HESI PN NUTRITION PRACTICE EXAM
WITH RATIONALE REAL EXAM
QUESTIONS WITH 100% CORRECT
ANSWERS
A client with parenteral nutrition (PN) infusing has disconnected the tubing from the central
line catheter. The nurse assesses the client and suspects an air embolism. The nurse should
immediately place the client in which position?
1. On the left side, with the head lower than the feet
2. On the left side, with the head higher than the feet
3. On the right side, with the head lower than the feet
4. On the right side, with the head higher than the feet ---- ANSWER----1Rationale: Air
embolism occurs when air enters the catheter system, such as when the system is opened
for intravenous (IV) tubing changes or when the IV tubing disconnects. Air embolism is a
critical situation; if it is suspected, the client should be placed in a left side-lying position.
The head should be lower than the feet. This position is used to minimize the effect of the
air traveling as a bolus to the lungs by trapping it in the right side of the heart. The
positions in the remaining options are inappropriate if an air embolism is suspected.
Which nursing action is essential prior to initiating a new prescription for 500 mL of fat
emulsion (lipids) to infuse at 50 mL/hour?
1. Ensure that the client does not have diabetes.
2. Determine whether the client has an allergy to eggs.
Page | 1
,3. Add regular insulin to the fat emulsion, using aseptic technique.
4. Contact the health care provider (HCP) to have a central line inserted for fat emulsion
infusion. ---- ANSWER----2Rationale: The client beginning infusions of fat emulsions
must be first assessed for known allergies to eggs to prevent anaphylaxis. Egg yolk is a
component of the solution and provides emulsification. The remaining options are
unnecessary and are not related specifically to the administration of fat emulsion.
The nurse monitors the client receiving parenteral nutrition (PN) for complications of the
therapy and should assess the client for which manifestations of hyperglycemia?
1. Fever, weak pulse, and thirst
2. Nausea, vomiting, and oliguria
3. Sweating, chills, and abdominal pain
4. Weakness, thirst, and increased urine output ---- ANSWER----4Rationale: The high
glucose concentration in PN places the client at risk for hyperglycemia. Signs of
hyperglycemia include excessive thirst, fatigue, restlessness, confusion, weakness,
Kussmaul respirations, diuresis, and coma when hyperglycemia is severe. If the client has
these symptoms, the blood glucose level should be checked immediately. The remaining
options do not identify signs specific to hyperglycemia.
The nurse is changing the central line dressing of a client receiving parenteral nutrition (PN)
and notes that the catheter insertion site appears reddened. The nurse should next assess
which item?
1. Client's temperature
2. Expiration date on the bag
3. Time of last dressing change
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,4. Tightness of tubing connections ---- ANSWER----1Rationale: Redness at the catheter
insertion site is a possible indication of infection. The nurse would next assess for other
signs of infection. Of the options given, the temperature is the next item to assess. The
tightness of tubing connections should be assessed each time the PN is checked; loose
connections would result in leakage, not skin redness. The expiration date on the bag is a
viable option, but this also should be checked at the time the solution is hung and with
each shift change. The time of the last dressing change should be checked with each shift
change.
A client with hypertension has been told to maintain a diet low in sodium. The nurse who is
teaching this client about foods that are allowed should include which food item in a list
provided to the client?
1. Tomato soup
2. Boiled shrimp
3. Instant oatmeal
4. Summer squash ---- ANSWER----4Rationale: Foods that are lower in sodium include fruits
and vegetables (summer squash), because they do not contain physiological saline. Highly
processed or refined foods (tomato soup, instant oatmeal) are higher in sodium unless their
food labels specifically state "low sodium." Saltwater fish and shellfish are high in sodium.
A postoperative client has been placed on a clear liquid diet. The nurse should provide the
client with which items that are allowed to be consumed on this diet? Select all that apply. 1.
Broth
2. Coffee
3. Gelatin
4. Pudding
5. Vegetable juice
Page | 3
, 6. Pureed vegetables ---- ANSWER----1, 2, 3Rationale: A clear liquid diet consists of foods
that are relatively transparent to light and are clear and liquid at room and body
temperature. These foods include items such as water, bouillon, clear broth, carbonated
beverages, gelatin, hard candy, lemonade, ice pops, and regular or decaffeinated coffee or
tea. The incorrect food items are items that are allowed on a full liquid diet.
The nurse is instructing a client with hypertension on the importance of choosing foods low
in sodium. The nurse should teach the client to limit intake of which food?
1. Apples
2. Bananas
3. Smoked sausage
4. Steamed vegetables ---- ANSWER----3Rationale: Smoked foods are high in sodium, which
is noted in the correct option. The remaining options are fruits and vegetables, which are
low in sodium.
A client who is recovering from surgery has been advanced from a clear liquid diet to a full
liquid diet. The client is looking forward to the diet change because he has been "bored" with
the clear liquid diet. The nurse should offer which full liquid item to the client? 1. Tea
2. Gelatin
3. Custard
4. Ice pop ---- ANSWER----3Rationale: Full liquid food items include items such as plain ice
cream, sherbet, breakfast drinks, milk, pudding and custard, soups that are strained, refined
cooked cereals, and strained vegetable juices. A clear liquid diet consists of foods that are
relatively transparent. The food items in the incorrect options are clear liquids.
Page | 4
WITH RATIONALE REAL EXAM
QUESTIONS WITH 100% CORRECT
ANSWERS
A client with parenteral nutrition (PN) infusing has disconnected the tubing from the central
line catheter. The nurse assesses the client and suspects an air embolism. The nurse should
immediately place the client in which position?
1. On the left side, with the head lower than the feet
2. On the left side, with the head higher than the feet
3. On the right side, with the head lower than the feet
4. On the right side, with the head higher than the feet ---- ANSWER----1Rationale: Air
embolism occurs when air enters the catheter system, such as when the system is opened
for intravenous (IV) tubing changes or when the IV tubing disconnects. Air embolism is a
critical situation; if it is suspected, the client should be placed in a left side-lying position.
The head should be lower than the feet. This position is used to minimize the effect of the
air traveling as a bolus to the lungs by trapping it in the right side of the heart. The
positions in the remaining options are inappropriate if an air embolism is suspected.
Which nursing action is essential prior to initiating a new prescription for 500 mL of fat
emulsion (lipids) to infuse at 50 mL/hour?
1. Ensure that the client does not have diabetes.
2. Determine whether the client has an allergy to eggs.
Page | 1
,3. Add regular insulin to the fat emulsion, using aseptic technique.
4. Contact the health care provider (HCP) to have a central line inserted for fat emulsion
infusion. ---- ANSWER----2Rationale: The client beginning infusions of fat emulsions
must be first assessed for known allergies to eggs to prevent anaphylaxis. Egg yolk is a
component of the solution and provides emulsification. The remaining options are
unnecessary and are not related specifically to the administration of fat emulsion.
The nurse monitors the client receiving parenteral nutrition (PN) for complications of the
therapy and should assess the client for which manifestations of hyperglycemia?
1. Fever, weak pulse, and thirst
2. Nausea, vomiting, and oliguria
3. Sweating, chills, and abdominal pain
4. Weakness, thirst, and increased urine output ---- ANSWER----4Rationale: The high
glucose concentration in PN places the client at risk for hyperglycemia. Signs of
hyperglycemia include excessive thirst, fatigue, restlessness, confusion, weakness,
Kussmaul respirations, diuresis, and coma when hyperglycemia is severe. If the client has
these symptoms, the blood glucose level should be checked immediately. The remaining
options do not identify signs specific to hyperglycemia.
The nurse is changing the central line dressing of a client receiving parenteral nutrition (PN)
and notes that the catheter insertion site appears reddened. The nurse should next assess
which item?
1. Client's temperature
2. Expiration date on the bag
3. Time of last dressing change
Page | 2
,4. Tightness of tubing connections ---- ANSWER----1Rationale: Redness at the catheter
insertion site is a possible indication of infection. The nurse would next assess for other
signs of infection. Of the options given, the temperature is the next item to assess. The
tightness of tubing connections should be assessed each time the PN is checked; loose
connections would result in leakage, not skin redness. The expiration date on the bag is a
viable option, but this also should be checked at the time the solution is hung and with
each shift change. The time of the last dressing change should be checked with each shift
change.
A client with hypertension has been told to maintain a diet low in sodium. The nurse who is
teaching this client about foods that are allowed should include which food item in a list
provided to the client?
1. Tomato soup
2. Boiled shrimp
3. Instant oatmeal
4. Summer squash ---- ANSWER----4Rationale: Foods that are lower in sodium include fruits
and vegetables (summer squash), because they do not contain physiological saline. Highly
processed or refined foods (tomato soup, instant oatmeal) are higher in sodium unless their
food labels specifically state "low sodium." Saltwater fish and shellfish are high in sodium.
A postoperative client has been placed on a clear liquid diet. The nurse should provide the
client with which items that are allowed to be consumed on this diet? Select all that apply. 1.
Broth
2. Coffee
3. Gelatin
4. Pudding
5. Vegetable juice
Page | 3
, 6. Pureed vegetables ---- ANSWER----1, 2, 3Rationale: A clear liquid diet consists of foods
that are relatively transparent to light and are clear and liquid at room and body
temperature. These foods include items such as water, bouillon, clear broth, carbonated
beverages, gelatin, hard candy, lemonade, ice pops, and regular or decaffeinated coffee or
tea. The incorrect food items are items that are allowed on a full liquid diet.
The nurse is instructing a client with hypertension on the importance of choosing foods low
in sodium. The nurse should teach the client to limit intake of which food?
1. Apples
2. Bananas
3. Smoked sausage
4. Steamed vegetables ---- ANSWER----3Rationale: Smoked foods are high in sodium, which
is noted in the correct option. The remaining options are fruits and vegetables, which are
low in sodium.
A client who is recovering from surgery has been advanced from a clear liquid diet to a full
liquid diet. The client is looking forward to the diet change because he has been "bored" with
the clear liquid diet. The nurse should offer which full liquid item to the client? 1. Tea
2. Gelatin
3. Custard
4. Ice pop ---- ANSWER----3Rationale: Full liquid food items include items such as plain ice
cream, sherbet, breakfast drinks, milk, pudding and custard, soups that are strained, refined
cooked cereals, and strained vegetable juices. A clear liquid diet consists of foods that are
relatively transparent. The food items in the incorrect options are clear liquids.
Page | 4
