EAQ-Pain Management , Safe Medication Administration & Foundations Hesi
C0MBINATION EXAMINATION 2025 – 2026 WITH QUESTIONS WITH CORRECT
ANSWERS VERIFIED 100% GRADED A+
Foundations Hesi
A male client with a history of hypertension tells the nurse that he is tired of
taking antihypertensive medications and is going to try spiritual meditation
instead. What should be the nurse's first response?
A. "It is important that you continue your medication while learning to
meditate."
B. "Spiritual meditation requires a time commitment of 15 to 20 minutes daily."
C. "Obtain your healthcare provider's permission before starting meditation."
D. "Complementary therapy and western medicine can be effective for you."
Ans: A
Rationale
The prolonged practice of meditation may lead to a reduced need for
antihypertensive medications. However, the medications must be continued while
the physiologic response to meditation is monitored. The healthcare provider should
be informed, but permission is not required to meditate. Although it is true that this
complementary therapy might be effective, it is essential that the client continue with
antihypertensive medications until the effect of meditation can be measured.
The nurse is examining a male client who reports itching on his right arm, The
nurse observes a rash made up of multiple flat areas of redness ranging from
pinpoint to 0.5 cm in diameter. How should the nurse record this finding?
A. Multiple vesicular areas surrounded by redness, ranging in size from 1 mm
to 0.5 cm.
B. Localized red rash comprised of flat areas, pinpoint to 0.5 cm in diameter.
C. Several areas of red, papular lesions from pinpoint to 0.5 cm in size.
D. Localized petechial areas, ranging in size from pinpoint to 0.5 cm in
diameter.
Ans: B
Rationale
Macules are localized flat skin discolorations less than 1 cm in diameter. However,
when recording such a finding the nurse should describe the appearance rather than
simply naming the condition. Vesicles are fluid-filled blisters. Papules are solid
elevated lesions and petechiae are pinpoint red to purple skin discolorations that do
not itch.
,During the initial morning assessment, a male client denies dysuria but reports
that his urine appears dark amber. Which intervention should the nurse
implement?
A. Provide additional coffee on the client's breakfast tray.
B. Exchange the client's grape juice for cranberry juice.
C.Bring the client additional fruit at mid-morning.
D. Encourage additional oral intake of juices and water.
Ans: D Rationale
Dark amber urine is characteristic of fluid volume deficit, and the client should be
encouraged to increase fluid intake (D). Caffeine, however, is a diuretic (A), and may
worsen the fluid volume deficit. Any type of juice will be beneficial (B), since the
client is not dysuric, a sign of an urinary tract infection. The client needs to restore
fluid volume more than solid foods (C).
Which action is most important for the nurse to implement when donning
sterile gloves?
A. Maintain thumb at a ninety degree angle.
B. Hold hands with fingers down while gloving.
C. Keep gloved hands above the elbows.
D. Put the glove on the dominant hand first.
Ans: C Rationale
Gloved hands held below waist level are considered unsterile. While it may be
helpful to put the glove on the dominant hand first, it is not necessary to ensure
asepsis.
The nurse is evaluating a client learning about a low-sodium diet. Selection of
which meal would indicate to the nurse that this client understands the dietary
restrictions? A. Tossed salad, low-sodium dressing, bacon and tomato
sandwich.
B. New England clam chowder, no-salt crackers, fresh fruit salad.
C. Skim milk, turkey salad, roll, vanilla ice cream.
D. Macaroni and cheese, diet Coke, a slice of cherry pie.
Ans: C Rationale
Skim milk, turkey, bread, and ice cream, while containing some sodium, are
considered low-sodium foods. Bacon, canned soups (especially those with seafood),
hard cheeses, macaroni, and most diet drinks are very high in sodium.
The nurse is performing nasotracheal suctioning. After suctioning the client's
trachea for fifteen seconds, large amounts of thick yellow secretions return.
What action should the nurse implement next?
A. Encourage the client to cough to help loosen secretions.
,B. Advise the client to increase the intake of oral fluids.
C. Rotate the suction catheter to obtain any remaining secretions.
D. Re-oxygenate the client before attempting to suction again.
Ans: D Rationale
Nasotracheal suctioning should not be continued for longer than ten to fifteen
seconds, since the client's oxygenation is compromised during this time. Additional
suctioning may continue after the client has received oxygen.
Docusate sodium (Colace) 0.3 grams is prescribed for a client who has
frequent constipation. Each capsule contains 100 mg. How many capsules
should the nurse administer?
Ans: 3
A resident in a skilled nursing facility for short-term rehabilitation after a hip
replacement tells the nurse, "I don't want any more blood taken for those
useless tests." Which narrative documentation should the nurse enter in the
client's medical record? A. Healthcare provider notified of failure to collect
specimens for prescribed blood studies.
B. Blood specimens not collected because client no longer wants blood tests
performed.
C. Healthcare provider notified of client's refusal to have blood specimens
collected for testing.
D. Client irritable, uncooperative, and refuses to have blood collected.
Healthcare provider notified.
Ans: C Rationale
When a client refuses a treatment, the exact words of the client regarding the client's
refusal of care should be documented in a narrative format. The nurse should not
editorialize, make judgments, or document assumptions about the client's wishes.
An older client with a fractured left hip is on strict bedrest. Which nursing
measure is essential to the client's nursing care?
A. Massage any reddened areas for at least five minutes.
B. Encourage active range of motion exercises on extremities.
C. Position the client laterally, prone, and dorsally in sequence.
D. Gently lift the client when moving into a desired position.
Ans: D Rationale
To avoid shearing forces when repositioning, the client should be lifted gently across
a surface. Reddened areas should not be massaged since this may increase the
damage to already traumatized skin. To control pain and muscle spasms, active
range of motion may be limited on the affected leg.
A client is in the radiology department at 0900 when the prescription
levofloxacin (Levaquin) 500 mg IV every 24 hours is scheduled to be
administered. The client returns to the unit at 1300. What is the best
intervention for the nurse to implement?
, Contact the healthcare provider and complete a medication variance form.
Administer the Levaquin at 1300 and resume the 0900 schedule in the
morning.
Notify the charge nurse and complete an incident report to explain the missed
dose.
Give the missed dose at 1300 and change the schedule to administer daily at
1300.
Ans: D
Rationale
To ensure that a therapeutic level of medication is maintained, the nurse should
administer the missed dose as soon as possible, and revise the administration
schedule accordingly to prevent dangerously increasing the level of the medication in
the bloodstream. The nurse should document the reason for the late dose, but
contacting the healthcare provider or the charge nurse are not warranted.
A young mother of three children complains of increased anxiety during her
annual physical exam. What information should the nurse obtain first?
Sexual activity patterns.
Nutritional history.
Leisure activities.
Financial stressors.
Ans: B
Rationale
Caffeine, sugars, and alcohol can lead to increased levels of anxiety, so a nutritional
history (C) should be obtained first so that health teaching can be initiated if
indicated. (A and C) can be used for stress management. Though (D) can be a
source of anxiety, a nutritional history should be obtained first.
The nurse observes an unlicensed assistive personnel (UAP) checking a
client's blood pressure with a cuff that is too small, but the blood pressure
reading obtained is within the client's usual range. Which action is most
important for the nurse to implement?
Tell the UAP to use a larger cuff at the next scheduled assessment.
Reassess the client's blood pressure using a larger cuff.
Have the unit educator review this procedure with the UAPs.
Teach the UAP the correct technique for assessing blood pressure.
Ans:B Rationale
An unlicensed assistive personnel (UAP) is using the wrong sized cuff to check a
blood pressure. The most important action is to ensure that an accurate blood
pressure reading is obtained. The nurse should reassess the blood pressure with the
correct size cuff. Reassessment should not be postponed.
C0MBINATION EXAMINATION 2025 – 2026 WITH QUESTIONS WITH CORRECT
ANSWERS VERIFIED 100% GRADED A+
Foundations Hesi
A male client with a history of hypertension tells the nurse that he is tired of
taking antihypertensive medications and is going to try spiritual meditation
instead. What should be the nurse's first response?
A. "It is important that you continue your medication while learning to
meditate."
B. "Spiritual meditation requires a time commitment of 15 to 20 minutes daily."
C. "Obtain your healthcare provider's permission before starting meditation."
D. "Complementary therapy and western medicine can be effective for you."
Ans: A
Rationale
The prolonged practice of meditation may lead to a reduced need for
antihypertensive medications. However, the medications must be continued while
the physiologic response to meditation is monitored. The healthcare provider should
be informed, but permission is not required to meditate. Although it is true that this
complementary therapy might be effective, it is essential that the client continue with
antihypertensive medications until the effect of meditation can be measured.
The nurse is examining a male client who reports itching on his right arm, The
nurse observes a rash made up of multiple flat areas of redness ranging from
pinpoint to 0.5 cm in diameter. How should the nurse record this finding?
A. Multiple vesicular areas surrounded by redness, ranging in size from 1 mm
to 0.5 cm.
B. Localized red rash comprised of flat areas, pinpoint to 0.5 cm in diameter.
C. Several areas of red, papular lesions from pinpoint to 0.5 cm in size.
D. Localized petechial areas, ranging in size from pinpoint to 0.5 cm in
diameter.
Ans: B
Rationale
Macules are localized flat skin discolorations less than 1 cm in diameter. However,
when recording such a finding the nurse should describe the appearance rather than
simply naming the condition. Vesicles are fluid-filled blisters. Papules are solid
elevated lesions and petechiae are pinpoint red to purple skin discolorations that do
not itch.
,During the initial morning assessment, a male client denies dysuria but reports
that his urine appears dark amber. Which intervention should the nurse
implement?
A. Provide additional coffee on the client's breakfast tray.
B. Exchange the client's grape juice for cranberry juice.
C.Bring the client additional fruit at mid-morning.
D. Encourage additional oral intake of juices and water.
Ans: D Rationale
Dark amber urine is characteristic of fluid volume deficit, and the client should be
encouraged to increase fluid intake (D). Caffeine, however, is a diuretic (A), and may
worsen the fluid volume deficit. Any type of juice will be beneficial (B), since the
client is not dysuric, a sign of an urinary tract infection. The client needs to restore
fluid volume more than solid foods (C).
Which action is most important for the nurse to implement when donning
sterile gloves?
A. Maintain thumb at a ninety degree angle.
B. Hold hands with fingers down while gloving.
C. Keep gloved hands above the elbows.
D. Put the glove on the dominant hand first.
Ans: C Rationale
Gloved hands held below waist level are considered unsterile. While it may be
helpful to put the glove on the dominant hand first, it is not necessary to ensure
asepsis.
The nurse is evaluating a client learning about a low-sodium diet. Selection of
which meal would indicate to the nurse that this client understands the dietary
restrictions? A. Tossed salad, low-sodium dressing, bacon and tomato
sandwich.
B. New England clam chowder, no-salt crackers, fresh fruit salad.
C. Skim milk, turkey salad, roll, vanilla ice cream.
D. Macaroni and cheese, diet Coke, a slice of cherry pie.
Ans: C Rationale
Skim milk, turkey, bread, and ice cream, while containing some sodium, are
considered low-sodium foods. Bacon, canned soups (especially those with seafood),
hard cheeses, macaroni, and most diet drinks are very high in sodium.
The nurse is performing nasotracheal suctioning. After suctioning the client's
trachea for fifteen seconds, large amounts of thick yellow secretions return.
What action should the nurse implement next?
A. Encourage the client to cough to help loosen secretions.
,B. Advise the client to increase the intake of oral fluids.
C. Rotate the suction catheter to obtain any remaining secretions.
D. Re-oxygenate the client before attempting to suction again.
Ans: D Rationale
Nasotracheal suctioning should not be continued for longer than ten to fifteen
seconds, since the client's oxygenation is compromised during this time. Additional
suctioning may continue after the client has received oxygen.
Docusate sodium (Colace) 0.3 grams is prescribed for a client who has
frequent constipation. Each capsule contains 100 mg. How many capsules
should the nurse administer?
Ans: 3
A resident in a skilled nursing facility for short-term rehabilitation after a hip
replacement tells the nurse, "I don't want any more blood taken for those
useless tests." Which narrative documentation should the nurse enter in the
client's medical record? A. Healthcare provider notified of failure to collect
specimens for prescribed blood studies.
B. Blood specimens not collected because client no longer wants blood tests
performed.
C. Healthcare provider notified of client's refusal to have blood specimens
collected for testing.
D. Client irritable, uncooperative, and refuses to have blood collected.
Healthcare provider notified.
Ans: C Rationale
When a client refuses a treatment, the exact words of the client regarding the client's
refusal of care should be documented in a narrative format. The nurse should not
editorialize, make judgments, or document assumptions about the client's wishes.
An older client with a fractured left hip is on strict bedrest. Which nursing
measure is essential to the client's nursing care?
A. Massage any reddened areas for at least five minutes.
B. Encourage active range of motion exercises on extremities.
C. Position the client laterally, prone, and dorsally in sequence.
D. Gently lift the client when moving into a desired position.
Ans: D Rationale
To avoid shearing forces when repositioning, the client should be lifted gently across
a surface. Reddened areas should not be massaged since this may increase the
damage to already traumatized skin. To control pain and muscle spasms, active
range of motion may be limited on the affected leg.
A client is in the radiology department at 0900 when the prescription
levofloxacin (Levaquin) 500 mg IV every 24 hours is scheduled to be
administered. The client returns to the unit at 1300. What is the best
intervention for the nurse to implement?
, Contact the healthcare provider and complete a medication variance form.
Administer the Levaquin at 1300 and resume the 0900 schedule in the
morning.
Notify the charge nurse and complete an incident report to explain the missed
dose.
Give the missed dose at 1300 and change the schedule to administer daily at
1300.
Ans: D
Rationale
To ensure that a therapeutic level of medication is maintained, the nurse should
administer the missed dose as soon as possible, and revise the administration
schedule accordingly to prevent dangerously increasing the level of the medication in
the bloodstream. The nurse should document the reason for the late dose, but
contacting the healthcare provider or the charge nurse are not warranted.
A young mother of three children complains of increased anxiety during her
annual physical exam. What information should the nurse obtain first?
Sexual activity patterns.
Nutritional history.
Leisure activities.
Financial stressors.
Ans: B
Rationale
Caffeine, sugars, and alcohol can lead to increased levels of anxiety, so a nutritional
history (C) should be obtained first so that health teaching can be initiated if
indicated. (A and C) can be used for stress management. Though (D) can be a
source of anxiety, a nutritional history should be obtained first.
The nurse observes an unlicensed assistive personnel (UAP) checking a
client's blood pressure with a cuff that is too small, but the blood pressure
reading obtained is within the client's usual range. Which action is most
important for the nurse to implement?
Tell the UAP to use a larger cuff at the next scheduled assessment.
Reassess the client's blood pressure using a larger cuff.
Have the unit educator review this procedure with the UAPs.
Teach the UAP the correct technique for assessing blood pressure.
Ans:B Rationale
An unlicensed assistive personnel (UAP) is using the wrong sized cuff to check a
blood pressure. The most important action is to ensure that an accurate blood
pressure reading is obtained. The nurse should reassess the blood pressure with the
correct size cuff. Reassessment should not be postponed.
