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?
- A Daily caloric intake.
- B Heart rate and body weight.
- C Report of bowel functioning since surgery.
- 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.
The nurse assists a client with Parkinson's disease (PD) to ambulate in the hallway. The client appears to "freeze" and then carefully lifts one leg and steps forward. The client tells the nurse he is pretending to step over a crack on the floor. How should the nurse respond?
- Confirm that this is an effective technique to help with ambulation.
- Assist the client to a carpeted area where he can walk more easily.
- Plan to assess the client's cognition after returning to his room.
- Reorient the client to his present location and circumstances.
Explanation
A. Confirm that this is an effective technique to help with ambulation.
Clients with Parkinson’s disease often experience freezing episodes when walking. Visual cues—such as imagining a line or crack on the floor—are well-known rehabilitation strategies that help break the freeze and improve gait initiation. This technique is safe, evidence-based, and commonly recommended by physical therapists. The nurse should reinforce this positive coping strategy to promote independence and mobility.
An adult client is admitted to the medical unit due to rectal bleeding after a colonoscopy in which a polyp was biopsied and cauterized. Which intervention should the nurse do first?
- A Encourage cough and deep breathing exercises.
- B Palpate all peripheral pulses in the extremities.
- C Initiate measurement of fluid intake and output.
- D Complete a focused assessment of the abdomen.
Explanation
D. Complete a focused assessment of the abdomen
Rectal bleeding after a colonoscopy with biopsy and cauterization can indicate post-procedural complications, such as perforation or significant hemorrhage. The nurse’s first priority is to perform a focused abdominal assessment to evaluate for distention, rigidity, guarding, bowel sounds, and pain—all key indicators of intra-abdominal bleeding or perforation. This assessment guides urgency, interventions, and notification of the healthcare provider.
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.
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 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.
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 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.
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.
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Begin a smoking cessation program.
-
Remain upright following meals.
Explanation
The Correct Answer is: D. Remain upright following meals
Explanation
The most important lifestyle modification for clients with GERD is to remain upright after meals. This reduces the risk of gastric contents refluxing into the esophagus by using gravity to aid gastric emptying. Patients are usually advised to sit upright for at least 2–3 hours post-meal. While diet, clothing, and smoking cessation are all helpful, positioning directly prevents immediate reflux and discomfort.
Why the other options are incorrect:
A. Minimize intake of spicy foods
Avoiding spicy foods can reduce irritation of the esophagus and lessen symptoms, but it does not address the direct mechanism of reflux as effectively as maintaining an upright position after meals.
B. Avoid wearing tight fitting clothes
Tight clothing around the abdomen increases intra-abdominal pressure, worsening reflux. This is useful advice, but it is less critical than upright positioning after meals, which directly prevents reflux events.
C. Begin a smoking cessation program
Smoking cessation is important for long-term health and can reduce acid production and esophageal irritation. However, it is not the immediate priority for controlling reflux symptoms compared to positional changes.
A client with hyperparathyroidism reports a sudden onset of severe flank pain. Which intervention should the nurse include in the client's plan of care (POC)?
- A Administer a PRN dose of a laxative.
- B Initiate cardiac telemetry.
- C Begin straining all urine.
- D Implement seizure precautions.
Explanation
C. Begin straining all urine
Hyperparathyroidism causes increased secretion of parathyroid hormone, which raises serum calcium levels. Chronic hypercalcemia leads to the formation of renal calculi (kidney stones). The client’s sudden, severe flank pain is classic for a stone moving through the urinary tract. Straining all urine is critical to capture stone fragments for analysis, confirm the diagnosis, and guide future treatment.
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