ADULT HEALTH II - HESI V2 EXAM
QUESTIONS & UPDATED CORRECT
ANSWERS ALL PASSED
An older adult woman with a long history of COPD is admitted with progressive shortness of
breath and a persistent cough, is anxious, and is complaining of dry mouth. Which intervention
should the nurse implement?
A. Administer a prescribed sedative
B. Encourage client to drink water
C. Apply a high flow venturi mask
D. Assist her to an upright position
D. Assist her to an upright position
A client with a history of asthma and bronchitis arrives at the clinic with shortness of breath,
productive cough with thickening mucous and the inability to walk up a flight of stairs without
experiencing breathlessness. Which action is most important for the nurse to instruct the client
about self care?
A. Increase the daily intake of oral fluids to liquify secretions
B. Avoid crowded enclosed areas to reduce pathogen exposure
C. Call the clinic if undesirable side effects or medications occur
D. Teach anxiety reduction methods for feelings of suffocation
A. Increase the daily intake of oral fluids to liquify secretions
A client with carcinoma of the lung is complaining of weakness and has a serum sodium level of
117 mEq/L. Which nursing problem should the nurse include in this clients plan of care?
A. Altered urinary elimination
B. Impaired gas exchange
C. Fluid volume excess
D. Decreased cardiac output
C. Fluid volume excess
While caring for a client with Amyotrophic Lateral Sclerosis (ALS), a nurse performs a
neurological assessment every 4 hours. Which assessment finding warrants immediate
intervention by the nurse?
, A. Inappropriate laughter
B. Increasing anxiety
C. Weakened cough effort
D. Asymmetrical weakness
D. Asymmetrical weakness
A client with Cushing's Syndrome is recovering from an elective laparoscopic procedure. Which
assessment finding warrants immediate intervention by the nurse?
A. Irregular apical pulse
B. Purple marks on skin of the abdomen.
C. Quarter sized blood spot on the dressing
D. Pitting ankle edema.
A. Irregular apical pulse.
While assisting a female client to the toilet, the client begins to have a seizure and the nurse
eases her to the floor. The nurse calls for help and monitors the client until the seizing stops.
Which intervention should the nurse implement first?
A. Document details of the seizure activity.
B. Observe for lacerations to the tongue.
C. Observe for prolonged periods of apnea.
D. Evaluate for evidence of incontinence.
C. Observe for prolonged periods of apnea.
The wife of a client with Parkinsons disease expresses concern because her husband has lost so
much weight. Which teaching is best for the nurse to provide?
A. Invite friends over regularly to share meal times
B. Encourage the client to drink clear liquids between meals
C. Coach the client to make an intentional effort to swallow
D. Talk to the HCP about prescribing an appetite stimulant
A. Invite friends over regularly to share meal times
A client who was discharged 8 months ago with cirrhosis and ascites is admitted with anorexia
and recent hemoptysis. The client is drowsy but responds to verbal stimuli. The nurse programs
a blood pressure monitor to take readings every 15 minutes. Which assessment should the
nurse implement first?
A. Evaluate distal capillary refill for delayed perfusion
B. Check the extremities for bruising and petechiae
QUESTIONS & UPDATED CORRECT
ANSWERS ALL PASSED
An older adult woman with a long history of COPD is admitted with progressive shortness of
breath and a persistent cough, is anxious, and is complaining of dry mouth. Which intervention
should the nurse implement?
A. Administer a prescribed sedative
B. Encourage client to drink water
C. Apply a high flow venturi mask
D. Assist her to an upright position
D. Assist her to an upright position
A client with a history of asthma and bronchitis arrives at the clinic with shortness of breath,
productive cough with thickening mucous and the inability to walk up a flight of stairs without
experiencing breathlessness. Which action is most important for the nurse to instruct the client
about self care?
A. Increase the daily intake of oral fluids to liquify secretions
B. Avoid crowded enclosed areas to reduce pathogen exposure
C. Call the clinic if undesirable side effects or medications occur
D. Teach anxiety reduction methods for feelings of suffocation
A. Increase the daily intake of oral fluids to liquify secretions
A client with carcinoma of the lung is complaining of weakness and has a serum sodium level of
117 mEq/L. Which nursing problem should the nurse include in this clients plan of care?
A. Altered urinary elimination
B. Impaired gas exchange
C. Fluid volume excess
D. Decreased cardiac output
C. Fluid volume excess
While caring for a client with Amyotrophic Lateral Sclerosis (ALS), a nurse performs a
neurological assessment every 4 hours. Which assessment finding warrants immediate
intervention by the nurse?
, A. Inappropriate laughter
B. Increasing anxiety
C. Weakened cough effort
D. Asymmetrical weakness
D. Asymmetrical weakness
A client with Cushing's Syndrome is recovering from an elective laparoscopic procedure. Which
assessment finding warrants immediate intervention by the nurse?
A. Irregular apical pulse
B. Purple marks on skin of the abdomen.
C. Quarter sized blood spot on the dressing
D. Pitting ankle edema.
A. Irregular apical pulse.
While assisting a female client to the toilet, the client begins to have a seizure and the nurse
eases her to the floor. The nurse calls for help and monitors the client until the seizing stops.
Which intervention should the nurse implement first?
A. Document details of the seizure activity.
B. Observe for lacerations to the tongue.
C. Observe for prolonged periods of apnea.
D. Evaluate for evidence of incontinence.
C. Observe for prolonged periods of apnea.
The wife of a client with Parkinsons disease expresses concern because her husband has lost so
much weight. Which teaching is best for the nurse to provide?
A. Invite friends over regularly to share meal times
B. Encourage the client to drink clear liquids between meals
C. Coach the client to make an intentional effort to swallow
D. Talk to the HCP about prescribing an appetite stimulant
A. Invite friends over regularly to share meal times
A client who was discharged 8 months ago with cirrhosis and ascites is admitted with anorexia
and recent hemoptysis. The client is drowsy but responds to verbal stimuli. The nurse programs
a blood pressure monitor to take readings every 15 minutes. Which assessment should the
nurse implement first?
A. Evaluate distal capillary refill for delayed perfusion
B. Check the extremities for bruising and petechiae
