HESI FUNDS practice questions

Which diagnostic study using radioisotope is used to detect increased metastatic activity? A) MRI B) Ultrasound C) Bone Scan D) Barium swallow

b. bone scan Rationale: Of the choices listed, only bone scan involves the use of a radioisotope to detect increased metastatic activity. MRI, ultrasound, and barium swallow may be used to detect metastatic activity, but these procedures do not involve the use of radioisotopes.

A nurse receives reports on the following clients. Which client should the nurse assess first? A) 25-year-old male client with a hemoglobin of 15.9 B) 56-year-old female client on warfarin C) 38-year-old female client with a serum calcium level of 9.4 D) 45-year-old male client with a BUN of 20 and a creatinine of 1.1

??? B) 56-year-old female client on warfarin

A client has a sacral pressure ulcer that is receiving wet-to-dry dressings. Which statement is most accurate regarding the rationale for this type of dressing? A) An occlusive dressing should cover the wet dressing. B) The wet-to-dry dressing should be tightly packed into the wound. C) The dressing should be allowed to dry completely before removal. D) A wet-to-dry dressing will provide mechanical debridement of this wound.

??? D) A wet-to-dry dressing will provide mechanical debridement of this wound.

Which term would a nurse use to best describe loss of hair in a small, round area on the scalp? A) Alopecia B) Extropia C) Amblyopia D) Seborrhea

A) Alopecia

A 55-year-old female client is receiving a course of outpatient chemotherapy and tells the nurse she feels lonely and isolated. The client further expresses to the nurse that she wants to resume some of her normal activities, such as socialization with friends. Which precaution should the nurse advise the client to take when she begins to resume these activities? A) Avoid crowds B) Drink only bottled water C) Do not eat outside your home D) Use only your own bathroom

A) Avoid crowds

Which nursing action should be performed first when caring for the client who has just sustained a fracture? A) Immobilize the affected extremity B) Administer pain medication C) prepare for immediate surgery E) Place the injured extremity in traction

A) Immobilize the affected extremity

A client with limited mobility is ready for discharge. Which instruction should the nurse emphasize with the client to prevent urinary stasis and formation of renal calculi? A) Increase oral fluid intake to 2 to 3 L per day B) Maintain bed rest after discharge C) Limit fluid intake to 1 L/day D) Void at least every hour

A) Increase oral fluid intake to 2 to 3 L per day

The nurse is assessing an edematous client and is aware that edema occurs in what extracellular fluid compartment? A) Interstitial B) Intercellular C) Intravascular D) Intracellular

A) Interstitial Rationale: Edema is defined as the accumulation of fluid in the interstitial spaces. The incorrect answer options occur in other compartments: intercellular means between or among cells; intravascular means within a vascular space; and intracellular means within a cell.

Which description is most accurate regarding a deep partial-thickness burn? A) Painful with weeping blisters B) Minimal damage to the epidermis C) Necrotic tissue through all layers of the skin D) Charring visible in the deepest areas

A) Painful with weeping blisters Rationale: A deep partial-thickness burn involves the epidermal and dermal layers of the skin. It is characterized by a wet, shiny, weeping surface marked by blisters and is painful and very sensitive to the touch. Necrosis and charring are seen with a full-thickness burn. Redness and pain with minimal damage to the epidermis are characteristics of a superficial, or first-degree, burn.

When a client who has MS has an exacerbation of sensory deficits, which nursing diagnostic statement should be assigned highest priority? A) Risk for Injury B) Fluid Volume deficit C) Acute Confusion D) Ineffective Thermoregulation

A) Risk for Injury

The client asks the nurse to recommend foods that might be included in a diet for diverticular disease. Which foods would be appropriate to include in the teaching plan? (Select all that apply.) A) Whole grains B) Cooked fruits and vegetables C) Nuts and seeds D) Red meat E) Milk and eggs

A) Whole grains B) Cooked fruits and vegetables C) Nuts and seeds

While caring for a client with a fractured hip, the nurse should place pillows around the injured leg to specifically maintain: A) abduction B) adduction C) traction D) elevation

A) abduction

A nurse is collecting health history information on a newly admitted female client who states "I had cancer in the cartilage of my left leg." The nurse would suspect this type of malignancy found in connective tissue to be: A) sarcoma B) osteoma C) adenoma D) myeloma

A) sarcoma

What are the best ways for a nurse to be protected legally? (Select all that apply) A) Follow the hospitals policy and procedure whenever possible B) Establish a therapeutic relationship with all clients and families C)Provide care within the parameters of the states nurse practice act D) Carry at least $100,000 worth of liability insurance E) Document consistently and objectively F) Clearly documents a client's nonadherence to the medical regimen.

A, C, E, F - Provide care within the parameters of the state's nurse practice act. - Document consistently and objectively. - Clearly document a client's non-adherence to the medical regimen. Malpractice or negligence must be proven legally. If a nurse is providing the best possible care under the circumstances, and within the scope of nursing practice, it would be difficult to prove allegations of malpractice. It is unrealistic that the nurse will have a therapeutic relationship with all clients. Liability insurance protects the nurse if found guilty and a monetary award is made, but it does not reduce the possibility of litigation. Consistent, objective, and clear documentation also support practice within legal parameters.

A client with a history of severe diarrhea for the past 3 days is admitted for dehydration. Which intravenous solution would the nurse anticipate the healthcare provider to order initially for this client? A) 3% sodium chloride B) 0.9% sodium chloride C) 5% dextrose and 0.9% sodium chloride D) 5% dextrose and lactated ringers

B) 0.9% sodium chloride

A nurse assesses a client and determines that he has a closed soft tissue injury. Which term might the nurse use to describe the injury? A) An abrasion B) A contusion C) A laceration D) An avulsion

B) A contusion

A client has an elevated ammonia level and has developed hepatic encephalopathy. Which assessment finding would the nurse note during a physical examination? A) Aphasia B) Asterixis C) Hyperactivity D) Acute dementia

B) Asterixis Rationale:Asterixis is a twitching spasm of the hands and wrists seen in patients with increased ammonia levels in conditions such as hepatic encephalopathy. Aphasia, hyperactivity, and acute dementia are manifestations not associated with hepatic encephalopathy. Besides asterixis, an increased serum ammonia level causes sedation and confusion that progress to a comatose state.

Which of the following conditions would a nurse suspect if a client's T3 and T4 cells were decreased and the TSH level increased? A) Hypoparathyroidism B) Hypothyroidism C) Hyperthyroidism D) Hyperparathyroidism

B) Hypothyroidism

A client is diagnosed with osteomyelitis and asks the nurse what the most effective treatment is for this problem. The nurse should explain that osteomyelitis is best managed with: A) traction B) IV antibiotics C) oral antibiotics D) pain medications

B) IV antibiotics

A client with COPD reports steady weight loss and that he is too tired to eat. Which nursing diagnosis would be most appropriate for this client? A) Fatigue related to weight loss secondary to COPD. B) Imbalanced nutrition: less than body requirements, related to fatigue C) Imbalanced nutrition: less than body requirements, related to COPD. D) Ineffective breathing pattern, related to alveolar hypoventilation

B) Imbalanced nutrition: less than body requirements, related to fatigue

Which nursing intervention is most important for a client with diabetes insipidus? A) Performing proper diet education B) Monitor strict fluid intake and output C) Assess for constipation daily D) Measuring a fingerstick blood glucose level

B) Monitor strict fluid intake and output Rationale: Maintaining adequate fluid and replacing vasopressin are the main objectives in treating diabetes insipidus. An excess of antidiuretic hormone leads to SIADH, causing the patient to retain fluid.

The nurse is caring for a client who is hyperventilating: the nurse know this puts the client at risk for which of the following disorders? A) Respiratory acidosis B) Respiratory alkalosis C) Respiratory compensation D) Respiratory decompensation

B) Respiratory alkalosis

A client is receiving a unit of packed red blood cells (PRBC). The client experiences tingling in the fingers and headache. What is the nurse's priority action? A) Call the physician B) Stop the transfusion C) Slow the infusion rate D) Assess the IV site for infiltration

B) Stop the transfusion Rationale: Tingling in the fingers and headache may be an indication of an adverse reaction to the transfusion. The infusion should be stopped, and normal saline should be used to KVO. The client should be assessed—including vital signs—then the physician should be notified.

A client questions the nurse regarding osteoarthritis. The nurse explains that osteoarthritis involves a process that is: A) malignant B) degenerative C) inflammatory D) immunological

B) degenerative

A nurse is caring for a client who has sustained burns covering the entire surface of both arms, the anterior trunk and the right leg. The nurse uses the rule of nines to estimate the percentage of the burn surface area to be: A) 27% B) 36% C) 54% D) 72%

C) 54% both arms on the front and back (18%) front and back of the right leg (18%), anterior trunk (18%)

The nurse receives a report on a newly admitted client who is positive for Clostridium difficile. Which category of isolation would the nurse implement for this client? A) Airborne precautions B) Droplet precautions C) Contact precautions D) Protective environment

C) Contact precautions

A nurse is assessing a client with osteoarthritis. What would be an expected finding with this disorder? A) Fever and malaise B) Morning stiffness of all joints C) Crepitation in the weight-bearing joints D) Elevated erythrocyte sedimentation rate

C) Crepitation in the weight-bearing joints Rationale: Osteoarthritis primarily affects the weight-bearing joints; therefore crepitation (a cracking or clicking sound heard in joint movement) may be present in affected individuals. Fever and malaise and increased erythrocyte sedimentation rate are manifestations of rheumatoid arthritis. Morning stiffness may appear in OA but usually resolves within 30 minutes instead of lasting all day.

Which of the following nursing diagnoses is correct for a nonambulatory client with a reddened sacrum that is unrelieved by repositioning? A) Risk for pressure ulcer B) Risk for impaired skin integrity C) Impaired skin integrity, related to infrequent turning and repositioning. D) Impaired skin integrity, related to the effects of pressure and shearing force.

C) Impaired skin integrity, related to infrequent turning and repositioning.

A client had a liver biopsy performed. The nursing action of highest priority to prevent post procedure hemorrhage would be to place the client: A) Supine and flat in bed B) In a sitting position C) On the right side D) On the left side

C) On the right side Rationale: think about the principles of anatomy, physiology, and pathophysiology. What do you do to prevent hemorrhage? You apply pressure. Where would you apply pressure? On the liver. Where is the liver? On the right side of the abdomen under the ribs.

A nurse is assessing a client who is suspected of having lung cancer. Which symptom is the client most likely to report as developing first? A) Chest pain B) Diaphoresis C) Persistent cough D) Low-grade fever

C) Persistent cough

A high-protein diet is recommended for a client recovering from a fracture. What is the rationale for a high-protein diet? A) Promotes gluconeogenesis B) Has an anti-inflammatory effect C) Promotes cell growth and bone union D) Decreases pain medication requirements

C) Promotes cell growth and bone union Rationale: There is an increased need for protein with any type of body tissue trauma. High protein intake in the client with a fractured bone promotes cell growth and therefore bone union. Intake of a high protein diet during recovery from a bone fracture is not related to gluconeogenesis, inflammation, or pain.

Which clinical manifestation would be observed in both ulcerative colitis and Crohn's disease? A) Vomiting B) Hypocalcemia C) Rectal bleeding D) Weight loss

C) Rectal bleeding

During the assessment of a newly admitted client, a nurse collects the following data. Which finding in this client would the nurse consider a classic sign of pernicious anemia? A) Diarrhea B) Indigestion C) Red, beefy tongue D) Flushed skin

C) Red, beefy tongue

A client with cancer is receiving chemotherapy treatment in the oncology clinic. The nurse suspects an IV infiltration of mechlorethamine hydrochloride (Mustargen). What action should the nurse take immediately? A)Slow the infusion and monitor the site hourly B) Stop the infusion and leave the IV cannula in place. C) Stop the infusion and remove the IV line D) Continue the infusion and monitor the vital signs

C) Stop the infusion and leave the IV cannula in place. Rationale: Infiltration of chemotherapy agents will cause tissue damage, and mechlorethamine (Mustargen) is destructive to tissues. The IV infusion needs to be stopped, but the cannula is left in place so that the extravasation antidote, 10% sodium thiosulfate in sterile water can be administered.

Which outcome would indicate that a client with advanced cirrhosis is experiencing a serious complication? A) Elevated blood glucose B) Urinary retention C) frequent nosebleeds and bruising D) No bowel movement in 3 days

C) frequent nosebleeds and bruising Rationale: The liver produces clotting factors. As cirrhosis becomes more advanced, the production of clotting factors is disrupted and thereby decreased, making the patient more susceptible to bleeding. Increasing frequency and severity of nosebleeds and bruising would indicate a deterioration in liver function. Urine retention, abnormal blood glucose, and constipation are not directly associated with advanced cirrhosis.

The nurse understands that the action of antidiuretic hormone (ADH) is to: A) reduce blood volume B) decrease water loss in urine C) increase urine output D) initiate the thirst mechanism

C) increase urine output

Which of the following legal defenses is the most important for the nurse to develop? A) Dedication B) Certification C) Assertiveness D) Accountability

D) Accountability

When assessing a client with suspected hepatitis A, a nurse would expect the client to report the development of which of the following symptoms first? A) Ascites B) Itching C) Jaundice D) Anorexia

D) Anorexia

A nurse applies a cold pack to treat an acute musculoskeletal injury. Cold therapy decreases pain by which of the following actions? A) Promotes analgesia and circulation B) Numbs the nerves and dilates the blood vessels C) Promotes circulation and reduction of muscle spasms D) Causes local vasoconstriction, prevents edema and muscle spasm

D) Causing local vasoconstriction, preventing edema and muscle spasms Rationale: Cold causes the blood vessels to constrict, which reduces the leakage of fluid into the tissues and prevents swelling and therefore muscle spasms. Cold does promote analgesia but not circulation. It may numb nerves but does not dilate blood vessels. Cold therapy also may numb the nerves and surrounding tissues, thus reducing pain.

A nurse preparing to apply restraints to a client should understand which of the following principles? A) The law prohibits restraining clients without a written order. B) Charges of felony may be leveled against nurses who use restraints improperly C) Nurses are not obligated to report institutions that use restraints unlawfully D) Charges of assault and battery may be leveled against nurses who use restraints improperly

D) Charges of assault and battery may be leveled against nurses who use restraints improperly

A nurse is caring for a client who suffered multiple traumas and has received multiple blood transfusions. As a result of the transfusions, the nurse should monitor the client for which sign? A) Hyponatremia B) Hypernatremia C) Hypercalcemia D) Hypocalcemia

D) Hypocalcemia Rationale: Recipients of massive transfusions may therefore develop electrolyte disturbances, with hypocalcemia, hypomagnesemia, and hyperkalemia most commonly reported.

A nurse is evaluating a 20-year-old female client who states she twisted her ankle while walking down steps. Besides edema, which of the following symptoms would most likely be observed if a nondisplaced simple fracture is present? A) Numbness, coolness and loss of pulse B) Loss of sensation, redness and warmth C) Coolness, redness and inability to bear weight D) Redness, warmth and inability to use the affected part

D) Redness, warmth and inability to use the affected part

When assessing a client suspected of having Cushing syndrome, the nurse is aware that the most prominent clinical manifestation is: A) dehydration and hypotension B) bulking of skeletal muscles C) hypoglycemia with intense hunger D) weight gain with truncal obesity

D) weight gain with truncal obesity Rationale: The most prominent clinical manifestation in Cushing's syndrome is weight gain leading to truncal obesity, with a characteristic rounded "moon face" and fat deposits in the neck and upper back, also known as a "buffalo hump." Cushing syndrome's results from an overproduction of adrenocorticosteroids or large doses of steroid medication. Dehydration and hypotension, bulking of skeletal muscle, and hypoglycemia with intense hunger are not directly associated with Cushing's syndrome.