HESI Adult Health 2025
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Free HESI Adult Health 2025 Questions
A client receiving thyroid replacement therapy following a thyroidectomy is seen in the clinic for a 6-week postoperative check-up. Which assessment is most important for the nurse to obtain?
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A Daily caloric intake.
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B Heart rate and body weight.
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C Report of bowel functioning since surgery.
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D Number of any missed doses of medication.
Explanation
B. Heart rate and body weight.
Monitoring heart rate and body weight is the most important assessment because these indicators reflect whether the thyroid replacement dose is appropriate. Excess thyroid hormone can cause tachycardia, palpitations, and unintentional weight loss, while inadequate dosing can lead to bradycardia and weight gain. At six weeks, the dose may require adjustment, making these measurements essential for identifying under- or overtreatment early.
Patient Data
History and Physical
A male client presents to the emergency department reporting shortness of breath with activity. Symptoms have progressed in severity over the past few weeks. Reports slight shortness of breath at rest and having no past medical history of respiratory issues. Informs that he has been becoming short of breath while walking around his house and that he has not been able to complete his normal routine without taking breaks. Reports he gardens often and the dark areas on his skin are "sunspots."
Nurses' Notes
0900
Assessment
· Cardiovascular: S1, S2 present.
. Respiratory: Significant hig -pitched wheezing to bilateral upper lobes with auscultation. Productive cough with clear sputum present.
· Neurological: Awake, alert, and oriented to person, place, time, and event.
· Gastrointestinal: Bowel sounds noted in four quadrants. Last bowel movement yesterday.
. Genitourinary: Last void reported at 0500.
· Integumentary: Small, flat, dark areas noted on skin.
· Musculoskeletal: Client reports occasional difficulty ambulating.
0915
In bed in a high Fowler's position. He informs he is a current smoker of 1 pack per day for 20 years. He informs he is now retired but worked in a coal factory and currently lives in a shared apartment in a city with a lot of smog. Has no history of heart problems, but says his grandmother had asthma. Denies allergies or recent lung infection.
0930
Healthcare provider (HCP) is at the bedside doing their assessment. Prescriptions are received.
1000
Chest x-ray (CXR) is completed.
1030
Arterial blood gas (ABG) analysis completed. Spirometry completed.
Flow Sheet
0900
Vital signs
· Temperature: 98.6° F (37° C)
· Heart rate: 105 beats/minute
· Respirations: 26 breaths/minute
· Blood pressure: 110/56 mm Hg
· Oxygen saturation: 88% on room air
· Pain: 0 on 0 to 10 scale
Orders
0930
. Chest x-ray (CXR)
. Respiratory therapy (RT) to perform spirometry
· Arterial blood gas (ABG) analysis
Imaging Studies
1000
· Flat diaphragm with hyperinflated lungs on chest x-ray. Indicative of chronic obstructive pulmonary disease (COPD).
The nurse considers educational needs.
Select which items the nurse should include in the discharge education for client with stable chronic obstructive pulmonary disease (COPD). Select all that apply.
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The need to switch to e-cigarettes instead of smoking tobacco cigarettes
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Importance of eating a balanced diet
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Need for influenza and pneumonia vaccination
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Regular exercise
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Supplemental oxygen instructions
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Smoking cessation
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Use of albuterol prior to exercise
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How to use a continuous positive airway pressure (CPAP) device at night
Explanation
The Correct Answers are:
B. Importance of eating a balanced diet
C. Need for influenza and pneumonia vaccination
D. Regular exercise
E. Supplemental oxygen instructions
F. Smoking cessation
G. Use of albuterol prior to exercise
Explanation of the Correct Answers
B. Importance of eating a balanced diet
Clients with COPD expend more energy on breathing and are prone to weight loss and muscle wasting. A balanced diet helps maintain energy, support respiratory muscles, and strengthen immunity.
C. Need for influenza and pneumonia vaccination
Vaccination reduces the risk of respiratory infections, which are a leading cause of exacerbations and hospitalizations in COPD patients. Preventive immunizations are essential in discharge teaching.
D. Regular exercise
Exercise, especially pulmonary rehabilitation or light daily activity like walking, helps improve endurance, reduce dyspnea, and maintain muscle strength. Activity should be balanced with rest to prevent fatigue.
E. Supplemental oxygen instructions
For clients prescribed oxygen, correct use, flow rate, and safety precautions must be taught. Oxygen helps maintain adequate saturation and decreases the risk of complications from chronic hypoxemia.
F. Smoking cessation
Stopping smoking is the most effective way to slow disease progression and improve quality of life. Continuing to smoke accelerates lung damage. Complete cessation, not switching methods, is critical.
G. Use of albuterol prior to exercise
Short-acting bronchodilators like albuterol taken before physical activity reduce exercise-induced dyspnea and improve exercise tolerance, supporting active daily living.
Why the Other Options Are Incorrect
A. The need to switch to e-cigarettes instead of smoking tobacco cigarettes
E-cigarettes are not a safe alternative. They still expose the lungs to harmful chemicals and do not halt COPD progression. Only full smoking cessation is appropriate.
H. How to use a continuous positive airway pressure (CPAP) device at night
CPAP is a treatment for obstructive sleep apnea, not stable COPD. Unless the patient also has diagnosed sleep apnea, CPAP education is not part of COPD discharge teaching.
While changing the dressing of a client who is immobile, the nurse notices the boundary of the wound has increased. Before reporting this finding to the healthcare provider, the nurse should evaluate which of the client's laboratory values?
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Neutrophil count
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Serum potassium and sodium levels
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Platelet count
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C-reactive protein level
Explanation
A. Neutrophil count
An expanding wound boundary suggests possible infection or delayed healing. Neutrophils are the body's primary responders to bacterial infection. An elevated neutrophil count (neutrophilia) indicates acute infection, while a low count (neutropenia) signals impaired ability to fight infection. Because changes in wound size often reflect infection progression, the nurse should check the neutrophil count before reporting to the healthcare provider.
The nurse is caring for a client who reports a sudden, severe headache, and facial numbness. The nurse asks the client to smile and observes an uneven smile with facial droop to the right side and a hand grasp strength that is weaker on the right than the left. The client denies a recent history of headaches or trauma. After obtaining vital signs, the nurse should implement which intervention?
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Obtain a focused history to determine recent bleeding and use of anticoagulants.
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Place an indwelling urinary catheter and measure strict intake and output.
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Administer aspirin to prevent further clot formation and platelet clumping.
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Initiate bilateral intermittent sequential pneumatic compression devices.
Explanation
The Correct Answer is: A. Obtain a focused history to determine recent bleeding and use of anticoagulants
Explanation
The client is exhibiting signs of an acute stroke (sudden severe headache, facial droop, unilateral weakness). Before any antiplatelet or anticoagulant therapy is considered, it is critical to determine whether the stroke is ischemic or hemorrhagic. A focused history—especially regarding recent bleeding or anticoagulant use—guides safe interventions and prevents complications. Administering aspirin or anticoagulants before ruling out hemorrhage could worsen bleeding and lead to life-threatening outcomes.
Why the other options are incorrect:
B. Place an indwelling urinary catheter and measure strict intake and output
While fluid balance may be monitored later, inserting a catheter is not an immediate priority in suspected stroke. Stroke management prioritizes airway, breathing, circulation, and determining stroke type for safe treatment.
C. Administer aspirin to prevent further clot formation and platelet clumping
Aspirin is appropriate in ischemic strokes, but only after hemorrhagic stroke has been ruled out by history and imaging. Giving aspirin before this step could be dangerous if the client has a hemorrhagic stroke.
D. Initiate bilateral intermittent sequential pneumatic compression devices
Compression devices help prevent deep vein thrombosis in immobile clients, but this is a secondary intervention. The immediate priority is confirming stroke type and ensuring safe, timely treatment.
While assessing a client following lithotripsy with stent insertion, which data indicates to the nurse that the procedure was successful?
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A Urine is pale pink with no observable blood clots.
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B Stone fragments are collected when straining the client's urine.
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C Client denies urinary frequency, urgency, or dysuria.
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D Serum creatinine and blood urea nitrogen (BUN) levels are within normal limits.
Explanation
B. Stone fragments are collected when straining the client's urine
The primary goal of lithotripsy is to break renal calculi into smaller fragments that can be passed naturally through the urinary tract. Finding stone fragments in strained urine is the most direct, objective evidence that the procedure successfully fragmented the calculi. This confirms that the treatment achieved its intended therapeutic effect.
A client with rheumatoid arthritis reports persistent fatigue caused by difficulty resting comfortably. The nurse identifies the nursing problem of “Fatigue related to chronic pain and disturbed rest.” Which intervention is most appropriate to add to the client’s plan of care?
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Request a referral for placement in an assisted living facility.
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Reassure the client that the fatigue phase of the illness will soon subside.
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Recommend strict bedrest to promote energy conservation.
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Teach the client how to prioritize daily tasks and pace activities.
Explanation
The Correct Answer is: D. Teach the client how to prioritize daily tasks and pace activities.
Explanation of the Correct Answer
Fatigue in rheumatoid arthritis is chronic and influenced by pain, inflammation, and poor rest. Encouraging the client to prioritize essential activities and balance rest with manageable activity promotes energy conservation and independence. This self-management strategy supports long-term coping and prevents overexertion, aligning with evidence-based care for chronic illness.
Why the Other Options Are Incorrect
A. Request a referral for placement in an assisted living facility
Premature, since most individuals with rheumatoid arthritis manage their condition at home. Assisted living is not a standard fatigue intervention.
B. Reassure the client that the fatigue phase of the illness will soon subside
Fatigue in rheumatoid arthritis is often ongoing and variable. False reassurance minimizes the client’s lived experience and does not offer a realistic coping tool.
C. Recommend strict bedrest to promote energy conservation
Prolonged bedrest worsens joint stiffness, reduces muscle strength, and increases fatigue. Clients benefit more from balancing activity with rest, not complete immobility.
The healthcare provider (HCP) prescribes cefazolin 800 mg IM every six hours. The available vial is labeled “Cefazolin 1 gram,” and the instructions for reconstitution state: for IM use add 2.5 mL sterile water for injection to provide a total volume of 3.0 mL. After reconstitution, the solution contains how many mg/mL? (Enter numerical value only. If rounding is required, round to the nearest whole number.)
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A 333 mg/mL
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B 250 mg/mL
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C 500 mg/mL
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D 100 mg/mL
Explanation
The vial contains 1 gram, which is 1000 mg of cefazolin. After reconstitution, the total volume is 3.0 mL. To find the concentration: 1000 mg ÷ 3.0 mL = 333.33 mg/mL. Rounding to the nearest whole number gives 333 mg/mL. This is the concentration that will be used to calculate the 800 mg IM dose.
After being transferred from the emergency department (ED) to a medical unit, a client vomits into an emesis basin. The nurse observes the emesis as seen in the picture. Which assessment should the nurse complete first?
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A Measure abdominal girth.
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B Observe for flushing.
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C Auscultate breath sounds.
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D Obtain current vital signs.
Explanation
D. Obtain current vital signs
Coffee-ground emesis indicates digested blood, suggesting an active or recent upper GI bleed. The first priority in any bleeding situation is to assess the client's hemodynamic stability. Vital signs provide immediate information about perfusion and potential shock—tachycardia, hypotension, and changes in respiratory rate may indicate ongoing blood loss. This initial assessment guides all urgent interventions and determines whether rapid escalation of care is required.
A client is admitted to the emergency department 5 days after an acute coronary syndrome (ACS) troubled by severe fatigue, muscle weakness, and shortness of breath. The client's electrocardiogram (ECG) indicates sinus tachycardia and the laboratory findings indicate an elevated serum brain natriuretic peptide (BNP) level. Which action is most important for the nurse to implement?
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Insert an indwelling urinary catheter.
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Obtain blood for serum cardiac enzymes.
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Provide emotional support.
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Auscultate lung fields for fine rales.
Explanation
The Correct Answer is: D. Auscultate lung fields for fine rales
Explanation
An elevated BNP level after ACS suggests the development of heart failure, since BNP is released in response to ventricular stretch. Symptoms of fatigue, weakness, and shortness of breath further support this diagnosis. The nurse’s most important action is to auscultate lung fields for fine rales, which indicate pulmonary congestion due to fluid overload. Early recognition of pulmonary edema is critical to preventing respiratory compromise and guiding treatment.
Why the other options are incorrect:
A. Insert an indwelling urinary catheter
Although monitoring output is important in heart failure, catheter insertion is not the priority. First, the nurse must assess for fluid overload and its effects on the lungs before invasive interventions.
B. Obtain blood for serum cardiac enzymes
Cardiac enzymes are most useful for diagnosing acute myocardial infarction. Since the ACS event was 5 days ago, enzyme levels would no longer be diagnostic, and the key concern now is heart failure, not a new infarct.
C. Provide emotional support
Emotional support is always valuable, but it is not the priority when there are objective signs of possible pulmonary edema. Physiological assessment must come before psychosocial interventions.
A client with pancreatitis is receiving 0.9% normal saline, and the prescribed IV infusion rate was increased from 100 mL/hour to 150 mL/hour. Which assessment finding indicates to the nurse that the prescription has a therapeutic outcome?
Reference Range:
Blood glucose: 70 to 110 mg/dL (less than 6.1 mmol/L)
Amylase: 60 to 120 units/dL (30 to 220 units/L)
Blood urea nitrogen (BUN): 10 to 20 mg/dL (3.6 to 7.1 mmol/L)
Hematocrit (HCT): 42% to 52% (0.42 to 0.52 volume fraction)
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A decrease in serum amylase from 24 units/dL (240 units/L) to 12 units/dL (120 units/L).
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An increase in the blood glucose level from 130 mg/dL (7.22 mmol/L).
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An increase in the hematocrit (HCT) from 42% (0.42 volume fraction) to 52% (0.52 volume fraction).
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A decrease in blood urea nitrogen (BUN) from 36 mg/dL (12.9 mmol/L) to 23 mg/dL (8.21 mmol/L).
Explanation
The Correct Answer is: D. A decrease in blood urea nitrogen (BUN) from 36 mg/dL (12.9 mmol/L) to 23 mg/dL (8.21 mmol/L).
Explanation of the Correct Answer
Clients with acute pancreatitis are often hypovolemic due to third spacing and fluid shifts. Increasing IV fluids helps restore intravascular volume and renal perfusion. A therapeutic outcome of fluid resuscitation is improved kidney function, reflected by a decrease in BUN toward the normal range. The drop from 36 to 23 mg/dL demonstrates effective hydration and improved renal clearance, showing the IV therapy is working as intended.
Why the Other Options Are Incorrect
A. A decrease in serum amylase from 24 units/dL (240 units/L) to 12 units/dL (120 units/L)
While amylase levels may decrease with recovery, this change is not directly related to IV fluid therapy. IV fluids primarily correct hypovolemia and improve kidney function, not enzyme levels.
B. An increase in the blood glucose level from 130 mg/dL (7.22 mmol/L)
An increased glucose level indicates worsening pancreatic endocrine function due to impaired insulin secretion. This is a complication, not a therapeutic effect of IV fluids.
C. An increase in the hematocrit (HCT) from 42% (0.42 volume fraction) to 52% (0.52 volume fraction)
An increased hematocrit reflects hemoconcentration, often due to dehydration. If fluids were effective, hematocrit should stabilize or decrease slightly. A rise suggests fluid resuscitation is inadequate, not therapeutic.
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