2024 HESI Fundamentals Practice Test A – B | Guaranteed A+ Actual Questions and Answers, Complete 100%
2024 Hesi Fundamentals Practice Test A
Guaranteed A+ Actual Questions and Answers, Complete 100%
- An elderly client with a fractured left hip is on strict bedrest. Which nursing
measure is essential to the client’s nursing care?
A. Massage any reddened areas for at least five minutes.
B. Encourage active range of motion exercises on extremities.
C. Position the client laterally, prone, and dorsally in sequence.
D. Gently lift the client when moving into a desired position.:
Answer:
To avoid shearing forces when repositioning, the client should be lifted gently
across a surface (D).
Reddened areas should not be massaged (A) since this may increase the damage
to already traumatized skin. To control pain and muscle spasms, active range of
motion (B) may be limited on the affected leg. The position described in (C) is
contraindicated for a client with a fractured left hip.
Correct Answer: D - The nurse is administering medications through a nasogastric tube (NGT)
which is connected to suction. After ensuring correct tube placement, what
action should the nurse take next?
A. Clamp the tube for 20 minutes.
B. Flush the tube with water.
C. Administer the medications as prescribed.
D. Crush the tablets and dissolve in sterile water.:
Answer:
The NGT should be flushed before, after and in between each medication
administered (B). Once all medications are administered, the NGT should be
clamped for 20 minutes (A). (C and D) may be implemented only after the tubing
has been flushed.
Correct Answer: B - A client who is in hospice care complains of increasing amounts of pain.
The healthcare provider prescribes an analgesic every four hours as needed.
Which action should the nurse implement?
A. Give an around-the-clock schedule for administration of analgesics.
B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so that the client can do daily activities.-:
Answer:
The most effective management of pain is achieved using an around-the-clock
schedule that provides analgesic medications on a regular basis (A) and in a
timely manner. Analgesics are less effective if pain persists until it is severe, so an
analgesic medication should be administered before the client’s pain peaks (B).
Providing comfort is a priority for the client who is dying, but sedation that impairs
the client’s ability to interact and experience the time before life ends should be
minimized (C). Offering a medication-free period allows the serum drug level to
fall, which is not an effective method to manage chronic pain (D).
Correct Answer: A
- When assessing a client with wrist restraints, the nurse observes that the
fingers on the right hand are blue. What action should the nurse implement
first?
A. Loosen the right wrist restraint.
B. Apply a pulse oximeter to the right hand.
C. Compare hand color bilaterally.
D. Palpate the right radial pulse.:
Answer:
The priority nursing action is to restore circulation by loosening the restraint (A),
because blue fingers (cyanosis) indicates decreased circulation. (C and D) are also
important nursing interventions, but do not have the priority of (A). Pulse oximetry
(B) measures the saturation of hemoglobin with oxygen and is not indicated in
situations where the cyanosis is related to mechanical compression (the restraints).
Correct Answer: A - The nurse is assessing the nutritional status of several clients. Which
client has the greatest nutritional need for additional intake of protein?
A. A college-age track runner with a sprained ankle.
B. A lactating woman nursing her 3-day-old infant.
C. A school-aged child with Type 2 diabetes.
D. An elderly man being treated for a peptic ulcer.:
Answer:
A lactating woman (B) has the greatest need for additional protein intake. (A, C,
and D) are all conditions that require protein, but do not have the increased
metabolic protein demands of lactation.
Correct Answer: B - A client is in the radiology department at 0900 when the prescription
levofloxacin (Levaquin) 500 mg IV q24h is scheduled to be administered. The
client returns to the unit at 1300. What is the best intervention for the nurse
to implement?
A. Contact the healthcare provider and complete a medication variance form.
B. Administer the Levaquin at 1300 and resume the 0900 schedule in the
morning.
C. Notify the charge nurse and complete an incident report to explain the
missed dose.
D. Give the missed dose at 1300 and change the schedule to administer
daily at 1300.:
Answer:
To ensure that a therapeutic level of medication is maintained, the nurse should
administer the missed dose as soon as possible, and revise the administration
schedule accordingly to prevent dangerously increasing the level of the medication
in the bloodstream (D). The nurse should document the reason for the late dose,
but (A and C) are not warranted. (B) could result in increased blood levels of the
drug.
Correct Answer: D
- While instructing a male client’s wife in the performance of passive
range-of-motion exercises to his contracted shoulder, the nurse observes
that she is holding his arm above and below the elbow. What nursing action
should the nurse implement?
A. Acknowledge that she is supporting the arm correctly.
B. Encourage her to keep the joint covered to maintain warmth.
C. Reinforce the need to grip directly under the joint for better support.
D. Instruct her to grip directly over the joint for better motion.:
Answer:
The wife is performing the passive ROM correctly, therefore the nurse should
acknowledge this fact (A). The joint that is being exercised should be uncovered
(B) while the rest of the body should remain covered for warmth and privacy. (C
and D) do not provide adequate support to the joint while still allowing for joint
movement.
Correct Answer: A - What is the most important reason for starting intravenous infusions in
the upper extremities rather than the lower extremities of adults?
A. It is more difficult to find a superficial vein in the feet and ankles.
B. A decreased flow rate could result in the formation of a thrombosis.
C. A cannulated extremity is more difficult to move when the leg or foot is
used.
D. Veins are located deep in the feet and ankles, resulting in a more painful
procedure.:
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2024 HESI Fundamentals Practice Test B
Guaranteed A+ Actual Questions and Answers, Complete 100%
- 1.What is the rationale for using the nursing process in planning care for
clients?
A. As a scientific process to identify nursing diagnoses of a clients’ healthcare
problems.
B. To establish nursing theory that incorporates the biopsychosocial nature
of humans.
C. As a tool to organize thinking and clinical decision making about clients’
healthcare needs.
D. To promote the management of client care in collaboration with other
healthcare professionals.:
Answer:
C (The nursing process is a problem-solving approach that provides an organized,
systematic, decision making process to effectively address the client’s needs and
problems. The nursing process includes an organized framework using knowledge,
judgments, and actions by the nurse as the client’s plan of care is determined, and
encompasses assessment, analysis, planning, implementation, and evaluation of
client care (C). (A, B, and D) do not support the basis for using the nursing
process.
Correct Answer: C) - 2.What activity should the nurse use in the evaluation phase of the nursing
process?
A. Ask a client to evaluate the nursing care provided.
B. Document the nursing care plan in the progress notes.
C. Determine whether a client’s health problems have been alleviated.
D. Examine the effectiveness of nursing interventions toward meeting client
outcomes.:
Answer:
In the nursing process, the evaluation component examines the effectiveness
of nursing interventions in achieving client outcomes (D). (A) is an
evaluation of client satisfaction, not outcomes. (B) is a written record of the plan
of care. Although (C) may occur when client outcomes are achieved, evaluation is
best determined by attainment of measurable client outcomes.
Correct Answer: D - 3.Which statement is an example of a correctly written nursing diagnosis
statement?
A. Altered tissue perfusion related to congestive heart failure.
B. Altered urinary elimination related to urinary tract infection.
C. Risk for impaired tissue integrity related to client’s refusal to turn.
D. Ineffective coping related to response to positive biopsy test results.:
Answer:
The first part of the nursing diagnosis statement is the diagnostic label and is
followed by related to the cause, which should direct the nurse to the appropriate
interventions.
(D) best fits this criteria. (A and B) contain a medical diagnosis. (C) includes
an observable cause, but (D) focuses on the client’s response, which the nurse
can provide support, reflection, and dialogue.
Correct Answer: D
- 4.What action by the nurse demonstrates culturally sensitive care?
A. Asks permission before touching a client.
B. Avoids questions about male-female relationships.
C. Explains the differences between Western medical care and cultural folk
remedies.
D. Applies knowledge of a cultural group unless a client embraces Western
customs.:
Answer:
Physical contact, such as touching the head, in some cultures is a sign
of respect, whereas in others, it is strictly forbidden. So asking permission before
touching a client (A) demonstrates culturally sensitive care. (B, C, and D) do not
demonstrate cultural awareness.
Correct Answer: A - 5.A nurse is becoming increasingly frustrated by the family members’
efforts to participate in the care of a hospitalized client. What action should
the nurse implement to cope with these feelings of frustration?
A. Suggest that other cultural practices be substituted by the family members.
B. Examine one’s own culturally based values, beliefs, attitudes, and practices.
C. Explain to the family that multiple visitors are exhausting to the client.
D. Allow the situation to continue until a family member’s action may harm
the client.:
Answer:
Acknowledging a client’s beliefs and customs related to sickness and health care
are valuable components in the plan of care that prevents conflict between the
goals of nursing and the client’s cultural practices. Cultural sensitivity begins with
examining one’s own cultural values (B) to compare, recognize, and acknowledge
cultural bias. (A and C) do not consider the family’s needs to care for the client and
are not the best ways to cope with the nurse’s frustration. Although (D) may be an
option, examining one’s cultural differences allows the nurse to cope, empathize,
and implement culturally specific interventions pertaining to the needs of the client
and the family.
Correct Answer: B
- 6.Which technique is most important for the nurse to implement when
performing a physical assessment?
A. A head-to-toe approach.
B. The medical systems model.
C. A consistent, systematic approach.
D. An approach related to a nursing model.:
Answer:
The most important factor in performing a physical assessment is following a
consistent and systematic technique (C) each time an assessment is performed to
minimize variation in sequence which may increase the likelihood of omitting a
step or exam of an isolated area.
The method of completing a physical assessment (A, B, and D) may be at the
discretion of the examiner, but a consistent sequence by the examiner provides
a reliable method to ensure thorough review of the clients’ history, complaints, or
body systems.
Correct Answer: C - 7.A 73-year-old Hispanic client is seen at the community health clinic with
a history of protein malnutrition. What information should the nurse obtain
first?
A. Amount of liquid protein supplements consumed daily.
B. Foods and liquids consumed during the past 24 hours.
C. Usual weekly intake of milk products and red meats.
D. Grains and legume combinations used by the client.:
Answer:
A client’s dietary habits should be determined first by the client’s dietary recall (B)
before suggesting protein sources or supplements (A and C) as options in the
client’s diet. Although grains and legumes (D) contain incomplete proteins that
reduces the essential amino acid pools inside the cells, the client’s cultural
preferences should be illicited after confirming the client’s dietary history.
Correct Answer: B - 8.The nurse formulates the nursing diagnosis of, “Ineffective health maintenance
related to lack of motivation” for a client with Type 2 diabetes. Which
finding supports this nursing diagnosis?
A. Does not check capillary blood glucose as directed.
B. Occasionally forgets to take daily prescribed medication.
C. Cannot identify signs or symptoms of high and low blood glucose.
D. Eats anything and does not think diet makes a difference in health.:
Answer:
The nursing diagnosis of ineffective health maintenance refers to an inability to
identify, manage, and/or seek out help to maintain health, and is best exemplified
in the client belief or understanding about diet and health maintenance (D). (A)
indicates noncompliance with an action to be done in the management of diabetes.
(B) represents inattentiveness. (C) reflects knowledge deficit.
Correct Answer: D
- 9.Which statement correctly identifies a written learning objective for a
client with peripheral vascular disease?
A. The nurse will provide client instruction for daily foot care.
B. The client will demonstrate proper trimming toenail technique.
C. Upon discharge, the client will list three ways to protect the feet from
injury.
D. After instruction, the nurse will ensure the client understands foot care
rationale.:
Answer:
An objective should contain four elements: who will perform the activity
or acquire the desired behavior, the actual behavior that the learner will exhibit,
the condition under which the behavior is to be demonstrated, and the specific
criteria to be used to measure success. (C) is a concise statement that is a
learning objective that defines exactly how the client will demonstrate mastery of
the content. (A, B, and D) lack one or more of these elements.
Correct Answer: C - 10.A middle-aged woman who enjoys being a teacher and mentor feels
that she should pass down her legacy of knowledge and skills to the younger
generation. According to Erikson, she is involved in what developmental
stage?
A. Generativity.
B. Ego integrity.
C. Identification.
D. Valuing wisdom.:
Answer:
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