BSN 266 HESI V2 EXAM QUESTIONS
WITH 100% CORRECT ANSWERS
Large waist Circumference with central fat. - Answer-Patient is an obese adult, and the
nurse is calculating BMI. Which additional assessment finding place the client at high
risk for cardiac disease?
Discuss the importance of a regular exercise program
Measure the client's BP in both arms
Screen for a family history of diabetes mellitus. - Answer-What is the nurses actions in
finding abdominal obesity and high waist-hip ratio with a BMI of 32? SATA
** - Answer-A patient who is an adult woman with Graves' disease admitted with severe
dehydration and malnutrition & restlessness refuses to eat. What action is most
important for the nurse to implement?
Measure vital signs - Answer-A patient is hospitalized with IBD exacerbation and treated
with coritcosteroid. The patient develops a rigid abdomen with rebound tenderness.
Which action should the nurse take?
* - Answer-A patient with obstructive sleep apnea has difficulty wearing CPAP due to it
being uncomfortable. The patient asks about alternative ways to manage sleep apnea.
Which recommendation should the nurse provide?
** - Answer-Which outcome should the nurse include in the plan of care for a patient
with hypertension who reports chest pain on exertion?
Report any changes in sputum color- This is a sign of infection. It is a common problem
in COPD patients and request immediate antibiotic therapy to prevent an acute and
prolonged exacerbation of COPD. - Answer-Which instructions is most important for the
nurse to emphasize in discharge teaching in patients with COPD?
check his fingerstick glucose level
assess his skin temperature and moisture
measure his pulse and BP - Answer-An overweight young adult diagnosed with type 2
diabetes is admitted for hernia repair, the patient feels weak and jittery. Which actions
should the nurse implement? SATA
8/10 x 2= 1.6 mL - Answer-O- 8 mg q 4h PRN. A- 10 mg/2 mL. How many mL should
the nurse administer?
, Sputum culture - Answer-A patient is suspected of having TB is in a private room with
airborne precautions pending test results. Which diagnostic test should the nurse review
to confirm the diagnosis of TB?
Monitor weight gain - Answer-Which instructions should the nurse include in the
discharge teaching plan of a patient started treatment for newly diagnosed diabetes
insipidus?
Assess swallowing abilities is a high priority for patients. - Answer-Which additional
nursing assessments takes priority in response to a patient with Parkinson's disease
exhibiting a mask like facial appearance?
Take prescribed cortisone accurately - Answer-A patient is recently diagnosed with
Addison's disease. Which instructions is most important for the nurse to include in
discharge teaching?
Teach the client to elevate the head of the bed on blocks - Answer-Which instructions is
most important for the nurse to emphasize during discharge for a patient with GERD?
Breath deeply and cough to produce sputum. - Answer-Which steps should the nurse
instruct the client to follow when collecting sputum?
250/4 = 62.5 = 63 mL/hr - Answer-The nurse should regulate the infusion pump to
deliver how many mL/hr? IV normal saline 250 mL with 30 mEq to administer over 4
hours is prescribed for post-op patients.
Oatmeal, raisins, and fruit with skin. - Answer-Which group of food is best for the nurse
to recommend for a patient with strong family history of colon and rectal cancer?
Instruct the patient to keep their fingernails short and file rough edges - Answer-Which
intervention should the nurse include in the teaching plan for a client with pruritus?
Guaifenesin - Answer-A patient with lung cancer who has a constant dry cough and is
exhausted from coughing. Which medication should the nurse administer to this
patient?
Serum electrolytes - Answer-A patient had surgery yesterday with a respiratory rate
increase to 38, and NG tube with yellow-green drainage over the last 4 hours. ABGs
indicate decreased Co2 and increased serum pH. Which serum lab value should the
nurse monitor first?
* - Answer-A patient with cirrhosis of the liver and hepatic failure placed on low sodium
diet and receiving periodic albumin infusions. Which assessment finding indicates
progress towards the desired effect of this treatment?
WITH 100% CORRECT ANSWERS
Large waist Circumference with central fat. - Answer-Patient is an obese adult, and the
nurse is calculating BMI. Which additional assessment finding place the client at high
risk for cardiac disease?
Discuss the importance of a regular exercise program
Measure the client's BP in both arms
Screen for a family history of diabetes mellitus. - Answer-What is the nurses actions in
finding abdominal obesity and high waist-hip ratio with a BMI of 32? SATA
** - Answer-A patient who is an adult woman with Graves' disease admitted with severe
dehydration and malnutrition & restlessness refuses to eat. What action is most
important for the nurse to implement?
Measure vital signs - Answer-A patient is hospitalized with IBD exacerbation and treated
with coritcosteroid. The patient develops a rigid abdomen with rebound tenderness.
Which action should the nurse take?
* - Answer-A patient with obstructive sleep apnea has difficulty wearing CPAP due to it
being uncomfortable. The patient asks about alternative ways to manage sleep apnea.
Which recommendation should the nurse provide?
** - Answer-Which outcome should the nurse include in the plan of care for a patient
with hypertension who reports chest pain on exertion?
Report any changes in sputum color- This is a sign of infection. It is a common problem
in COPD patients and request immediate antibiotic therapy to prevent an acute and
prolonged exacerbation of COPD. - Answer-Which instructions is most important for the
nurse to emphasize in discharge teaching in patients with COPD?
check his fingerstick glucose level
assess his skin temperature and moisture
measure his pulse and BP - Answer-An overweight young adult diagnosed with type 2
diabetes is admitted for hernia repair, the patient feels weak and jittery. Which actions
should the nurse implement? SATA
8/10 x 2= 1.6 mL - Answer-O- 8 mg q 4h PRN. A- 10 mg/2 mL. How many mL should
the nurse administer?
, Sputum culture - Answer-A patient is suspected of having TB is in a private room with
airborne precautions pending test results. Which diagnostic test should the nurse review
to confirm the diagnosis of TB?
Monitor weight gain - Answer-Which instructions should the nurse include in the
discharge teaching plan of a patient started treatment for newly diagnosed diabetes
insipidus?
Assess swallowing abilities is a high priority for patients. - Answer-Which additional
nursing assessments takes priority in response to a patient with Parkinson's disease
exhibiting a mask like facial appearance?
Take prescribed cortisone accurately - Answer-A patient is recently diagnosed with
Addison's disease. Which instructions is most important for the nurse to include in
discharge teaching?
Teach the client to elevate the head of the bed on blocks - Answer-Which instructions is
most important for the nurse to emphasize during discharge for a patient with GERD?
Breath deeply and cough to produce sputum. - Answer-Which steps should the nurse
instruct the client to follow when collecting sputum?
250/4 = 62.5 = 63 mL/hr - Answer-The nurse should regulate the infusion pump to
deliver how many mL/hr? IV normal saline 250 mL with 30 mEq to administer over 4
hours is prescribed for post-op patients.
Oatmeal, raisins, and fruit with skin. - Answer-Which group of food is best for the nurse
to recommend for a patient with strong family history of colon and rectal cancer?
Instruct the patient to keep their fingernails short and file rough edges - Answer-Which
intervention should the nurse include in the teaching plan for a client with pruritus?
Guaifenesin - Answer-A patient with lung cancer who has a constant dry cough and is
exhausted from coughing. Which medication should the nurse administer to this
patient?
Serum electrolytes - Answer-A patient had surgery yesterday with a respiratory rate
increase to 38, and NG tube with yellow-green drainage over the last 4 hours. ABGs
indicate decreased Co2 and increased serum pH. Which serum lab value should the
nurse monitor first?
* - Answer-A patient with cirrhosis of the liver and hepatic failure placed on low sodium
diet and receiving periodic albumin infusions. Which assessment finding indicates
progress towards the desired effect of this treatment?
