NURSING MSN570 HESI RN ADVANCED 100
CERTIFICATION EVALUATION 2026 SOLVED
QUESTIONS
◉ One week after being told that she has terminal cancer with a life
expectancy of 3 weeks, a female client tells the nurse, "I think I will
plan a big party for all my friends." How should the nurse respond?
A. "You may not have enough energy before long to hold a big party."
B. "Do you mean to say that you want to plan your funeral and
wake?"
C. "Planning a party and thinking about all your friends sounds like
fun."
D. "You should be thinking about spending your last days with your
family." Answer: C
Rationale: Setting goals that bring pleasure is appropriate and
should be encouraged by the nurse as long as the nurse does not
perpetuate a client's denial. Option A is a negative response,
implying that the client should not plan a party. Option B puts words
in the client's mouth that may not be accurate. The nurse should
support the client's goals rather than telling the client how to spend
her time.
◉ The nurse observes a UAP taking a client's blood pressure in the
lower extremity. Which observation of this procedure requires the
nurse's intervention?
,A. The cuff wraps around the girth of the leg.
B. The UAP auscultates the popliteal pulse with the cuff on the lower
leg.
C. The client is placed in a prone position.
D. The systolic reading is 20 mm Hg higher than the blood pressure
in the client's arm. Answer: B
Rationale: When obtaining the blood pressure in the lower
extremities, the popliteal pulse is the site for auscultation when the
blood pressure cuff is applied around the thigh. The nurse should
intervene with the UAP who has applied the cuff on the lower leg.
Option A ensures an accurate assessment, and option C provides the
best access to the artery. Systolic pressure in the popliteal artery is
usually 10 to 40 mm Hg higher than in the brachial artery.
◉ During a clinic visit, the mother of a 7-year-old reports to the
nurse that her child is often awake until midnight playing and is then
very difficult to awaken in the morning for school. Which
assessment data should the nurse obtain in response to the mother's
report?
A. The occurrence of any episodes of sleep apnea
B. The child's blood pressure, pulse, and respirations
C. Length of rapid eye movement (REM) sleep that the child is
experiencing
D. Description of the family's home environment Answer: D
,Rationale: School-age children often resist bedtime. The nurse
should begin by assessing the environment of the home to
determine factors that may not be conducive to the establishment of
bedtime rituals that promote sleep. Option A often causes daytime
fatigue rather than resistance to going to sleep. Option B is unlikely
to provide useful data. The nurse cannot determine option C.
◉ The nurse assesses a 2-year-old who is admitted for dehydration
and finds that the peripheral IV rate by gravity has slowed, even
though the venous access site is healthy. What should the nurse do
next?
A. Apply a warm compress proximal to the site.
B. Check for kinks in the tubing and raise the IV pole.
C. Adjust the tape that stabilizes the needle.
D. Flush with normal saline and recount the drop rate. Answer: B
Rationale: The nurse should first check the tubing and height of the
bag on the IV pole, which are common factors that may slow the
rate. Gravity infusion rates are influenced by the height of the bag,
tubing clamp closure or kinks, needle size or position, fluid viscosity,
client blood pressure (crying in the pediatric client), and infiltration.
Venospasm can slow the rate and often responds to warmth over the
vessel, but the nurse should first adjust the IV pole height. The nurse
may need to adjust the stabilizing tape on a positional needle or
flush the venous access with normal saline, but less invasive actions
should be implemented first.
, ◉ Which client is most likely to be at risk for spiritual distress?
A. Roman Catholic woman considering an abortion
B. Jewish man considering hospice care for his wife
C. Seventh-Day Adventist who needs a blood transfusion
D. Muslim man who needs a total knee replacement Answer: A
Rationale: In the Roman Catholic religion, any type of abortion is
prohibited, so facing this decision may place the client at risk for
spiritual distress. There is no prohibition of hospice care for
members of the Jewish faith. Jehovah's Witnesses, not Seventh-Day
Adventists, prohibit blood transfusions. There is no conflict in the
Muslim faith with regard to joint replacement.
◉ Which intervention is most important to include in the plan of
care for a client at high risk for the development of postoperative
thrombus formation?
A. Instruct in the use of the incentive spirometer.
B. Elevate the head of the bed during all meals.
C. Use aseptic technique to change the dressing.
D. Encourage frequent ambulation in the hallway. Answer: D
Rationale: Thrombus (clot) formation can occur in the lower
extremities of immobile clients, so the nurse should plan to
encourage activities to increase mobility, such as frequent
ambulation in the hallway. Option A helps promote alveolar
expansion, reducing the risk for atelectasis. Option B reduces the
CERTIFICATION EVALUATION 2026 SOLVED
QUESTIONS
◉ One week after being told that she has terminal cancer with a life
expectancy of 3 weeks, a female client tells the nurse, "I think I will
plan a big party for all my friends." How should the nurse respond?
A. "You may not have enough energy before long to hold a big party."
B. "Do you mean to say that you want to plan your funeral and
wake?"
C. "Planning a party and thinking about all your friends sounds like
fun."
D. "You should be thinking about spending your last days with your
family." Answer: C
Rationale: Setting goals that bring pleasure is appropriate and
should be encouraged by the nurse as long as the nurse does not
perpetuate a client's denial. Option A is a negative response,
implying that the client should not plan a party. Option B puts words
in the client's mouth that may not be accurate. The nurse should
support the client's goals rather than telling the client how to spend
her time.
◉ The nurse observes a UAP taking a client's blood pressure in the
lower extremity. Which observation of this procedure requires the
nurse's intervention?
,A. The cuff wraps around the girth of the leg.
B. The UAP auscultates the popliteal pulse with the cuff on the lower
leg.
C. The client is placed in a prone position.
D. The systolic reading is 20 mm Hg higher than the blood pressure
in the client's arm. Answer: B
Rationale: When obtaining the blood pressure in the lower
extremities, the popliteal pulse is the site for auscultation when the
blood pressure cuff is applied around the thigh. The nurse should
intervene with the UAP who has applied the cuff on the lower leg.
Option A ensures an accurate assessment, and option C provides the
best access to the artery. Systolic pressure in the popliteal artery is
usually 10 to 40 mm Hg higher than in the brachial artery.
◉ During a clinic visit, the mother of a 7-year-old reports to the
nurse that her child is often awake until midnight playing and is then
very difficult to awaken in the morning for school. Which
assessment data should the nurse obtain in response to the mother's
report?
A. The occurrence of any episodes of sleep apnea
B. The child's blood pressure, pulse, and respirations
C. Length of rapid eye movement (REM) sleep that the child is
experiencing
D. Description of the family's home environment Answer: D
,Rationale: School-age children often resist bedtime. The nurse
should begin by assessing the environment of the home to
determine factors that may not be conducive to the establishment of
bedtime rituals that promote sleep. Option A often causes daytime
fatigue rather than resistance to going to sleep. Option B is unlikely
to provide useful data. The nurse cannot determine option C.
◉ The nurse assesses a 2-year-old who is admitted for dehydration
and finds that the peripheral IV rate by gravity has slowed, even
though the venous access site is healthy. What should the nurse do
next?
A. Apply a warm compress proximal to the site.
B. Check for kinks in the tubing and raise the IV pole.
C. Adjust the tape that stabilizes the needle.
D. Flush with normal saline and recount the drop rate. Answer: B
Rationale: The nurse should first check the tubing and height of the
bag on the IV pole, which are common factors that may slow the
rate. Gravity infusion rates are influenced by the height of the bag,
tubing clamp closure or kinks, needle size or position, fluid viscosity,
client blood pressure (crying in the pediatric client), and infiltration.
Venospasm can slow the rate and often responds to warmth over the
vessel, but the nurse should first adjust the IV pole height. The nurse
may need to adjust the stabilizing tape on a positional needle or
flush the venous access with normal saline, but less invasive actions
should be implemented first.
, ◉ Which client is most likely to be at risk for spiritual distress?
A. Roman Catholic woman considering an abortion
B. Jewish man considering hospice care for his wife
C. Seventh-Day Adventist who needs a blood transfusion
D. Muslim man who needs a total knee replacement Answer: A
Rationale: In the Roman Catholic religion, any type of abortion is
prohibited, so facing this decision may place the client at risk for
spiritual distress. There is no prohibition of hospice care for
members of the Jewish faith. Jehovah's Witnesses, not Seventh-Day
Adventists, prohibit blood transfusions. There is no conflict in the
Muslim faith with regard to joint replacement.
◉ Which intervention is most important to include in the plan of
care for a client at high risk for the development of postoperative
thrombus formation?
A. Instruct in the use of the incentive spirometer.
B. Elevate the head of the bed during all meals.
C. Use aseptic technique to change the dressing.
D. Encourage frequent ambulation in the hallway. Answer: D
Rationale: Thrombus (clot) formation can occur in the lower
extremities of immobile clients, so the nurse should plan to
encourage activities to increase mobility, such as frequent
ambulation in the hallway. Option A helps promote alveolar
expansion, reducing the risk for atelectasis. Option B reduces the
