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 weeks postoperative check up. Which assessment is most important for the nurse to obtain?
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Daily caloric intake.
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Heart rate and body weight.
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Report of bowel functioning since surgery.
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Number of any missed doses of medication.
Explanation
The Correct Answer is: Heart rate and body weight
Explanation
Monitoring heart rate and body weight is the most important assessment at the six-week postoperative follow-up after thyroidectomy and initiation of thyroid replacement therapy. These parameters reflect the effectiveness of levothyroxine dosing. Tachycardia, palpitations, or rapid weight loss may indicate excessive dosing, while bradycardia and weight gain may suggest under-replacement. Assessing these objective clinical indicators helps the nurse identify whether medication adjustments are needed to maintain euthyroid balance.
Why the other options are incorrect:
Daily caloric intake
Although caloric intake can influence weight and energy levels, it does not directly measure the effectiveness of thyroid hormone replacement. The nurse’s priority is to assess physiologic markers like heart rate and weight rather than diet reporting, which is less reliable for evaluating therapeutic response.
Report of bowel functioning since surgery
Bowel changes, such as constipation or diarrhea, can occur with thyroid imbalances, but they are secondary indicators. While useful for a broader review, bowel function is not as direct or reliable a measure of thyroid hormone replacement effectiveness as heart rate and weight trends.
Number of any missed doses of medication
Medication adherence is important, but self-reported missed doses may be inaccurate and do not provide an objective measure of hormone replacement effectiveness. Clinical assessment findings such as weight changes and heart rate provide more reliable, immediate data for guiding therapy adjustments.
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 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 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 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.
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 assesses an adult client 24 hours following abdominal surgery and finds the client's blood pressure is 98/40 mm Hg. The client is tachycardic, restless, and irritable. Which action should the nurse perform first?
- A Check under the back for evidence of bleeding.
- B Ensure the IV solution is infusing at the prescribed rate.
- C Notify the healthcare provider of the findings.
- D Listen to lung sounds.
Explanation
A. Check under the back for evidence of bleeding
The client’s symptoms—hypotension, tachycardia, restlessness, and irritability—are classic early signs of postoperative hemorrhage and hypovolemic shock. Abdominal surgical patients can bleed into the incision site or into the bed linens without obvious external signs. The first nursing action is to quickly assess for active bleeding under the back and around the surgical site. Identifying ongoing blood loss is critical before taking further steps, because it determines urgency and guides interventions.
An older adult client arrives at the outpatient eye surgery clinic for a right cataract extraction and lens implant. During the immediate postoperative period, which intervention should the nurse implement?
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Obtain vital signs every 2 hours during hospitalization.
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Provide an eye shield to be worn while sleeping.
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Teach a family member to administer eye drops.
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Encourage deep breathing and coughing exercises.
Explanation
The Correct Answer is: B. Provide an eye shield to be worn while sleeping.
Explanation of the Correct Answer
B. Provide an eye shield to be worn while sleeping
After cataract extraction and lens implant, the eye is vulnerable to pressure or trauma. An eye shield protects the surgical site from accidental rubbing or injury, especially during sleep. This intervention is essential to prevent complications such as wound dehiscence or increased intraocular pressure, supporting safe healing during the immediate postoperative period.
Why the Other Options Are Incorrect
A. Obtain vital signs every 2 hours during hospitalization
Cataract surgery is usually an outpatient procedure, and frequent vital sign monitoring every 2 hours is not necessary once the client is stable. Post-op care focuses more on eye protection and medication compliance.
C. Teach a family member to administer eye drops
Teaching is important, but in the immediate postoperative period the nurse’s priority is to protect the operative eye. Education about medications is typically reinforced before discharge, not as the first intervention.
D. Encourage deep breathing and coughing exercises
Coughing should be avoided after eye surgery because it increases intraocular pressure, which could disrupt healing. Gentle deep breathing for relaxation may be allowed, but coughing is contraindicated.
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.
An adult female client, who is an office worker, comes to the occupational health clinic with an edematous right leg twice the size of the left leg. The client reports that she is otherwise healthy, smokes 2 packs of cigarettes a day, and takes birth control pills on a regular basis. Which initial nursing action should the occupational health nurse take?
- A Treat with ice then apply an elastic bandage wrap.
- B Check the leg for warmth and erythema.
- C Ask the client to rate her pain on a scale from 0 to 10.
- D Teach the client to keep the leg elevated.
Explanation
B. Check the leg for warmth and erythema
This client has multiple major risk factors for a deep vein thrombosis (DVT): unilateral leg swelling, smoking, and use of oral contraceptives. The first nursing action should be to assess for clinical signs that support this life-threatening condition—specifically warmth, redness, firmness, and tenderness. Early identification is critical to prevent pulmonary embolism. A focused vascular assessment is the safest and most appropriate initial action.
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