Download H.E.S.I Fundamentals Exam 2025 Study Guide: Complete Overview of Questions, Topics and more Exams Nursing in PDF only on Docsity!
HESI Fundamentals Exam 2025 Study Guide:
Complete Overview of Questions, Topics, and Test
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Question 1: A client who has a pressure-relieving mattress overlay is mobilized to a chair and imprints of the client's buttocks, heels, and scapula are evident on the mattress overlay. What action should the practical nurse implement? A) Document the findings as normal for this type of mattress. B) Reposition the client more frequently while in bed. C) Apply a different pressure-relieving device and assess its effectiveness for this client. D) Limit the client's time spent in the chair. Rationale: The correct answer is C. The presence of imprints on a pressure-relieving mattress indicates that it may not be adequately redistributing pressure for this particular client, increasing the risk of pressure ulcer development. A different device should be tried, and its effectiveness should be evaluated. Question 2: The practical nurse (PN) is obtaining information for a male client's psychosocial assessment. Which action should the PN implement first? A) Review the client's medical history. B) Contact the client's family members for information. C) Establish a therapeutic relationship. D) Administer a standardized psychosocial assessment tool. Rationale: The correct answer is C. Establishing a therapeutic relationship based on trust and rapport is the foundation for obtaining honest and comprehensive information during a psychosocial assessment. Question 3: In planning care for an older client on bed rest, which intervention should the practical nurse include in the prevention of pressure ulcers? A) Massage bony prominences frequently.
B) Use donut-shaped cushions under pressure points. C) Elevate the head of the bed less than 30 degrees. D) Apply heat lamps to increase circulation. Rationale: The correct answer is C. Elevating the head of the bed to less than 30 degrees helps to reduce shearing forces and pressure on the sacrum and heels, common sites for pressure ulcer development. Massaging bony prominences (A) can damage tissues. Donut-shaped cushions (B) can impair circulation. Heat lamps (D) can cause burns. Question 4: A client's indwelling urinary catheter is removed at 9:30 AM. The practical nurse (PN) assesses the client every 2 hours for the desire to void. Which documented assessment is the earliest time requiring further intervention by the PN? A) 11:30 AM: states no urge to void. B) 1:30 PM: states no urge to void. C) 3:30 PM: states no urge to void. D) 5:30 PM: unable to void. Rationale: The correct answer is D. Most clients should void within 6-8 hours after catheter removal. Inability to void by 5:30 PM (8 hours after removal) requires further assessment and intervention to rule out urinary retention. Question 5: A male client who is 2 days postoperative for exploratory abdominal surgery is ambulating in the hall with the practical nurse (PN). The client tells the PN, "I think something in my incision just let go." Which action should the PN implement first? A) Leave the client standing and inspect the incision. B) Help the client sit in a nearby chair. C) Assist the client to a supine position. D) Call for assistance from another nurse. Rationale: The correct answer is C. The client's statement suggests potential wound dehiscence or evisceration. Placing the client supine with knees bent helps to reduce tension on the abdominal incision and prevents further protrusion of tissues or organs. Question 6:
Rationale: The correct answer is C. The client's concern warrants verification of the medication order to ensure the correct drug, dose, and form are being administered. Question 9: The practical nurse (PN) is assessing a client with dark skin who is in respiratory distress. Which client response should the PN evaluate to determine cyanosis in this client? A) Assess the nail beds for a bluish tinge. B) Observe the sclera for a yellowish discoloration. C) The lips and mucous membranes of a client with dark skin are dusky in color. D) Evaluate the skin on the palms and soles for pallor. Rationale: The correct answer is C. Cyanosis, a bluish discoloration indicating hypoxemia, is best assessed in the mucous membranes (lips, gums, tongue) and conjunctiva in clients with dark skin. Question 10: An older female recently diagnosed with coronary artery disease (CAD) cooks at home using saturated fats. Which intervention should the practical nurse implement to help the client reduce modifiable risk factors? A) Suggest eliminating all fats from her diet. B) Recommend using butter instead of margarine. C) Encourage food preparation with various vegetable oils. D) Advise her to increase her intake of red meat. Rationale: The correct answer is C. Replacing saturated fats with unsaturated fats, such as those found in vegetable oils, can help lower LDL cholesterol levels and reduce the risk of CAD. Question 11: A family member of a dying client asks the practical nurse (PN) if the client knows the family is at the bedside. The PN explains that which of the five senses persists the longest during the dying process? A) Sight.
B) Taste. C) Touch. D) Hearing. Rationale: The correct answer is D. Hearing is often the last sense to be lost as the body systems begin to shut down during the dying process. Question 12: The practical nurse (PN) is changing a postoperative dressing for a client with a horizontal lower abdominal incision. What method should the PN use to remove the tape from the dressing? A) Pull all pieces of tape quickly and simultaneously. B) Remove each piece of tape by pulling it away from the incision line. C) Remove all four sides by moving to the center of the incision. D) Lift each end of the tape and pull upward at a 90-degree angle. Rationale: The correct answer is C. Removing tape by pulling towards the center of the incision minimizes stress and tension on the healing wound edges. Question 13: A client with cancer who has been taking opioid analgesics for two years now requires increased doses to obtain pain relief. The client expresses fear about becoming addicted to these drugs. What information should the practical nurse (PN) provide? A) "You should try to decrease your dose to avoid addiction." B) "Prescribed opiates for cancer pain relief improve quality of life." C) "Addiction is a common problem with long-term opioid use." D) "We can switch you to a non-opioid pain medication." Rationale: The correct answer is B. For clients with chronic cancer pain, the focus of opioid therapy is pain relief and improved quality of life. Tolerance (requiring increased doses) is different from psychological addiction. Question 14:
- E) Use enema fluid that is cooler than body temperature: Enema fluid should be near body temperature (around 105°F or 40.5°C) to minimize discomfort and cramping. Question 16: Which assessment should the practical nurse (PN) make to best evaluate a client's fluid status? A) Hourly urine output. B) Skin turgor and mucous membranes. C) Daily body weight. D) Intake and output records every shift. Rationale: The correct answer is C. Daily body weight is a sensitive indicator of fluid balance. A sudden increase or decrease in weight often reflects changes in fluid volume. Question 17: The practical nurse (PN) obtains an elevated blood pressure reading for an older male client who is alert. When the PN offers the client his morning blood pressure medication, he refuses to take it. What action should the PN take? A) Document the refusal and notify the healthcare provider. B) Insist that the client take the medication as prescribed. C) Explain the importance of routine use of antihypertensives. D) Withhold the medication and offer it again later. Rationale: The correct answer is C. As an alert adult, the client has the right to refuse medication. However, the nurse should provide education about the importance of taking prescribed medications for managing hypertension. Question 18: During insertion of a nasogastric tube (NGT) into the right nares, the client starts to cough. Which action should the practical nurse (PN) implement? A) Tell the client to try to stop coughing. B) Advance the NGT quickly before the client can cough again.
C) Withdraw the NGT to the oral pharynx, reposition client's head and reinsert. D) Temporarily stop the insertion and then continue when the client stops coughing. Rationale: The correct answer is C. Coughing during NGT insertion suggests the tube may have entered the trachea. The tube should be withdrawn to the oral pharynx, the client's head should be flexed forward (if tolerated), and then reinsertion should be attempted. Question 19: An older male client tells the practical nurse (PN) that his religion does not permit him to bathe daily. How should the PN respond? A) Tell the client that daily bathing is important for hygiene. B) Ask the client to clarify his religious beliefs about bathing. C) Explain that the hospital policy requires daily bathing. D) Offer the client a sponge bath instead of a shower. Rationale: The correct answer is B. Respecting the client's religious beliefs is important. The nurse should ask the client to explain their beliefs to understand any specific restrictions or practices related to hygiene. Question 20: Which growth and developmental characteristic should the practical nurse (PN) consider when discussing spirituality with an adolescent client? A) Adolescents typically accept their family's religious beliefs without question. B) Adolescents are usually not interested in spiritual topics. C) Adolescents often question religious practices and values. D) Adolescents have a fully formed and stable spiritual identity. Rationale: The correct answer is C. Adolescence is a period of questioning and exploration, including spiritual and religious beliefs. Teenagers often begin to critically examine the values and practices they were raised with. Question 21:
Rationale: The correct answer is C. Before any preparation steps, the nurse must verify that the correct drug, dose, route, and time are being prepared by comparing the medication label with the MAR. Question 24: The practical nurse (PN) is assisting a client plan a balanced vegetarian diet that provides the highest in protein quality. Which selection should the PN recommend to the client? A) Whole wheat bread and peanut butter. B) Rice and beans. C) Corn and lentils. D) Soybeans. Rationale: The correct answer is D. Soybeans are a complete protein, meaning they contain all nine essential amino acids in sufficient amounts, making them a high-quality protein source for vegetarians. While combining grains and legumes (A, B, C) can create complementary proteins, soybeans are complete on their own. Question 25: The practical nurse (PN) is irrigating a client's indwelling urinary catheter. After injecting sterile solution as prescribed, what action should the PN implement? A) Clamp the catheter tubing for 30 minutes. B) Aspirate the irrigating solution back into the syringe. C) Unclamp the tubing and lower the collection bag. D) Immediately remove the syringe from the catheter. Rationale: The correct answer is C. After instilling the irrigating solution, the tubing should be unclamped and the collection bag lowered to allow the solution and any debris to drain out by gravity. Question 26: When irrigating the external ear canals of an older adult client, which action should the practical nurse (PN) use to soften dry cerumen for removal? A) Use cold water for the irrigation solution. B) Instill mineral oil in the external auditory canal overnight before irrigation.
C) Irrigate with a forceful stream of water. D) Use cotton swabs to manually remove the cerumen. Rationale: The correct answer is B. Instilling mineral oil overnight helps to soften impacted, dry cerumen, making it easier and safer to remove with gentle irrigation. Question 27: The practical nurse (PN) observes a client who begins to choke during a meal. After determining that the client cannot speak, what action should the PN implement? A) Encourage the client to cough forcefully. B) Perform abdominal thrusts (Heimlich maneuver). C) Perform chest thrusts. D) Sweep the client's mouth with a finger. Rationale: The correct answer is B. The inability to speak indicates a complete airway obstruction. Abdominal thrusts (Heimlich maneuver) are the recommended first-aid technique to dislodge the obstruction in an adult. Question 28: Which intervention provides confirmation of nasogastric tube (NGT) placement before NGT feedings are started? A) Auscultation of air instilled into the stomach. B) pH testing of aspirated gastric contents. C) Measurement of the exposed length
