HESI COMPREHENSIVE EXAM QUESTIONS AND
ANSWERS LATEST VERSION 2024 VERIFIED
RATIONALE GRADED A+
after total abdominal hysterectomy with bilateral salpingo-oophorectomy. What does the nurse instruct the client to do during
chemotherapy? Select all that apply.
Eat foods that are low in fat and protein
Obtain pneumococcal and influenza vaccines
Drink copious amounts of fluid and void frequently
Avoid contact with any individual who has signs/symptoms of a cold
Avoid contact with all individuals other than immediate family members - ansDrink copious amounts of fluid and void frequently
Avoid contact with any individual who has signs/symptoms of a cold
Rationale: Hemorrhagic cystitis is an adverse effect of this medication. The client is encouraged to drink copious amounts of fluid at
least 24 hours before, during, and after chemotherapy, and avoid contact with individuals who are ill, have a cold, or have recently
received a live-virus vaccine. The client is also encouraged to void frequently to prevent cystitis. The client is not to receive
immunizations without the primary health care provider's approval, because they could diminish the body's resistance, putting the
client at increased risk for infection. It is not necessary for the client to avoid contact with all individuals other than immediate family
members. The client should, however, avoid contact with individuals who are ill, have a cold, or have recently received a live-virus
vaccine. Encouraging adequate dietary intake is appropriate, but a low-protein or low-fat diet is not necessary.
A client diagnosed with advanced chronic kidney disease (CKD) and oliguria has been taught about sodium and potassium
restriction between dialysis treatments. The nurse determines that the client understands this restriction if the client states that what
is acceptable to use?
Salt substitutes
Herbs and spices
Salt with cooking only
Processed foods as desired - ansHerbs and spices
Rationale: Most clients with CKD retain sodium. The client with CKD is instructed not to add salt at the table or during food
preparation. Herbs and spices may be used as an alternative to salt to enhance the flavor of food. The client with advanced CKD is
instructed to limit potassium intake. The client is also instructed to avoid salt substitutes, many of which are composed of potassium
chloride, if oliguria is present. Processed foods are discouraged because they are high in sodium.
A client diagnosed with chronic kidney disease who requires dialysis three times a week for the rest of his life says to the nurse,
"Why should I even bother to watch what I eat and drink? It doesn't really matter what I do if I'm never going to get better!" On the
basis of the client's statement, the nurse determines that the client is experiencing which problem?
Anxiety
Powerlessness
Ineffective coping
,HESI COMPREHENSIVE EXAM QUESTIONS AND
ANSWERS LATEST VERSION 2024 VERIFIED
RATIONALE GRADED A+
Disturbed body image - ansPowerlessness
Rationale: Powerlessness is present when a client believes that he or she has no control over the situation or that his or her actions
will not affect an outcome in any significant way. Anxiety is a vague uneasy feeling of apprehension. Some factors in anxiety include
a threat or perceived threat to physical or emotional integrity or self-concept, changes in role function, and a threat to or change in
socioeconomic status. Ineffective coping is present when the client exhibits impaired adaptive abilities or behaviors in meeting the
demands or roles expected. Disturbed body image is diagnosed when there is an alteration in the way the client perceives his or her
own body image.
A client diagnosed with depression is anorexic. Which measure does the nurse take to assist the client in meeting nutritional needs?
Providing food and fluid as the client requests
Offering high-calorie and high-protein foods and fluids frequently throughout the day
Completing the dietary menu for the client to ensure that adequate nutrition is provided
Weighing the client daily so that the client may determine whether the nutritional plan is working - ansOffering high-calorie and high-
protein foods and fluids frequently throughout the day
Rationale: The client should be offered high-calorie and high-protein foods and fluids frequently throughout the day. Small, frequent
snacks are more easily tolerated than large plates of food when the client is anorexic. The client should be offered choices of foods
and fluids he/she likes, because the client is more likely to consume foods he/she has selected. The client should be weighed
weekly, not daily. Weight gain may not be noted daily, which may cause the client to view the interventions to improve nutritional
status as useless.
A client diagnosed with depression is being encouraged to attend art therapy as part of the treatment plan. The client refuses,
stating, "I can't draw or paint." Which response by the nurse is therapeutic?
"Why don't you really want to attend?"
"This is what your primary health care provider has prescribed for you as part of the treatment plan."
"OK, let's have you attend music therapy. You can sing there. How does that sound?"
"Perhaps you could attend and talk to the other clients and see what they're drawing and painting." - ans"Perhaps you could attend
and talk to the other clients and see what they're drawing and painting."
Rationale: The correct response encourages the client to socialize and deflects the client's attention from the issue of drawing and
painting. "Why don't you really want to attend?" challenges the client. "This is what your primary health care provider has prescribed
for you as part of the treatment plan" ignores the client's rights. "OK, let's have you attend music therapy. You can sing there. How
does that sound?" does not address the client's concern.
A client diagnosed with heart failure suddenly experiences profound dyspnea, pallor, audible wheezing, and cyanosis, and the nurse
suspects pulmonary edema. What should the nurse do first?
,HESI COMPREHENSIVE EXAM QUESTIONS AND
ANSWERS LATEST VERSION 2024 VERIFIED
RATIONALE GRADED A+
Obtain a pulse oximetry reading
Raise the head of the client's bed
Administer a dose of morphine sulfate
Obtain a specimen for an arterial blood gas determination - ansRaise the head of the client's bed
Rationale: The nurse would first raise the head of the client's bed and position the client to maximize chest expansion to ease the air
hunger that the client is experiencing. Acute pulmonary edema is characterized by profound dyspnea, pallor, audible wheezing, and
cyanosis. An arterial blood gas or pulse oximetry reading will reveal the need for supplemental oxygen. Morphine sulfate may be
administered because it blunts the sympathetic response and promotes peripheral vasodilation. However, the nurse also needs to
contact the primary health case provider to prescribe that medication. On the basis of the options provided, however, the initial
action is placing the client in a head-elevated position.
A client diagnosed with HIV infection who has been found to have histoplasmosis is being treated with intravenous amphotericin B.
Which parameter does the nurse check to detect the most common adverse effect of this medication?
Temperature
Blood pressure
Peripheral pulses
Intake and output - ansIntake and output
Rationale: As a means of detecting renal injury, tests of kidney function should be performed weekly, and intake and output should
be monitored closely. Amphotericin B, an antifungal medication, is highly toxic, and infusion reactions and renal damage occur, to
varying degrees, in all clients. Other adverse effects include delirium, hypotension, hypertension, wheezing, and hypoxia. The
remaining options are not associated with an adverse effect of the medication.
A client diagnosed with hypoparathyroidism is taking calcium gluconate to treat hypocalcemia. The client calls the clinic nurse and
complains of becoming constipated since starting the medication. What should the nurse tell the client to do?
Stop the medication
Contact the primary health care provider immediately
Increase intake of high-fiber foods
Add a half-ounce (15 ml) of mineral oil to the daily diet - ansIncrease intake of high-fiber foods
Rationale: The nurse should tell the client to increase intake of high-fiber foods. Calcium gluconate is a calcium supplement, and
constipation is a side effect of calcium gluconate. It is not necessary for the client to contact the primary health care provider
immediately if constipation occurs. Rather, the nurse would suggest interventions to alleviate and prevent constipation (e.g.,
increased fluid intake, high-fiber diet, exercise). Clients taking calcium supplements should be instructed to avoid the use of mineral
oil as a laxative because it reduces vitamin D absorption, and vitamin D is needed to assist in the absorption of calcium. The client
should not stop taking the medication.
, HESI COMPREHENSIVE EXAM QUESTIONS AND
ANSWERS LATEST VERSION 2024 VERIFIED
RATIONALE GRADED A+
A client diagnosed with post-traumatic stress disorder tells the nurse that he/she has stopped taking his/her prescribed medication
because he/she didn't like how the medication was making him/her feel. Which initial response by the nurse is appropriate?
"That's all right. I'd stop, too, if it made me feel funny."
"Tell me more about how the medication was making you feel."
"Did you let your doctor know that you stopped taking the medication?"
"It doesn't make sense to stop the medication. I don't know why you took it upon yourself to do that." - ans"Tell me more about how
the medication was making you feel."
Rationale: The appropriate response by the nurse acknowledges the client's feelings and opens the channel of communication
between the nurse and client. "That's all right. I'd stop, too, if it made me feel funny," indicating approval, is a nontherapeutic
response and is therefore inappropriate. "Did you let your doctor know that you stopped taking the medication?" may be an
appropriate question at some point during the conversation, but it is not the most appropriate initial question. "It doesn't make sense
to stop the medication. I don't know why you took it upon yourself to do that" demeans the client.
A client diagnosed with schizophrenia says to the nurse, "I decided not to take my medication because it can't help. I am the only
one who can help me." Which nursing response is therapeutic in this situation?
"Only you can help?"
"You decided not to take your medication?"
"If you can make that observation, you probably don't need your medication any longer."
"Your doctor wants you to continue this medication because it's helping you. Do you recall needing to be hospitalized because you
stopped your medication?" - ans"Your doctor wants you to continue this medication because it's helping you. Do you recall needing
to be hospitalized because you stopped your medication?"
Rationale: Noncompliance with antipsychotic medication is one of the reasons clients with schizophrenia have relapses. The nurse
should give a response to the schizophrenic client that will help the client identify the causes of relapse. The therapeutic response
by the nurse is, "Your doctor wants you to continue this medication because it's helping you. Do you recall needing to be
hospitalized because you stopped your medication?" In asking, "Only you can help?" the nurse is employing restating, which can be
therapeutic but is not useful in this client's situation. "You decided not to take your medication?" is another example of restating. In
stating, "If you can make this observation, you probably don't need your medication any longer," the nurse is using an illogical,
judgmental, and biased response that is not therapeutic.
A client diagnosed with tuberculosis will be taking pyrazinamide, and the nurse provides instructions about the adverse effects of the
medication. For which occurrence does the nurse tell the client to contact the primary health care provider?
Headache
Yellow skin
Difficulty sleeping
Nasal congestion - ansYellow skin
ANSWERS LATEST VERSION 2024 VERIFIED
RATIONALE GRADED A+
after total abdominal hysterectomy with bilateral salpingo-oophorectomy. What does the nurse instruct the client to do during
chemotherapy? Select all that apply.
Eat foods that are low in fat and protein
Obtain pneumococcal and influenza vaccines
Drink copious amounts of fluid and void frequently
Avoid contact with any individual who has signs/symptoms of a cold
Avoid contact with all individuals other than immediate family members - ansDrink copious amounts of fluid and void frequently
Avoid contact with any individual who has signs/symptoms of a cold
Rationale: Hemorrhagic cystitis is an adverse effect of this medication. The client is encouraged to drink copious amounts of fluid at
least 24 hours before, during, and after chemotherapy, and avoid contact with individuals who are ill, have a cold, or have recently
received a live-virus vaccine. The client is also encouraged to void frequently to prevent cystitis. The client is not to receive
immunizations without the primary health care provider's approval, because they could diminish the body's resistance, putting the
client at increased risk for infection. It is not necessary for the client to avoid contact with all individuals other than immediate family
members. The client should, however, avoid contact with individuals who are ill, have a cold, or have recently received a live-virus
vaccine. Encouraging adequate dietary intake is appropriate, but a low-protein or low-fat diet is not necessary.
A client diagnosed with advanced chronic kidney disease (CKD) and oliguria has been taught about sodium and potassium
restriction between dialysis treatments. The nurse determines that the client understands this restriction if the client states that what
is acceptable to use?
Salt substitutes
Herbs and spices
Salt with cooking only
Processed foods as desired - ansHerbs and spices
Rationale: Most clients with CKD retain sodium. The client with CKD is instructed not to add salt at the table or during food
preparation. Herbs and spices may be used as an alternative to salt to enhance the flavor of food. The client with advanced CKD is
instructed to limit potassium intake. The client is also instructed to avoid salt substitutes, many of which are composed of potassium
chloride, if oliguria is present. Processed foods are discouraged because they are high in sodium.
A client diagnosed with chronic kidney disease who requires dialysis three times a week for the rest of his life says to the nurse,
"Why should I even bother to watch what I eat and drink? It doesn't really matter what I do if I'm never going to get better!" On the
basis of the client's statement, the nurse determines that the client is experiencing which problem?
Anxiety
Powerlessness
Ineffective coping
,HESI COMPREHENSIVE EXAM QUESTIONS AND
ANSWERS LATEST VERSION 2024 VERIFIED
RATIONALE GRADED A+
Disturbed body image - ansPowerlessness
Rationale: Powerlessness is present when a client believes that he or she has no control over the situation or that his or her actions
will not affect an outcome in any significant way. Anxiety is a vague uneasy feeling of apprehension. Some factors in anxiety include
a threat or perceived threat to physical or emotional integrity or self-concept, changes in role function, and a threat to or change in
socioeconomic status. Ineffective coping is present when the client exhibits impaired adaptive abilities or behaviors in meeting the
demands or roles expected. Disturbed body image is diagnosed when there is an alteration in the way the client perceives his or her
own body image.
A client diagnosed with depression is anorexic. Which measure does the nurse take to assist the client in meeting nutritional needs?
Providing food and fluid as the client requests
Offering high-calorie and high-protein foods and fluids frequently throughout the day
Completing the dietary menu for the client to ensure that adequate nutrition is provided
Weighing the client daily so that the client may determine whether the nutritional plan is working - ansOffering high-calorie and high-
protein foods and fluids frequently throughout the day
Rationale: The client should be offered high-calorie and high-protein foods and fluids frequently throughout the day. Small, frequent
snacks are more easily tolerated than large plates of food when the client is anorexic. The client should be offered choices of foods
and fluids he/she likes, because the client is more likely to consume foods he/she has selected. The client should be weighed
weekly, not daily. Weight gain may not be noted daily, which may cause the client to view the interventions to improve nutritional
status as useless.
A client diagnosed with depression is being encouraged to attend art therapy as part of the treatment plan. The client refuses,
stating, "I can't draw or paint." Which response by the nurse is therapeutic?
"Why don't you really want to attend?"
"This is what your primary health care provider has prescribed for you as part of the treatment plan."
"OK, let's have you attend music therapy. You can sing there. How does that sound?"
"Perhaps you could attend and talk to the other clients and see what they're drawing and painting." - ans"Perhaps you could attend
and talk to the other clients and see what they're drawing and painting."
Rationale: The correct response encourages the client to socialize and deflects the client's attention from the issue of drawing and
painting. "Why don't you really want to attend?" challenges the client. "This is what your primary health care provider has prescribed
for you as part of the treatment plan" ignores the client's rights. "OK, let's have you attend music therapy. You can sing there. How
does that sound?" does not address the client's concern.
A client diagnosed with heart failure suddenly experiences profound dyspnea, pallor, audible wheezing, and cyanosis, and the nurse
suspects pulmonary edema. What should the nurse do first?
,HESI COMPREHENSIVE EXAM QUESTIONS AND
ANSWERS LATEST VERSION 2024 VERIFIED
RATIONALE GRADED A+
Obtain a pulse oximetry reading
Raise the head of the client's bed
Administer a dose of morphine sulfate
Obtain a specimen for an arterial blood gas determination - ansRaise the head of the client's bed
Rationale: The nurse would first raise the head of the client's bed and position the client to maximize chest expansion to ease the air
hunger that the client is experiencing. Acute pulmonary edema is characterized by profound dyspnea, pallor, audible wheezing, and
cyanosis. An arterial blood gas or pulse oximetry reading will reveal the need for supplemental oxygen. Morphine sulfate may be
administered because it blunts the sympathetic response and promotes peripheral vasodilation. However, the nurse also needs to
contact the primary health case provider to prescribe that medication. On the basis of the options provided, however, the initial
action is placing the client in a head-elevated position.
A client diagnosed with HIV infection who has been found to have histoplasmosis is being treated with intravenous amphotericin B.
Which parameter does the nurse check to detect the most common adverse effect of this medication?
Temperature
Blood pressure
Peripheral pulses
Intake and output - ansIntake and output
Rationale: As a means of detecting renal injury, tests of kidney function should be performed weekly, and intake and output should
be monitored closely. Amphotericin B, an antifungal medication, is highly toxic, and infusion reactions and renal damage occur, to
varying degrees, in all clients. Other adverse effects include delirium, hypotension, hypertension, wheezing, and hypoxia. The
remaining options are not associated with an adverse effect of the medication.
A client diagnosed with hypoparathyroidism is taking calcium gluconate to treat hypocalcemia. The client calls the clinic nurse and
complains of becoming constipated since starting the medication. What should the nurse tell the client to do?
Stop the medication
Contact the primary health care provider immediately
Increase intake of high-fiber foods
Add a half-ounce (15 ml) of mineral oil to the daily diet - ansIncrease intake of high-fiber foods
Rationale: The nurse should tell the client to increase intake of high-fiber foods. Calcium gluconate is a calcium supplement, and
constipation is a side effect of calcium gluconate. It is not necessary for the client to contact the primary health care provider
immediately if constipation occurs. Rather, the nurse would suggest interventions to alleviate and prevent constipation (e.g.,
increased fluid intake, high-fiber diet, exercise). Clients taking calcium supplements should be instructed to avoid the use of mineral
oil as a laxative because it reduces vitamin D absorption, and vitamin D is needed to assist in the absorption of calcium. The client
should not stop taking the medication.
, HESI COMPREHENSIVE EXAM QUESTIONS AND
ANSWERS LATEST VERSION 2024 VERIFIED
RATIONALE GRADED A+
A client diagnosed with post-traumatic stress disorder tells the nurse that he/she has stopped taking his/her prescribed medication
because he/she didn't like how the medication was making him/her feel. Which initial response by the nurse is appropriate?
"That's all right. I'd stop, too, if it made me feel funny."
"Tell me more about how the medication was making you feel."
"Did you let your doctor know that you stopped taking the medication?"
"It doesn't make sense to stop the medication. I don't know why you took it upon yourself to do that." - ans"Tell me more about how
the medication was making you feel."
Rationale: The appropriate response by the nurse acknowledges the client's feelings and opens the channel of communication
between the nurse and client. "That's all right. I'd stop, too, if it made me feel funny," indicating approval, is a nontherapeutic
response and is therefore inappropriate. "Did you let your doctor know that you stopped taking the medication?" may be an
appropriate question at some point during the conversation, but it is not the most appropriate initial question. "It doesn't make sense
to stop the medication. I don't know why you took it upon yourself to do that" demeans the client.
A client diagnosed with schizophrenia says to the nurse, "I decided not to take my medication because it can't help. I am the only
one who can help me." Which nursing response is therapeutic in this situation?
"Only you can help?"
"You decided not to take your medication?"
"If you can make that observation, you probably don't need your medication any longer."
"Your doctor wants you to continue this medication because it's helping you. Do you recall needing to be hospitalized because you
stopped your medication?" - ans"Your doctor wants you to continue this medication because it's helping you. Do you recall needing
to be hospitalized because you stopped your medication?"
Rationale: Noncompliance with antipsychotic medication is one of the reasons clients with schizophrenia have relapses. The nurse
should give a response to the schizophrenic client that will help the client identify the causes of relapse. The therapeutic response
by the nurse is, "Your doctor wants you to continue this medication because it's helping you. Do you recall needing to be
hospitalized because you stopped your medication?" In asking, "Only you can help?" the nurse is employing restating, which can be
therapeutic but is not useful in this client's situation. "You decided not to take your medication?" is another example of restating. In
stating, "If you can make this observation, you probably don't need your medication any longer," the nurse is using an illogical,
judgmental, and biased response that is not therapeutic.
A client diagnosed with tuberculosis will be taking pyrazinamide, and the nurse provides instructions about the adverse effects of the
medication. For which occurrence does the nurse tell the client to contact the primary health care provider?
Headache
Yellow skin
Difficulty sleeping
Nasal congestion - ansYellow skin
