Download Duke university school of nursing NU272 H.E.S.I Practice Exam 2025: 100 Questions & Ans and more Exams Nursing in PDF only on Docsity!
Duke university school of nursing Ultimate 2025
HESI Comprehensive Exam Prep: Study Tips, 150
Sample Test Questions, and Review Guide for
Nursing School
A nurse in the cardiac care unit (CCU) is told that a client with a diagnosis of myocardial infarction (MI) will be admitted from the emergency department (ED). Which item does the nurse give priority to placing at the client's bedside? Bedside commode Suctioning equipment Electrocardiography machine Oxygen cannula and flowmeter - - correct ans- - Oxygen cannula and flowmeter Rationale: The oxygen cannula and flowmeter are the priority. The client will require oxygen therapy after myocardial infarction to improve oxygen supply to the myocardium and ease the pain resulting from ischemia. Suctioning equipment is not the priority item but may be needed if a complication occurs. An electrocardiogram machine and bedside commode may be necessary but are not the priority items. A laxative has been prescribed for a client with diminished colonic motor response as a means of promoting defecation. The nurse provides information to the client about the medication. What does the nurse tell the client to do? Increase fluid intake Consume low-fiber foods Consume foods that are low in potassium Contact the primary health care provider if the urine turns yellow-brown - - correct ans-
Rationale: The nurse encourages the client to increase fluid intake, to consume a high- fiber diet, and to exercise. Hypokalemia may result from use of a laxative, so the nurse encourages the client to consume foods high in potassium. The client's urine may turn pink-red, red-violet, red-brown, or yellow-brown, but the client is told that this is a temporary, harmless effect. Cyclobenzaprine is prescribed to a client with multiple sclerosis for the treatment of muscle spasms. For which common side effect of this medication does the nurse monitor the client? Diarrhea Drowsiness Abdominal pain Increased salivation - - correct ans- - Drowsiness Rationale: Drowsiness, dizziness, and dry mouth are the most common side effects of cyclobenzaprine. Cyclobenzaprine is a centrally acting skeletal muscle relaxant used in the management of muscle spasm accompanying a variety of conditions. Rare side effects include fatigue, tiredness, blurred vision, headache, nervousness, confusion, nausea, constipation, dyspepsia, and an unpleasant taste in the mouth. A nurse administers nitroglycerin sublingually to a client diagnosed with angina pectoris who reports chest pain. The medication is ineffective, so the nurse prepares to administer a second dose. Before administering the nitroglycerin, which action does the nurse make a priority? Checking the client's blood pressure Obtaining blood levels of cardiac enzymes Asking the client if experiencing headache Obtaining a 12-lead electrocardiogram (ECG) - - correct ans- - Checking the client's blood pressure
Rationale: There is a need for further instruction if the client states, "I need to participate in aerobic and weightlifting exercise three times a week." The client should avoid activities that involve straining, including weightlifting, push-ups and pull-ups, and straining during bowel movements. The client with CAD should participate in a simple exercise program on a regular basis. The client may begin a simple walking program by walking 400 feet (122 metres) twice a day at a rate of 1 mph (1.6 km/hr) the first week after discharge and increasing the distance and rate as tolerated, usually weekly, until he or she can walk 2 miles (3.2 km) at 3 to 4 mph (4.8 to 6.4 km/hr). The client should always carry nitroglycerin and must comply with dietary restrictions, including avoiding foods with saturated fats and foods high in cholesterol. The nurse instructs the client to take a pulse reading before, halfway through, and after exercise. A nurse provides information to a client who will be undergoing endoscopic retrograde cholangiopancreatography (ERCP). What does the nurse tell the client? There is no need to fast (NPO status) before the procedure The gallbladder is easily removed during this procedure if gallstones are found The procedure is only performed to visualize the esophagus, stomach, and duodenum Dye may be injected during the procedure to permit visualization of the pancreatic and biliary ducts - - correct ans- - Dye may be injected during the procedure to permit visualization of the pancreatic and biliary ducts Rationale: The nurse tells the client that dye may be injected to outline the pancreatic and biliary ducts. ERCP involves the oral insertion of an endoscope with a side-viewing tip and a cannula that can be maneuvered into the ampulla of Vater. The procedure may be combined with papillotomy to enlarge the sphincter and release gallstones. However, the gallbladder itself cannot be removed during this procedure. As with any endoscopic procedure, the client must remain NPO for 8 hours before the test. A client who has undergone knee-replacement surgery will be self-administering enoxaparin sodium at home. The nurse teaches the client about the medication. What does the nurse tell the client?
Store the medication in the refrigerator Lie down to administer the subcutaneous injection Inject the medication in the upper outer aspect of the arm Discard the medication if the solution appears pale yellow - - correct ans- - Lie down to administer the subcutaneous injection Rationale: The client is instructed to lie down to administer the injection and to introduce the entire length of the needle (½ inch [1.25 cm]) into a skin fold held between the thumb and forefinger. Enoxaparin sodium is an anticoagulant that is administered by way of subcutaneous injection. It is injected into the abdominal wall. The solution, which appears clear and colorless to pale yellow, is stored at room temperature. An intravenous dose of adenosine is prescribed for a client to treat Wolff-Parkinson- White syndrome. Which piece of equipment does the nurse make a priority of obtaining before administering the medication? Pulse oximeter Cardiac monitor Blood-pressure cuff Suction catheter and suction machine - - correct ans- - Cardiac monitor Rationale: Obtaining a cardiac monitor is the priority. Wolff-Parkinson-White syndrome is an abnormality of cardiac rhythm that is manifested as supraventricular tachycardia. Adenosine is an antidysrhythmic medication used to treat this dysrhythmia. It is administered intravenously. A pulse oximeter and blood pressure cuff will each provide information about the client's cardiovascular status, but neither is the priority. There is no information in the question to indicate that a suction catheter and suction machine are necessary. A nurse provides information about smoking-cessation measures to a client diagnosed with coronary artery disease (CAD). Which statement by the client indicates a need for further information?
A client diagnosed with heart failure suddenly experiences profound dyspnea, pallor, audible wheezing, and cyanosis, and the nurse suspects pulmonary edema. What should the nurse do first? Obtain a pulse oximetry reading Raise the head of the client's bed Administer a dose of morphine sulfate Obtain a specimen for an arterial blood gas determination - - correct ans- - Raise the head of the client's bed Rationale: The nurse would first raise the head of the client's bed and position the client to maximize chest expansion to ease the air hunger that the client is experiencing. Acute pulmonary edema is characterized by profound dyspnea, pallor, audible wheezing, and cyanosis. An arterial blood gas or pulse oximetry reading will reveal the need for supplemental oxygen. Morphine sulfate may be administered because it blunts the sympathetic response and promotes peripheral vasodilation. However, the nurse also needs to contact the primary health case provider to prescribe that medication. On the basis of the options provided, however, the initial action is placing the client in a head-elevated position. The nurse administers intravenous morphine sulfate to a client in pulmonary edema. For which intended effect of the medication does the nurse monitor the client? Relief of pain Relief of anxiety Decreased urine output Increased blood pressure - - correct ans- - Relief of anxiety Rationale: Morphine sulfate reduces anxiety in the client in pulmonary edema. It blunts the sympathetic response and increases venous capacitance, thereby decreasing left atrial pressure. It also promotes peripheral vasodilation and causes blood to pool in the periphery. The client receiving morphine sulfate is monitored for signs/symptoms of respiratory depression and extreme decreases in blood pressure, especially when the
medication is administered intravenously. Although morphine sulfate is an opioid analgesic and relieves pain, it is not administered to the client with pulmonary edema for its analgesic effect. Furosemide is administered to the client with pulmonary edema to increase urine output. A nurse is providing home care instructions to a client diagnosed with coronary artery disease (CAD) who will be discharged home and will be taking 1 aspirin daily. What does the nurse tell the client? To stop the aspirin if nausea occurs To take the aspirin on an empty stomach That ringing in the ears is a sign of toxicity That the aspirin is a short-term treatment and will probably be discontinued in 2 weeks -
- correct ans- - That ringing in the ears is a sign of toxicity Rationale: Ringing in the ears (tinnitus) is a sign of toxicity; if it occurs, the client should contact the primary health care provider. Aspirin, an antiplatelet agent, helps prevent blood clotting. A single low daily dose of aspirin may be a long-term component of the standard treatment regimen for the client with CAD. Gastric irritation may occur with the use of aspirin, and the client is advised to take the daily dose with food to prevent this. The client would not stop the medication if nausea occurs but would instead take the medication with food to relieve this discomfort. A client receiving parenteral nutrition (PN) suddenly experiences chest pain and dyspnea, and the nurse suspects an air embolism. The nurse immediately places the client in a lateral Trendelenburg position, on the left side. What action does the nurse take next? Auscultating heart sounds Clamping the intravenous catheter Checking the client's blood pressure Obtaining an arterial blood gas specimen - - correct ans- - Clamping the intravenous catheter
Trapeze bar Bedside commode - - correct ans- - Trapeze bar Rationale: The most important item for the client in skeletal traction to use is a trapeze bar. This bar is a triangular device that hangs from a securely fastened overhead bar that is attached to the bed frame. It allows the client to pull up with the upper extremities to raise the trunk off the bed. It is a useful device for helping increase independence, maintain upper-body strength, and reducing the shearing action that results when the client slides across or up and down in the bed. The client in traction would not be allowed to get out of bed to use a bedside commode; rather, a bedpan or fracture pan would be used. Although a telephone and a television are helpful for diversion and maintaining social contact, they are not the most important items. A nurse taking the vital signs of a client immediately after she has delivered a newborn notes that the client's heart rate is 110 beats/min. What should the nurse do first? Document the findings Offer the client oral fluids Recheck the heart rate in 1 hour Check the uterus and amount of lochia discharge - - correct ans- - Check the uterus and amount of lochia discharge Rationale: If tachycardia is noted, the nurse should first assess the location and firmness of the uterus and amount of lochia. Additional assessments including blood pressure, estimated blood loss at delivery, and hemoglobin and hematocrit determinations should be carried out. After delivery, the normal heart rate ranges from 60 to 90 beats/min. Tachycardia may indicate excitement, fatigue, dehydration, hypovolemia, pain, or infection. Although the nurse would document the findings, it is most appropriate for the nurse to assess the client to determine the cause of the tachycardia. Oral fluids are important if the client is dehydrated, but further assessment of the problem is required and dehydration would first need to be confirmed. Rechecking the heart rate in 1 hour will delay necessary interventions.
A client is receiving an intravenous infusion of alteplase. For which adverse effect of the medication does the nurse monitor the client most closely? Bleeding Hearing loss Decreased urine output Increased blood pressure - - correct ans- - Bleeding Rationale: Alteplase is a thrombolytic agent used to dissolve existing thrombi. The nurse needs to monitor the client most closely for bleeding. It is the most common adverse effect, and the nurse must monitor the client for obvious or occult signs of bleeding. Hearing loss and decreased urine output are not associated with the use of this medication. The medication may also cause a decrease in blood pressure and an allergic reaction, denoted by a rash or wheezing. The nurse is performing a sterile change of an abdominal dressing. Once the dressing has been removed and discarded in a waterproof bag, which action should the nurse take next? Assessing the wound Donning sterile gloves Cleansing the wound Setting up the sterile field - - correct ans- - Assessing the wound Rationale: View video. The nurse next assesses the wound for size; redness; swelling; and amount, color, odor, and type of drainage, if drainage is present. When performing a dressing change, the nurse dons clean gloves and removes the old dressing; checks the dressing for drainage, noting the amount, color, and odor if drainage is present; and discards the gloves and dressing. Next the nurse washes the hands and sets up the sterile field; dons sterile gloves; cleanses the wound with solution as prescribed, moving from the least to the most contaminated area; and redresses the wound. If a drain is present, the nurse applies additional layers of gauze as needed.
A nurse in a primary health care provider's office is talking to a client who underwent mastectomy of the right breast 2 weeks ago. The client says to the nurse, "I hate looking at this incision. I feel that I'm not even myself anymore." The nurse interprets this statement to mean that the client is experiencing which problem? Inability to cope Distorted body image Inability to care for self Inability to maintain health - - correct ans- - Distorted body image Rationale: Distorted body image is characterized by negative verbalizations or feelings about a body part. This is a common response after mastectomy. The nurse supports the client and helps her work through these feelings. There is no information in the question to indicate that inability to care for self, inability to cope, or inability to maintain health is a problem. The nurse discovers that a client receiving heparin sodium by way of continuous intravenous (IV) infusion has removed the IV tubing from the infusion pump to change his hospital gown. After assessing the client and placing the tubing back in the infusion pump, which medication does the nurse check for in the medication room in case a heparin overdose has occurred? Enoxaparin Phytonadione Protamine sulfate Aminocaproic acid - - correct ans- - Protamine sulfate Rationale: The nurse checks for protamine sulfate in the medication room in case a heparin overdose occurs. If the IV tubing is removed from an infusion pump and the tubing is not clamped, the client will receive a bolus of the solution of the medication contained in the solution. Heparin is an anticoagulant, and the client who receives a bolus dose of heparin is at risk for bleeding. The nurse would notify the primary health
care provider. A blood sample for partial thromboplastin time (PTT) would be drawn and the results of testing evaluated. If the PTT is too high, the infusion may be stopped for a time, or a dose of protamine sulfate, the antidote for heparin, may be prescribed. Enoxaparin is an anticoagulant. Phytonadione is the antidote for warfarin sodium.Aminocaproic acid is an antifibrinolytic, inhibiting clot breakdown. The nurse is explaining the diagnosis of congenital diaphragmatic hernia (CDH) related to a left posterolateral defect (also called Bochdalek hernia) to a postpartum client. What body system does the nurse emphasize is the system most at risk for problems? Respiratory system Genitourinary system Musculoskeletal system Gastrointestinal system - - correct ans- - Respiratory system Rationale: With a congenital diaphragmatic hernia, abdominal contents herniate through an opening in the diaphragm. If caused by a left posterolateral defect, the respiratory system is most at risk for problems. This serious defect requires prompt recognition (usually in utero) and aggressive treatment to reduce its high mortality. Intestines and other abdominal structures, such as the liver, can enter the thoracic cavity, compressing the lung. Lung hypoplasia may occur on the affected side and to a lesser degree on the contralateral side. Ventilation is further compromised by hypoplasia and compression of the lung, including the airways and blood vessels. In addition to the anatomic defect, pulmonary hypoplasia and pulmonary hypertension have also been recently recognized as components in the pathology of CDH. A nurse is performing an assessment of a newborn with a diagnosis of esophageal atresia (EA) and tracheoesophageal fistula (TEF). Which findings does the nurse expect to note in the infant? Select all that apply. Drooling Wheezing Hiccuping
second feeding after the vomiting episode, weight loss, signs/symptoms of dehydration, and a distended upper abdomen. A readily palpable olive-shaped mass in the epigastrium just to the right of the umbilicus is noted, and gastric peristaltic waves, moving from left to right across the epigastrium, are visible. Laboratory findings include metabolic alkalosis, a result of the vomiting that occurs in this disorder. Facial edema and metabolic acidosis do not occur in this disorder. The nurse is assessing a client who has a history of Prinzmetal's angina. The nurse knows that what type of medication is given to treat this condition? Inotropes Beta blockers ACE inhibitors Calcium channel blockers - - correct ans- - Calcium channel blockers Rationale: Prinzmetal's, or variant, angina is prolonged and severe and occurs at the same time each day, most often at rest. The treatment of choice is usually a calcium channel blocker. Calcium channel blockers relax and dilate the vascular smooth muscle, thus relieving the coronary artery spasm in variant angina. Inotropes, beta blockers, and angiotensin-converting enzyme (ACE) inhibitors are not given to treat this disorder. Methylergonovine is prescribed for a client to control postpartum bleeding. Which action does the nurse take before administering the medication? Checking the episiotomy site Palpating the client's bladder Checking the client's blood pressure Ensuring that the uterus is contracted - - correct ans- - Checking the client's blood pressure
Rationale: Because the medication causes arterial vasoconstriction and hypertension, the nurse checks the client's blood pressure before administering the medication. Methylergonovine is an oxytocic that stimulates contraction of the uterus and causes arterial vasoconstriction. It is used for the prevention and treatment of postpartum and postabortal hemorrhage caused by uterine atony or subinvolution. There is no information to indicate that the client has had an episiotomy. Although the nurse may palpate the client's bladder, this action is unrelated to the use of the medication. A nurse is teaching a client with angina pectoris who is being discharged from the hospital about managing chest pain at home. Which statement by the client indicates a need for further teaching? "I need to keep fresh nitroglycerin available in case I need it." "I need to check the expiration date on the nitroglycerin bottle." "If I have any chest pain, I need to stop what I am doing and sit or lie down." "If I get chest pain, I should put 3 nitroglycerin tablets under my tongue and then go to the emergency department if that doesn't work." - - correct ans- - "If I get chest pain, I should put 3 nitroglycerin tablets under my tongue and then go to the emergency department if that doesn't work." Rationale: There is a need for further teaching if the client states, "If I get chest pain, I should put 3 nitroglycerin tablets under my tongue and then go to the emergency department if that doesn't work." The client is instructed to place 1 nitroglycerin tablet, not 3 tablets, under the tongue and allow it to dissolve. The client needs to obtain instructions from the primary health care provider about the preferred procedure for administering nitroglycerin. The remaining statements reflect accurate understanding of the nurse's teaching. A nurse develops a list of home care instructions for a client who is wearing a halo fixation device after sustaining a cervical fracture. Which instructions should the nurse include? Select all that apply. Use a straw to drink. Avoid sexual activity while the vest is in place.
pain) caused by esophageal or gastric disorders. An upright sitting position, the administration of an analgesic, or the administration of an antiinflammatory medication often relieves chest pain (sudden, sharp, and stabbing) caused by pericarditis. A nurse has provided nutrition instructions to a mother of an infant. Which statement by the mother indicates to the nurse that the mother requires further instruction? "It's best to use cow's milk, as long as it's whole milk and not skim." "When I start feeding solid foods, I might need to add water to the food." "When the baby starts to take juices, I shouldn't warm the juice, because that will destroy the vitamin C." "The baby will get the right nutrition if I feed breast milk or store-bought formula that's been fortified with iron." - - correct ans- - "It's best to use cow's milk, as long as it's whole milk and not skim." Rationale: Cow's milk (whole, skim, 1%, 2%) is not recommended in the first 12 months of life. It contains too little iron, its high renal solute load and unmodified derivatives can put small infants at risk for dehydration, and the tough, hard curd is difficult for infants to digest. In addition, skim milk and reduced-fat milk deprive the infant of needed calories and essential fatty acids. Breast milk or commercially prepared iron-fortified formula should be used to feed the infant and provides adequate nutrition throughout the infancy period. The remaining options are correct statements about feeding an infant. A pediatric nurse is caring for a hospitalized toddler. Which activity does the nurse deem the most appropriate for the toddler? Singing games Watching videos Simple board games Large building blocks - - correct ans- - Large building blocks
Rationale: The toddler is developing the use of motor skills and enjoys manipulating small objects such as blocks, push-pull toys, and toy people, cars, and animals. Therefore large building blocks are appropriate for a client of this age. Singing games, simple board games, and videos are appropriate for the preschooler. A nurse in a primary health care provider's office is reviewing the medical record of a child with a diagnosis of lactose intolerance. Which finding does the nurse expect to see documented in the child's record? Fatty stools Episodes of foul-smelling ribbon-like stools Episodes of profuse watery diarrhea and vomiting Episodes of cramping abdominal pain and excessive flatus - - correct ans- - Episodes of cramping abdominal pain and excessive flatus Rationale: Manifestations of lactose intolerance include diarrhea that is frothy (but not fatty), abdominal distention, cramping abdominal pain, and excessive flatus. The presence of fatty stools may indicate a problem with bile flow. Foul-smelling ribbon-like stool is a clinical manifestation of Hirschsprung disease. Profuse watery diarrhea and vomiting is one clinical manifestation of celiac disease. A nurse is providing dietary instructions to the mother of a child with celiac disease. What does the nurse tell the mother is acceptable to give the child? Boiled rice Cooked pasta Warm oatmeal Baked macaroni and cheese - - correct ans- - Boiled rice Rationale: The nurse tells the mother that corn, rice, and millet may be substituted as grains. Celiac disease is a disorder in which the affected person has an intolerance to wheat, rye, barley, and oats. Dietary management is the mainstay of treatment for the
