FUNDAMENTAL HESI UPDATED STUDY EXAMS
GUIDE QUESTIONS AND ANSWERS SURE A+
✔✔The nurse is teaching a client proper use of an inhaler. When should the client
administer the inhaler-delivered medication to demonstrate correct use of the inhaler?
A. Immediately after exhalation.
B. During the inhalation
C. At the end of three inhalers
D. Immediately after inhalation - ✔✔B. During the inhalation.
(The client should be instructed to deliver the medication during the last part of
inhalation (B). After the medication is delivered, the client should remove the
mouthpiece, keeping his/her lips closed and breath held for several seconds to allow for
distribution of the medication. The client should not deliver the dose as started in (A or
D), and should deliver no more than two inhalations at a time (C).)
✔✔An IV infusion terbutaline sulfate 5 mg in 500 mL of D5W, infusing at a rate of 30
mcg/min, is prescribed for a client in premature labor. How many ml/hr should the nurse
set the infusion pump? - ✔✔180
✔✔The healthcare provider prescribes the diuretic metolazone (Zaroxolyn) 7.5 mg PO.
Zaroxoltn is available in 5 mg tablets. How much should the nurse plan to administer? -
✔✔1 1/2 tablets
,✔✔The healthcare provider prescribes furosemide (Lasix) 15 mg IV stat. On hand is
Lasix 20 mg/2ml. How many millileters should the nurse administer? - ✔✔1.5 mL
✔✔Heparin 20,000 units in 500 mL D5W at 50 mL/hour has been infusing for 5.5 hours.
How much heparin has the client received? - ✔✔11,000 units
✔✔The nurse is caring for a client who is receiving 24-hour total parenteral nutrition
(TPN) via a central line at 54 mL/hr. When initially assessing the client, the nurse notes
that the TPN solution has run out and the next TPN solution is not available. What
immediate action should the nurse take?
A. Infuse normal saline at a keep vein open rate.
B. Discontinue the IV and flush the port with heparin.
C. Infuse 10% dextrose and water at 54 mL/hour.
D. Obtain a stat blood glucose level and notify the HCP. - ✔✔C. Infuse 10% dextrose
and water at 54 mL/hour.
(TPN is discontinued gradually to allow the client to adjust decreased levels of glucose.
Administering 10% dextrose in water at the prescribed rate (C) will keep the client from
experiencing hypoglycemia until the next TPN solution is available. The client could
experience a hypoglycemic reaction if the current level of glucose (A) is not maintained
or if the TPN is discontinued abruptly (B). There is no reason to obtain a stat blood-
glucose level (D) and the HCP cannot do anything about this situation.)
✔✔Examination of a client complaining of itching on his right arm reveals a rash made
up of multiple flat areas of redness ranging from pinpoint to 0.5 cm in diameter. How
should the nurse record this finding?
A. Multiple vesicular areas surrounded by redness, ranging in size from 1 mm to 0.5 cm.
B. Localized red rash comprised of flat areas, pinpoint to 0.5 cm in diameter.
C. Several areas of red, papular lesions from pinpoint to 0.5 cm in size.
D. Localized petechial areas, ranging in size from pinpoint to 0.5 cm in diameter. - ✔✔B.
Localized red rash comprised of flat areas, pinpoint to 0.5 cm in diameter. (Macules are
localized flat skin discolorations less than 1 cm in diameter. However, when recording
such a finding the nurse should describe the appearance (B) rather than simply naming
the condition. (A) identifies vesicles-- fluid filled blisters--an incorrect description given
the symptoms listed. (C) identifies papule-- solid elevated lesions, again not correctly
identifying the symptoms. (D) identifies petechiae-- pinpoint red to purple skin
discolorations that do not itch, again an incorrect identification.)
✔✔At the time of the first dressing change, the client refuses to look at her mastectomy
incision. The nurse tells the client that the incision is healing well, but the client refuses
to talk about it. What would be an appropriate response to this client's silence?
A. "It is normal to feel angry and depressed, but the sooner you deal with this surgery,
the better you will feel."
B. "Looking at your incision can be frightening, but facing this fear is a necessary part of
your recovery."
, C. "It is OK if you don't want to talk about your surgery. I will be available when you are
ready."
D. "I will ask a woman who has had a mastectomy to come by and share her
experiences with you." - ✔✔C. "It is OK if you don't want to talk about your surgery. I will
be available when you are ready."
( (C) displays sensitivity and understanding without judging the client. (A) is judgmental
in that it is telling the client how she feels and is also insensitive. (B) would give the
client a chance to talk, but is also demanding and demeaning. (D) displays a positive
action, but, because the nurse's personal support if not offered, this response could be
interpreted as dismissing the client and avoiding the problem.)
✔✔The nurse is evaluating a client learning about a low-sodium diet. Selection of which
meal would indicate to the nurse that this client understands the dietary restrictions? -
✔✔Skim milk, turkey salad, roll, and vanilla ice cream
✔✔The nurse prepares a 1000 mL IV of 5% dextrose and water to be infused over 8
hours. The infusion set delivers 10 drops per milliliter . The nurse should regulate the IV
to administer approximately how many drops per minute? - ✔✔21
✔✔An elderly male client who is unresponsive following a cerebral vascular accident
(CVA) is receiving bolus enteral feedings through a gastronomy tube. What is the best
client position for administration of the bolus tube feedings?
A. Prone
B. Fowler's
C. Sim's
D. Supine - ✔✔B. Fowler's
(The client should be positioned in a semi-setting (B) position during feeding to
decrease occurrence of aspiration. A gastronomy tube, known as PEG tube, due to
placement by a percutaneous endoscopic gastronomy procedure, is inserted directly
into the stomach through an incision in the abdomen for long-term administration of
nutrition and hydration in the debilitated client. In (A and/or C), the client is placed on
the abdomen, an unsafe position for feeding. Placing the client in (D) increases the risk
for aspiration.)
✔✔Which action is the most important to implement when donning sterile gloves?
A. Maintain thumb at a ninety degree angle.
B. Hold hands with fingers down while gloving.
C. Keep gloved hands above the elbows.
D. Put the glove on the dominant hand first. - ✔✔C. Keep gloved hands above the
elbows. (Gloved hands held below waist level are considered unsterile (C). (A and B)
are not essential to maintaining asepsis. While it may be helpful to put the glove on the
dominant hand first, it is not necessary to ensure asepsis (D).)
✔✔The nurse is teaching a client with numerous allergies how to avoid allergens. Which
instruction should be included in this teaching plan?
GUIDE QUESTIONS AND ANSWERS SURE A+
✔✔The nurse is teaching a client proper use of an inhaler. When should the client
administer the inhaler-delivered medication to demonstrate correct use of the inhaler?
A. Immediately after exhalation.
B. During the inhalation
C. At the end of three inhalers
D. Immediately after inhalation - ✔✔B. During the inhalation.
(The client should be instructed to deliver the medication during the last part of
inhalation (B). After the medication is delivered, the client should remove the
mouthpiece, keeping his/her lips closed and breath held for several seconds to allow for
distribution of the medication. The client should not deliver the dose as started in (A or
D), and should deliver no more than two inhalations at a time (C).)
✔✔An IV infusion terbutaline sulfate 5 mg in 500 mL of D5W, infusing at a rate of 30
mcg/min, is prescribed for a client in premature labor. How many ml/hr should the nurse
set the infusion pump? - ✔✔180
✔✔The healthcare provider prescribes the diuretic metolazone (Zaroxolyn) 7.5 mg PO.
Zaroxoltn is available in 5 mg tablets. How much should the nurse plan to administer? -
✔✔1 1/2 tablets
,✔✔The healthcare provider prescribes furosemide (Lasix) 15 mg IV stat. On hand is
Lasix 20 mg/2ml. How many millileters should the nurse administer? - ✔✔1.5 mL
✔✔Heparin 20,000 units in 500 mL D5W at 50 mL/hour has been infusing for 5.5 hours.
How much heparin has the client received? - ✔✔11,000 units
✔✔The nurse is caring for a client who is receiving 24-hour total parenteral nutrition
(TPN) via a central line at 54 mL/hr. When initially assessing the client, the nurse notes
that the TPN solution has run out and the next TPN solution is not available. What
immediate action should the nurse take?
A. Infuse normal saline at a keep vein open rate.
B. Discontinue the IV and flush the port with heparin.
C. Infuse 10% dextrose and water at 54 mL/hour.
D. Obtain a stat blood glucose level and notify the HCP. - ✔✔C. Infuse 10% dextrose
and water at 54 mL/hour.
(TPN is discontinued gradually to allow the client to adjust decreased levels of glucose.
Administering 10% dextrose in water at the prescribed rate (C) will keep the client from
experiencing hypoglycemia until the next TPN solution is available. The client could
experience a hypoglycemic reaction if the current level of glucose (A) is not maintained
or if the TPN is discontinued abruptly (B). There is no reason to obtain a stat blood-
glucose level (D) and the HCP cannot do anything about this situation.)
✔✔Examination of a client complaining of itching on his right arm reveals a rash made
up of multiple flat areas of redness ranging from pinpoint to 0.5 cm in diameter. How
should the nurse record this finding?
A. Multiple vesicular areas surrounded by redness, ranging in size from 1 mm to 0.5 cm.
B. Localized red rash comprised of flat areas, pinpoint to 0.5 cm in diameter.
C. Several areas of red, papular lesions from pinpoint to 0.5 cm in size.
D. Localized petechial areas, ranging in size from pinpoint to 0.5 cm in diameter. - ✔✔B.
Localized red rash comprised of flat areas, pinpoint to 0.5 cm in diameter. (Macules are
localized flat skin discolorations less than 1 cm in diameter. However, when recording
such a finding the nurse should describe the appearance (B) rather than simply naming
the condition. (A) identifies vesicles-- fluid filled blisters--an incorrect description given
the symptoms listed. (C) identifies papule-- solid elevated lesions, again not correctly
identifying the symptoms. (D) identifies petechiae-- pinpoint red to purple skin
discolorations that do not itch, again an incorrect identification.)
✔✔At the time of the first dressing change, the client refuses to look at her mastectomy
incision. The nurse tells the client that the incision is healing well, but the client refuses
to talk about it. What would be an appropriate response to this client's silence?
A. "It is normal to feel angry and depressed, but the sooner you deal with this surgery,
the better you will feel."
B. "Looking at your incision can be frightening, but facing this fear is a necessary part of
your recovery."
, C. "It is OK if you don't want to talk about your surgery. I will be available when you are
ready."
D. "I will ask a woman who has had a mastectomy to come by and share her
experiences with you." - ✔✔C. "It is OK if you don't want to talk about your surgery. I will
be available when you are ready."
( (C) displays sensitivity and understanding without judging the client. (A) is judgmental
in that it is telling the client how she feels and is also insensitive. (B) would give the
client a chance to talk, but is also demanding and demeaning. (D) displays a positive
action, but, because the nurse's personal support if not offered, this response could be
interpreted as dismissing the client and avoiding the problem.)
✔✔The nurse is evaluating a client learning about a low-sodium diet. Selection of which
meal would indicate to the nurse that this client understands the dietary restrictions? -
✔✔Skim milk, turkey salad, roll, and vanilla ice cream
✔✔The nurse prepares a 1000 mL IV of 5% dextrose and water to be infused over 8
hours. The infusion set delivers 10 drops per milliliter . The nurse should regulate the IV
to administer approximately how many drops per minute? - ✔✔21
✔✔An elderly male client who is unresponsive following a cerebral vascular accident
(CVA) is receiving bolus enteral feedings through a gastronomy tube. What is the best
client position for administration of the bolus tube feedings?
A. Prone
B. Fowler's
C. Sim's
D. Supine - ✔✔B. Fowler's
(The client should be positioned in a semi-setting (B) position during feeding to
decrease occurrence of aspiration. A gastronomy tube, known as PEG tube, due to
placement by a percutaneous endoscopic gastronomy procedure, is inserted directly
into the stomach through an incision in the abdomen for long-term administration of
nutrition and hydration in the debilitated client. In (A and/or C), the client is placed on
the abdomen, an unsafe position for feeding. Placing the client in (D) increases the risk
for aspiration.)
✔✔Which action is the most important to implement when donning sterile gloves?
A. Maintain thumb at a ninety degree angle.
B. Hold hands with fingers down while gloving.
C. Keep gloved hands above the elbows.
D. Put the glove on the dominant hand first. - ✔✔C. Keep gloved hands above the
elbows. (Gloved hands held below waist level are considered unsterile (C). (A and B)
are not essential to maintaining asepsis. While it may be helpful to put the glove on the
dominant hand first, it is not necessary to ensure asepsis (D).)
✔✔The nurse is teaching a client with numerous allergies how to avoid allergens. Which
instruction should be included in this teaching plan?
