Fundamentals of Nursing HESI

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A male client presents to the clinic stating that he has a high-stress job and is having difficulty falling asleep at night. The client reports having a constant headache and is seeking medication to help with sleep. Which intervention should the nurse implement?

  • A. Determine the client's sleep and activity patterns
  • B. Obtain a prescription for the client to take when stressed
  • C. Refer the client for a sleep study and neurological follow-up
  • D. Teach coping strategies to use when feeling stressed
Correct Answer: A

Rationale: Assessing the client's sleep and activity patterns is crucial in understanding the factors contributing to the sleep difficulties and headaches. By evaluating these patterns, the nurse can identify triggers, stressors, and lifestyle habits that may be impacting the client's sleep quality and overall well-being. This assessment will guide the nurse in formulating an appropriate care plan tailored to the client's specific needs. Option B is not appropriate as it focuses solely on providing medication without addressing underlying issues. Option C is premature as a thorough assessment should precede any referrals for specialized studies. Option D, while important, should come after understanding the client's sleep patterns to provide more targeted coping strategies.

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The healthcare provider is assessing a client with a history of congestive heart failure. Which assessment finding would be most concerning?

  • A. Shortness of breath on exertion
  • B. Weight gain of 2 pounds in a week
  • C. Orthopnea
  • D. Crackles in the lungs
Correct Answer: D

Rationale: Crackles in the lungs are concerning because they indicate pulmonary congestion, a serious complication of congestive heart failure. The presence of crackles suggests fluid accumulation in the lungs, requiring immediate attention to prevent respiratory distress and worsening heart failure. While shortness of breath on exertion, weight gain, and orthopnea are common signs and symptoms of heart failure, crackles specifically point to acute pulmonary edema or worsening congestion, making them the most concerning finding in this scenario.

A client is lying on the bathroom floor after a nurse responds to a call light. Which of the following actions should the nurse take first?

  • A. Check the client for injuries
  • B. Move hazardous objects away from the client
  • C. Notify the provider
  • D. Ask the client to describe how she felt prior to the fall
Correct Answer: A

Rationale: The nurse's priority in this situation is to assess the client for injuries. Checking for injuries first is crucial to determine the extent of harm caused by the fall and to provide immediate care. Moving hazardous objects can wait until the client's safety is ensured. Notifying the provider and asking the client about how she felt prior to the fall are important but are secondary to assessing for injuries in this urgent scenario. It is essential to address immediate physical needs before investigating the cause of the fall or notifying other healthcare team members.

When teaching adult cardiopulmonary resuscitation (CPR) to a group of newly licensed nurses, what should the charge nurse instruct as the initial response in CPR?

  • A. Confirm unresponsiveness
  • B. Check for a pulse
  • C. Begin chest compressions
  • D. Call for emergency help
Correct Answer: A

Rationale: The correct initial response in CPR is to confirm unresponsiveness. This step is crucial to ensure that the person actually needs CPR before proceeding with further actions. Checking for unresponsiveness is essential to determine if the individual is in need of immediate assistance. Checking for a pulse or beginning chest compressions without confirming unresponsiveness could waste valuable time and potentially harm the individual. Calling for emergency help is important, but it should follow the confirmation of unresponsiveness to ensure timely activation of emergency services.

A nurse is caring for a postoperative client following knee arthroplasty who requires thigh-high compression sleeves. What should the nurse do?

  • A. Make sure two fingers can fit under the sleeve.
  • B. Apply the sleeve tightly to prevent blood clots.
  • C. Ensure the sleeve is snug and comfortable.
  • D. Check that the sleeve is loose enough to avoid constriction.
Correct Answer: A

Rationale: The correct answer is to make sure two fingers can fit under the sleeve. This allows for proper circulation and ensures that the sleeve is not too tight, which can lead to complications such as impaired blood flow or tissue damage. Choice B is incorrect because applying the sleeve tightly can actually cause harm rather than prevent blood clots. Choice C is incorrect as snugness alone may not guarantee proper fit. Choice D is incorrect as a sleeve that is too loose can be ineffective in providing the necessary compression.

The nurse plans to assist a male client out of bed for the first time since his surgery yesterday. His wife objects and tells the nurse to get out of the room because her husband is too ill to get out of bed.

  • A. Administer nasal oxygen at a rate of 5 L/min
  • B. Help the client to lie back down in the bed
  • C. Quickly pivot the client to the chair and elevate the legs
  • D. Check the client's blood pressure and pulse deficit
Correct Answer: D

Rationale: Checking the client's blood pressure and pulse deficit is essential before mobilizing a client out of bed, especially after surgery. This assessment helps ensure the client's stability and readiness for mobilization. Administering oxygen or pivoting the client without prior assessment could pose risks if the client is not medically stable. Helping the client lie back down without proper evaluation may delay necessary interventions if the client is indeed ready for mobilization.

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