HESI RN Adult Health (D444)
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Free HESI RN Adult Health (D444) Questions
A client with a diagnosis of schizophrenia sits in the day room and fails to interact with the staff or peers. Which intervention is best for the nurse to implement with this client?
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Give the client a schedule of planned daily activities
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Engage the client in a game of cards
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Encourage the client to have lunch off the unit.
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Complete an assessment of social support
Explanation
Correct Answer:
A. Give the client a schedule of planned daily activities
Explanation
Providing a structured daily schedule helps clients with schizophrenia feel more organized, reduces anxiety, and promotes engagement. Structure offers predictability, which supports the client’s ability to participate in activities at their own pace. This intervention creates a therapeutic environment by giving the client direction without overwhelming them, making it the best first step to encourage socialization and participation.
Why Other Options Are Wrong
B. Engage the client in a game of cards
Although games can encourage interaction, directly pressuring a withdrawn client into a social activity may increase anxiety. Structure should be established first before encouraging group engagement.
C. Encourage the client to have lunch off the unit
Leaving the unit may be too overwhelming and stressful for a client who is currently withdrawn. This intervention is inappropriate at this stage of recovery.
D. Complete an assessment of social support
Assessment is important, but it does not provide immediate therapeutic benefit. Direct interventions that encourage participation in structured activities should be prioritized before conducting support assessments.
Which breakfast selection should the nurse recommend for a 16-year-old with diarrhea?
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Buttered whole wheat toast and coffee.
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Sausage, poached eggs, and milk.
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Granola, strawberries, and tea
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Oatmeal, banana, and herbal tea
Explanation
Correct Answer:
D. Oatmeal, banana, and herbal tea
Explanation
For a client with diarrhea, the diet should be bland, low in fat, and easy to digest. Bananas are part of the BRAT diet (bananas, rice, applesauce, toast), which helps bulk stools. Oatmeal provides soluble fiber, which absorbs excess fluid and improves stool consistency. Herbal tea avoids caffeine, which can worsen diarrhea. This selection is gentle on the digestive tract and supports recovery.
Why Other Options Are Wrong
A. Buttered whole wheat toast and coffee
Coffee contains caffeine, which stimulates the gastrointestinal tract and increases fluid loss. Butter adds unnecessary fat, which can worsen diarrhea.
B. Sausage, poached eggs, and milk
Sausage is high in fat and may irritate the GI tract. Eggs can be tolerated in moderation, but the high-fat meal combined with milk (which may worsen diarrhea if lactose intolerance develops) is not recommended.
C. Granola, strawberries, and tea
Granola is high in insoluble fiber, which increases stool bulk and worsens diarrhea. Strawberries contain seeds that can further irritate the bowel. Regular tea contains caffeine, which is not recommended.
When planning care for an adolescent with anorexia nervosa, which nursing problem has the highest priority?
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Disturbed Body Image.
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Interrupted Family Processes.
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Imbalanced Nutrition: less than body requirements
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Noncompliance with treatment regimen
Explanation
Correct Answer:
C. Imbalanced Nutrition: less than body requirements
Explanation
The most immediate, life-threatening complication of anorexia nervosa is severe malnutrition, which can result in electrolyte imbalances, cardiac arrhythmias, multi-organ failure, and death. Therefore, the priority nursing problem is Imbalanced Nutrition: less than body requirements. Restoring adequate nutrition and stabilizing the client’s physical health must occur before addressing psychological, family, or compliance issues.
Why Other Options Are Wrong
A. Disturbed Body Image
This is an important psychological issue in anorexia nervosa but is not the immediate life-threatening priority. It is addressed after stabilization of nutrition and physical health.
B. Interrupted Family Processes
Family dynamics often contribute to and are affected by anorexia nervosa, but this is not as critical as correcting malnutrition to preserve life.
D. Noncompliance with treatment regimen
Noncompliance can hinder recovery, but it is not the first priority. The nurse must first intervene to correct nutritional deficits before focusing on adherence.
A hospice client who has severe pain asks for another dose of oxycodone. Which consideration is the nurse's primary concern when responding to the client's request
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Prevent addiction.
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Determine why the medication is needed.
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Provide alternative comfort measures.
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Reduce the client's pain.
Explanation
Correct Answer D. Reduce the client's pain
Explanation:
In hospice care, the primary focus is comfort and quality of life. For a client experiencing severe pain, the nurse’s priority is prompt pain relief. Concerns about long-term consequences like addiction are not relevant at the end-of-life stage. The goal is to alleviate suffering and maintain dignity through effective pain management.
Why Other Options Are Incorrect:
A. Prevent addiction
Addiction is not a primary concern in hospice care because the focus is on comfort and symptom control, not long-term dependency risks.
B. Determine why the medication is needed
In hospice care, severe pain reported by the client is reason enough for medication without unnecessary questioning or delay.
C. Provide alternative comfort measures
While nonpharmacologic measures can complement treatment, they should not replace rapid pharmacologic intervention for severe pain.
A client with leukemia who is receiving myelosuppressive chemotherapy has a platelet count of 25,000/mm³ (25 × 10⁹/L). Which intervention is most important for the nurse to include in this client's plan of care?
Reference Range:
Platelet Count [150,000 to 400,000/mm³ (150–400 × 10⁹/L)]
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Assess urine and stool for occult blood.
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Obtain client's temperature every 4 hours
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Monitor for signs of activity intolerance
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Require visitors to wear respiratory masks
Explanation
Correct Answer:
A. Assess urine and stool for occult blood
Explanation
A platelet count of 25,000/mm³ places the client at high risk for spontaneous bleeding. The most important nursing intervention is to monitor for bleeding, which may be internal and subtle, such as occult blood in urine or stool. Early detection allows timely intervention to prevent life-threatening hemorrhage.
Why Other Options Are Wrong
B. Obtain client's temperature every 4 hours
This is important for infection monitoring in neutropenia, but the immediate priority with thrombocytopenia this severe is bleeding risk.
C. Monitor for signs of activity intolerance
Activity intolerance is expected with leukemia and chemotherapy, but it is not life-threatening compared to the risk of hemorrhage from severe thrombocytopenia.
D. Require visitors to wear respiratory masks
Masking visitors is an infection-control measure useful for neutropenic precautions, not thrombocytopenia. The client’s greatest danger here is bleeding, not infection.
When should the nurse conduct an Allen's test?
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Just before arterial blood gasses are drawn peripherally.
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Prior to attempting a cardiac output calculation.
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To assess for presence of a deep vein thrombus in the leg
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When pulmonary artery pressures are obtained.
Explanation
Correct Answer:
A. Just before arterial blood gasses are drawn peripherally
Explanation
The Allen’s test is performed to assess the adequacy of collateral circulation in the hand before puncturing the radial artery for arterial blood gas (ABG) sampling or for inserting a radial arterial line. The test ensures that if the radial artery is damaged or occluded, the ulnar artery can provide sufficient blood flow to the hand. This step is essential to prevent ischemic complications.
Why Other Options Are Wrong
B. Prior to attempting a cardiac output calculation
Cardiac output measurement is not related to peripheral arterial circulation in the hand and does not require an Allen’s test.
C. To assess for presence of a deep vein thrombus in the leg
Deep vein thrombosis (DVT) is evaluated with Doppler ultrasound, Homan’s sign (not recommended anymore), or venography, not with an Allen’s test.
D. When pulmonary artery pressures are obtained
Pulmonary artery pressure monitoring involves a Swan-Ganz catheter and does not require assessment of collateral circulation in the hand.
A client with cancer is admitted to the oncology unit and tells the nurse that he is in the hospital for palliative care measures. The nurse notes that the client's admission prescriptions include radiation therapy. Which action should the nurse implement?
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Notify the radiation department to withhold the treatments for now
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Ask the client about his expected goals for this hospitalization.
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Determine if the client wishes to cancel further radiation treatments
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Explain that palliative care measures can be provided at home.
Explanation
Correct Answer:
B. Ask the client about his expected goals for this hospitalization
Explanation
Palliative care focuses on improving quality of life and aligning treatments with the patient’s goals, values, and preferences. Radiation therapy can be a valid palliative intervention, often prescribed to relieve symptoms such as pain, bleeding, or obstruction. The nurse should first clarify the client’s understanding and expectations for hospitalization, ensuring that the care plan supports the client’s specific goals. This therapeutic approach empowers the client while maintaining a holistic, patient-centered perspective.
Why Other Options Are Wrong
A. Notify the radiation department to withhold the treatments for now
The nurse should not unilaterally cancel or delay prescribed therapy. Without first understanding the client’s goals and discussing them with the provider, withholding treatment could inappropriately interfere with care that might improve comfort.
C. Determine if the client wishes to cancel further radiation treatments
This approach presumes that radiation is inconsistent with palliative care. However, radiation may still meet palliative goals, such as pain relief. The first priority is to explore the client’s goals before presenting treatment options.
D. Explain that palliative care measures can be provided at home
While true, this does not address the client’s current hospitalization. The immediate responsibility is to clarify goals of care in the hospital, not to redirect the discussion toward home-based options.
The nurse is caring for a client with the sexually transmitted infection (STI) genital herpes. The client reports having sex with multiple partners. Which response should the nurse provide?
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Remain non-judgmental and assure the client of confidentiality.
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Provide counseling that most contraceptives protect against infection.
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Clarify that all STIs are transmitted through sexual intercourse
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Inform the client that complications will not result from reinfection
Explanation
Correct Answer:
A. Remain non-judgmental and assure the client of confidentiality
Explanation
When discussing sexually transmitted infections, the nurse’s priority is to establish trust and provide a safe environment for honest communication. Remaining non-judgmental and assuring confidentiality encourages the client to share sensitive information openly, which is essential for proper counseling, education, and treatment planning. This therapeutic approach promotes effective nurse-client communication and adherence to care.
Why Other Options Are Wrong
B. Provide counseling that most contraceptives protect against infection
This is inaccurate. While condoms can reduce transmission of some STIs, many contraceptives (like oral pills, IUDs, or implants) do not protect against infections. Providing false information could harm the client.
C. Clarify that all STIs are transmitted through sexual intercourse
Not all STIs are exclusively spread by intercourse; some can spread through blood (HIV, hepatitis B), perinatal transmission, or skin-to-skin contact (genital herpes, HPV). This statement is misleading.
D. Inform the client that complications will not result from reinfection
This is incorrect. Reinfection or repeated outbreaks of herpes can increase complications, such as more severe lesions, increased transmission risk, and neonatal herpes if the client becomes pregnant.
An older adult client is admitted to the psychiatric unit for assessment of a recent onset of dementia. The nurse notices that in the evening this client often becomes restless, confused, and agitated. Which intervention is most important for the nurse to implement?
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Ask family members to remain with the client in the evenings from 1700 to 2100
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Administer a prescribed PRN benzodiazepine at the onset of a confused state
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Postpone administration of nighttime medications until after 2300.
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Ensure that the client is assigned to a room close to the nurses' station
Explanation
Correct Answer:
D. Ensure that the client is assigned to a room close to the nurses' station.
Explanation
Older adults with dementia often experience “sundowning,” where confusion, agitation, and restlessness worsen in the evening. The most important nursing intervention is to prioritize safety, as these clients are at risk for wandering, falls, or harm. Assigning the client to a room near the nurses' station ensures frequent observation, quicker response to needs, and better monitoring of behaviors. This proactive measure minimizes risk while still supporting therapeutic management.
Why Other Options Are Wrong
A. Ask family members to remain with the client in the evenings from 1700 to 2100
Family presence can provide comfort and reduce agitation, but it is not a consistently reliable intervention because family members may not always be available. Safety monitoring by nursing staff remains the priority.
B. Administer a prescribed PRN benzodiazepine at the onset of a confused state
Medication is not the first-line intervention because sedatives increase the risk of falls, confusion, and dependence in older adults. Nonpharmacologic measures and safety precautions are preferred before resorting to PRN drugs.
C. Postpone administration of nighttime medications until after 2300
Delaying medications does not address the underlying safety risk posed by evening confusion. In fact, it may disrupt treatment schedules and could worsen agitation if therapeutic medications are missed at the appropriate time.
Vital signs
Heart rate 159 bpm
Blood pressure 89/51 mmHg
Respiratory rate 55 breaths/min
Oxygen saturation 95% on 2 L of oxygen via nasal cannula
Temperature 103 °F (39.4 °C)
What information should the nurse collect as part of the focused assessment for dehydration in this child? Select all that apply.
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Level of consciousness
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Capillary refill
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Temperature
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Blood pressure
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Mucous membrane moisture and urine output
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Pupil size and reactiveness
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Skin turgor
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Heart rate
Explanation
Correct Answer: B. Capillary refill
Capillary refill is an important indicator of peripheral perfusion and hydration status. A delayed refill time suggests poor circulation due to intravascular fluid deficit. It is a quick, reliable, and noninvasive method to assess the severity of dehydration and guides the nurse in determining if the child is compensating or deteriorating.
Correct Answer: C. Temperature
Temperature must be monitored because fever contributes to increased insensible water loss through sweating and tachypnea. In children with dehydration, fever can quickly worsen fluid deficit, and tracking it helps the nurse adjust fluid replacement needs appropriately.
Correct Answer: D. Blood pressure
Blood pressure is a late but critical sign in pediatric dehydration assessment. Hypotension indicates severe volume depletion and progression toward decompensated shock. Because children often maintain normal blood pressure until late stages, monitoring it carefully is essential to identify advanced dehydration and circulatory compromise.
Correct Answer: E. Mucous membrane moisture and urine output
Moisture of oral mucous membranes and urine output are direct markers of hydration. Dry mucosa, absence of tears, and oliguria reflect significant fluid loss. These findings give the nurse concrete evidence of hydration status and are key components of focused dehydration assessment.
Correct Answer: H. Heart rate
Tachycardia is an early compensatory response to hypovolemia in children. It often appears before hypotension and signals worsening dehydration. Monitoring heart rate trends provides crucial information about the child’s volume status and the effectiveness of rehydration therapy.
Why Other Options Are Wrong
A. Level of consciousness
Although changes in alertness can occur with severe dehydration and shock, it is not the most specific or early indicator compared with perfusion and hydration measures such as heart rate and mucous membranes
F. Pupil size and reactiveness
This is used to assess neurologic function, not hydration status. It does not provide useful information about fluid deficit or volume replacement.
G. Skin turgor
Skin turgor can be unreliable in infants and young children due to elasticity differences, fever, and nutritional status. It may supplement assessment but is less accurate than capillary refill, mucous membranes, and urine output.
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