HESI Adaptive Quizzes

A client's labor has progressed to the point where she is 6 cm dilated; however, the fetal head is not engaged. An amniotomy is performed. After this procedure, the nurse checks the fetal heart rate. What other nursing action should be performed at this time? 1. Inspecting the perineum 2. Preparing for an immediate birth 3. Measuring the maternal blood pressure 4. Increasing the intravenous (IV) fluid rate

1. Inspecting the perineum After the rupture of membranes, the umbilical cord may prolapse if the fetal head does not engage immediately, and this can lead to fetal compromise. The perineal area should be inspected at this time and frequently thereafter for evidence of cord prolapse.

Which features distinguish nursing diagnoses from medical diagnoses? Select all that apply. 1 Nursing diagnoses involve the client when possible. 2 Nursing diagnoses are based on results of diagnostic tests and procedures. 3 Nursing diagnoses are the identification of a disease condition in the client. 4 Nursing diagnoses involve the sorting of health problems within the nursing domain. 5 Nursing diagnoses involve clinical judgment about the client's response to health problem

1. Nursing diagnoses involve the client when possible 4. Nursing diagnoses involve the sorting of health problems within the nursing domain 5. Nursing diagnoses involve clinical judgment about the client's response to health problems.

While caring for a client with heat stroke, the nurse measured the temperature and noted it as 39ºC. What is this temperature in Fahrenheit? Round your answer to one decimal place

102.2 F Take 39C x 1.8 + 32 = 102.2 F

While assessing the nails of a client with diabetes, the nurse finds that the skin on the client's hands and feet are dry due to infection. What could be the reason for this dryness? 1. Applying moisturizing lotion between toes 2. Cutting nails after soaking them for 10 minutes in warm water 3. Cutting nails straight across and even with the tops of the fingers or toes 4.Using sharp objects to poke or dig under the toenail or around the cuticle

2. Cutting nails after soaking them for 10 minutes in warm water. Normally, nails should be cut after soaking them in warm water for 10 minutes. This action should not be performed for diabetic patients because soaking the nails will dry out the hands and feet, which may lead to infection.

A client reports vomiting and diarrhea for 3 days. Which clinical indicator is most commonly used to determine whether the client has a fluid deficit? 1. Presence of dry skin 2. Loss of body weight 3. Decrease in blood pressure 4. Altered general appearance

2. Loss of body weight

The nurse places fetal and uterine monitors on the abdomen of a client in labor. While observing the relationship between the fetal heart rate and uterine contractions, the nurse identifies four late decelerations. Which condition is most commonly associated with late decelerations? 1. Head compression 2. Maternal hypothyroidism 3. Uteroplacental insufficiency 4. Umbilical cord compression

3. Uteroplacental insufficiency Late decelerations, suggestive of fetal hypoxia, occur in the setting of uteroplacental insufficiency. Head compression results in early decelerations; this finding is considered benign.

The registered nurse (RN) asks the nursing student about theories related to the aging process. Which statement made by the nursing student indicates the theory of continuity? 1. "The aging process in individuals is genetically programmed." 2. "Aging individuals withdraw from customary roles." 3. "The accumulated damage of the aging process leads to physical changes in individuals." 4. "The personality of an individual remains stable and behavior becomes predictable as they age."

4. "The personality of an individual remains stable and behavior becomes predictable as they age."

Which sign or symptom leads the nurse to suspect that a client is experiencing a tubal pregnancy? 1. A painful, tender area in the epigastric region after meals 2. Lower abdominal cramping of 1 week's duration with constipation 3. Leukorrhea or dysuria occurring a few days after the first missed menstrual period 4. A sharp pain in the lower right or left side of the abdomen, radiating to the shoulder

4. A sharp pain in the lower right or left side of the abdomen, radiating to the shoulder The pain is sudden, intense, and knifelike, not prolonged or cramping.

The nurse is caring for an African American client with renal failure. The client states that the illness is a punishment for sins. Which cultural health belief does the client communicate? 1. Yin/Yang balance 2. Biomedical belief 3. Determinism belief 4. Magicoreligious belief

4. Magicoreligious belief An African American client may have magicoreligious beliefs, which focuses on hexes or supernatural forces that cause illness.

A pregnant client's blood test reveals an increased alpha-fetoprotein (AFP) level. Which condition does the nurse suspect that this result indicates? 1. Cystic fibrosis 2. Phenylketonuria 3. Down syndrome 4. Neural tube defect

4. Neural tube defect Increased levels of alpha-fetoprotein in pregnant women have been found to reflect open neural tube defects such as spina bifida and anencephaly.