HESI Adult Health 2025
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Free HESI Adult Health 2025 Questions
The nurse is caring for a client who is dehydrated. Which action by the nurse is the best assessment of the client's hydration status?
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Measure the blood pressure.
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Take the client's temperature.
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Obtain the client's weight.
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Count the pulse rate.
Explanation
The Correct Answer is: C. Obtain the client's weight.
Explanation of the Correct Answer
Daily weight is the most accurate indicator of fluid balance and hydration status. Small changes in body weight reflect fluid gains or losses more precisely than vital signs or temperature. A 1 kg (2.2 lb) weight change corresponds to approximately 1 liter of fluid, making it the best ongoing assessment of hydration in a dehydrated client.
Why the Other Options Are Incorrect
A. Measure the blood pressure
Although hypotension can occur with dehydration, blood pressure is not a reliable or early indicator because it may remain normal until dehydration is severe or accompanied by shock.
B. Take the client’s temperature
Dehydration may cause a low-grade fever, but temperature changes are nonspecific and can also be caused by infection or other conditions. It does not directly measure hydration status.
D. Count the pulse rate
Tachycardia may indicate dehydration, but it is a compensatory response to decreased circulating volume. Like blood pressure, it is not as accurate or consistent as monitoring weight for hydration status.
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.
The nurse reviews discharge instructions with a client who has gastroesophageal reflux disease (GERD). Which instruction is most important for the nurse to emphasize?
- Minimize intake of spicy foods.
- Avoid wearing tight-fitting clothes.
- Begin a smoking cessation program.
- Remain upright following meals.
Explanation
D. Remain upright following meals
Remaining upright for at least 2–3 hours after eating is one of the most critical interventions for GERD management. Gravity helps prevent gastric acid from refluxing into the esophagus. Lying down immediately after meals worsens symptoms, increases acid exposure, and raises the risk for esophagitis. This instruction provides immediate and significant symptom relief, so it must be emphasized as the highest priority lifestyle modification.
A client with chronic obstructive pulmonary disease (COPD) has become extremely dyspneic. After determining that the client is in high-Fowler's position and is receiving oxygen via nasal cannula at 2 liters/minute, which immediate action should the nurse take?
- A Obtain a stat arterial blood gas (ABG).
- B Encourage the client to use pursed lip breathing.
- C Lower the bed to a semi-Fowler's position.
- D Increase the client's oxygen to 6 liters/minute.
Explanation
B. Encourage the client to use pursed lip breathing
Pursed-lip breathing is the fastest and safest immediate intervention for acute dyspnea in a COPD client. This technique prolongs exhalation, prevents airway collapse, reduces air trapping, decreases work of breathing, and improves oxygenation within seconds. It can be done instantly at the bedside and directly relieves dyspnea without risking CO₂ retention or oxygen toxicity.
A client with a large pleural effusion undergoes a thoracentesis. Following the procedure, which observation warrants immediate intervention by the nurse?
Reference Range:
Arterial Blood Gas (ABG)
pH [ 7.35 to 7.45]
PaCO2 [35 to 45 mm Hg]
HCO3- [21 to 28 mEq/L (21 to 28 mmol/L)]
PaO2 [80 to 100 mm Hg]
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The client's arterial blood gas result is a pH 7.35, PaCO₂ 35 mm Hg, HCO₃⁻ 26 mEq (26 mmol/L), PaO₂ 85 mm Hg.
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The client's chest x-ray indicates decreased pleural effusion.
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The client has asymmetrical chest wall expansion.
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The client reports pain at the insertion site.
Explanation
The Correct Answer is: C. The client has asymmetrical chest wall expansion.
Explanation of the Correct Answer
C. The client has asymmetrical chest wall expansion
After a thoracentesis, asymmetrical chest expansion may indicate a serious complication such as pneumothorax, which occurs if air enters the pleural space during the procedure. This requires immediate intervention, including oxygen support and possible chest tube insertion, to prevent respiratory collapse.
Why the Other Options Are Incorrect
A. The client's arterial blood gas result is a pH 7.35, PaCO₂ 35 mm Hg, HCO₃⁻ 26 mEq, PaO₂ 85 mm Hg
These ABG values are within normal limits: normal pH (7.35–7.45), normal PaCO₂ (35–45), normal HCO₃⁻ (21–28), and PaO₂ within acceptable range (80–100). This finding is stable and does not require urgent intervention.
B. The client's chest x-ray indicates decreased pleural effusion
This is an expected and desired outcome of a thoracentesis. The removal of excess fluid allows the lung to re-expand, improving breathing. It does not signal a complication.
D. The client reports pain at the insertion site
Mild pain or discomfort at the site is common and expected after thoracentesis. It should be monitored and treated with analgesics if necessary, but it is not an emergency.
A client with type 2 diabetes mellitus (DM) is admitted to the hospital for uncontrolled DM. Insulin therapy is initiated with an initial dose of insulin isophane (NPH) subcutaneous at 0800. At 1600, the client reports having diaphoresis, rapid heartbeat, and feeling shaky. Which should the nurse do first?
- A Give the client one half cup (120 mL) of fruit juice.
- B Determine the client's current glucose level.
- C Give the client skim milk and crackers.
- D Assess the client's oxygen saturation level.
Explanation
B. Determine the client's current glucose level.
These symptoms—diaphoresis, tachycardia, and shakiness—strongly indicate possible hypoglycemia, which often occurs when NPH peaks around 1600. Before administering carbohydrates, the nurse must confirm the blood glucose level to ensure the symptoms are due to hypoglycemia. This step guides safe and appropriate intervention, prevents overtreatment, and aligns with priority nursing action: assess before implementing.
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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reactive protein level.
Explanation
The Correct Answer is: A. Neutrophil count
Explanation
An enlarging wound boundary suggests possible infection or worsening inflammation. Neutrophils are the primary white blood cells that respond to bacterial infection. Evaluating the neutrophil count helps determine if infection is contributing to wound progression. Elevated neutrophils would support an acute infection, while a low count may indicate impaired immune response, both critical for guiding the provider’s management plan.
Why the other options are incorrect:
B. Serum potassium and sodium levels
Electrolyte levels are important for overall health and healing but do not directly reflect infection or wound progression. They are not the priority in this scenario.
C. Platelet count
Platelets are involved in clotting and wound healing, but changes in wound boundary are more indicative of infection or inflammation than clotting dysfunction. Platelet count is not the most relevant lab here.
D. C-reactive protein level
CRP is a nonspecific marker of inflammation. While it may be elevated in infection, it is less specific than evaluating the neutrophil count, which directly indicates the body’s immune response to possible infection.
A client who has had diabetes for the past 10 years has an elevated blood pressure and bilateral ankle edema. Which laboratory result should the nurse report to the healthcare provider?
- Liver function
- Lipoprotein panel
- Kidney function
- Serum glucose
Explanation
C. Kidney function
A client with long-standing diabetes who presents with hypertension and bilateral ankle edema is showing classic signs of diabetic nephropathy, a form of chronic kidney disease. The kidneys regulate fluid and blood pressure, so decreased kidney function leads to fluid retention (edema) and increased blood pressure. Reporting kidney function results—such as serum creatinine, BUN, and estimated GFR—is essential because worsening kidney function can progress to renal failure if unaddressed.
A client with chronic venous insufficiency is being discharged from the hospital, and plans to return home. Which client statement indicates an understanding of home care instructions?
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"I will avoid sitting and crossing my legs."
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"I will lift weights every other day."
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"I will be able to stand as long as my legs do not hurt."
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"I will need to get someone to walk my dog."
Explanation
The Correct Answer is: A. "I will avoid sitting and crossing my legs."
Explanation
Chronic venous insufficiency requires lifestyle modifications that improve venous return and reduce venous stasis. Avoiding prolonged sitting and crossing legs helps prevent impaired circulation, swelling, and worsening of venous insufficiency. This statement shows correct understanding of home care instructions.
Why the other options are incorrect:
B. "I will lift weights every other day."
Weightlifting is not specifically recommended and may strain circulation if not balanced with leg elevation and walking. Exercise is beneficial, but the focus should be on activities that enhance venous return, such as walking, not heavy lifting.
C. "I will be able to stand as long as my legs do not hurt."
Prolonged standing worsens venous pooling and swelling even if no pain is present. Patients should avoid standing for extended periods to prevent progression of venous disease.
D. "I will need to get someone to walk my dog."
Walking is actually encouraged because it activates the calf muscle pump, promoting venous return. Clients with venous insufficiency should remain active with regular walking, not avoid it.
The nurse is evaluating a client's symptoms, and formulates the nursing problem, "High risk for injury due to potential urinary tract infection." Which symptoms indicate the need for this nursing problem?
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Straining on urination and nocturia.
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Hematuria and proteinuria.
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Azotemia and anorexia.
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Fever and dysuria.
Explanation
The Correct Answer is: D. Fever and dysuria.
Explanation of the Correct Answer
D. Fever and dysuria
These are classic symptoms of a urinary tract infection (UTI). Dysuria indicates irritation and inflammation of the urinary tract, while fever suggests a systemic response to infection. Together, they confirm the risk of injury related to infection and justify the nursing problem identified. Prompt recognition ensures early treatment to prevent complications such as pyelonephritis or sepsis.
Why the Other Options Are Incorrect
A. Straining on urination and nocturia
These symptoms are more consistent with bladder outlet obstruction, often related to benign prostatic hyperplasia (BPH), not necessarily a UTI. While bothersome, they do not directly indicate infection risk.
B. Hematuria and proteinuria
Blood and protein in the urine are more characteristic of glomerular disease (e.g., glomerulonephritis) or renal pathology, not a straightforward urinary tract infection.
C. Azotemia and anorexia
Azotemia is an elevation of nitrogenous waste in the blood, usually seen in renal failure. Anorexia often accompanies renal dysfunction. These findings suggest chronic kidney disease rather than a urinary tract infection.
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