Hesi Rn Fundamental NSG
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Free Hesi Rn Fundamental NSG Questions
The nurse observes an unlicensed assistive personnel (UAP) who is providing a total bed bath for a confused and lethargic client. The UAP is soaking the client’s foot in a basin of warm water placed on the bed. Which action should the nurse take?
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Remind the UAP to dry between the client’s toes completely.
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Advise the UAP that this procedure is damaging to the skin.
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Add skin cream to the basin of water while the foot is soaking.
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Remove the basin of water from the client’s bed immediately.
Explanation
Correct Answer:
Remove the basin of water from the client’s bed immediately.
Explanation:
Soaking a client's foot in water while on the bed creates a safety hazard, including risk of spills, electrical injury, or skin breakdown due to prolonged moisture exposure. Since the client is confused and lethargic, they are at greater risk for injury. The nurse must act immediately to eliminate the risk.
Why Other Options are Wrong:
Remind the UAP to dry between the client’s toes completely.
Drying is important to prevent fungal infections, but the current setup poses an immediate safety hazard that must be addressed first.
Advise the UAP that this procedure is damaging to the skin.
This feedback is educational but not urgent. Immediate removal of the hazard is the priority.
Add skin cream to the basin of water while the foot is soaking.
This is inappropriate and may further damage the skin or cause slipperiness and injury risk.
The nurse examines a client admitted with a deep, constant pain in the abdomen that radiates to the back. Which finding is most important for the nurse to report to the healthcare provider (HCP)?
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A bulge over umbilicus when coughing
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An audible abdominal bruit.
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Intermittent pain on deep inspiration.
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Hypoactive bowel sounds in all quadrants.
Explanation
Correct Answer:
B An audible abdominal bruit.
Explanation:
An audible abdominal bruit is an important finding that suggests possible vascular issues, such as an abdominal aortic aneurysm (AAA). Given the client's deep, constant abdominal pain that radiates to the back, the bruit may indicate a serious and life-threatening condition, such as an aneurysm. A bruit should be promptly reported to the healthcare provider as it requires immediate assessment and intervention to prevent complications, including rupture.
Why the Other Options are Incorrect:
A A bulge over the umbilicus when coughing: This finding may suggest the presence of an umbilical hernia, which, while important, is less urgent than the possibility of a vascular emergency like an aneurysm.
C Intermittent pain on deep inspiration: Intermittent pain with deep inspiration could suggest musculoskeletal or pleural causes, which are less critical than a potential vascular event.
D Hypoactive bowel sounds in all quadrants: Hypoactive bowel sounds could indicate a gastrointestinal issue, such as an ileus or bowel obstruction, but it does not carry the same immediate threat to life as the possibility of an aneurysm indicated by a bruit.
A nurse finds a client sitting on the floor beside the bed. The client is alert, denies pain, and states they slipped while trying to get up. What is the nurse’s priority action?
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Assist the client back to bed and perform a head-to-toe assessment.
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Complete an incident report and notify the charge nurse.
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Ask the client why they got out of bed unassisted.
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Document the event in the nurse’s notes and monitor the client for 24 hours.
Explanation
Correct Answer:
Assist the client back to bed and perform a head-to-toe assessment.
Explanation:
The first priority is client safety. Even if the client appears uninjured, an assessment must be performed before moving or continuing with documentation. This ensures no injuries are missed and establishes a baseline.
Why Other Options are Wrong:
Complete an incident report and notify the charge nurse.
This is necessary but not the priority. Assessment must occur before any administrative steps.
Ask the client why they got out of bed unassisted.
This could be part of the conversation later but is not urgent. Ensuring physical safety comes first.
Document the event in the nurse’s notes and monitor the client for 24 hours.
Documentation and monitoring are important, but only after the initial assessment is done to check for injury
The nurse is obtaining a health history for a client wishing to obtain a life insurance policy. When evaluating the abdomen, the client reports taking several antacids for heartburn that only occurs at night. Which additional finding associated with gastroesophageal reflux should the nurse ask the client to identify?
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Small frequent meals cause heartburn to worsen.
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Hyperactive bowel sounds are present in all quadrants.
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Bowel movements are light grey and chalky.
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Heartburn occurs when lying down at night.
Explanation
Correct Answer:
D. Heartburn occurs when lying down at night.
Explanation:
Gastroesophageal reflux disease (GERD) is a condition where stomach acid or bile irritates the food pipe lining, often leading to heartburn or acid reflux. One of the hallmark symptoms of GERD is the worsening of heartburn when lying down, particularly at night. This happens because when a person is in a supine position, gravity no longer helps keep the stomach contents from flowing back into the esophagus, which can lead to a more severe sensation of heartburn.
Why the Other Options are Incorrect:
A. Small frequent meals cause heartburn to worsen: While large meals can exacerbate heartburn, small meals typically help alleviate symptoms. Small, frequent meals are generally recommended to reduce reflux.
B. Hyperactive bowel sounds are present in all quadrants: Hyperactive bowel sounds are more commonly associated with gastrointestinal conditions such as diarrhea or infections, not specifically GERD.
C. Bowel movements are light grey and chalky: Light grey or chalky stool may indicate a problem with bile secretion or liver function, such as biliary obstruction, rather than GERD.
Which assessment data reflects the need for the nurse to include the problem, “Risk for falls” in a client’s plan of care?
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Expressed feelings of depression.
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Recent serum hemoglobin level of 16 g/dL (160 g/L).
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Opioid analgesic received one hour ago.
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Stooped posture with a steady gait.
Explanation
Correct Answer:
Opioid analgesic received one hour ago.
Explanation:
Opioids commonly cause sedation, dizziness, or impaired coordination, especially shortly after administration. These side effects significantly increase the risk of falls and must be addressed in the plan of care through fall precautions and close monitoring.
Why Other Options are Wrong:
Expressed feelings of depression.
Depression may affect activity levels but is not a direct or immediate risk factor for falls unless accompanied by psychomotor retardation or medication effects.
Recent serum hemoglobin level of 16 g/dL (160 g/L).
This is a normal hemoglobin level, indicating good oxygen-carrying capacity. It does not contribute to fall risk.
Stooped posture with a steady gait.
Posture alone does not necessarily indicate instability or fall risk, especially if the gait remains steady.
When inspecting a client's skin, the nurse observes an area of erythema on the arm. Which follow up assessment should the nurse complete?
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Determine the client's oxygen saturation
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Observe the appearance of the nailbeds
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Palpate the area for warmth and swelling
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Measure the degree of skin elasticity
Explanation
Correct Answer:
C. Palpate the area for warmth and swelling
Explanation:
Erythema refers to redness of the skin, which often indicates increased blood flow to the area due to inflammation, infection, or irritation. The appropriate follow-up assessment after noting erythema is palpation to determine if the area is also warm or swollen, which could suggest an inflammatory or infectious process. Warmth and swelling are classic signs of localized inflammation and help the nurse gather more data about the underlying cause of the erythema.
Why the other options are incorrect:
A. Determine the client's oxygen saturation
Oxygen saturation is more relevant when assessing cyanosis or other signs of hypoxia. Erythema does not typically suggest impaired oxygenation and does not warrant checking SpO2 as a direct follow-up.
B. Observe the appearance of the nailbeds
Nailbed assessment is useful when evaluating circulation, perfusion, or oxygenation. However, it is unrelated to localized erythema on the arm and would not provide specific information about that finding.
D. Measure the degree of skin elasticity
Skin elasticity is typically assessed in the context of hydration status, not inflammation or erythema. It would not help determine the cause or significance of the red area on the arm.
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 semiprivate room with a roommate who has the same diagnosis and airborne precautions.
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A semiprivate room with a roommate who has the same diagnosis and contact precautions.
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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.
Explanation
Correct Answer:
A private room with both contact and airborne precautions.
Explanation:
Varicella zoster virus (chickenpox or shingles) requires both airborne and contact precautions due to the virus being spread via respiratory droplets and direct contact with lesions. The patient must be in a private room to prevent transmission to others who may be susceptible.
Why Other Options are Wrong:
A semiprivate room with a roommate who has the same diagnosis and airborne precautions.
Even with the same diagnosis, this still poses unnecessary risk. Contact precautions are also required, and private room isolation is best practice.
A semiprivate room with a roommate who has the same diagnosis and contact precautions.
This setup misses the airborne precaution requirement. Both airborne and contact precautions must be used concurrently, and private rooms are preferred for infection control.
A private room with both standard and droplet precautions.
Droplet precautions are not sufficient for airborne pathogens like varicella. Airborne precautions require a negative-pressure room and specific PPE like N95 masks.
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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Ensure that the restraints are not too tight.
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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.
Explanation
Correct Answer:
Demonstrate proper securing of the restraints.
Explanation:
Securing restraints to movable parts like bedside rails is dangerous because it can lead to injury if the bed is adjusted. The priority is to prevent harm by immediately correcting the improper technique and demonstrating how to properly secure restraints to an immovable part of the bed frame.
Why Other Options are Wrong:
Ensure that the restraints are not too tight.
While tightness is important for circulation and skin integrity, correcting the attachment to a movable rail takes priority due to the immediate safety risk.
Complete an adverse occurrence/incident report.
Documentation can occur later if needed, but the first action must be to stop the unsafe practice.
Initiate the facility’s restraint flow sheet.
This is part of ongoing documentation, but addressing the unsafe application of restraints is more urgent.
Which assessment action should the nurse use when performing a cognitive ability exam?
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Observe physical grooming and hygiene.
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Tell the client to repeat a phrase that was said earlier.
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Ask the client to describe reactions in a difficult situation.
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Evaluate ability to brush and floss teeth.
Explanation
Correct Answer:
B. Tell the client to repeat a phrase that was said earlier.
Explanation:
In a cognitive ability exam, one of the most important aspects is assessing memory and recall, which can be tested by asking the client to repeat a phrase or a series of words after a short delay. This tests both short-term memory and attention, which are key components of cognitive function.
Why the other options are incorrect:
A. Observe physical grooming and hygiene.
While observing grooming and hygiene can provide information about a client's functional status and self-care abilities, it does not directly assess cognitive function. Cognitive assessments focus more on memory, attention, reasoning, and other cognitive processes.
C. Ask the client to describe reactions in a difficult situation.
While this might be useful for assessing emotional responses or coping mechanisms, it does not directly evaluate cognitive abilities like memory, orientation, or attention.
D. Evaluate ability to brush and floss teeth.
This would assess a client’s functional abilities and motor skills, not their cognitive abilities. Cognitive exams usually assess areas such as memory, attention, language, and executive functioning rather than physical tasks.
The nurse completes percussion of the abdomen on an adult client. Which finding is considered normal?
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Absolute dullness.
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Pain.
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Musical and drum-like.
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Absent sounds.
Explanation
Correct Answer:
C Musical and drum-like.
Explanation:
Musical and drum-like sounds heard during percussion of the abdomen are indicative of tympany, which is the normal finding when percussing over air-filled structures, such as the stomach and intestines. This sound occurs when the percussing hand strikes air, and it is the most common and expected sound heard in the abdominal cavity.
Why the Other Options are Incorrect:
A Absolute dullness: Dullness during percussion could indicate the presence of a solid mass, fluid, or an enlarged organ. It is not a normal finding in a healthy abdomen.
B Pain: Pain during percussion may indicate inflammation, infection, or other underlying conditions and is not a normal finding.
D Absent sounds: Absent sounds (silent abdomen) may suggest an obstruction or other severe gastrointestinal issues. It is not a normal finding in a healthy abdomen.
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