HESI Adult Health 2025
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Free HESI Adult Health 2025 Questions
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 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.
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.
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.
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 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.
Which set of actions, parameters to monitor, and potential condition is most appropriate?
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A
Actions: Apply pressure-reduction mattress; Request service of wound care nurse
Parameters to Monitor: Progression of wound; Adherence to repositioning schedule
Condition: Poor healing of stage 2 pressure injury -
B
Actions: Insert indwelling urinary catheter; Ambulate every four hours
Parameters to Monitor: Temperature; Laboratory studies for malnutrition status
Condition: Immobility -
C
Actions: Begin enteral feedings; Sterile dressing changes
Parameters to Monitor: Progression of wound; Temperature
Condition: Malnutrition -
D
Actions: Apply pressure-reduction mattress; Begin enteral feedings
Parameters to Monitor: Laboratory studies for malnutrition status; Adherence to repositioning schedule
Condition: Dehydration
Explanation
The client has a stage 2 pressure injury with significant risk factors according to the Braden Scale (low sensory perception, decreased mobility, poor nutrition, friction/shear). The most appropriate actions focus on preventing further skin breakdown and promoting wound healing. Using a pressure-reduction mattress reduces pressure on the trochanter, and consulting a wound care nurse ensures specialized management. Monitoring wound progression and adherence to repositioning verifies both treatment effectiveness and preventative efforts, directly addressing the condition of poor wound healing.
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?
- A Measure abdominal girth.
- B Observe for flushing.
- C Auscultate breath sounds.
- 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.
The nurse establishes a nursing problem, "Fatigue related to inability to rest comfortably secondary to rheumatoid arthritis."
Which nursing intervention should the nurse include in the plan of care (POC) for this client?
- A. Consult the discharge planner about transferring the client to an assisted living center.
- B. Offer assurance that the fatigue-inducing stage of the disease does not last.
- C. Instruct the client about the importance of maintaining bedrest.
- D. Assist the client with learning how to set priorities and pace activities.
Explanation
D. Assist the client with learning how to set priorities and pace activities.
Rheumatoid arthritis causes chronic pain, stiffness, and fatigue that worsen when the client becomes overexerted. Teaching the client to prioritize essential tasks, alternate activity with rest, and pace daily routines is an evidence-based intervention that helps preserve energy while preventing fatigue accumulation. Energy conservation techniques are central to managing RA symptoms and improving quality of life.
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
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.
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