HESI RN FUNDAMENTALS LATEST
TEST BANK
1.
Wheezing is often associated with asthma
- assess breathing patterns and learn about any precipitating
factors that caused the onset of the wheezing
2.
A male client with limited mobility is discharged with home health
services. When the home health nurse arrives, the client asks
what he does for the swelling in his leg. Which should the nurse
implement?
-instruct the client to flex both of his feet several times a day
3.
A client at an outpatient clinic submits a clean-catch midstream
urine specimen for routine urinalysis. In later review of the client’s
medical record, which data indicates to the nurse that the
specimen collection should be repeated?
-the urine specimen shows multiple organisms in low colony
counts
Rationale: *often indicates that a contaminated specimen was
obtained
4.
During the admission assessment of a terminally ill male client,
the client states that he is an agnostic. What is the best nursing
action in response to this statement?
-document the statement in the client’s spiritual assessment
5.
The nurse observes a newly admitted older adult female take
short stems and walk very slowly while pushing a walker in front
of her. What action should the nurse take in response to these
observations?
,
-complete a full fall risk assessment of the client
6.
The nurse notes that a client has cyanosis of the toes and
fingertips. Which vital signs should the nurse obtain first?
-respiratory rate
Rationale: *cyanosis is a bluish discoloration, an indication of
hypoxemia
7.
A middle-aged male client tells the nurse that two weeks ago, he
began exercising four times a week to lose weight and to help him
sleep better. He states that it still takes him an hour to fall
asleepat night. Which action should the nurse implement?
-ask the client to describe the exercise schedule that he has
been following
Rationale: *to determine if he is exercising too close to bedtime
8.
While suctioning a client's nasopharynx, the nurse observes that
the patient's oxygen saturation remains at 94%, which is the same
reading obtained before starting the procedure. What action
should the nurse take in response to this finding?
-complete the intermittent suction of nasopharynx *suctioning
can be continued if the client’s oxygen saturation remains above
90% or does not decrease 5% from the initial baseline
9.
An older male client returns to the clinic for chronic pain
management after taking morphine sulfate (MS Contin) 25 mg
every 12 hours.He states he took the medication only when the
pain was too severe to sleep. What action should the nurse
implement?
-instruct the client to take the MS Contin every 12 hours as
prescribed
10.
A female, unlicensed assistive personnel (UAP) is assigned to take
the vital signs of a client with pertussis for whom droplet
TEST BANK
1.
Wheezing is often associated with asthma
- assess breathing patterns and learn about any precipitating
factors that caused the onset of the wheezing
2.
A male client with limited mobility is discharged with home health
services. When the home health nurse arrives, the client asks
what he does for the swelling in his leg. Which should the nurse
implement?
-instruct the client to flex both of his feet several times a day
3.
A client at an outpatient clinic submits a clean-catch midstream
urine specimen for routine urinalysis. In later review of the client’s
medical record, which data indicates to the nurse that the
specimen collection should be repeated?
-the urine specimen shows multiple organisms in low colony
counts
Rationale: *often indicates that a contaminated specimen was
obtained
4.
During the admission assessment of a terminally ill male client,
the client states that he is an agnostic. What is the best nursing
action in response to this statement?
-document the statement in the client’s spiritual assessment
5.
The nurse observes a newly admitted older adult female take
short stems and walk very slowly while pushing a walker in front
of her. What action should the nurse take in response to these
observations?
,
-complete a full fall risk assessment of the client
6.
The nurse notes that a client has cyanosis of the toes and
fingertips. Which vital signs should the nurse obtain first?
-respiratory rate
Rationale: *cyanosis is a bluish discoloration, an indication of
hypoxemia
7.
A middle-aged male client tells the nurse that two weeks ago, he
began exercising four times a week to lose weight and to help him
sleep better. He states that it still takes him an hour to fall
asleepat night. Which action should the nurse implement?
-ask the client to describe the exercise schedule that he has
been following
Rationale: *to determine if he is exercising too close to bedtime
8.
While suctioning a client's nasopharynx, the nurse observes that
the patient's oxygen saturation remains at 94%, which is the same
reading obtained before starting the procedure. What action
should the nurse take in response to this finding?
-complete the intermittent suction of nasopharynx *suctioning
can be continued if the client’s oxygen saturation remains above
90% or does not decrease 5% from the initial baseline
9.
An older male client returns to the clinic for chronic pain
management after taking morphine sulfate (MS Contin) 25 mg
every 12 hours.He states he took the medication only when the
pain was too severe to sleep. What action should the nurse
implement?
-instruct the client to take the MS Contin every 12 hours as
prescribed
10.
A female, unlicensed assistive personnel (UAP) is assigned to take
the vital signs of a client with pertussis for whom droplet
