HESI REVIEW #1 BSN 266 EXAM
QUESTIONS AND CORRECT
DETAILED SOLUTIONS TESTED AND
GRADED A+ WITH RATIONALES
The nurse is caring for a client with non-Hodgkin's lymphoma who is receiving
chemotherapy. Laboratory results reveal a platelet count of 10,000/ml. What
action should the nurse implement?
A. Encourage fluids to 3000 ml/day.
B. Check stools for occult blood.
C. Provide oral hygiene every 2 hours.
Check for fever every 4 hours - ✔✔✔ Correct Answer > B Rationale
Platelet counts less than 100,000/mm3 are indicative of thrombocytopenia, a
common side effect of chemotherapy. A client with thrombocytopenia should
be assessed frequently for occult bleeding in the emesis, sputum, feces, urine,
nasogastric secretions, or wounds.
Which action should the nurse implement on the scheduled day of surgery for a
client with type 1 diabetes mellitus (DM)? A. Obtain a prescription for an
adjusted dose of insulin.
B. Administer an oral anti-diabetic agent.
C. Give an insulin dose using parameters of a sliding scale.
Page 1 of 57
,Withhold insulin while the client is NPO - ✔✔✔ Correct Answer > A
Rationale
Stressors, such as surgery, increase serum glucose levels. A client with type 1
DM who is NPO for scheduled surgery should receive a prescribed adjusted
dose of insulin.
The nurse should explain to a client with lung cancer that pleurodesis is
performed to achieve which expected outcome? A. Prevent the formation of
effusion fluid.
B. Remove fluid from the intrapleural space.
C. Debulk tumor to maintain patency of air passages.
Relieve empyema after pneumonectomy - ✔✔✔ Correct Answer > A
Rationale
Instillation of a sclerosing agent to create pleurodesis is aimed at preventing the
formation of a pleural effusion by causing the pleural spaces sealed together,
thereby preventing the accumulation of pleural fluid.
The nurse obtains a client's history that includes right mastectomy and radiation
therapy for cancer of the breast 10 years ago. Which current health problem
should the nurse consider is a consequence of the radiation therapy? A. Asthma.
B. Myocardial infarction.
C. Chronic esophagitis with gastroesophageal reflux.
Pathologic fracture of two ribs on the right chest - ✔✔✔ Correct
Page 2 of 57
,Answer > D
Rationale
The ribs lie in the radiation pathway and lose density over time, becoming thin
and brittle, so the occurence of two right-sided ribs with pathological fractures
resulting without evidence of trauma is related to radiation damage
Three weeks after discharge for an acute myocardial infarction (MI), a client
returns to the cardiac center for follow-up. When the nurse asks about sleep
patterns, the client tells the nurse that he sleeps fine but that his wife moved into
the spare bedroom to sleep when he returned home. He states, "I guess we will
never have sex again after this." Which response is best for the nurse to
provide?
A. Sexual intercourse can be strenuous on your heart, but closeness and
intimacy, such as holding and cuddling, can be maintained with your wife.
B. Sexual activity can be resumed whenever you and your wife feel like it
because the sexual response is more emotional rather than physical.
C. You should discuss your questions about your sexual activity with your
healthcare provider because sexual activity may be limited by your heart
damage.
D. Sexual activity is similar in cardiac workload and energy expenditure as
climbing - ✔✔✔ Correct Answer > D
Rationale
Sexual intercourse after an MI, or acute coronary syndrome, has been found to
require no more energy expenditure or cardiac stress than walking briskly up
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, two flights of stairs, so if you do not experience shortness of breath or chest
discomfort doing the stairs then you should be okay to resume sexual activity
The nurse is caring for a client scheduled to undergo insertion of a percutaneous
endoscopic gastrostomy (PEG) tube. The client asks the nurse to explain how a
PEG tube differs from a gastrostomy tube (GT). Which explanation best
describes how they are different?
A. Method of insertion.
B. Location of the tubes.
C. Diameter of the tubes.
D. Procedure for feedings. - ✔✔✔ Correct Answer > A
Rationale
The best explanation of how a PEG tube differs from a GT is by the method of
insertion. GT insertion involves making an incision in the wall of the abdomen
and suturing the tube to the gastric wall. A PEG tube is more commonly used
due to the fact it does not require general anesthesia and less invasive due to
being inserted with endoscopic visualization through the esophagus into the
stomach and then pulled through a small incision in the abdominal wall and
held in place by a tiny plastic device called a "bumper" that holds the g-tube in
place inside the stomach and a small water-filled balloon which keeps the
stomach in place against the abdominal wall
A client with a recent history of blood in his stools is scheduled for a
proctosigmoidoscopy. The nurse should implement which protocols to prepare
the client for this procedure? (Select all that apply.)
Page 4 of 57
QUESTIONS AND CORRECT
DETAILED SOLUTIONS TESTED AND
GRADED A+ WITH RATIONALES
The nurse is caring for a client with non-Hodgkin's lymphoma who is receiving
chemotherapy. Laboratory results reveal a platelet count of 10,000/ml. What
action should the nurse implement?
A. Encourage fluids to 3000 ml/day.
B. Check stools for occult blood.
C. Provide oral hygiene every 2 hours.
Check for fever every 4 hours - ✔✔✔ Correct Answer > B Rationale
Platelet counts less than 100,000/mm3 are indicative of thrombocytopenia, a
common side effect of chemotherapy. A client with thrombocytopenia should
be assessed frequently for occult bleeding in the emesis, sputum, feces, urine,
nasogastric secretions, or wounds.
Which action should the nurse implement on the scheduled day of surgery for a
client with type 1 diabetes mellitus (DM)? A. Obtain a prescription for an
adjusted dose of insulin.
B. Administer an oral anti-diabetic agent.
C. Give an insulin dose using parameters of a sliding scale.
Page 1 of 57
,Withhold insulin while the client is NPO - ✔✔✔ Correct Answer > A
Rationale
Stressors, such as surgery, increase serum glucose levels. A client with type 1
DM who is NPO for scheduled surgery should receive a prescribed adjusted
dose of insulin.
The nurse should explain to a client with lung cancer that pleurodesis is
performed to achieve which expected outcome? A. Prevent the formation of
effusion fluid.
B. Remove fluid from the intrapleural space.
C. Debulk tumor to maintain patency of air passages.
Relieve empyema after pneumonectomy - ✔✔✔ Correct Answer > A
Rationale
Instillation of a sclerosing agent to create pleurodesis is aimed at preventing the
formation of a pleural effusion by causing the pleural spaces sealed together,
thereby preventing the accumulation of pleural fluid.
The nurse obtains a client's history that includes right mastectomy and radiation
therapy for cancer of the breast 10 years ago. Which current health problem
should the nurse consider is a consequence of the radiation therapy? A. Asthma.
B. Myocardial infarction.
C. Chronic esophagitis with gastroesophageal reflux.
Pathologic fracture of two ribs on the right chest - ✔✔✔ Correct
Page 2 of 57
,Answer > D
Rationale
The ribs lie in the radiation pathway and lose density over time, becoming thin
and brittle, so the occurence of two right-sided ribs with pathological fractures
resulting without evidence of trauma is related to radiation damage
Three weeks after discharge for an acute myocardial infarction (MI), a client
returns to the cardiac center for follow-up. When the nurse asks about sleep
patterns, the client tells the nurse that he sleeps fine but that his wife moved into
the spare bedroom to sleep when he returned home. He states, "I guess we will
never have sex again after this." Which response is best for the nurse to
provide?
A. Sexual intercourse can be strenuous on your heart, but closeness and
intimacy, such as holding and cuddling, can be maintained with your wife.
B. Sexual activity can be resumed whenever you and your wife feel like it
because the sexual response is more emotional rather than physical.
C. You should discuss your questions about your sexual activity with your
healthcare provider because sexual activity may be limited by your heart
damage.
D. Sexual activity is similar in cardiac workload and energy expenditure as
climbing - ✔✔✔ Correct Answer > D
Rationale
Sexual intercourse after an MI, or acute coronary syndrome, has been found to
require no more energy expenditure or cardiac stress than walking briskly up
Page 3 of 57
, two flights of stairs, so if you do not experience shortness of breath or chest
discomfort doing the stairs then you should be okay to resume sexual activity
The nurse is caring for a client scheduled to undergo insertion of a percutaneous
endoscopic gastrostomy (PEG) tube. The client asks the nurse to explain how a
PEG tube differs from a gastrostomy tube (GT). Which explanation best
describes how they are different?
A. Method of insertion.
B. Location of the tubes.
C. Diameter of the tubes.
D. Procedure for feedings. - ✔✔✔ Correct Answer > A
Rationale
The best explanation of how a PEG tube differs from a GT is by the method of
insertion. GT insertion involves making an incision in the wall of the abdomen
and suturing the tube to the gastric wall. A PEG tube is more commonly used
due to the fact it does not require general anesthesia and less invasive due to
being inserted with endoscopic visualization through the esophagus into the
stomach and then pulled through a small incision in the abdominal wall and
held in place by a tiny plastic device called a "bumper" that holds the g-tube in
place inside the stomach and a small water-filled balloon which keeps the
stomach in place against the abdominal wall
A client with a recent history of blood in his stools is scheduled for a
proctosigmoidoscopy. The nurse should implement which protocols to prepare
the client for this procedure? (Select all that apply.)
Page 4 of 57
