HESI Adult Health 2025
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Free HESI Adult Health 2025 Questions
A client with heart failure (HF) returns to the clinic two weeks after adjustments were made to the prescribed cardiac glycoside, diuretic, and potassium supplement. The client's lungs are clear, heart rate is 58 beats/minute, and serum potassium level is 2.9 mEq/L (2.9 mmol/L). Which action is most important for the nurse to implement?
Reference Range:
Potassium (K⁺) [3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]
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Check the pretibial areas and ankles for edema.
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Report serum potassium to healthcare provider (HCP).
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Compare the weight with what it was at last visit.
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Review the dietary history from the past week.
Explanation
The Correct Answer is: B. Report serum potassium to healthcare provider (HCP).
Explanation of the Correct Answer
B. Report serum potassium to healthcare provider (HCP)
The potassium level of 2.9 mEq/L indicates hypokalemia, which is below the normal range of 3.5–5.0 mEq/L. In a client taking a cardiac glycoside such as digoxin, hypokalemia greatly increases the risk of digoxin toxicity and life-threatening dysrhythmias. Promptly reporting this abnormal lab value to the provider ensures that urgent corrective action, such as potassium replacement or medication adjustment, can be taken.
Why the Other Options Are Incorrect
A. Check the pretibial areas and ankles for edema
Edema assessment is useful for monitoring fluid balance in HF, but it is not the most urgent action. The immediate danger lies in the critically low potassium level, which can cause arrhythmias.
C. Compare the weight with what it was at last visit
Daily weight is an important indicator of fluid status in HF, but this is not as urgent as addressing severe hypokalemia, which presents an immediate cardiac risk.
D. Review the dietary history from the past week
Dietary review may help identify causes of hypokalemia, but it is not the priority. The nurse must first report the abnormal potassium result so treatment can begin quickly.
Two weeks following a Billroth II (gastrojejunostomy), a client develops nausea, diarrhea, and diaphoresis after every meal. When the nurse develops a teaching plan for this client, which expected outcome statement is the most relevant?
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Client describes a schedule for antacid use with other prescribed medications.
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Client agrees to participate in a variety of stress reduction techniques
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Client selects a pattern of small meals alternating with fluid intake
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Client expresses a willingness to reduce nicotine intake
Explanation
The Correct Answer is: C. Client selects a pattern of small meals alternating with fluid intake.
Explanation of the Correct Answer
Dumping syndrome is a common complication after a Billroth II procedure. Food moves too quickly into the small intestine, causing nausea, diarrhea, diaphoresis, and sometimes dizziness after meals. The most effective strategy is dietary modification: eating small, frequent meals, avoiding fluids with meals, and lying down briefly after eating to slow gastric emptying. By selecting a pattern of small meals alternating with fluid intake, the client adopts behaviors that directly reduce dumping syndrome symptoms and improve nutritional absorption.
Why the Other Options Are Incorrect
A. Client describes a schedule for antacid use with other prescribed medications
Antacids may be used to reduce gastric irritation, but they do not address the pathophysiology of dumping syndrome. The client’s symptoms are best managed through dietary changes, not antacid scheduling.
B. Client agrees to participate in a variety of stress reduction techniques
While stress can worsen gastrointestinal symptoms, dumping syndrome is caused by altered gastric emptying after surgery, not stress. Stress reduction may help overall well-being, but it does not resolve the client’s core postoperative complication.
D. Client expresses a willingness to reduce nicotine intake
Nicotine cessation is beneficial for overall healing and health, but it does not directly alleviate the rapid emptying and fluid shifts responsible for the symptoms. Thus, while advisable, it is not the most relevant expected outcome for this situation.
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.
The client's laboratory results indicate that the serum potassium level is 2.5 mEq/L (2.5 mmol/L). Which action should the nurse take?
Reference Range:
Potassium (K⁺) [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]
-
Change the plan of care (POC) to include hourly urinary output measurements.
-
Inform the healthcare provider (HCP) of the need for potassium replacement.
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Prepare to administer a glucose, then insulin, then potassium infusion.
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Instruct the client to increase daily intake of potassium rich foods.
Explanation
The Correct Answer is: B. Inform the healthcare provider (HCP) of the need for potassium replacement.
Explanation of the Correct Answer
B. Inform the healthcare provider (HCP) of the need for potassium replacement
A potassium level of 2.5 mEq/L represents severe hypokalemia, which places the client at high risk for life-threatening dysrhythmias and muscle weakness. This requires urgent correction with IV or oral potassium as ordered by the healthcare provider. Prompt reporting ensures immediate treatment to restore potassium to a safe range.
Why the Other Options Are Incorrect
A. Change the plan of care (POC) to include hourly urinary output measurements
While urine monitoring is important in clients receiving potassium, this action does not address the immediate danger of severe hypokalemia. Replacement therapy is the priority.
C. Prepare to administer a glucose, then insulin, then potassium infusion
This protocol is used to treat hyperkalemia, not hypokalemia. Giving insulin and glucose would further lower potassium levels and worsen the problem.
D. Instruct the client to increase daily intake of potassium rich foods
Dietary changes are helpful for mild hypokalemia or long-term management but are not sufficient for a dangerously low potassium level of 2.5 mEq/L. Immediate replacement therapy is required.
The nurse includes the problem of "Risk for infection" in the plan of care (POC) for a client with myelosuppression. Which laboratory value provides the greatest support for this nursing problem?
- A Red blood cell count of 3.5 × 10⁶/µL (3.5 × 10¹²/L)
- B White blood cell count of 1,500/mm³ (1.5 × 10⁹/L)
- C Hemoglobin of 10 g/dL (100 g/L)
- D Hematocrit of 33% (0.33 volume fraction)
Explanation
B. White blood cell count of 1,500/mm³
A WBC count this low indicates severe leukopenia, a hallmark of myelosuppression and the most direct indicator of high infection risk. When WBCs fall below 2,000/mm³, the immune system cannot effectively defend against pathogens. The client is highly susceptible to opportunistic infections and may require neutropenic precautions. This lab value most strongly supports the nursing problem “Risk for infection.”
A client admitted with thyrotoxicosis is reporting a "pounding heart in the chest." Which assessment finding warrants immediate intervention by the nurse?
- A Fever.
- B Dyspnea.
- C Hyperglycemia.
- D Anxiety.
Explanation
B. Dyspnea.
Dyspnea in a client with thyrotoxicosis indicates possible cardiovascular compromise, such as severe tachycardia or impending thyroid storm. Difficulty breathing suggests decreased oxygenation caused by an overactive metabolic state stressing the heart. Because airway and breathing are always top priority, dyspnea requires immediate assessment and intervention to prevent respiratory failure or circulatory collapse.
The nurse is evaluating the effectiveness of the incentive spirometer implemented in the client's plan of care. Which outcome statement best describes the effectiveness of the incentive spirometer?
- A Client exhibits a frequent productive cough.
- B Client demonstrates proper use of an incentive spirometer.
- C Client's breath sounds are clear to auscultation bilaterally.
- D Client reports using the incentive spirometer every hour while awake.
Explanation
C. Client's breath sounds are clear to auscultation bilaterally
The purpose of an incentive spirometer is to improve lung expansion, prevent atelectasis, and enhance ventilation. The best indicator of effectiveness is improved respiratory status, demonstrated by clear breath sounds. This shows that alveoli are open, lung inflation has improved, and airway secretions are reduced—reflecting the desired therapeutic outcome of incentive spirometry.
The nurse has determined that a client with trigeminal neuralgia has the nursing problem, “Imbalanced nutrition, less than body requirements.” Which cause is most likely contributing to the problem?
- Pain when eating.
- Nausea.
- Altered taste sensation.
- Fatigue.
Explanation
A. Pain when eating
Trigeminal neuralgia causes sudden, intense, stabbing facial pain triggered by activities such as chewing, talking, brushing teeth, touching the face, or even exposure to wind. Because chewing often provokes severe pain, clients commonly avoid eating, which quickly leads to insufficient caloric intake and weight loss. Pain during meals is the primary and most direct contributor to imbalanced nutrition in trigeminal neuralgia.
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.
The nurse has determined that a client with trigeminal neuralgia has the nursing problem, "Imbalanced nutrition, less than body requirements." Which cause is most likely contributing to the problem?
-
Pain when eating.
-
Nausea
-
Altered taste sensation
-
Fatigue
Explanation
The Correct Answer is: A. Pain when eating
Explanation
Trigeminal neuralgia is characterized by sudden, severe facial pain triggered by routine activities such as chewing, swallowing, or even light touch. Because eating can precipitate intense pain, clients often avoid food intake, leading to poor nutritional status. Thus, pain with eating is the most direct and likely cause of imbalanced nutrition in these clients.
Why the other options are incorrect:
B. Nausea
Nausea is not a typical symptom of trigeminal neuralgia. It may contribute to poor intake in other conditions but is not relevant to this diagnosis.
C. Altered taste sensation
Taste disturbances are not common in trigeminal neuralgia. The disorder affects sensory nerve fibers of the face, not taste pathways.
D. Fatigue
While chronic pain can cause fatigue, it is not the main reason patients avoid eating. Pain during eating itself is the most direct cause of reduced nutrition.
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