HESI Adult Health 2025
HESI Adult Health 2025 Exam Review
Boost your exam performance with Ulosca’s HESI Adult Health 2025 review. This guide is designed for nursing students preparing to demonstrate mastery of adult health concepts, clinical judgment, and evidence-based interventions critical for safe, effective nursing practice.
Everything you need to answer with confidence:
- Covers all major HESI Adult Health topics including cardiovascular disorders, respiratory function, endocrine and metabolic regulation, gastrointestinal and renal care, musculoskeletal and neurological disorders, hematology and oncology, infection control, perioperative management, and fluid and electrolyte balance.
- Features timed practice sets with priority-based, case-based, and NCLEX-style questions that mirror the actual HESI Adult Health 2025 exam format.
- Strengthens your ability to identify urgent complications, apply the nursing process, manage complex patient conditions, and prioritize safe interventions in acute and chronic care scenarios.
- Fully aligned with HESI Adult Health course objectives and program outcomes to prepare you for real-world patient care and licensure success.
- Unlimited access for just $30/month.
Join nursing students who rely on Ulosca to sharpen their clinical judgment, build exam confidence, and pass the HESI Adult Health exam — the first time.
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Free HESI Adult Health 2025 Questions
A client with coronary artery disease is hospitalized with unstable angina. To reduce cardiac workload, which intervention should the nurse include in the client's plan of care?
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Provide a bedside commode for toileting.
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Encourage active range of motion exercises.
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Teach to sleep in a side lying position.
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Assist with ambulation in the hallway.
Explanation
The Correct Answer is: A. Provide a bedside commode for toileting.
Explanation of the Correct Answer
A. Provide a bedside commode for toileting
Using a bedside commode instead of walking to the bathroom decreases physical exertion and prevents an increase in oxygen demand on the heart. In unstable angina, reducing cardiac workload is critical to prevent myocardial infarction. This intervention directly conserves energy and supports cardiac rest.
Why the Other Options Are Incorrect
B. Encourage active range of motion exercises
Exercises would increase oxygen demand and cardiac workload, which could worsen angina symptoms. In unstable angina, activity should be minimized until the client is stabilized.
C. Teach to sleep in a side lying position
Side-lying positioning does not significantly reduce cardiac workload. Clients with cardiac issues often benefit more from semi-Fowler’s positioning, which reduces venous return and decreases the heart’s workload, not side-lying.
D. Assist with ambulation in the hallway
Ambulation increases cardiac workload and oxygen consumption, which is unsafe for a client with unstable angina. Bed rest and energy conservation are emphasized until the condition is controlled.
Patient Data
History and Physical
A 59-year-old male client presents to the clinic reporting pain in the right great toe. The client says that the pain feels like it is another attack of gout, which he has had on 2 other occasions in the last 4 months. The client tells the nurses that the pain started about 9 days ago in the evening and that it got very painful and swollen shortly thereafter. In the past, the gout attacks have resolved without treatment after about 5 days, but the client reports that his condition has not improved and that he is unable to walk or work without excruciating pain in the great toe joint. The client has type 2 diabetes mellitus, osteoarthritis, hypertension, obesity, and sleep apnea. Currently, the client takes metformin, aspirin, and enalapril daily. Ibuprofen is taken as needed for pain. The client reports that he has never smoked or used tobacco products. He does not use recreational drugs. Typically, he drinks 2 to 3 dark beers nightly.
Nurses' Notes
0830
Assessment
. Neurological: Within normal limits (WNL).
· Cardiovascular: 1+ edema in bilateral lower extremities.
. Respiratory: Diminished breath sounds in bilateral bases of the lungs.
. Gastrointestinal: WNL.
· Genitourinary: WNL.
. Integumentary: Redness and warmth at the right great toe. On palpation, noted small hard firm deposits under the skin on the right great toe.
. Musculoskeletal: Pain and swelling in right great toe. Great toe is slightly deformed at the joint. Right sided limp present when ambulating.
Flow Sheet
0830
Vital signs
· Temperature: 100.5° F (38.1° C), orally
. Heart rate: 97 beats/minute
· Respirations: 18 breaths/minute
· Blood pressure: 151/87 mm Hg
· Oxygen saturation: 95% on room air
· Height: 5 ft 11 in (180.34 cm)
· Weight: 228 lb (103.4 kg)
· Body mass index (BMI): is 31.8 kg/m2 (normal 18.0 to 24.9 kg/m2)
. Pain: rated 8 on a 0 to 10 scale, in the right foot
Client history has been collected, and the nurse performs a physical assessment and records vital signs. Which finding(s) in the client's health record should the nurse recognize that places the client at a greater risk of developing gout? Select all that apply.
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Osteoarthritis
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Nonsmoker
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Ibuprofen for pain
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Obesity
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Drinks beer nightly
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Type 2 diabetes mellitus
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Sleep apnea
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Daily aspirin
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Hypertension
Explanation
The Correct Answers are: D. Obesity, E. Drinks beer nightly, F. Type 2 diabetes mellitus, H. Daily aspirin, I. Hypertension
Explanation of Correct Answers
D. Obesity
Obesity increases uric acid production and reduces renal clearance, making it a major modifiable risk factor for gout. Excess weight also contributes to metabolic syndrome, which is strongly linked to hyperuricemia.
E. Drinks beer nightly
Alcohol, especially beer, contains purines that are metabolized into uric acid. Frequent alcohol use increases both uric acid levels and the risk of recurrent gout flares.
F. Type 2 diabetes mellitus
Diabetes is associated with insulin resistance, which reduces the kidneys’ ability to excrete uric acid. This directly increases the risk of gout.
H. Daily aspirin
Low-dose aspirin reduces renal excretion of uric acid, raising serum urate levels. Daily use is a well-recognized contributor to gout flares in at-risk clients.
I. Hypertension
High blood pressure is commonly associated with impaired renal function and diuretic use, both of which reduce uric acid clearance and contribute to gout development.
Why the Other Options Are Incorrect
A. Osteoarthritis
While it causes joint pain and deformity, osteoarthritis itself does not increase uric acid levels or gout risk.
B. Nonsmoker
Not smoking is protective for health in general but has no link to increased risk of gout.
C. Ibuprofen for pain
NSAIDs like ibuprofen are actually used as treatment for acute gout flares; they do not increase risk.
G. Sleep apnea
Though associated with obesity and metabolic syndrome, sleep apnea itself is not a direct risk factor for gout.
While assessing a client with type 2 diabetes mellitus (DM), the nurse observes an absence of hair growth on the client's lower legs. Which assessment provides further data to support this finding?
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Presence of bilateral femoral pulses
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Altered posture and balance during ambulation.
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Appearance of the skin on the client's legs.
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Signs of old and new ecchymosis
Explanation
The Correct Answer is: C. Appearance of the skin on the client's legs.
Explanation of the Correct Answer
C. Appearance of the skin on the client's legs
In clients with diabetes, absent hair growth on the lower extremities often suggests peripheral arterial disease (PAD) caused by poor circulation. Examining the skin for additional changes—such as shiny, thin skin, cool temperature, or discoloration—provides supporting evidence of impaired blood flow. These findings help confirm vascular complications of diabetes.
Why the Other Options Are Incorrect
A. Presence of bilateral femoral pulses
Checking femoral pulses assesses circulation in the upper legs but does not directly correlate with distal perfusion where hair loss is noted. Peripheral pulses (pedal or posterior tibial) would be more relevant than femoral pulses.
B. Altered posture and balance during ambulation
Balance and gait disturbances are usually related to neuropathy, musculoskeletal issues, or neurologic problems—not impaired circulation. This does not provide supporting data for hair loss from vascular insufficiency.
D. Signs of old and new ecchymosis
Ecchymosis reflects bleeding or bruising tendencies, which are not directly linked to impaired circulation or hair loss in diabetes. This finding does not confirm vascular insufficiency as the underlying cause.
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?
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Pain when eating.
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Nausea
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Altered taste sensation
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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.
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 nurse is collecting a urine specimen for a client with symptoms related to urethritis. Which collection method should the nurse implement?
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A 24-hour specimen.
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Any specimen voided after drinking adequate fluids.
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First voided specimen in the morning.
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A clean catch specimen.
Explanation
The Correct Answer is: D. A clean catch specimen
Explanation
For suspected urethritis, a clean catch midstream urine specimen is required because it minimizes contamination from surrounding genital tissues and provides the most accurate sample for detecting bacteria, white blood cells, or other indicators of infection. This method ensures diagnostic accuracy for urinary tract infections and urethritis.
Why the other options are incorrect:
A. A 24-hour specimen
A 24-hour collection is used for kidney function studies (e.g., creatinine clearance, proteinuria), not for detecting infection in urethritis.
B. Any specimen voided after drinking adequate fluids
This method risks contamination and dilution, making it less reliable for detecting infection. It is not the recommended approach for urethritis.
C. First voided specimen in the morning
First morning specimens are more concentrated and useful for pregnancy tests or some metabolic studies but are not specific for diagnosing urethritis.
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)]
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Change the plan of care (POC) to include hourly urinary output measurements.
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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.
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.
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.
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?
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Liver function.
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Lipoprotein panel.
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Kidney function.
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Serum glucose.
Explanation
The Correct Answer is: C. Kidney function
Explanation
This client shows signs of diabetic nephropathy: elevated blood pressure, bilateral ankle edema, and long-standing diabetes. Kidney function tests (BUN, creatinine, GFR, urine albumin) are the most important to assess and report because they indicate renal damage, a common complication of diabetes that can progress to chronic kidney disease. Reporting impaired kidney function ensures timely intervention to slow progression.
Why the other options are incorrect:
A. Liver function
Liver function tests are useful for detecting hepatic disease but are not directly tied to the client’s presenting symptoms of hypertension and edema.
B. Lipoprotein panel
A lipid panel is important in diabetes management to assess cardiovascular risk but is not immediately related to ankle edema and hypertension, which point toward renal involvement.
D. Serum glucose
While glucose control is critical in diabetes, an isolated high or low glucose level does not explain the combination of edema and elevated blood pressure. Kidney function is more directly linked to these symptoms.
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HESI Adult Health 2025 – Comprehensive Study Notes
This exam evaluates nursing students’ ability to apply critical thinking, clinical judgment, and evidence-based practice in the care of adult clients with acute and chronic health conditions. Candidates are tested on safe, priority-based nursing interventions, patient education, and recognition of complications across multiple body systems.
Endocrine & Metabolic Disorders
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Management of hypothyroidism and thyrotoxicosis, including recognition of life-threatening complications such as hypoventilation and thyroid storm.
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Monitoring effectiveness of thyroid replacement therapy.
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Nursing priorities in diabetes mellitus management, including insulin therapy, hypoglycemia recognition, and safe interventions.
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Hyperparathyroidism and hypercalcemia: risk for renal calculi, urine straining, and monitoring cardiac complications.
Neurological & Musculoskeletal Disorders
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Recognition and intervention for increased intracranial pressure (ICP) following head trauma.
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Parkinson’s disease: mobility strategies and freezing management.
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Rheumatoid arthritis: fatigue management, pacing of activities, and prioritizing energy conservation.
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Postoperative fracture care: neurovascular checks, pain management, and prevention of complications.
Cardiac & Vascular Disorders
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Prioritizing care for unstable angina and acute coronary syndromes (ACS).
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Identifying lab values that increase risk for dysrhythmias, including potassium and calcium imbalances.
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Use of BNP as an indicator of heart failure progression.
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Risk factors and nursing assessments for deep vein thrombosis (DVT).
Respiratory System
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Evaluation of incentive spirometry effectiveness.
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COPD management: pursed-lip breathing, smoking cessation, supplemental oxygen, and discharge teaching.
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Post-thoracentesis care: recognizing pneumothorax.
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Chest tube drainage monitoring and culture collection for changes in drainage character.
Gastrointestinal & Renal Disorders
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Recognition and immediate response to GI bleeding (coffee-ground emesis, rectal bleeding after colonoscopy).
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Dumping syndrome management following gastric surgery.
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Pancreatitis: fluid resuscitation and monitoring kidney function.
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Lithotripsy: evaluating for successful stone passage.
Safety, Pharmacology, & Procedures
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Preoperative assessments: identifying critical electrolyte imbalances such as hypokalemia.
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Safe IV medication administration and infusion calculations (gtt/min).
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Monitoring myelosuppression: WBC values and infection risk.
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Post-cataract extraction care and eye protection measures.
Clinical Judgment & Nursing Prioritization
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Tanner’s Clinical Judgment Model in decision-making.
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Identifying priority nursing actions in emergent scenarios (shock, seizures, airway compromise).
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Differentiating between urgent complications and routine monitoring needs.
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Using assessment data (labs, vital signs, physical findings) to guide safe interventions.