HESI Fundamental Practice Exam

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A healthcare professional is planning teaching for a group of adolescents who each recently had surgical placement of an ostomy. Which of the following methods should the healthcare professional use as a psychomotor approach to learning?

  • A. Practice sessions
  • B. Demonstrations
  • C. Written instructions
  • D. Group discussions
Correct Answer: A

Rationale: Practice sessions are an effective psychomotor approach to learning for adolescents with ostomies as they involve hands-on practice of ostomy care skills, which can help reinforce learning through active engagement. Demonstrations (choice B) can be helpful in providing visual guidance but may not offer the same level of active participation and practice as practice sessions. Written instructions (choice C) may be useful for reference but may not be as effective in developing psychomotor skills. Group discussions (choice D) focus more on verbal exchange and may not directly address the need for hands-on skill development required in managing ostomies. Therefore, practice sessions are the most suitable method for enhancing psychomotor learning in this scenario.

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The patient has been diagnosed with a spinal cord injury and needs to be repositioned using the logrolling technique. Which technique will the healthcare team use for logrolling?

  • A. Involve at least three to four people.
  • B. Instruct the patient not to reach for the opposite side rail when turning.
  • C. Move the bottom part of the patient's torso first and then the top part.
  • D. Use pillows for support before turning.
Correct Answer: A

Rationale: The correct technique for logrolling involves at least three to four people to ensure the safety and proper alignment of the patient's spine. Logrolling requires coordinated effort from multiple individuals to prevent twisting or bending of the spine, hence option A is correct. Option B is incorrect as patients with spinal cord injuries should not be instructed to reach for the opposite side rail due to the risk of causing harm. Option C is incorrect as moving the bottom part of the patient's torso first could lead to spinal misalignment. Option D is incorrect as pillows should be used for support and comfort after the patient has been successfully turned, not before.

The mother of a 2 year-old hospitalized child asks the nurse's advice about the child's screaming every time the mother gets ready to leave the hospital room. What is the best response by the nurse?

  • A. I think you or your partner needs to stay with the child while in the hospital.
  • B. Oh, that behavior will stop in a few days.
  • C. Keep in mind that for the age this is a normal response to being in the hospital.
  • D. You might want to 'sneak out' of the room once the child falls asleep.
Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

A client has had their diet prescription changed to a mechanical soft diet. Which of the following food items should the nurse remove from the client's breakfast tray?

  • A. smoothie
  • B. sliced banana
  • C. pancakes
  • D. sunny side up (fried) eggs
Correct Answer: D

Rationale: The correct answer is 'D: sunny side up (fried) eggs.' Fried eggs should be removed as they are not suitable for a mechanical soft diet due to their texture. The yolk of a fried egg is usually too hard and can be difficult for a client on a mechanical soft diet to chew and swallow. Poached or scrambled eggs are better alternatives for this diet as they are softer and easier to consume. Choices A, B, and C are all suitable for a mechanical soft diet as they are softer in texture and easier to chew and swallow.

The nurse is caring for a client with a newly placed colostomy. Which statement by the client indicates a need for additional teaching?

  • A. I will need to change the colostomy bag every day.
  • B. I should avoid foods that can cause gas, such as beans and carbonated drinks.
  • C. I need to empty the colostomy bag when it is one-third to one-half full.
  • D. I will need to take care of the skin around the stoma to prevent irritation.
Correct Answer: A

Rationale: The correct answer is A. Changing the colostomy bag every day is not necessary; it should be changed as needed, usually every 3-7 days. This statement indicates a need for additional teaching as frequent changes can irritate the skin and are not typically required. Choices B, C, and D are all correct statements regarding colostomy care. Avoiding gas-producing foods, emptying the bag when it is one-third to one-half full, and taking care of the skin around the stoma are all essential aspects of colostomy care to prevent complications and maintain skin integrity.

A client with chronic kidney disease is being assessed. Which laboratory value would be most concerning?

  • A. Serum creatinine of 3.0 mg/dL
  • B. Blood urea nitrogen (BUN) of 45 mg/dL
  • C. Serum potassium of 6.5 mEq/L
  • D. Hemoglobin of 10 g/dL
Correct Answer: C

Rationale: In a client with chronic kidney disease, an elevated serum potassium level (hyperkalemia) is the most concerning finding. Hyperkalemia can lead to life-threatening cardiac dysrhythmias due to its effect on the electrical conduction system of the heart. Monitoring and managing serum potassium levels are crucial in patients with chronic kidney disease to prevent serious complications. While elevated serum creatinine (Choice A) and Blood Urea Nitrogen (BUN) levels (Choice B) indicate impaired kidney function, hyperkalemia poses an immediate risk of cardiac complications. Hemoglobin levels (Choice D) are typically lower in chronic kidney disease due to decreased erythropoietin production, but they do not present an immediate life-threatening risk like hyperkalemia.

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