HESI 315EXAM

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Sample questions from HESI 315EXAM

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, the nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client 1 day after abdominal surgery reporting incisional pain of 7/10
   • B.A client 2 hours after thyroidectomy who has new inspiratory stridor
   • C.A client with pneumonia whose temperature is 38.1 C (100.6 F)
   • D.A client with heart failure who has 2+ ankle edema

   Rationale: New stridor after thyroid surgery can indicate airway obstruction from edema or bleeding and requires immediate assessment and intervention. Fever, edema, and postoperative pain need attention but do not take priority over a threatened airway. Use airway, breathing, and circulation to guide prioritization.

2. 2.Refer to the client's chart. In the pediatric emergency department, which action should the nurse take first for the 6-year-old client?

   • A.Offer oral fluids and reassess in 1 hour
   • B.Obtain a urine specimen before beginning treatment
   • C.Prepare to administer an isotonic IV fluid bolus as prescribed
   • D.Administer an antidiarrheal medication

   Rationale: The client's tachycardia, delayed capillary refill, dry mucosa, and low urine output indicate significant dehydration; the prescribed isotonic bolus supports circulating volume promptly. Oral fluids are insufficient for the current perfusion findings, and antidiarrheals are not the priority. Collecting urine should not delay fluid resuscitation.

3. 3.On a rehabilitation unit, a client with expressive aphasia after a stroke needs help making a decision about discharge. Which nursing action best supports the client's autonomy?

   • A.Ask the client's family to make the decision
   • B.Assume the client cannot understand the discharge options
   • C.Ask the provider to choose the safest option without client input
   • D.Provide communication aids and allow time for the client to respond

   Rationale: Aphasia can impair expression without impairing comprehension or decision-making capacity. Communication aids and adequate response time enable the client to participate. Family input may be helpful but does not replace the capable client's preferences, and the nurse should not presume incapacity.

4. 4.During a home visit, a nurse finds that a client with diabetes has missed several appointments because the bus route was discontinued. Which response best addresses the barrier to care?

   • A.Collaborate with the client to identify transportation resources and arrange follow-up
   • B.Tell the client to use a taxi for every appointment
   • C.Document nonadherence and end the visit
   • D.Ask the client to reschedule when transportation becomes available

   Answer and rationale are in the full material.

5. 5.Refer to the client's chart. At 1000, which findings require the nurse to notify the rapid response team or provider immediately? Select all that apply.

   • A.Potassium of 4.1 mEq/L
   • B.Temperature of 37.2 C
   • C.New confusion compared with the 0800 assessment
   • D.Respiratory rate of 30/min
   • E.Oxygen saturation of 88% on 4 L/min nasal cannula

   Answer and rationale are in the full material.