with cold ones d. Apply wet dressing, cover with dry dressing - correct answers.A