HESI Fundamentals Exam

HESI Fundamentals Exam Related

Review HESI Fundamentals Exam related questions and content

A client is receiving teaching from a healthcare provider about reducing the adverse effects of immobility. Which of the following statements by the client indicates an understanding of the teaching?

  • A. I will perform ankle and knee exercises every hour - Range of motion (ROM) is needed to prevent contractures.
  • B. I will hold my breath when rising from a sitting position.
  • C. I will remove my antiembolic stockings while I am in bed.
  • D. I will have my partner help me change positions every 4 hours.
Correct Answer: A

Rationale: Choice A is correct because performing ankle and knee exercises every hour helps prevent contractures and other adverse effects of immobility. Contractures are a common complication of immobility, and range of motion (ROM) exercises can help maintain joint flexibility and prevent contractures. This statement indicates an understanding of the teaching provided by the healthcare provider. Choices B, C, and D are incorrect. Holding the breath when rising from a sitting position can increase the risk of orthostatic hypotension, not reduce adverse effects of immobility. Removing antiembolic stockings while in bed can compromise their effectiveness in preventing deep vein thrombosis (DVT), which is not a measure to reduce immobility-related complications. Having a partner help change positions every 4 hours may not be frequent enough to prevent immobility-related complications effectively; changing positions more frequently is usually recommended to prevent issues like pressure ulcers and muscle stiffness.

You may also like to solve these questions

The healthcare provider is caring for a client with a history of atrial fibrillation. Which assessment finding would be most concerning?

  • A. Blood pressure of 150/90 mmHg
  • B. Irregular heart rhythm
  • C. Shortness of breath
  • D. Fatigue
Correct Answer: C

Rationale: Shortness of breath is the most concerning assessment finding in a client with a history of atrial fibrillation. It can indicate a worsening of the condition, pulmonary edema, or the development of a complication such as heart failure. A blood pressure of 150/90 mmHg, while elevated, is not as immediately concerning as respiratory distress in this context. An irregular heart rhythm is expected in atrial fibrillation and may not necessarily be a new or concerning finding. Fatigue is a common symptom in atrial fibrillation but is not as acutely concerning as shortness of breath, which may indicate compromised oxygenation and circulation.

A client requires gastric decompression, and a nurse is inserting an NG tube. Which action should the nurse take to verify proper placement of the tube?

  • A. Assess the client for a gag reflex
  • B. Measure the pH of the gastric aspirate
  • C. Place the end of the NG tube in water to observe for bubbling
  • D. Auscultate 2.5 cm (1 in) above the umbilicus while injecting 15 mL of sterile water
Correct Answer: B

Rationale: Measuring the pH of the gastric aspirate is the most reliable method to confirm proper placement of an NG tube. Gastric fluid has an acidic pH, typically ranging from 1 to 5. Assessing the client for a gag reflex (choice A) is important for airway protection but does not confirm tube placement. Placing the NG tube in water to observe for bubbling (choice C) is incorrect and not a reliable method for verifying placement. Auscultating 2.5 cm above the umbilicus while injecting sterile water (choice D) is an outdated method and is not recommended for verifying NG tube placement.

A client with Guillain-Barre syndrome is in a non-responsive state, yet vital signs are stable and breathing is independent. What should the nurse document to most accurately describe the client's condition?

  • A. Comatose, breathing unlabored
  • B. Glascow Coma Scale 8, respirations regular
  • C. Appears to be sleeping, vital signs stable
  • D. Glascow Coma Scale 13, no ventilator required
Correct Answer: B

Rationale: The correct answer is B. When documenting a client in a non-responsive state with stable vital signs and independent breathing, the nurse should document the Glasgow Coma Scale score to assess the level of consciousness and the regularity of respirations. Choice A is incorrect because 'comatose' implies a deeper level of unconsciousness than described in the scenario. Choice C is incorrect as it does not provide a specific assessment like the Glasgow Coma Scale score. Choice D is incorrect as a Glasgow Coma Scale score of 13 indicates a more alert state than described in the scenario.

The healthcare provider is providing oral care to an unconscious patient and notes that the patient has extremely bad breath. Which term will the healthcare provider use when reporting to the oncoming shift?

  • A. Cheilitis
  • B. Halitosis
  • C. Glossitis
  • D. Dental caries
Correct Answer: B

Rationale: The correct term the healthcare provider will use when reporting the extremely bad breath of the unconscious patient to the oncoming shift is 'Halitosis' (Choice B). Halitosis specifically refers to bad breath. Cheilitis (Choice A) is inflammation of the lips, not related to bad breath. Glossitis (Choice C) is inflammation of the tongue, not directly associated with bad breath. Dental caries (Choice D) are cavities in the teeth, which can contribute to bad breath but are not the term used to describe bad breath itself.

A nurse is evaluating teaching about nutrition with the guardians of an 11-year-old child. Which of the following statements should indicate to the nurse an understanding of the teaching?

  • A. "Our child wants to eat as much as we do, but we're afraid it will lead to becoming overweight."
  • B. "Our child skips lunch sometimes, but we figure it's okay as long as we eat a healthy breakfast and dinner."
  • C. "We limit fast-food restaurant meals to three times a week now."
  • D. "We reward school achievements with a point system instead of pizza or ice cream."
Correct Answer: D

Rationale: The correct answer is D. Rewarding school achievements with a point system rather than food items like pizza or ice cream is a healthier approach. This choice indicates an understanding of the teaching about nutrition and the importance of not using food as a reward. Choices A, B, and C do not demonstrate a clear understanding of the teaching as they focus on concerns about overeating, skipping meals, and limiting fast-food consumption but do not address the concept of avoiding food rewards for achievements.

Copyright © 2025 Nokea. All rights reserved.