HESI FUND Practice Test
An older client is receiving normal saline at 83 ml/hour per gravity. At the end-of-shift assessments, the practical nurse (PN) calculates the client's intake and output and determines that the infusion delivered 500 ml in the last hour. Which action should the PN take first? A) assess the lower extremities for pitting edema B) auscultate the lungs for crackles C) notify the healthcare provider D) check the amount of urinary output
B) auscultate the lungs for crackles
Which food should the practical nurse (PN) recommend for a client to increase the dietary intake of potassium? A) corn B) baked Potatoe C) popcorn D) grape juice
B) baked Potatoe
The practical nurse (PN) identifies several findings in an older client who is on prolonged bed rest. Which finding requires prompt action by the PN? A) heart rate increase of 10 beats per min B) bowel movements decrease to one every third day C) urinary output decreases by 250 ml in the past 24 hours D) systolic blood pressure decreases of 10 mm hg
B) bowel movements decrease to one every third day
In planning care for an older client on bed rest, which intervention should the practical nurse include in the prevention of pressure ulcers? A) massage carefully over each boney prominence B) elevate the head of the bed less than 30 degrees C) place the client in a lateral position over the trochanter D) use a donut device when placing he client in a sitting position
B) elevate the head of the bed less than 30 degrees
A client who is two days postoperative for a colectomy and temporary colostomy tells the practical nurse (PN) that the drainage bag is full of gas. What action should the PN take? A) Assess the client for signs of intestinal obstruction. B) Open the bag's clamp to release the flatus. C) Administer a PRN dose of simethicone (Mylicon). D) Change the bag to determine character of output.
B) Open the bag's clamp to release the flatus.
The practical nurse is administering otic drops to an adult client with otitis externa. Which action describes the correct administration technique? A) Manipulate the ear lobe back and down. B) Pull the pinna of the ear up and out. C) Apply drops to a cotton-tipped applicator for insertion. D) Administer the drops at a cool room temperature.
B) Pull the pinna of the ear up and out.
Which finding should the practical nurse (PN) report to the healthcare provider prior to administering as IV infusion with added potassium chloride (KCL)? A) Oral temperature of 100.4 F (38 C). B) Urine output of 120 ml in 8 hours. C) Hemoglobin of 9.6 grams/dl. D) Pulse oximeter 91% on room air.
B) Urine output of 120 ml in 8 hours.
A client with Clostridium difficile is placed on isolation precautions. Which transmission-based precaution should the practical nurse implement? A) Don a particulate respirator mask when in the room. B) Wear gown and gloves when rendering direct care. C) Close the door to the private negative airflow room. D) Prevent the client from leaving the room without a mask.
B) Wear gown and gloves when rendering direct care.
A male client who is 2 days postoperative for exploratory abdominal surgery is ambulating in the hall with the practical nurse (PN). The client tells the PN, "I think something in my incision just let go." Which action should the PN implement first? A) notify the healthcare professional B) assist the client to the supine position C) instruct the client to avoid deep breathing D) request an abdominal binder from a coworker
B) assist the client to the supine position
The practical nurse (PN) is obtaining information for a male client's psychosocial assessment. Which action should the PN implement first? A) determine the value the client places on his health B) establish a therapeutic relationship C) determine if he has abnormal behaviors D) ask the client to share information about his past
B) establish a therapeutic relationship
The practical nurse (PN) is adding tap water to several medications for administration via feeding tube. Which preparation should the PN administer without delay? A) reconstituted powder B) timed release capsule C) cherry flavored elixir D) flavorless suspension
B) timed release capsule
The practical nurse (PN) is documenting the administration of a client's medication. Which entry by the PN complies with The Joint Commission (TJC) guidelines for use of abbreviations? A) MS 4.0 mg IM given for pain rated "8" on a scale of "0-10." B) Novolog insulin 4 u given SC in the right arm. C) Doses of clonidine 0.15 mg given AC BID. D) oral liquid vitamin supplement changed from 2.0cc to 3.0cc qd
C) Doses of clonidine 0.15 mg given AC BID.
The practical nurse (PN) is reinforcing self-care with a male client who is being discharged with an ileostomy. Which client behavior best indicates to the PN that he understands ileostomy care? A) Affirms his understanding of the process and has no more questions. B) States that liquid stools will be reported to the healthcare provider. C) Empties the ileostomy appliance bag when it is about one-third full. D) Cuts the skin barrier wafer opening 1/2 inch smaller than the stoma.
C) Empties the ileostomy appliance bag when it is about one-third full.
Which technique is most important for the practical nurse to implement when obtaining a specimen for urinalysis, culture, and sensitivity for a male client? A) Direct client to void in toilet collect urine midstream in specimen cup. B) Label the sterile specimen container for culture, sensitivity, and urinalysis. C) Ensure client understands to retract the foreskin and cleanse meatus. D) Obtain the specimen at the next time the client has the urge to void.
C) Ensure client understands to retract the foreskin and cleanse meatus.
The practical nurse (PN) is assessing a client and obtains a pulse rate of 120 beats/minute, respirations of 28 breaths/minute, and a blood pressure of 80/60. Which action should the PN take first? A) Determine the client's orientation status. B) Encourage client to take slow deep breaths. C) Position the client flat in the bed. D) Measure the client's SpO2 using a pulse oximeter.
C) Position the client flat in the bed.
A client is receiving supplemental oxygen. The practical nurse (PN) walks in the room and sees a fire in the bedside wastebasket. Which action should the PN take first? A) Smother the fire in the wastebasket. B) Pull the fire lever to alert others. C) Take client out of room. D) Close door to prevent smoke from spreading.
C) Take client out of room.
The practical nurse (PN) is irrigating a client's indwelling urinary catheter. After injecting sterile solution as prescribed, what action should the PN implement? A) Massage the client's bladder for 30 to 45 seconds. B) Keep the tubing clamped for 30 to 45 minutes. C) Unclamp the tubing and lower the collection bag. D) Ask the client to take a deep breath and hold it.
C) Unclamp the tubing and lower the collection bag.
An older male client who is incontinent receives a prescription for a condom (external) catheter. Which steps should the practical nurse implement when applying the external catheter? (Select all that apply.) A) wrap the adhesive strip in a spiral around the penis B) shave the perineal area before beginning C) apply skin prep to the penile shaft and allow to dry D) leave 1 to 2 inches between the tip of the penis and the condom catheter E) don sterile gloves prior to the application of the condom catheter
C) apply skin prep to the penile shaft and allow to dry D) leave 1 to 2 inches between the tip of the penis and the condom catheter
Which intervention should the practical nurse (PN) implement to reduce the incidence of urinary tract infections in a client with an indwelling catheter? A) irrigate the catheter with a sterile distilled water B) dilute an antiseptic solution in the perineal wash C) cleanse perineal area with soap and water BID and PRN D) apply an antibiotic ointment BID around the urinary meatus
C) cleanse perineal area with soap and water BID and PRN Rationale: Daily perineal care BID and PRN should include cleansing of the meatus and catheter junction with soap and water. The other actions do not support the concept of medical asepsis and indwelling urinary catheter care.
The practical nurse (PN) is giving oral care to an older female client. The client has tender gums that bleed easily because of a medication she is taking. What intervention should the PN implement? A) encourage the client to massage the gums B) tell the client to use mouthwash daily C) obtain a soft bristle brush for the client D) have the client rinse with warm salt water
C) obtain a soft bristle brush for the client
While taking an adult's vital signs, the practical nurse (PN) notes an irregular radial pulse. What action should the PN implement to obtain the most accurate assessment? A) use a doppler for the radial pulse while monitoring the apical B) obtain the radial pulse again for ne min followed by the apical C) perform an apical-radial pulse assessment with another nurse D) verify the finding by counting the apical pulse with a stethoscope
C) perform an apical-radial pulse assessment with another nurse
A client is receiving a daily prescription for furosemide (Lasix) 40 mg PO but is unable to swallow. The practical nurse (PN) should consult with the healthcare provider about which component of the prescription? A) time of does B) prescribed dosage C) route of administration D) available generic drug
C) route of administration
Which action should the practical nurse (PN) implement when administering a subcutaneous injection to a client who weighs 325 pounds? A) produce a bleb at the injection site B) insert the needle at a 15-degree angle C) select a needle with a longer shaft D) rub vigorously for a faster response
C) select a needle with a longer shaft
What position should the practical nurse (PN) place a client in who is receiving an enteral tube feeding? A) sitting up right B) lying on the side C) supine with the head of the bed elevated 30 to 45 degrees D) fowlers with the head of the bed elevated 45 to 60 degrees
C) supine with the head of the bed elevated 30 to 45 degrees
A client is receiving a Mantoux test for tuberculosis screening. Which angle should the practical nurse (PN) insert the needle for injection? A) 15 degrees B) 30 degrees C) 45 degrees D) 90 degrees
A) 15 degrees
Which intervention is most important for the practical nurse (PN) to implement to decrease the number of falls for clients in a long-term care facility? A) Ask about the need to use bathroom. B) Determine the client's mental status. C) Inquire about the client's level of pain. D) Ensure that the floor is free of clutter.
A) Ask about the need to use bathroom.
Which factors influence how the practical nurse (PN) obtains vital signs on a client? (Select all that apply.) A) Client height 5 feet 6 inches, weight 240 pounds (109 kg). B) History of right radical mastectomy two years ago. C) Daily use of oral digoxin (Lanoxin). D) NPO status of 12 hours for fasting blood test. E) Nasal congestion related to a "cold".
A) Client height 5 feet 6 inches, weight 240 pounds (109 kg). B) History of right radical mastectomy two years ago. C) Daily use of oral digoxin (Lanoxin).
The practical nurse (PN) is reviewing the schedule of yearly Inservice programs for competency-based nursing care. Which criteria should the PN use in selecting programs that provide the best content to maintain nursing competency? A) Complex procedures that are done only a few times a month. B) Techniques that involve management of biohazard waste products. C) Competency demonstrated in orientation with electronic medication administration. D) Urgent needs identified by quality assurance to ensure national patient safety goals.
A) Complex procedures that are done only a few times a month.
The practical nurse (PN) is providing skin care to an older male client who has the tendency to stay on his left side in a lying position. Which bony prominence should the PN identify as the site most likely to develop alterations in skin integrity? A) Ilium. B) Heels C) Sacrum. D) Scapula
A) Ilium.
A client presents to the emergent care center reporting chest pain and feeling "lightheaded," as if he is "going to faint." What is the most important action the practical nurse (PN) should implement? A) Place client in a chair or upright on a stretcher. B) Obtain orthostatic blood pressure readings. C) Attach cardiac monitor electrodes on the client's chest. D) Give oxygen at 2 liters per nasal cannula.
A) Place client in a chair or upright on a stretcher.
The healthcare provider calls the nurses' station to give telephone call prescriptions for a client who is recently admitted to the unit. The practical nurse (PN) is unsure of the prescription given by the healthcare provider. Which action should the PN take? A) Read back the prescription to the healthcare provider. B) Ask another nurse to listen to the healthcare provider's prescription. C) Explain that the PN is unable to accept the telephone prescription. D) Clarify the prescription specifics with the pharmacist.
A) Read back the prescription to the healthcare provider.
The practical nurse (PN) is administering eye drops to a client with glaucoma. Which technique should the PN implement to ensure the eyes drops are effectively absorbed topically? A) Tell the client to move closed eyes from side to side. B) Retract the upper eyelid using the non-dominant hand. C) Gently place the dropper tip on the conjunctival sac. D) Place pressure at the outer canthus after instillation.
A) Tell the client to move closed eyes from side to side.
The practical nurse (PN) is administering scheduled morning medications to a client who states, "I haven't seen that pill before. Are you sure it's correct?" Which action should the PN take? A) Verify the prescription before administrating the medication. B) Withhold the dose to confirm its use with the healthcare provider. C) Reassure the client that the medication is prescribed for a reason. D) Check with the pharmacy to ensure the dispensed medication is correct.
A) Verify the prescription before administrating the medication.
A client with a possible mumps infection is admitted to an acute care facility. Which infection control precaution should the practical nurse (PN) implement? A) Wear a mask or respirator within 3 feet of the client. B) Don a gown prior to entering the room. C) Move the client to a negative airflow room. D) Use only dedicated bedside equipment for care.
A) Wear a mask or respirator within 3 feet of the client
The practical nurse (PN) is applying a dry, sterile dressing to a client's abdominal wound. Which allergy should the PN verify with the client? A) tape B) antibiotic ointment C) povidone-iodine D) hydrogen peroxide
A) tape
A young woman who is the primary caregiver for her mother who has Alzheimer's disease tells the practical nurse (PN), "Sometimes I hate my mother for living this long and my dad for dying and not caring for her." What response should the PN offer? A) what do you do to cope with these feelings? B) have you told your family how you feel? C) its normal to feel these emotions when you are stressed. D) don't worry, at least you can talk about your anger.
A) what do you do to cope with these feelings?
A client's indwelling urinary catheter is removed at 9:30 AM. The practical nurse (PN) assesses the client every 2 hours for the desire to void. Which documented assessment is the earliest time requiring further intervention by the PN? A) 130 pm unable to void B) 530 pm unable to void C) 330 pm unable to void D) 1130 am unable to void
B) 530 pm unable to void Rationale: A client is due to void within 8 hours of catheter removal, so at 5:30 PM, longer than 8 hours after removal, catheter reinsertion may be necessary. If the bladder is not distended, further action may not be needed at earlier times.
A client who has a pressure-relieving mattress overlay is mobilized to a chair and imprints of the client's buttocks, heels, and scapula are evident on the mattress overlay. What action should the practical nurse implement? A) Turn the mattress overlay to the opposite side. B) No action is needed because this is the mechanism of action for the overlay. C) Apply a different pressure-relieving device and assess its effectiveness for this client. D) Reinforce with cushions between the mattress and the overlay where the imprints are located.
C) Apply a different pressure-relieving device and assess its effectiveness for this client.
A client with a forearm laceration arrives in the clinic applying direct pressure with a clean washcloth. The practical nurse (PN) notes that the washcloth is saturated with blood. What action should the PN implement? A) Remove the saturated dressing and apply a new one. B) Place a new dressing on top of the saturated one. C) Apply digital pressure to arm above the injury. D) Place an ice pack over the dressed wound.
C) Apply digital pressure to arm above the injury.
Which finding indicates to the practical nurse that the client is meeting the rehabilitation goals after an acute brain attack? A) Turns head away from any painful stimuli. B) Tolerates tube feedings with residuals under 50 ml. C) Compensates by limiting use of affected extremity. D) Puts hands on chair arms when standing to use a walker.
D) Puts hands on chair arms when standing to use a walker.
The practical nurse (PN) is administering medications to several clients. Which client requires immediate action by the PN? A) An older female who is having difficulty swallowing. B) An older male who states he is tired of taking pills. C) A female client who reports the onset of a rash. D) A male client who states that his throat feels tight.
D) A male client who states that his throat feels tight.
The practical nurse (PN) finds an older female client lying on the floor. What action should the PN take first? A) Inquire if the client has any pain. B) Assist the client back to bed. C) Ask the client why she got up. D) Obtain the client's vital signs.
D) Obtain the client's vital signs.
Which action should the practical nurse (PN) implement to minimize the risk of hypernatremia for an older client? A) Encourage adding oranges and bananas in the diet. B) Decrease the intake of high salt foods. C) Administer a prescribed loop diuretic in early morning. D) Offer fluids on a set schedule throughout the day.
D) Offer fluids on a set schedule throughout the day.
When providing perineal care for an uncircumcised male client, the practical nurse (PN) should implement which action? A) Provide perineal care the same as for a circumcised male. B) Minimize the amount of touching of the glans during the procedure. C) Ensure the foreskin is retracted and the glans is exposed at the end of the procedure. D) Retract the foreskin before cleansing the glans and replace the foreskin after the procedure.
D) Retract the foreskin before cleansing the glans and replace the foreskin after the procedure.
The practical nurse (PN) uses the SBAR format to report an acute client situation to the healthcare provider. Which information is the correct understanding of this method? A) The "S" stands for safety and indicates any issues related to safety, such as restraints. B) The "B" stands for bleeding and indicates any signs of hemorrhage. C) The "A" stands for airway and reports on the client's airway status. D) The "R" stands for recommendation and suggests an action for the healthcare provider.
D) The "R" stands for recommendation and suggests an action for the healthcare provider.
Which intervention should the practical nurse (PN) implement to help a client cope effectively with chronic pain? A) administer around the clock opioid drugs B) give scheduled does of benzodiazepines C) recommend avoiding painful activities D) encourage using relaxation techniques
D) encourage using relaxation techniques
An older client who is admitted to the hospital with dehydration and electrolyte imbalance is confused and incontinent of urine. Which action provides the best strategy for the practical nurse (PN) to implement for the client's incontinence? A) insert an indwelling catheter B) apply incontinent absorbent pads C) restrict fluids after the evening meal D) establish a two-hour voiding schedule
D) establish a two-hour voiding schedule
A client reports feeling dizzy and lightheaded when moving from a supine position to a sitting position. What is the practical nurse's priority intervention? A) determine the pulse pressure B) measure pulse oximetry C) assess peripheral pulse points D) obtain orthostatic blood pressure
D) obtain orthostatic blood pressure
The practical nurse (PN) is changing a postoperative dressing for a client with a horizontal lower abdominal incision. What method should the PN use to remove the tape from the dressing? A) pull from the left to the right across the abdomen B) peel across the abdomen from right to left C) start from the top of the incision moving to the bottom D) remove all four sides by moving to the center of the incision
D) remove all four sides by moving to the center of the incision Rationale: The tape should be removed by starting all four sides and moving toward the center of the incision to prevent disruption of the wound. Pulling tape away from the approximated wound edges causes tension on the suture line and may lead to wound dehiscence. Although the incision should be cleansed from the top toward the bottom and from the center to the outside edge of the wound, the removal of tape in this direction stresses the suture line.
An older male client tells the practical nurse (PN) that his religion does not permit him to bathe daily. How should the PN respond? A) state the HCP has prescribed a bath today B) offer the client several choices of times to bathe during the day C) review the importance of hygienic measures to improved health D) request that the client clarify his religious beliefs about bathing
D) request that the client clarify his religious beliefs about bathing
