HESI Comprehensive Exam review
with correct answers.
A client diagnosed with chronic kidney disease who requires dialysis three times a week for the
rest of his life says to the nurse, "Why should I even bother to watch what I eat and drink? It
doesn't really matter what I do if I'm never going to get better!" On the basis of the client's
statement, the nurse determines that the client is experiencing which problem?
Anxiety
Powerlessness
Ineffective coping
Disturbed body image - Ans Powerlessness
Rationale: Powerlessness is present when a client believes that he or she has no control over
the situation or that his or her actions will not affect an outcome in any significant way. Anxiety
is a vague uneasy feeling of apprehension. Some factors in anxiety include a threat or perceived
threat to physical or emotional integrity or self-concept, changes in role function, and a threat
to or change in socioeconomic status. Ineffective coping is present when the client exhibits
impaired adaptive abilities or behaviors in meeting the demands or roles expected. Disturbed
body image is diagnosed when there is an alteration in the way the client perceives his or her
own body image.
A nurse is providing morning care to a client in end-stage kidney disease. The client is reluctant
to talk and shows little interest in participating in hygiene care. Which statement by the nurse
would be therapeutic?
"What are your feelings right now?"
"Why don't you feel like washing up?"
"You aren't talking today. Cat got your tongue?"
,"You need to get yourself cleaned up. You have company coming today." - Ans "What are your
feelings right now?"
Rationale: Asking, "What are your feelings right now?" encourages the client to identify his or
her emotions or feelings, which is a therapeutic communication technique. In stating, "Why
don't you feel like washing up?" the nurse is requesting an explanation of feelings and
behaviors for which the client may not know the reason. Requesting an explanation is a
nontherapeutic communication technique. "You aren't talking today. Cat got your tongue?" is a
nontherapeutic cliché. The statement "You need to get yourself cleaned up. You have company
coming today" is demanding, demeaning to the client, and nontherapeutic.
Empyema develops in a client with an infected pleural effusion, and the nurse prepares the
client for thoracentesis. The nurse is assisting the primary health care provider with the
procedure. What characteristics of the fluid removed during thoracentesis should the nurse
expect to note?
Clear and yellow
Thick and opaque
White and odorless
Clear, with a foul odor - Ans Thick and opaque
Rationale: Empyema is the accumulation of pus in the pleural space. Empyema fluid is thick,
opaque, exudative, and intensely foul-smelling. Clear and yellow, white and odorless, and clear
and foul-smelling are incorrect descriptions of the fluid that occurs in this disorder.
An emergency department nurse is told that a client with carbon monoxide poisoning resulting
from a suicide attempt is being brought to the hospital by emergency medical services. Which
intervention will the nurse carry out as a priority upon arrival of the client?
,Administering 100% oxygen
Having a crisis counselor available
Instituting suicide precautions for the client
Obtaining blood for determination of the client's carboxyhemoglobin level - Ans Administering
100% oxygen
Rationale: With a client with carbon monoxide poisoning, the priority is to treat the client with
inhalation of 100% oxygen to shorten the half-life of carbon monoxide to around an hour.
Hyperbaric oxygen may be required to reduce the half-life to minutes by forcing the carbon
monoxide off the hemoglobin molecule. Because the poisoning occurred as a result of a suicide
attempt, a crisis counselor should be consulted, but this is not the priority. Suicide precautions
should be instituted once emergency interventions have been completed and the client has
been admitted to the hospital. The diagnosis is confirmed with a measurement of the
carboxyhemoglobin level in the client's blood. Obtaining a blood specimen to measure the
carboxyhemoglobin level is a priority; however, the nurse would immediately administer 100%
oxygen to the client.
A nurse is caring for a client with sarcoidosis. The client is upset because he has missed work
and worried about how he will care financially for his wife and three small children. On the
basis of the client's concern, which problem does the nurse identify?
Anxiety
Powerlessness
Disruption of thought processes
Inability to maintain health - Ans Anxiety
Rationale: Anxiety is a vague, uneasy feeling of apprehension. Some related factors include a
threat or perceived threat to physical or emotional integrity or self-concept, changes in function
in one's role, and threats to or changes in socioeconomic status. The client experiencing
, powerlessness expresses feelings of having no control over a situation or outcome. Disruption
of thought processes involves disturbance of cognitive abilities or thought. Inability to maintain
health is being incapable of seeking out help needed to maintain health.
A nurse, performing an assessment of a client who has been admitted to the hospital with
suspected silicosis, is gathering both subjective and objective data. Which question by the nurse
would elicit data specific to the cause of this disorder?
"Do you chew tobacco?"
"Do you smoke cigarettes?"
"Have you ever worked in a mine?"
"Are you frequently exposed to paint products?" - Ans "Have you ever worked in a mine?"
Rationale: Silicosis is a chronic fibrotic disease of the lungs caused by the inhalation of free
crystalline silica dust over a long period. Mining and quarrying are each associated with a high
incidence of silicosis. Hazardous exposure to silica dust also occurs in foundry work, tunneling,
sandblasting, pottery-making, stone masonry, and the manufacture of glass, tile, and bricks. The
finely ground silica used in soaps, polishes, and filters also presents a risk. The assessment
questions noted in the other options are unrelated to the cause of silicosis.
A primary health care provider prescribes a dose of morphine sulfate 2.5 mg stat to be
administered intravenously to a client in pain. The nurse preparing the medication notes that
the label on the vial of morphine sulfate solution for injection reads "4 mg/mL." How many
milliliters (mL) must the nurse draw into a syringe for administration to the client? Type the
answer in the space provided. _____ mL - Ans 0.625
A client undergoing therapy with carbidopa/levodopa calls the nurse at the clinic and reports
that his urine has become darker since he started taking the medication. What should the nurse
tell the client?
with correct answers.
A client diagnosed with chronic kidney disease who requires dialysis three times a week for the
rest of his life says to the nurse, "Why should I even bother to watch what I eat and drink? It
doesn't really matter what I do if I'm never going to get better!" On the basis of the client's
statement, the nurse determines that the client is experiencing which problem?
Anxiety
Powerlessness
Ineffective coping
Disturbed body image - Ans Powerlessness
Rationale: Powerlessness is present when a client believes that he or she has no control over
the situation or that his or her actions will not affect an outcome in any significant way. Anxiety
is a vague uneasy feeling of apprehension. Some factors in anxiety include a threat or perceived
threat to physical or emotional integrity or self-concept, changes in role function, and a threat
to or change in socioeconomic status. Ineffective coping is present when the client exhibits
impaired adaptive abilities or behaviors in meeting the demands or roles expected. Disturbed
body image is diagnosed when there is an alteration in the way the client perceives his or her
own body image.
A nurse is providing morning care to a client in end-stage kidney disease. The client is reluctant
to talk and shows little interest in participating in hygiene care. Which statement by the nurse
would be therapeutic?
"What are your feelings right now?"
"Why don't you feel like washing up?"
"You aren't talking today. Cat got your tongue?"
,"You need to get yourself cleaned up. You have company coming today." - Ans "What are your
feelings right now?"
Rationale: Asking, "What are your feelings right now?" encourages the client to identify his or
her emotions or feelings, which is a therapeutic communication technique. In stating, "Why
don't you feel like washing up?" the nurse is requesting an explanation of feelings and
behaviors for which the client may not know the reason. Requesting an explanation is a
nontherapeutic communication technique. "You aren't talking today. Cat got your tongue?" is a
nontherapeutic cliché. The statement "You need to get yourself cleaned up. You have company
coming today" is demanding, demeaning to the client, and nontherapeutic.
Empyema develops in a client with an infected pleural effusion, and the nurse prepares the
client for thoracentesis. The nurse is assisting the primary health care provider with the
procedure. What characteristics of the fluid removed during thoracentesis should the nurse
expect to note?
Clear and yellow
Thick and opaque
White and odorless
Clear, with a foul odor - Ans Thick and opaque
Rationale: Empyema is the accumulation of pus in the pleural space. Empyema fluid is thick,
opaque, exudative, and intensely foul-smelling. Clear and yellow, white and odorless, and clear
and foul-smelling are incorrect descriptions of the fluid that occurs in this disorder.
An emergency department nurse is told that a client with carbon monoxide poisoning resulting
from a suicide attempt is being brought to the hospital by emergency medical services. Which
intervention will the nurse carry out as a priority upon arrival of the client?
,Administering 100% oxygen
Having a crisis counselor available
Instituting suicide precautions for the client
Obtaining blood for determination of the client's carboxyhemoglobin level - Ans Administering
100% oxygen
Rationale: With a client with carbon monoxide poisoning, the priority is to treat the client with
inhalation of 100% oxygen to shorten the half-life of carbon monoxide to around an hour.
Hyperbaric oxygen may be required to reduce the half-life to minutes by forcing the carbon
monoxide off the hemoglobin molecule. Because the poisoning occurred as a result of a suicide
attempt, a crisis counselor should be consulted, but this is not the priority. Suicide precautions
should be instituted once emergency interventions have been completed and the client has
been admitted to the hospital. The diagnosis is confirmed with a measurement of the
carboxyhemoglobin level in the client's blood. Obtaining a blood specimen to measure the
carboxyhemoglobin level is a priority; however, the nurse would immediately administer 100%
oxygen to the client.
A nurse is caring for a client with sarcoidosis. The client is upset because he has missed work
and worried about how he will care financially for his wife and three small children. On the
basis of the client's concern, which problem does the nurse identify?
Anxiety
Powerlessness
Disruption of thought processes
Inability to maintain health - Ans Anxiety
Rationale: Anxiety is a vague, uneasy feeling of apprehension. Some related factors include a
threat or perceived threat to physical or emotional integrity or self-concept, changes in function
in one's role, and threats to or changes in socioeconomic status. The client experiencing
, powerlessness expresses feelings of having no control over a situation or outcome. Disruption
of thought processes involves disturbance of cognitive abilities or thought. Inability to maintain
health is being incapable of seeking out help needed to maintain health.
A nurse, performing an assessment of a client who has been admitted to the hospital with
suspected silicosis, is gathering both subjective and objective data. Which question by the nurse
would elicit data specific to the cause of this disorder?
"Do you chew tobacco?"
"Do you smoke cigarettes?"
"Have you ever worked in a mine?"
"Are you frequently exposed to paint products?" - Ans "Have you ever worked in a mine?"
Rationale: Silicosis is a chronic fibrotic disease of the lungs caused by the inhalation of free
crystalline silica dust over a long period. Mining and quarrying are each associated with a high
incidence of silicosis. Hazardous exposure to silica dust also occurs in foundry work, tunneling,
sandblasting, pottery-making, stone masonry, and the manufacture of glass, tile, and bricks. The
finely ground silica used in soaps, polishes, and filters also presents a risk. The assessment
questions noted in the other options are unrelated to the cause of silicosis.
A primary health care provider prescribes a dose of morphine sulfate 2.5 mg stat to be
administered intravenously to a client in pain. The nurse preparing the medication notes that
the label on the vial of morphine sulfate solution for injection reads "4 mg/mL." How many
milliliters (mL) must the nurse draw into a syringe for administration to the client? Type the
answer in the space provided. _____ mL - Ans 0.625
A client undergoing therapy with carbidopa/levodopa calls the nurse at the clinic and reports
that his urine has become darker since he started taking the medication. What should the nurse
tell the client?
