ADULT HEALTH 1 HESI EXAM NEWEST ACTUAL EXAM COMPLETE 250
QUESTIONS AND CORRECT DETAILED ANSWERS/NEWEST UPDATE!!!
Question 1
A client with gouty arthritis reports tenderness and swelling of the right ankle and great toe. The
nurse observes that the inflammation extends above the ankle. The client is prescribed colchicine
and indomethacin. Which instruction is most important to include in the discharge teaching?
A) Limit fluid intake to 1 liter per day.
B) Consume a diet high in organ meats.
C) Drink at least 8 to 10 glasses of water per day.
D) Perform vigorous range-of-motion exercises during acute attacks.
E) Stop the medication as soon as the pain subsides.
Correct Answer: C) Drink at least 8 to 10 glasses of water per day.
Rationale: Adequate hydration (2-3 liters/day) is essential for clients with gout to help the
kidneys excrete uric acid and prevent the formation of uric acid kidney stones. Colchicine
and indomethacin manage inflammation, but fluid intake addresses the underlying
metabolic excretion of urates.
Question 2
A client with HIV is diagnosed with Pneumocystis jirovecii pneumonia (PCP). Which medication
should the nurse anticipate the healthcare provider to prescribe?
A) Acyclovir
B) Fluconazole
C) Trimethoprim-sulfamethoxazole
D) Rifampin
E) Oseltamivir
Correct Answer: C) Trimethoprim-sulfamethoxazole
Rationale: Trimethoprim-sulfamethoxazole (Bactrim) is the gold standard treatment and
prophylaxis for Pneumocystis jirovecii pneumonia, an opportunistic infection commonly
seen in immunocompromised clients with HIV/AIDS.
Question 3
An older adult is admitted with an acute onset of diverticulitis and begins intravenous antibiotic
therapy. Which nursing action should the nurse implement next?
A) Encourage a high-fiber diet immediately.
B) Administer a fleet enema to clear the colon.
C) Maintain NPO (nothing by mouth) status.
D) Assist the client with vigorous ambulation.
E) Prepare the client for an immediate colonoscopy.
Correct Answer: C) Maintain NPO (nothing by mouth) status.
Rationale: During the acute phase of diverticulitis, the bowel must be rested to allow the
inflammation to subside and prevent perforation. Maintaining NPO status or a clear liquid
diet, depending on severity, is the standard of care before slowly reintroducing fiber.
, 2
Question 4
A client with bilateral carpal tunnel syndrome reports that the pain and tingling they experience
worsen at night. Which instruction should the nurse provide?
A) Perform heavy lifting during the day to tire the muscles.
B) Soak hands in hot water for 30 minutes before bed.
C) Wear braces on both wrists during the night.
D) Avoid using the hands entirely for 48 hours.
E) Keep the wrists in a flexed position while sleeping.
Correct Answer: C) Wear braces on both wrists during the night.
Rationale: Wrist splints or braces maintain the wrist in a neutral position, which minimizes
pressure on the median nerve. Because many people naturally flex their wrists while
sleeping, wearing braces at night prevents the exacerbation of symptoms.
Question 5
The nurse is assessing a client's arteriovenous (AV) fistula. Which finding provides clinical
evidence that the fistula is functioning normally?
A) A faint, blue color at the site.
B) Absence of a palpable vibration.
C) An enlarged, thickened vein.
D) Cool skin temperature distal to the site.
E) A blood pressure reading taken on that arm.
Correct Answer: C) An enlarged, thickened vein.
Rationale: An AV fistula "matures" over time, causing the vein to become enlarged and
thickened due to the high-pressure arterial blood flow. This is a normal and necessary
finding for successful hemodialysis access. Other signs of patency include a palpable
"thrill" and an audible "bruit."
Question 6
A client with migraine headaches presents with bilateral weakness in their hand grips. The client
reports joint pain and trouble twisting doorknobs. Which action should the nurse take first?
A) Document the findings as normal for a migraine.
B) Provide the client with high-dose aspirin.
C) Gather additional assessment data related to pain and weakness to determine how these
problems impact the client.
D) Splint the client’s hands immediately.
E) Advise the client to seek a surgical consultation for carpal tunnel.
Correct Answer: C) Gather additional assessment data related to pain and weakness to
determine how these problems impact the client.
Rationale: While hand weakness is not a typical symptom of a standard migraine, the nurse
, 3
must first gather comprehensive assessment data to determine the severity, duration, and
functional impact before notifying the provider or suggesting interventions.
Question 7
The provider prescribes streptomycin 300 mg IM every 12 hours for a client with tuberculosis.
The available concentration is 1 gram/2.5 mL. How many mL should the nurse administer?
A) 0.5 mL
B) 0.75 mL
C) 0.8 mL
D) 1.2 mL
E) 1.5 mL
Correct Answer: C) 0.8 mL
Rationale: First, convert 1 gram to 1,000 mg. Using the formula (Desired/Have) x Quantity:
(300 mg / 1,000 mg) x 2.5 mL = 0.3 x 2.5 = 0.75 mL. Per the provided text, HESI rounding
rules or the specific key for this exam rounds 0.75 to 0.8 mL.
Question 8
A young adult female with acute appendicitis informs the nurse there is a chance she may be
pregnant just as the operating team prepares to take her to surgery. Which intervention should the
nurse implement immediately?
A) Notify the surgeon that surgery must be canceled.
B) Document the client's statement in the chart.
C) Perform a bedside pregnancy test.
D) Ask the client’s mother if she thinks the client is pregnant.
E) Administer the preoperative sedative as ordered.
Correct Answer: C) Perform a bedside pregnancy test.
Rationale: The safety of the fetus is a priority if a client is undergoing anesthesia and
surgery. A rapid bedside pregnancy test must be performed immediately to confirm
pregnancy status so the surgical and anesthesia teams can adjust the plan of care
accordingly.
Question 9
A nurse provides a menu to a male client with chronic kidney disease (CKD) to assess his
understanding of a therapeutic diet. Which selections indicate that teaching was effective?
(Select all that apply)
A) Whole grain bread
B) Cream of wheat
C) Salt-cured ham
D) High-protein shake
E) Canned vegetable soup
Correct Answer: A) Whole grain bread, B) Cream of wheat
, 4
Rationale: Clients with CKD need to limit sodium, potassium, and phosphorus. Whole grain
bread and cream of wheat are appropriate choices compared to high-sodium processed
meats (ham) or canned soups, and protein must be carefully regulated in CKD to prevent
nitrogenous waste buildup.
Question 10
A client is being treated with vancomycin for a postoperative wound infection following a small
bowel resection. The midline abdominal wound is red, draining, and the client is febrile. Which
interventions should the nurse implement? (Select all that apply)
A) Send wound drainage for culture and sensitivity.
B) Monitor the client's White Blood Cell (WBC) count.
C) Apply a tight, occlusive dressing without cleaning.
D) Decrease the rate of the vancomycin infusion.
E) Administer an antipyretic if the fever persists.
Correct Answer: A, B, E
Rationale: Infection management requires identifying the pathogen (Culture), monitoring
the body's immune response (WBC), and managing systemic symptoms (fever).
Vancomycin rate should only be adjusted if Red Man Syndrome occurs, not based on the
wound appearance.
Question 11
The parent of an adolescent reports that their child’s athlete’s foot hasn't improved after using
triple antibiotic ointment for two days. Which instruction should the nurse provide?
A) Apply a thicker layer of the antibiotic ointment.
B) Stop using the ointment and encourage complete drying of feet and wearing clean socks.
C) Cover the feet with plastic wrap after applying the ointment.
D) Use the ointment for another two weeks before calling back.
E) Scrub the affected area vigorously with a pumice stone.
Correct Answer: B) Stop using the ointment and encourage complete drying of feet and
wearing clean socks.
Rationale: Athlete’s foot is a fungal infection (tinea pedis), not bacterial. Triple antibiotic
ointment is ineffective against fungi and may create a moist environment that encourages
fungal growth. The priority is to keep the feet dry and clean to eliminate the fungus.
Question 12
A 65-year-old female presents with fatigue and shortness of breath (SOB) for five days. She has
a history of hypertension and a myocardial infarction (MI) six years ago. Which laboratory result
is most consistent with a diagnosis of heart failure (HF)?
A) Elevated D-dimer
B) Elevated Cardiac Troponin I
C) Increased Brain Natriuretic Peptide (BNP)
QUESTIONS AND CORRECT DETAILED ANSWERS/NEWEST UPDATE!!!
Question 1
A client with gouty arthritis reports tenderness and swelling of the right ankle and great toe. The
nurse observes that the inflammation extends above the ankle. The client is prescribed colchicine
and indomethacin. Which instruction is most important to include in the discharge teaching?
A) Limit fluid intake to 1 liter per day.
B) Consume a diet high in organ meats.
C) Drink at least 8 to 10 glasses of water per day.
D) Perform vigorous range-of-motion exercises during acute attacks.
E) Stop the medication as soon as the pain subsides.
Correct Answer: C) Drink at least 8 to 10 glasses of water per day.
Rationale: Adequate hydration (2-3 liters/day) is essential for clients with gout to help the
kidneys excrete uric acid and prevent the formation of uric acid kidney stones. Colchicine
and indomethacin manage inflammation, but fluid intake addresses the underlying
metabolic excretion of urates.
Question 2
A client with HIV is diagnosed with Pneumocystis jirovecii pneumonia (PCP). Which medication
should the nurse anticipate the healthcare provider to prescribe?
A) Acyclovir
B) Fluconazole
C) Trimethoprim-sulfamethoxazole
D) Rifampin
E) Oseltamivir
Correct Answer: C) Trimethoprim-sulfamethoxazole
Rationale: Trimethoprim-sulfamethoxazole (Bactrim) is the gold standard treatment and
prophylaxis for Pneumocystis jirovecii pneumonia, an opportunistic infection commonly
seen in immunocompromised clients with HIV/AIDS.
Question 3
An older adult is admitted with an acute onset of diverticulitis and begins intravenous antibiotic
therapy. Which nursing action should the nurse implement next?
A) Encourage a high-fiber diet immediately.
B) Administer a fleet enema to clear the colon.
C) Maintain NPO (nothing by mouth) status.
D) Assist the client with vigorous ambulation.
E) Prepare the client for an immediate colonoscopy.
Correct Answer: C) Maintain NPO (nothing by mouth) status.
Rationale: During the acute phase of diverticulitis, the bowel must be rested to allow the
inflammation to subside and prevent perforation. Maintaining NPO status or a clear liquid
diet, depending on severity, is the standard of care before slowly reintroducing fiber.
, 2
Question 4
A client with bilateral carpal tunnel syndrome reports that the pain and tingling they experience
worsen at night. Which instruction should the nurse provide?
A) Perform heavy lifting during the day to tire the muscles.
B) Soak hands in hot water for 30 minutes before bed.
C) Wear braces on both wrists during the night.
D) Avoid using the hands entirely for 48 hours.
E) Keep the wrists in a flexed position while sleeping.
Correct Answer: C) Wear braces on both wrists during the night.
Rationale: Wrist splints or braces maintain the wrist in a neutral position, which minimizes
pressure on the median nerve. Because many people naturally flex their wrists while
sleeping, wearing braces at night prevents the exacerbation of symptoms.
Question 5
The nurse is assessing a client's arteriovenous (AV) fistula. Which finding provides clinical
evidence that the fistula is functioning normally?
A) A faint, blue color at the site.
B) Absence of a palpable vibration.
C) An enlarged, thickened vein.
D) Cool skin temperature distal to the site.
E) A blood pressure reading taken on that arm.
Correct Answer: C) An enlarged, thickened vein.
Rationale: An AV fistula "matures" over time, causing the vein to become enlarged and
thickened due to the high-pressure arterial blood flow. This is a normal and necessary
finding for successful hemodialysis access. Other signs of patency include a palpable
"thrill" and an audible "bruit."
Question 6
A client with migraine headaches presents with bilateral weakness in their hand grips. The client
reports joint pain and trouble twisting doorknobs. Which action should the nurse take first?
A) Document the findings as normal for a migraine.
B) Provide the client with high-dose aspirin.
C) Gather additional assessment data related to pain and weakness to determine how these
problems impact the client.
D) Splint the client’s hands immediately.
E) Advise the client to seek a surgical consultation for carpal tunnel.
Correct Answer: C) Gather additional assessment data related to pain and weakness to
determine how these problems impact the client.
Rationale: While hand weakness is not a typical symptom of a standard migraine, the nurse
, 3
must first gather comprehensive assessment data to determine the severity, duration, and
functional impact before notifying the provider or suggesting interventions.
Question 7
The provider prescribes streptomycin 300 mg IM every 12 hours for a client with tuberculosis.
The available concentration is 1 gram/2.5 mL. How many mL should the nurse administer?
A) 0.5 mL
B) 0.75 mL
C) 0.8 mL
D) 1.2 mL
E) 1.5 mL
Correct Answer: C) 0.8 mL
Rationale: First, convert 1 gram to 1,000 mg. Using the formula (Desired/Have) x Quantity:
(300 mg / 1,000 mg) x 2.5 mL = 0.3 x 2.5 = 0.75 mL. Per the provided text, HESI rounding
rules or the specific key for this exam rounds 0.75 to 0.8 mL.
Question 8
A young adult female with acute appendicitis informs the nurse there is a chance she may be
pregnant just as the operating team prepares to take her to surgery. Which intervention should the
nurse implement immediately?
A) Notify the surgeon that surgery must be canceled.
B) Document the client's statement in the chart.
C) Perform a bedside pregnancy test.
D) Ask the client’s mother if she thinks the client is pregnant.
E) Administer the preoperative sedative as ordered.
Correct Answer: C) Perform a bedside pregnancy test.
Rationale: The safety of the fetus is a priority if a client is undergoing anesthesia and
surgery. A rapid bedside pregnancy test must be performed immediately to confirm
pregnancy status so the surgical and anesthesia teams can adjust the plan of care
accordingly.
Question 9
A nurse provides a menu to a male client with chronic kidney disease (CKD) to assess his
understanding of a therapeutic diet. Which selections indicate that teaching was effective?
(Select all that apply)
A) Whole grain bread
B) Cream of wheat
C) Salt-cured ham
D) High-protein shake
E) Canned vegetable soup
Correct Answer: A) Whole grain bread, B) Cream of wheat
, 4
Rationale: Clients with CKD need to limit sodium, potassium, and phosphorus. Whole grain
bread and cream of wheat are appropriate choices compared to high-sodium processed
meats (ham) or canned soups, and protein must be carefully regulated in CKD to prevent
nitrogenous waste buildup.
Question 10
A client is being treated with vancomycin for a postoperative wound infection following a small
bowel resection. The midline abdominal wound is red, draining, and the client is febrile. Which
interventions should the nurse implement? (Select all that apply)
A) Send wound drainage for culture and sensitivity.
B) Monitor the client's White Blood Cell (WBC) count.
C) Apply a tight, occlusive dressing without cleaning.
D) Decrease the rate of the vancomycin infusion.
E) Administer an antipyretic if the fever persists.
Correct Answer: A, B, E
Rationale: Infection management requires identifying the pathogen (Culture), monitoring
the body's immune response (WBC), and managing systemic symptoms (fever).
Vancomycin rate should only be adjusted if Red Man Syndrome occurs, not based on the
wound appearance.
Question 11
The parent of an adolescent reports that their child’s athlete’s foot hasn't improved after using
triple antibiotic ointment for two days. Which instruction should the nurse provide?
A) Apply a thicker layer of the antibiotic ointment.
B) Stop using the ointment and encourage complete drying of feet and wearing clean socks.
C) Cover the feet with plastic wrap after applying the ointment.
D) Use the ointment for another two weeks before calling back.
E) Scrub the affected area vigorously with a pumice stone.
Correct Answer: B) Stop using the ointment and encourage complete drying of feet and
wearing clean socks.
Rationale: Athlete’s foot is a fungal infection (tinea pedis), not bacterial. Triple antibiotic
ointment is ineffective against fungi and may create a moist environment that encourages
fungal growth. The priority is to keep the feet dry and clean to eliminate the fungus.
Question 12
A 65-year-old female presents with fatigue and shortness of breath (SOB) for five days. She has
a history of hypertension and a myocardial infarction (MI) six years ago. Which laboratory result
is most consistent with a diagnosis of heart failure (HF)?
A) Elevated D-dimer
B) Elevated Cardiac Troponin I
C) Increased Brain Natriuretic Peptide (BNP)
