EVOLVE FUNDAMENTALS HESI EXAM QUESTIONS

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EVOLVE FUNDAMENTALS HESI EXAM QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

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-Guarantee passing score -100 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation Question 1: A client's infusion of normal saline infiltrated earlier today, and approximately 500 ml of saline infused into the subcutaneous tissue. The client is now complaining of excruciating arm pain and demanding stronger pain medications. What initial action is most important for the nurse to take?

• Ask about any past history of drug abuse or addiction.
• Measure the pulse volume and capillary refill distal to the infiltration.
• Compress the infiltrated tissue to measure the degree of edema.
• Evaluate the extent of ecchymosis over the forearm area.

Answer:

Pain and diminished pulse volume (B) are signs of compartment syndrome, which can progress to complete loss of the peripheral pulse in the extremity. Compartment syndrome occurs when external pressure (usually from a cast), or internal pressure (usually from subcutaneous infused fluid), exceeds capillary perfusion pressure resulting in decreased blood flow to the extremity. (A) should not be pursued until physical causes of the pain are ruled out. (C) is of less priority than determining the effects of the edema on circulation and nerve function. Further assessment of the client's ecchymosis can be delayed until the signs of edema and compression that suggest compartment syndrome have been examined (D).

Correct Answer: B

Question 2: A 73-year-old female client had a hemiarthroplasty of the left hip yesterday due to a fracture resulting from a fall. In reviewing hip precautions with the client, which instruction should the nurse include in this client's teaching plan?

• "In 8 weeks you will be able to bend at the waist to reach items on the floor."
• "Place a pillow between your knees while lying in bed to prevent hip dislocation."
• "It is safe to use a walker to get out of bed, but you need assistance when walking."
• "Take pain medication 30 minutes after your physical therapy sessions."

Answer:

The client's affected hip joint following a hemiarthroplasty (partial hip replacement) is at risk of dislocation for 6 months to a year following the procedure. Hip precautions to prevent dislocation include placing a pillow between the knees to maintain abduction of the hips (B). Clients should be instructed to avoid bending at the waist (A), to seek assistance for both standing and walking until they are stable on a walker or cane (C), and to take pain medication 20 to 30 minutes prior to physical therapy sessions, rather than waiting until the pain level is high after their therapy.

Correct Answer: B

Question 3: A male client being discharged with a prescription for the bronchodilator theophylline tells the nurse that he understands he is to take three doses of the medication each day. Since, at the time of discharge, timed-release capsules are not available, which dosing schedule should the nurse advise the client to follow?

• 9 a.m., 1 p.m., and 5 p.m.
• 8 a.m., 4 p.m., and midnight.
• Before breakfast, before lunch and before dinner.
• With breakfast, with lunch, and with dinner.

Answer:

Theophylline should be administered on a regular around-the-clock schedule (B) to provide the best bronchodilating effect and reduce the potential for adverse effects. (A, C, and

• do not provide around-the-clock dosing. Food may alter absorption of the medication (D).

Correct Answer: B

Question 4: Heparin 20,000 units in 500 ml D5W at 50 ml/hour has been infusing for 5½ hours.How much heparin has the client received?

• 11,000 units.
• 13,000 units.
• 15,000 units.
• 17,000 units.

Answer:

(A) is the correct calculation: 20,000 units/500 ml = 40 units (the amount of units in one ml of fluid). 40 units/ml x 50 ml/hr = 2,000 units/hour (1,000 units in 1/2 hour). 5.5 x 2,000 = 11,000 (A). OR, multiply 5 x 2,000 and add the 1/2 hour amount of 1,000 to reach the same conclusion = 11,000 units.

Correct Answer: A

Question 5: Three days following surgery, a male client observes his colostomy for the first time. He becomes quite upset and tells the nurse that it is much bigger than he expected. What is the best response by the nurse?

• Reassure the client that he will become accustomed to the stoma appearance in time.
• Instruct the client that the stoma will become smaller when the initial swelling diminishes.
• Offer to contact a member of the local ostomy support group to help him with his concerns.
• Encourage the client to handle the stoma equipment to gain confidence with the procedure.

Answer:

Postoperative swelling causes enlargement of the stoma. The nurse can teach the client that the stoma will become smaller when the swelling is diminished (B). This will help reduce the client's anxiety and promote acceptance of the colostomy. (A) does not provide helpful teaching or support. (C) is a useful action, and may be taken after the nurse provides pertinent teaching. The client is not yet demonstrating readiness to learn colostomy care (D).

Correct Answer: B

Question 6: The nurse is completing a mental assessment for a client who is demonstrating slow thought processes, personality changes, and emotional lability. Which area of the brain controls these neuro-cognitive functions?

• Thalamus.
• Hypothalamus.

• Frontal lobe.
• Parietal lobe.

Answer:

The frontal lobe (C) of the cerebrum controls higher mental activities, such as memory, intellect, language, emotions, and personality. (A) is an afferent relay center in the brain that directs impulses to the cerebral cortex. (B) regulates body temperature, appetite, maintains a wakeful state, and links higher centers with the autonomic nervous and endocrine systems, such as the pituitary. (D) is the location of sensory and motor functions.

Correct Answer: C

Question 7: An adult male client with a history of hypertension tells the nurse that he is tired of taking antihypertensive medications and is going to try spiritual meditation instead. What should be the nurse's first response?

Answer:

It is important that you continue your medication while learning to meditate.Question 8: The healthcare provider prescribes the diuretic metolazone (Zaroxolyn) 7.5 mg PO.Zaroxolyn is available in 5 mg tablets. How much should the nurse plan to administer?

• ½ tablet.
• 1 tablet.
• 1½ tablets.
• 2 tablets.

Answer:

(C) is the correct calculation: D/H × Q = 7.5/5 × 1 tablet = 1½ tablets.

Correct Answer: C

Question 9: A client who is a Jehovah's Witness is admitted to the nursing unit. Which concern should the nurse have for planning care in terms of the client's beliefs?

Answer:

Blood transfusions are forbidden.