hesi foundation of nursing
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Free hesi foundation of nursing Questions
A client with atrial fibrillation receives a prescription for a loading dose of digoxin 0.5 mg PO. The medication is available in 125 mcg tablets. How many tablets should the nurse administer? (Enter numerical value only.)
Explanation
Correct Answer: 4 tablets
First, convert units to ensure consistency: 0.5 mg = 500 mcg. Then apply the dose calculation formula: Desired dose ÷ Available dose = Number of tablets. 500 mcg ÷ 125 mcg per tablet = 4 tablets. The nurse should administer 4 tablets to deliver the prescribed 0.5 mg loading dose of digoxin.
The palliative care nurse receives a consult for a terminally ill client in the intensive care unit. The client is weak, mouth breathing, and refusing anything to eat or drink. Which intervention should the nurse include in the plan of care?
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Record the client's daily weight
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Maintain in high Fowler's position
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Report any change in urine color
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Keep mucous membranes moist
Explanation
Correct Answer: D) Keep mucous membranes moist
In palliative and end-of-life care, the priority is comfort and symptom management rather than curative treatment. A terminally ill client who is mouth breathing and refusing food and fluids is at high risk for dry, cracked mucous membranes, which cause significant discomfort.
Keeping mucous membranes moist through frequent oral care is a direct comfort measure that alleviates suffering. Recording daily weight is focused on monitoring fluid status and nutritional changes, which is not a priority in end-of-life comfort care.
High Fowler's position is not specifically indicated and may not be the most comfortable position for a weak, terminally ill client. Reporting changes in urine color is a monitoring intervention inconsistent with the palliative focus on comfort rather than clinical intervention.
When administering a new medication to a client, the nurse logs in the electronic medication administration record (eMAR). Which action should the nurse take next?
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Remove the medication from the unit dose packaging while verifying the dose
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Reconcile the medication to be administered with the initial client prescription
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Scan the medication barcode to document administration on the eMAR
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Verify client's identification by scanning the barcode on the armband
Explanation
Correct Answer: D) Verify client's identification by scanning the barcode on the armband
After logging into the eMAR, the next critical step before administering any medication is to verify the client's identity using at least two identifiers — in this case, by scanning the barcode on the client's armband.
This is a fundamental patient safety practice that ensures the right medication is being given to the right patient, preventing potentially life-threatening medication errors. Scanning the medication barcode comes after patient identification is confirmed. Removing medication from packaging before verifying the client's identity is premature.
Reconciling with the initial prescription is an earlier step in the medication verification process that occurs before reaching the bedside.
A client is being admitted to the unit with a varicella zoster virus infection. Which room should the charge nurse assign to the client?
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A private room with both standard and droplet precautions
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A private room with both contact and airborne precautions
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A semi-private room with a roommate who has the same diagnosis and contact precautions
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A semi-private room with a roommate who has the same diagnosis and airborne precautions
Explanation
Correct Answer: B) A private room with both contact and airborne precautions
Varicella zoster (chickenpox) requires both contact and airborne precautions because it is transmitted through direct contact with the lesions as well as through airborne droplet nuclei that can remain suspended in the air for extended periods.
The client must be placed in a private room with negative pressure airflow to prevent airborne transmission to other patients and staff. Standard and droplet precautions alone are insufficient for varicella.
A semi-private room is inappropriate regardless of the roommate's diagnosis, as airborne pathogens can spread beyond shared spaces and immunocompromised individuals nearby remain at risk.
The nurse observes the unlicensed assistive personnel (UAP) securing a client's wrist restraints to the bedside rails. Which action is most important for the nurse to implement?
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Demonstrate proper securing of the restraints
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Complete an adverse occurrence/incident report
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Initiate the facility's restraint flow sheet
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Ensure that the restraints are not too tight
Explanation
Correct Answer: A) Demonstrate proper securing of the restraints
Securing restraints to the bedside rails is a safety violation and incorrect technique. If the bed rails are raised or lowered, restraints attached to them can cause serious injury, strangulation, or death by pulling the client's limbs into dangerous positions. Restraints must always be secured to the moveable part of the bed frame, not the side rails.
The most important and immediate nursing action is to intervene and demonstrate the correct technique to the UAP to prevent imminent patient harm. Completing an incident report and initiating the restraint flow sheet are important documentation steps but are not the priority when the client is at immediate risk. Checking that restraints are not too tight is also important but is secondary to first correcting the dangerous placement.
A 75-year-old male presents to the emergency department with poorly controlled diabetes. He has been experiencing polyuria, nausea and vomiting, confusion, and unstable blood sugars. He was stabilized in the ED and transferred to the medical unit. He has a history of moderate obesity, insulin dependent diabetes, smoking one pack per day for 40 years, and mobility issues requiring a walker. The nurse reviews the client's data. Which potential condition, actions to take, and parameters to monitor are most appropriate for this client? Select all that apply.
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Administer an enema
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Contact adult protective services
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Offload coccyx and other bony prominences
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Cleanse and dress wound
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Immediately begin a bowel training program
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Bowel obstruction
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Altered nutrition
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Pressure injury
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Elder abuse
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Documentation of skin prevention measures
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Wound status
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Incontinence episodes
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Family dynamics
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Vital signs
Explanation
Correct Answers: Actions to Take: C) Offload coccyx and other bony prominences and D) Cleanse and dress wound | Potential Condition: C) Pressure injury | Parameters to Monitor: A) Documentation of skin prevention measures and B) Wound status
This client is at high risk for a pressure injury due to multiple compounding risk factors including advanced age (75 years), obesity, immobility requiring a walker, poorly controlled diabetes which impairs circulation and wound healing, and a long history of smoking which reduces tissue oxygenation.
The priority potential condition is a pressure injury. The appropriate nursing actions are to offload the coccyx and other bony prominences to relieve pressure and prevent further tissue damage, and to cleanse and dress any existing wound to promote healing and prevent infection.
The most relevant parameters to monitor are documentation of skin prevention measures to ensure consistent preventive care is being implemented, and wound status to track healing progress or detect deterioration.
Elder abuse and bowel obstruction are not supported by the clinical data provided. Vital signs, while always important, are not the most specific parameters for monitoring pressure injury progress in this scenario.
Which action should the nurse implement when inserting an indwelling catheter for an uncircumcised male client?
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Advance the catheter before inflating balloon
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Position the sterile field even with the nurse's hips
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Clean the urinary meatus before retracting the foreskin
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Use a swab to wipe the meatus in back-and-forth motions
Explanation
Correct Answer: A) Advance the catheter until urine flows and then advance 1-2 inches more before inflating the balloon
When inserting an indwelling urinary catheter, the balloon must never be inflated until urine return is confirmed and the catheter has been advanced an additional 1–2 inches to ensure the balloon is fully inside the bladder and not in the urethra. Inflating the balloon in the urethra causes severe pain and urethral injury.
For an uncircumcised male, the foreskin must be retracted before cleaning — not after — to properly expose and clean the urinary meatus. Cleaning should be performed in a circular motion from the meatus outward, not back-and-forth which would introduce bacteria. The sterile field should be positioned at thigh level, not at the nurse's hips, to maintain sterility and proper technique.
The nurse educators on a cardiovascular unit of a healthcare facility are creating a social media project that addresses improving outcomes for clients with heart failure. Which action should the nurses implement to protect client privacy?
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Respect all copyright laws when adding website content
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May use information from the client's relatives instead
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Implement full disclosure policy especially when giving examples
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Remove client identifying information of those who participate
Explanation
Correct Answer: D) Remove client identifying information of those who participate
When creating any public-facing project such as a social media initiative, protecting client privacy requires the removal of all identifying information — including name, date of birth, medical record number, diagnosis details, photographs, or any combination of details that could identify a specific individual.
This is consistent with HIPAA regulations, which strictly prohibit the disclosure of protected health information (PHI) without explicit written consent. Using information from relatives does not eliminate privacy concerns. A full disclosure policy would actually increase the risk of privacy violations. Copyright compliance is important for content creation but does not address client privacy specifically.
The nurse educator is conducting a class for unlicensed assistive personnel (UAP). Which action indicates that a UAP understands gloving procedures?
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Uses sterile gloves when handling body fluids
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Keeps a pair of gloves in uniform pocket
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Dons sterile gloves when caring for clients with HIV
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Puts on new gloves when entering a client's room
Explanation
Correct Answer: A) Uses sterile gloves when handling body fluids
Standard infection control practice requires the use of gloves when handling body fluids to protect both the healthcare worker and the client from transmission of infectious organisms. Using gloves when handling body fluids demonstrates correct understanding of gloving procedures and standard precautions.
Keeping gloves in a uniform pocket is incorrect — gloves stored in pockets become contaminated and are not appropriate for use. Sterile gloves are not required for routine care of clients with HIV — clean gloves are sufficient for standard precautions, as HIV is not transmitted through casual contact.
Putting on new gloves simply when entering a client's room without a specific indication is not a recommended practice and wastes resources.
A 36-year-old female presents to the clinic reporting difficulty sleeping that began 2 years ago following her father's death. She has no medical problems, takes an oral contraceptive and a multivitamin daily, does not smoke, and drinks 1 to 2 glasses of wine every evening. Which recommendations could the nurse give to help the client achieve better sleep? Select all that apply.
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Avoid alcohol in the evening
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Take an analgesic before bed
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Watch television in bed to fall asleep
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Try to go to bed and awaken at the same time every day
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Avoid naps
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Eat a heavy meal before bed
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Exercise in the evening
Explanation
Correct Answers: A) Avoid alcohol in the evening, D) Try to go to bed and awaken at the same time every day, and E) Avoid naps
This client's insomnia likely has both a psychological trigger (grief following her father's death) and a behavioral contributor (nightly alcohol use). Although alcohol may initially induce drowsiness, it disrupts sleep architecture and reduces sleep quality — making avoiding alcohol in the evening a key recommendation.
Maintaining a consistent sleep and wake schedule reinforces the body's circadian rhythm and is one of the most evidence-based interventions for insomnia. Avoiding daytime naps helps build sleep pressure at night, making it easier to fall and stay asleep. Taking an analgesic is not indicated as the client has no pain complaints.
Watching television in bed is counterproductive as it associates the bed with wakefulness rather than sleep — a violation of good sleep hygiene. Eating a heavy meal before bed can cause discomfort and disrupt sleep. Exercising in the evening can be stimulating and may delay sleep onset for some individuals, making earlier in the day the preferred time for exercise.
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