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NUR 3226 – Adult Health Nursing II (HESI Specialty style) Questions and Correct Answers (, Exams of Nursing

UNAD FloridaNursing

NUR 3226 – Adult Health Nursing II (HESI Specialty style) Questions and Correct Answers (Verified Answers) with Rationales 2025 Questions are formatted similarly to what you'd expect on the HESI Adult Health Specialty exam

Typology: Exams

2024/2025

Available from 06/23/2025

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NUR 3226 – Adult Health Nursing II (HESI Specialty
style) Questions and Correct Answers (Verified
Answers) with Rationales 2025
Questions are formatted similarly to what you'd expect on the HESI Adult Health
Specialty exam.
1. A nurse is caring for a client with a chest tube. What is the priority action if
the chest tube becomes dislodged from the chest?
Apply a sterile occlusive dressing and notify the healthcare provider immediately.
This prevents air from entering the pleural space and worsening a pneumothorax.
2. A client with chronic obstructive pulmonary disease (COPD) is
experiencing shortness of breath. Which position should the nurse place
the client in?
High Fowler’s with arms supported on an overbed table
This position promotes maximum lung expansion and eases breathing.
3. A client with heart failure is receiving furosemide. Which laboratory value
should the nurse monitor closely?
Potassium
Loop diuretics like furosemide can cause hypokalemia, which may lead to arrhythmias.
4. A nurse is monitoring a client with a newly inserted central venous
catheter. Which finding requires immediate intervention?
Shortness of breath and chest pain
These signs could indicate a pneumothorax or air embolism, which are emergencies.
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Download NUR 3226 – Adult Health Nursing II (HESI Specialty style) Questions and Correct Answers ( and more Exams Nursing in PDF only on Docsity!

NUR 3226 – Adult Health Nursing II (HESI Specialty

style) Questions and Correct Answers (Verified

Answers) with Rationales 2025

Questions are formatted similarly to what you'd expect on the HESI Adult Health Specialty exam.

  1. A nurse is caring for a client with a chest tube. What is the priority action if the chest tube becomes dislodged from the chest? Apply a sterile occlusive dressing and notify the healthcare provider immediately. This prevents air from entering the pleural space and worsening a pneumothorax.
  2. A client with chronic obstructive pulmonary disease (COPD) is experiencing shortness of breath. Which position should the nurse place the client in? High Fowler’s with arms supported on an overbed table This position promotes maximum lung expansion and eases breathing.
  3. A client with heart failure is receiving furosemide. Which laboratory value should the nurse monitor closely? Potassium Loop diuretics like furosemide can cause hypokalemia, which may lead to arrhythmias.
  4. A nurse is monitoring a client with a newly inserted central venous catheter. Which finding requires immediate intervention? Shortness of breath and chest pain These signs could indicate a pneumothorax or air embolism, which are emergencies.
  1. A client with type 2 diabetes is taking metformin. What is the most important instruction for the nurse to give before a CT scan with contrast? Hold the metformin before and for 48 hours after the procedure. This reduces the risk of lactic acidosis if kidney function is impaired by the contrast.
  2. A client is admitted with suspected appendicitis. Which assessment finding should the nurse report immediately? Rebound tenderness and a rigid abdomen These may indicate peritonitis from a ruptured appendix.
  3. A nurse is teaching a client with hypertension about lifestyle changes. Which statement indicates a need for further teaching? “I can stop taking my medications once my blood pressure is normal.” Antihypertensive therapy is usually lifelong; stopping suddenly can cause rebound hypertension.
  4. A nurse assesses a client with cirrhosis. Which finding is expected? Spider angiomas Spider angiomas are common in liver disease due to estrogen metabolism disturbances.
  5. Which intervention is most appropriate for a client with nephrotic syndrome? Monitor for signs of infection. Nephrotic syndrome involves protein loss, including immunoglobulins, increasing infection risk.
  6. A client receiving heparin develops hematuria. What action should the nurse take?

Assess the fit of the appliance and provide skin barrier products. Improper fit can cause leakage and irritation; skin protection is essential.

  1. The nurse is preparing to administer digoxin. The client's pulse is 54 bpm. What is the priority action? Hold the dose and notify the healthcare provider. Digoxin can cause bradycardia; hold if HR < 60 bpm in adults.
  2. A client with deep vein thrombosis is prescribed warfarin. What should be monitored? INR INR monitors therapeutic effects of warfarin to prevent bleeding or clotting.
  3. A client is admitted with diabetic ketoacidosis. Which insulin should the nurse prepare? Regular insulin IV Only regular insulin can be given IV in emergencies like DKA.
  4. A client with liver cirrhosis has a high ammonia level. What is the likely clinical manifestation? Confusion and altered mental status High ammonia causes hepatic encephalopathy, leading to neurologic changes.
  5. A nurse notes blood pressure 80/50 mmHg post-surgery. What is the priority action? Assess the client’s level of consciousness and signs of shock. Hypotension may indicate hypovolemia or hemorrhage post-op.
  6. A nurse receives a client from PACU with an indwelling catheter and no urine output for 3 hours. What is the initial action?

Check for catheter kinks or obstruction. Ensure the catheter is patent before assuming kidney dysfunction.

  1. A client with asthma is using albuterol frequently. What adverse effect should the nurse monitor? Tachycardia Beta-agonists like albuterol stimulate the heart and can cause tachycardia.
  2. A client with tuberculosis is prescribed rifampin. What teaching is essential? “Your urine and other secretions may turn orange.” This is a harmless but expected side effect of rifampin.
  3. A nurse is assessing a client with peripheral arterial disease. What symptom is expected? Pain when walking that is relieved by rest This is called intermittent claudication, common in PAD.
  4. Which finding is most concerning in a client with a tracheostomy? Coughing and gurgling sounds from the trach These indicate secretion buildup and possible airway obstruction.
  5. A client is taking prednisone. Which symptom should be reported immediately? Black tarry stools This suggests GI bleeding, a potential side effect of corticosteroids.
  6. Which of the following diets is best for a client with congestive heart failure?
  1. A nurse is caring for a post-op client with an NG tube. The output is green. What is the appropriate action? Document the finding as normal Green fluid indicates gastric content and is expected.
  2. What is the most important lab value to monitor in a client taking enoxaparin? Platelet count Low platelets may indicate heparin-induced thrombocytopenia (HIT).
  3. Which intervention prevents complications in a client with a femoral vein catheter for hemodialysis? Avoid taking BP or blood draws in the catheter arm Protects the integrity of the access site.
  4. What is a priority action for a client experiencing acute angina? Administer sublingual nitroglycerin Relieves ischemic chest pain by dilating coronary arteries.
  5. A nurse is reviewing discharge teaching for a client with GERD. Which statement indicates understanding? “I will avoid lying down after meals.” Reduces reflux by using gravity to keep acid in the stomach.
  6. A client with a mechanical valve replacement is on warfarin. What should the nurse teach? Report any signs of bleeding immediately. Anticoagulation increases bleeding risk.
  1. A client with COPD is prescribed oxygen at 4 L/min via nasal cannula. What is the appropriate action? Contact the provider to decrease the flow rate. High flow oxygen may reduce the hypoxic drive in COPD clients.
  2. A nurse is caring for a client post-thyroidectomy. What is the priority assessment? Airway patency and signs of bleeding Post-op complications include airway obstruction from hematoma or swelling.
  3. A nurse assesses a client post-laparoscopic cholecystectomy. Which finding requires immediate attention? Shoulder pain unrelieved by analgesics May indicate bile leak or diaphragmatic irritation.
  4. What is the best indicator of fluid status in a heart failure client? Daily weight It reflects fluid gain or loss more accurately than I&O.
  5. A nurse is teaching a client with iron-deficiency anemia. What food should be included? Red meat and leafy green vegetables These are high in iron and help treat anemia.
  6. What is a common side effect of opioids? Constipation Opioids slow bowel motility and often require stool softeners.
  1. A client is receiving morphine for pain. Which assessment finding is most concerning? Respiratory rate of 8/min Morphine can depress the respiratory center; immediate intervention is needed.
  2. A client has a potassium level of 6.2 mEq/L. What is the most important intervention? Administer sodium polystyrene sulfonate as ordered It helps remove potassium via the GI tract, lowering serum levels.
  3. What is the priority teaching for a client newly prescribed levothyroxine? Take the medication on an empty stomach in the morning Absorption is optimal when taken before food.
  4. A nurse is assessing a client with right-sided heart failure. Which symptom is expected? Peripheral edema Right-sided failure causes fluid buildup in the systemic circulation.
  5. A client is admitted for an adrenal crisis. What is the priority intervention? Administer IV hydrocortisone This replaces the cortisol the body cannot produce during crisis.
  6. A nurse is caring for a client with diabetic neuropathy. What should the nurse include in discharge teaching? Inspect feet daily with a mirror Neuropathy can lead to unnoticed injuries and ulcers.
  7. What is a key safety measure when administering potassium IV?

Use an infusion pump to control the rate Rapid potassium infusion can cause fatal arrhythmias.

  1. A client with COPD is receiving corticosteroids. What adverse effect should the nurse monitor? Hyperglycemia Steroids increase blood glucose levels.
  2. A client with GI bleeding has a BUN of 40 mg/dL. What does this suggest? Possible upper GI bleeding BUN increases due to digestion of blood proteins in the GI tract.
  3. Which finding indicates a complication of peritoneal dialysis? Cloudy peritoneal fluid Cloudiness may signal peritonitis, a serious infection.
  4. A nurse is reviewing ABG results: pH 7.32, PaCO2 52, HCO3 24. What is the interpretation? Respiratory acidosis pH is low and CO2 is high, indicating a respiratory problem.
  5. A client with anemia reports fatigue and dyspnea. What is the most appropriate initial nursing action? Assess oxygen saturation Oxygen delivery may be impaired due to low hemoglobin.
  6. What is the most accurate method to confirm a nasogastric tube placement?

Elevate the head of the bed 30–45 degrees Reduces the risk of aspiration and VAP.

  1. A client reports chest pain unrelieved by rest. What is the first nursing action? Administer prescribed nitroglycerin First-line treatment for angina is nitrates.
  2. Which condition is a contraindication to thrombolytic therapy in stroke? Recent surgery Thrombolytics increase bleeding risk and are contraindicated post-op.
  3. A client receiving amphotericin B reports chills and fever. What is the nurse’s priority action? Notify the healthcare provider and monitor vitals These are common but serious side effects.
  4. What symptom is expected in a client with multiple sclerosis? Muscle weakness and spasticity MS involves demyelination of nerves, affecting movement.
  5. A nurse notes a pressure injury with exposed muscle. What stage is this? Stage 4 Full-thickness tissue loss with exposed bone, muscle, or tendon.
  6. A client reports palpitations after taking albuterol. What should the nurse do? Assess vital signs and notify provider if abnormal Palpitations may be due to systemic beta-agonist effects.
  1. What lab value should be monitored with enalapril? Serum potassium ACE inhibitors can cause hyperkalemia.
  2. A client with ascites is scheduled for paracentesis. What is the priority action? Have the client empty their bladder Prevents bladder injury during the procedure.
  3. A nurse reviews ECG and notes ST-segment elevation. What does this suggest? Myocardial infarction ST elevation is a hallmark sign of acute MI.
  4. A nurse is preparing a client for cardiac catheterization. Which allergy is a priority concern? Iodine or shellfish Contrast media may trigger an allergic reaction.
  5. A client with COPD reports feeling drowsy. ABG results show pH 7.28, PaCO2 58. What is the nurse’s priority? Initiate noninvasive positive pressure ventilation Improves ventilation and corrects respiratory acidosis.
  6. A client with HIV has a CD4 count of 150. What should the nurse anticipate? Start prophylaxis for opportunistic infections CD4 < 200 increases infection risk; prophylaxis is required.

Assess urine output and fluid status Kidney function must be monitored to guide fluid and medication management.

  1. What action helps prevent complications in a client with a urinary catheter? Keep the drainage bag below bladder level Prevents backflow and infection.
  2. A client is taking metronidazole. Which instruction is essential? Avoid alcohol during and after treatment Causes a disulfiram-like reaction (nausea, vomiting, hypotension).
  3. Which finding indicates effective treatment of pneumonia? Clear lung sounds and oxygen saturation above 95% These suggest improved ventilation and gas exchange.
  4. What is a priority nursing diagnosis for a client with acute pancreatitis? Acute pain Pain from inflammation is severe and must be addressed first.
  5. A client with ARDS is on a ventilator. Which setting supports oxygenation? Positive end-expiratory pressure (PEEP) PEEP keeps alveoli open to improve oxygen exchange.
  6. What lab result is most important in a client receiving gentamicin? Serum creatinine Gentamicin is nephrotoxic and requires renal monitoring.
  7. What symptom suggests a complication of percutaneous coronary intervention (PCI)?

Back pain and hypotension May indicate retroperitoneal bleeding, a serious complication.

  1. A client is receiving TPN. What should the nurse monitor closely? Blood glucose levels TPN is high in dextrose and can cause hyperglycemia.
  2. A nurse is caring for a client with sickle cell crisis. What is the priority intervention? Administer IV fluids Hydration helps reduce blood viscosity and prevent sickling.
  3. What is the best indicator of long-term glycemic control? Hemoglobin A1c Reflects average glucose levels over the past 2–3 months.