BSN 246 HESI Exam Practice Questions and Answers
Question 1
A client with cirrhosis of the liver asks the registered nurse (RN) to explain how varicose veins can occur in the
esophagus. Which statement should the RN provide to teach the client about the physiological etiology?
The enlarged liver presses on the lower half of the esophagus which weakens blood vessel walls.
Abnormal vessels form as a result of liver damage that causes chronic low serum protein levels.
Esophageal swelling and tissue damage causes blood to circulate blood back through the stomach.
Increased portal pressure causes blood flow through liver to be shunted to the esophageal vessels.
Correct Answer
Increased portal pressure causes blood flow through liver to be shunted to the esophageal vessels.
Rationale
Cirrhotic and fibrosed liver damage causes obstructed blood flow through portal vessels to the liver which
increases the portal pressure causing the blood flow through the liver to be shunted to the esophageal vessels.
The result of this shunting of blood causes the esophageal vessels (veins) to balloon out and weaken. As the
portal hypertension increases, these esophageal varices can rupture and cause bleeding resulting in bloody
emesis and black tarry stools
Page 1 of 52
,Question 2
The registered nurse (RN) is assessing a client who was discharged home after management of chronic
hypertension. Which equipment should the RN instruct the client to use at home?
Exercise bicycle.
Sphygmomanometer.
Blood glucose monitor.
Weekly medication box.
Correct Answer
Sphygmomanometer.
Rationale
Self-awareness is the best way for a client to manage chronic hypertension, so the client should obtain a
sphygmomanometer and learn how to monitor blood pressure daily and maintain a record.
Page 2 of 52
,Question 3
The registered nurse (RN) is caring for a client who developed oliguria and was diagnosed with sepsis and
dehydration 48 hours ago. Which assessment finding indicates to the RN that the client is stabilizing?
Urine output of 40 mL/hour.
Apical pulse 100 and blood pressure 76/42.
Urine specific gravity 1.001.
Tented skin on dorsal surface of hands.
Correct Answer
Urine output of 40 mL/hour.
Rationale
A decrease in urinary output is a sign of dehydration. When the urine output returns to a normal range, 40
mL/hour, the client's kidneys are perfusing adequately and indicates the client's status is stablizing.
Page 3 of 52
, Question 4
Twenty four hours after a client returns from surgical gastric bypass, the registered nurse (RN) observes large
amounts of blood in the nasogastric tube (NGT) cannister. Which assessment finding should the RN report as early
signs of hypovolemic shock?
Faint pedal pulses.
Decrease in blood pressure.
Lethargy.
Slow breathing.
Correct Answer
Lethargy.
Rationale
One of the early signs of hypovolemic shock is changes in the client's level of consciousness due to the decrease
perfusion to the brain which can manifests as lethargy or confusion.
Page 4 of 52
Question 1
A client with cirrhosis of the liver asks the registered nurse (RN) to explain how varicose veins can occur in the
esophagus. Which statement should the RN provide to teach the client about the physiological etiology?
The enlarged liver presses on the lower half of the esophagus which weakens blood vessel walls.
Abnormal vessels form as a result of liver damage that causes chronic low serum protein levels.
Esophageal swelling and tissue damage causes blood to circulate blood back through the stomach.
Increased portal pressure causes blood flow through liver to be shunted to the esophageal vessels.
Correct Answer
Increased portal pressure causes blood flow through liver to be shunted to the esophageal vessels.
Rationale
Cirrhotic and fibrosed liver damage causes obstructed blood flow through portal vessels to the liver which
increases the portal pressure causing the blood flow through the liver to be shunted to the esophageal vessels.
The result of this shunting of blood causes the esophageal vessels (veins) to balloon out and weaken. As the
portal hypertension increases, these esophageal varices can rupture and cause bleeding resulting in bloody
emesis and black tarry stools
Page 1 of 52
,Question 2
The registered nurse (RN) is assessing a client who was discharged home after management of chronic
hypertension. Which equipment should the RN instruct the client to use at home?
Exercise bicycle.
Sphygmomanometer.
Blood glucose monitor.
Weekly medication box.
Correct Answer
Sphygmomanometer.
Rationale
Self-awareness is the best way for a client to manage chronic hypertension, so the client should obtain a
sphygmomanometer and learn how to monitor blood pressure daily and maintain a record.
Page 2 of 52
,Question 3
The registered nurse (RN) is caring for a client who developed oliguria and was diagnosed with sepsis and
dehydration 48 hours ago. Which assessment finding indicates to the RN that the client is stabilizing?
Urine output of 40 mL/hour.
Apical pulse 100 and blood pressure 76/42.
Urine specific gravity 1.001.
Tented skin on dorsal surface of hands.
Correct Answer
Urine output of 40 mL/hour.
Rationale
A decrease in urinary output is a sign of dehydration. When the urine output returns to a normal range, 40
mL/hour, the client's kidneys are perfusing adequately and indicates the client's status is stablizing.
Page 3 of 52
, Question 4
Twenty four hours after a client returns from surgical gastric bypass, the registered nurse (RN) observes large
amounts of blood in the nasogastric tube (NGT) cannister. Which assessment finding should the RN report as early
signs of hypovolemic shock?
Faint pedal pulses.
Decrease in blood pressure.
Lethargy.
Slow breathing.
Correct Answer
Lethargy.
Rationale
One of the early signs of hypovolemic shock is changes in the client's level of consciousness due to the decrease
perfusion to the brain which can manifests as lethargy or confusion.
Page 4 of 52
