HESI Adult Health 2025
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Free HESI Adult Health 2025 Questions
A client is admitted with heart failure (HF) and left ventricular hypertrophy. Which intervention is most likely to avert development of cardiomegaly and improve myocardial contractility?
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A Maintain continuous monitoring of heart rate and rhythm
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B Teach about compliance to reduce blood pressure
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C Administer nitroglycerin daily
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D Provide rest periods and portable oxygen
Explanation
The Correct Answer is: B. Teach about compliance to reduce blood pressure
Teaching the client the importance of maintaining controlled blood pressure directly addresses the primary cause of left ventricular hypertrophy: chronic hypertension. Lowering afterload reduces the strain on the myocardium, helping prevent further enlargement of the heart and improving contractility. Consistent medication adherence, diet modification, and lifestyle changes can significantly slow structural cardiac changes and improve long-term outcomes in heart failure.
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)?
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A Administer a PRN dose of a laxative.
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B Initiate cardiac telemetry.
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C Begin straining all urine.
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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.
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?
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A Treat with ice then apply an elastic bandage wrap.
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B Check the leg for warmth and erythema.
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C Ask the client to rate her pain on a scale from 0 to 10.
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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.
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.
The nurse reviews the prescriptions and plans initial steps for caring for the client.
Which nursing interventions are appropriate for this postoperative client? Select all that apply.
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Administer ondansetron 4 mg IV push
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Inspect the surgical bandage for drainage
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Perform range of motion exercises on the left upper extremity
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Check capillary refill on both upper extremities
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Provide morphine 2 mg IV push for severe pain
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Palpate and compare radial pulses bilaterally
Explanation
Explanation of Correct Answers
A. Administer ondansetron 4 mg IV push
The client reports nausea after surgery and has a prescription for ondansetron. Postoperative nausea is expected due to anesthesia and opioid analgesics. Treating nausea prevents vomiting, aspiration, and increased pain from retching. This intervention is safe and indicated.
B. Inspect the surgical bandage for drainage
Although the provider will remove the dressing on postoperative day 1, the nurse must still assess the dressing for drainage, bleeding, saturation, or signs of compromise. Inspection does NOT remove the dressing; it is a required postoperative assessment.
D. Check capillary refill on bilateral upper extremities
The client has a surgical repair of the left shoulder and noted decreased sensation/cool skin before surgery. Postoperative neurovascular checks (capillary refill, pulses, color, temperature) are priority to detect compartment syndrome or vascular compromise.
E. Provide morphine 2 mg IV push
The client has a PRN prescription for morphine if pain is >7/10. The postoperative pain score is not provided, but severe pain is expected after humeral head/neck fracture surgical repair. Morphine is appropriate and ordered.
F. Palpate and compare radial pulses
The preoperative left radial pulse was 1+. Because swelling and neurovascular changes are common after humeral fractures, the nurse must evaluate radial pulses bilaterally for changes in perfusion. This is essential postoperative assessment.
he nurse is caring for a client who reports a sudden, severe headache and facial numbness. The nurse asks the client to smile and observes facial droop on the right side and weaker right-hand grasp. The client denies trauma or prior headaches. 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
A. Obtain a focused history to determine recent bleeding and use of anticoagulants
The client is showing acute neurologic deficits—sudden severe headache, facial droop, and unilateral weakness—which are classic signs of a stroke. Before the client can receive emergency stroke treatment (including fibrinolytics such as alteplase), the nurse must immediately determine:
• Any history of internal bleeding
• Use of anticoagulants
• Recent surgeries or trauma
• Onset time of symptoms
This assessment is time-critical because it determines whether the client is eligible for thrombolytic therapy. This is the next priority intervention after vital signs in suspected stroke.
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?
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Confirm that this is an effective technique to help with ambulation.
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Assist the client to a carpeted area where he can walk more easily.
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Plan to assess the client's cognition after returning to his room.
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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.
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.
The nurse is reviewing the client's medical record to better understand the previous gout attacks.
Based on these findings, which clinical feature is most consistent with chronic gout?
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A Occurs in more than 1 joint
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B Visible tophi
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C Low grade fever
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D Pain at the affected joint
Explanation
Explanation of Correct Answer
Visible or palpable tophi are firm urate crystal deposits under the skin that indicate long-standing hyperuricemia and repeated gout attacks. Their presence signifies chronic gout, not a simple isolated acute flare. In your patient, the hard deposits and slight joint deformity strongly support chronic disease progression.
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.
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