HESI Fundamentals Practice Test

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The healthcare professional in the emergency department observes a colleague viewing the electronic health record (EHR) of a client who holds an elected position in the community. The client is not a part of the colleague's assignment. Which action should the healthcare professional implement?

  • A. Communicate the colleague's actions to the unit charge nurse
  • B. Send an email to facility administration reporting the action
  • C. Write an anonymous complaint to a professional website
  • D. Post a comment about the action on a staff discussion board
Correct Answer: A

Rationale: Observing a colleague accessing a patient's EHR without a legitimate reason is a violation of HIPAA, which protects patient confidentiality. The appropriate action in this scenario is to communicate the colleague's actions to the unit charge nurse immediately. The charge nurse can then address the issue internally and ensure that patient privacy is maintained. Reporting the incident through the appropriate channels within the healthcare facility is the most effective and professional way to handle such breaches of patient confidentiality. Choices B, C, and D are incorrect because they do not involve addressing the issue internally within the healthcare facility. Reporting such incidents internally is essential to ensure that patient privacy is protected, and the matter is handled appropriately by healthcare authorities.

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What is the most important action for the nurse to take when caring for a client with a spinal cord injury experiencing autonomic dysreflexia?

  • A. Elevate the head of the bed to 45 degrees.
  • B. Monitor the client's respiratory rate.
  • C. Administer an antihypertensive medication.
  • D. Assess the client's blood glucose level.
Correct Answer: A

Rationale: In a client with autonomic dysreflexia, the most critical action is to elevate the head of the bed to 45 degrees (A). This positioning helps reduce blood pressure, which is essential in managing autonomic dysreflexia. Monitoring the client's respiratory rate (B) is important for overall assessment but not the priority in this situation. Administering an antihypertensive medication (C) without addressing the positioning issue first can lead to further complications. Assessing the client's blood glucose level (D) is not directly related to autonomic dysreflexia and is not the initial priority in this scenario.

A client is admitted with a diagnosis of diabetic ketoacidosis (DKA). Which assessment finding should the nurse anticipate?

  • A. Oliguria.
  • B. Kussmaul respirations.
  • C. Fruity odor on the breath.
  • D. Blood glucose level of 250 mg/dL.
Correct Answer: B

Rationale: Kussmaul respirations (B) are a deep and labored breathing pattern associated with diabetic ketoacidosis (DKA) and are expected in this condition. While oliguria (A), fruity odor on the breath (C), and elevated blood glucose level (D) are also signs of DKA, Kussmaul respirations are more specific and critical to the condition, indicating severe metabolic acidosis.

When entering the room of an adult male, the nurse finds that the client is very anxious. Before providing care, what action should the nurse take first?

  • A. Divert the client's attention
  • B. Call for additional help from staff
  • C. Document the planned action
  • D. Re-assess the client's situation
Correct Answer: D

Rationale: Before providing care to an anxious client, it is crucial for the nurse to first re-assess the client's situation. By re-assessing, the nurse can understand the underlying cause of the client's anxiety, which will help in tailoring appropriate care interventions. Re-assessment ensures that care provided is individualized and addresses the client's specific needs, promoting effective and client-centered care delivery. Diverting the client's attention (Choice A) may not address the root cause of the anxiety. Calling for additional help (Choice B) may be necessary in some situations but should not be the first action. Documenting the planned action (Choice C) should come after re-assessing the client's situation to ensure accurate documentation based on the current assessment.

A male healthcare provider is assigned to care for a female Muslim client. When the provider offers to bathe the client, the client requests that a female healthcare provider perform this task. How should the male healthcare provider respond?

  • A. May I ask a female colleague to help you with your personal hygiene?
  • B. I will ask one of the female healthcare providers to bathe you.
  • C. A staff member on the next shift will help you.
  • D. I will keep you draped and hand you the supplies as you need them.
Correct Answer: B

Rationale: The most culturally sensitive response is for the male healthcare provider to ask one of the female healthcare providers to bathe the client. This approach respects the client's cultural and spiritual preferences by ensuring that their modesty and beliefs are honored during the care process. Choice A is incorrect as it puts the responsibility on the client to seek help, while the provider should take the initiative to arrange for appropriate care. Choice C is incorrect as it delays the assistance unnecessarily. Choice D, although helpful in maintaining modesty, does not address the client's request for a female healthcare provider to perform the task.

After a needle stick occurs while removing the cap from a sterile needle, what action should the individual take?

  • A. Complete an incident report.
  • B. Select another sterile needle.
  • C. Disinfect the needle with an alcohol swab.
  • D. Notify the supervisor immediately.
Correct Answer: B

Rationale: In the scenario described, the correct action after a needle stick injury is to discard the contaminated needle safely and choose a new sterile needle to continue the procedure. This step helps prevent potential transmission of infections and ensures the safety of both the individual and the patient. Disinfecting the needle with an alcohol swab is not adequate to address the risk of infection transmission. While completing an incident report and notifying the supervisor are important, the immediate action should be to replace the contaminated needle with a new sterile one to prevent any potential harm.

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