HESI RN Adult Health (D444)
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Free HESI RN Adult Health (D444) Questions
After a spider bite on the lower extremity, a client is admitted for treatment of an infection that is spreading up the leg. Which admission assessment finding(s) should the nurse report to the healthcare provider? (Select all that apply.)
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Red blood cell count (RBC).
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Core body temperature.
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Swollen lymph nodes in the groin.
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Location of the initial intravenous (IV) site
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White blood cell count (WBC)
Explanation
Correct Answers:
B. Core body temperature, C. Swollen lymph nodes in the groin, E. White blood cell count (WBC)
Explanation of Correct Answers
B. Core body temperature
An elevated temperature can indicate systemic infection (sepsis). This is an important clinical finding that must be reported promptly.
C. Swollen lymph nodes in the groin
Lymphadenopathy near the infected extremity indicates the spread of infection through the lymphatic system. This suggests progression and requires provider notification.
E. White blood cell count (WBC)
An elevated WBC count is a key indicator of infection. Reporting this value helps the provider determine the severity of infection and guide antibiotic therapy.
Why the Other Options Are Wrong
A. Red blood cell count (RBC)
RBC levels do not provide immediate or relevant information about infection status. They are more related to anemia or blood loss than to an acute infection.
D. Location of the initial intravenous (IV) site
IV site location is a routine documentation detail but does not provide clinically significant information about infection severity or systemic spread.
A client with a chlamydia infection receives a prescription for a single dose azithromycin 1 gram by mouth. The bottle is labeled "Azithromycin for Oral Suspension, USP 200 mg per 5 mL."
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15 mL
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20 mL
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25 mL
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30 mL
Explanation
Correct Answer:
C. 25 mL
Explanation
Step 1: Convert the ordered dose.
1 g = 1000 mg
Step 2: Find concentration in 1 mL.
200 mg ÷ 5 mL = 40 mg per 1 mL
Step 3: Calculate required volume.
1000 mg ÷ 40 mg per mL = 25 mL
Why Other Options Are Wrong
A. 15 mL
15 mL × 40 mg = 600 mg, which is below the prescribed 1000 mg dose and would underdose the client.
B. 20 mL
20 mL × 40 mg = 800 mg, which is less than 1 g, so the client would not receive the full therapeutic dose.
D. 30 mL
30 mL × 40 mg = 1200 mg, which exceeds the prescribed dose and could result in overdosing the client.
A client with myasthenia gravis receives a new prescription for pyridostigmine. Which information should the nurse obtain prior to administering the medication
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Unexplained weight loss.
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Trouble sleeping
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Difficulty with urination
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Recent oral intake
Explanation
Correct Answer D. Recent oral intake
Explanation:
Pyridostigmine should be administered in coordination with meals to ensure peak muscle strength during chewing and swallowing. This reduces the risk of aspiration in clients with myasthenia gravis, whose weakened muscles may impair eating. Assessing recent oral intake helps the nurse time the dose effectively, providing the greatest therapeutic benefit and promoting safety during mealtimes. Administering too early or too late could result in muscle weakness during eating, increasing aspiration risk.
Why Other Options Are Incorrect:
A. Unexplained weight loss:
While weight loss may indicate disease progression in myasthenia gravis, it does not affect the immediate decision to administer pyridostigmine. This information is important for nutritional assessment and long-term management but is not the critical factor before giving the medication.
B. Trouble sleeping:
Sleep disturbances are not a common concern with pyridostigmine and do not affect its safe administration. This information may be relevant to overall patient care but does not directly relate to the timing or effectiveness of the medication.
C. Difficulty with urination:
Although cholinergic drugs can affect bladder function, urinary difficulty is not a priority assessment before pyridostigmine administration unless there is a known obstruction. The immediate concern with this drug is timing it with meals to optimize swallowing safety, making this less critical.
The nurse implements a primary prevention program for sexually transmitted diseases in a nurse-managed health center. Which outcome indicates that the program was effective?
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New screening protocols were developed, validated, and implemented.
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Clients who incurred disease complications promptly received rehabilitation.
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Average client scores improved on specific risk factor knowledge tests.
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More than half at risk clients were diagnosed early in the disease process
Explanation
Correct Answer:
C. Average client scores improved on specific risk factor knowledge tests
Explanation
Primary prevention focuses on preventing disease before it occurs through education, risk-reduction strategies, and health promotion. Improved client knowledge of risk factors and preventive practices—demonstrated by higher test scores—shows that the program successfully reduced the likelihood of new sexually transmitted disease (STD) cases.
Why Other Options Are Wrong
A. New screening protocols were developed, validated, and implemented
This is part of secondary prevention, which focuses on early detection of disease through screening.
B. Clients who incurred disease complications promptly received rehabilitation
This reflects tertiary prevention, which addresses limiting disability and restoring function after disease complications occur.
D. More than half at risk clients were diagnosed early in the disease process
Early diagnosis is also secondary prevention, not primary prevention. The goal of primary prevention is to stop infection before it develops.
The nurse on a medical-surgical unit is receiving a client from the postanesthesia care unit (PACU) with a Penrose drain. Before choosing a room for this client, which information is most important for the nurse to obtain
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If suctioning will be needed for drainage of the wound
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If the family would prefer a private or semiprivate room
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If the client also has a Hemovac in place
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If the client's wound is infected
Explanation
Correct Answer D. If the client's wound is infected
Explanation:
The most important consideration before room assignment is whether the client’s wound is infected. A Penrose drain is an open drainage system that can allow direct contact between drainage and the environment, increasing the risk of spreading infection. If the wound is infected, the client must be placed in a private room or with another client with the same infection (cohorting) to prevent cross-contamination.
Why Other Options Are Incorrect:
A. If suctioning will be needed for drainage of the wound
A Penrose drain functions via gravity, not suction, so suctioning is not relevant for its operation.
B. If the family would prefer a private or semiprivate room
Family preference may be considered later, but infection control and safety are higher priorities in determining placement.
C. If the client also has a Hemovac in place
The presence of a Hemovac (a closed drainage system) does not determine room placement in the same way an infection risk would.
Which snack selection indicates to the nurse that a school-age child with gastroesophageal reflux understands the dietary restrictions?
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Tacos
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Chocolate milkshake
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Pizza
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Sugar cookies
Explanation
Correct Answer:
D. Sugar cookies.
Explanation
Children with gastroesophageal reflux (GERD) are advised to avoid foods that relax the lower esophageal sphincter or increase gastric acid production, such as spicy, greasy, fatty, or chocolate-containing foods. Sugar cookies are a better snack option because they are bland, non-spicy, low in fat, and unlikely to trigger reflux symptoms. This choice demonstrates the child’s understanding of dietary restrictions for GERD.
Why Other Options Are Wrong
A. Tacos
Tacos are spicy and greasy, both of which can exacerbate reflux by irritating the esophagus and increasing gastric acid.
B. Chocolate milkshake
Chocolate and high-fat dairy products are known triggers for reflux because they relax the lower esophageal sphincter and increase acid exposure.
C. Pizza
Pizza is high in fat, greasy, and often contains tomato sauce, which is acidic and can worsen reflux symptoms.
An older woman who has difficulty hearing is being discharged from day surgery following a cataract extraction and lens implantation. Which intervention is most important for the nurse to implement to help ensure the client's compliance with self-care?
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Have the client vocalize the instructions provided
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Provide written instructions for eye drop administration
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Speak clearly and face the client for lip reading
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Ensure that someone will stay with the client for 24 hours
Explanation
Correct Answer:
A. Have the client vocalize the instructions provided
Explanation
Having the client repeat or vocalize the instructions back to the nurse ensures understanding and retention of critical information. This "teach-back" method confirms comprehension, especially important for an older adult with hearing difficulties. It allows the nurse to identify any gaps in understanding and correct them before discharge, which supports safe and effective self-care at home.
Why Other Options Are Wrong
B. Provide written instructions for eye drop administration
Written instructions are useful but do not confirm comprehension. A client may misinterpret or overlook details, so this is not as reliable as immediate verbal confirmation.
C. Speak clearly and face the client for lip reading
While this aids communication during teaching, it does not guarantee that the client retained the instructions or will comply correctly after discharge.
D. Ensure that someone will stay with the client for 24 hours
Having support is important for safety after anesthesia, but it does not ensure that the client understands or can follow through with essential self-care tasks such as medication administration.
In assessing a client at 34 weeks gestation, the nurse notes that she has a slightly elevated total T4 with a slightly enlarged thyroid, a hematocrit of 28% (0.28 volume fraction), a heart rate of 92 beats per minute, and a systolic murmur. Which finding requires follow-up?
Reference Range:
Hematocrit [37% to 47% (0.37 to 0.47 volume fraction)]
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Hematocrit of 28% (0.28 volume fraction).
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Heart rate of 92 beats per minute
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Systolic murmur
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Elevated thyroid hormone level.
Explanation
Correct Answer:
A. Hematocrit of 28% (0.28 volume fraction)
Explanation
During pregnancy, a slight increase in thyroid hormones, a mild systolic murmur, and an increased heart rate are normal physiologic changes due to increased blood volume and cardiac workload. However, a hematocrit of 28% is significantly below the expected pregnancy-adjusted range (usually >33% in the third trimester). This indicates anemia, which requires follow-up to prevent complications such as maternal fatigue, preterm labor, or fetal growth restriction.
Why Other Options Are Wrong
B. Heart rate of 92 beats per minute
Mild tachycardia is normal in pregnancy due to increased cardiac output and blood volume. A heart rate of 92 bpm does not require follow-up.
C. Systolic murmur
A soft systolic murmur is common in pregnancy from increased blood flow and is not considered pathologic unless accompanied by other abnormal cardiac signs.
D. Elevated thyroid hormone level
A slight elevation in total T4 is expected because of increased thyroid-binding globulin in pregnancy. It is physiologic and does not require intervention unless accompanied by clinical hyperthyroidism.
The nurse has administered sublingual nitroglycerin. Which outcome would the nurse use to determine the effectiveness of sublingual nitroglycerin
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Relief of anginal pain
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Improved cardiac output
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Decreased blood pressure
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Ease in respiratory effort
Explanation
Correct Answer A. Relief of anginal pain
Explanation:
Sublingual nitroglycerin works by dilating coronary arteries and reducing myocardial oxygen demand, which helps relieve the ischemia that causes anginal pain. The primary measure of effectiveness is the client’s reported decrease or elimination of chest pain.
Why Other Options Are Incorrect:
B. Improved cardiac output
While nitroglycerin may indirectly improve cardiac output by reducing afterload and preload, this is not the primary indicator of effectiveness in acute angina.
C. Decreased blood pressure
A drop in blood pressure can occur due to vasodilation, but this is a side effect, not the main therapeutic goal.
D. Ease in respiratory effort
Nitroglycerin does not primarily treat shortness of breath unless it is related to heart failure with pulmonary congestion; angina relief is the direct therapeutic measure.
The nurse is triaging several children as they present to the emergency room after a school bus accident. Which child requires the most immediate intervention by the nurse?
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A 12-year-old reporting neck, arm, and lower back discomfort.
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An 8-year-old with a full leg air splint for a possible broken tibia
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A 6-year-old with multiple superficial lacerations of all extremities
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An 11-year-old with a headache, nausea, and projectile vomiting.
Explanation
Correct Answer:
D. An 11-year-old with a headache, nausea, and projectile vomiting
Explanation
Projectile vomiting following a head injury is a red flag for increased intracranial pressure (ICP). This can rapidly become life-threatening if not addressed immediately. The child requires urgent intervention to prevent brain herniation or further neurologic deterioration.
Why Other Options Are Wrong
A. A 12-year-old reporting neck, arm, and lower back discomfort
This child may have a musculoskeletal injury or possible spinal involvement, which requires evaluation, but the presentation is stable and not immediately life-threatening compared to signs of increased ICP.
B. An 8-year-old with a full leg air splint for a possible broken tibia
The splint suggests stabilization is already in place. This is a serious but not emergent condition compared to neurologic compromise.
C. A 6-year-old with multiple superficial lacerations of all extremities
Although painful and requiring wound care, superficial lacerations are not immediately life-threatening.
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Topics include cardiovascular care, respiratory care, renal health, endocrine disorders, gastrointestinal health, patient assessments, pharmacology, and nursing interventions.
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