HESI NG222

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Sample questions from HESI NG222

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, four clients require assessment. Which client should the RN assess first?

   • A.A 60-year-old with chronic arthritis reporting unchanged knee pain of 6/10
   • B.A 72-year-old with pneumonia whose SpO2 decreased from 95% to 88% on oxygen at 2 L/min
   • C.A 45-year-old awaiting discharge who requests clarification about a prescription
   • D.A 33-year-old scheduled for surgery who has questions about the consent form

   Rationale: The falling oxygen saturation despite supplemental oxygen indicates an acute breathing problem requiring immediate assessment. Prescription clarification and consent questions require attention but do not indicate current physiologic instability. Unchanged chronic pain is less urgent than deteriorating oxygenation. Prioritize an acute change in airway, breathing, or circulation over stable needs.

2. 2.During morning rounds in the surgical unit, the RN reviews a 68-year-old client's changing condition. Refer to the client's chart. Which action has the highest priority?

   • A.Reassess urine output in 2 hours
   • B.Request a routine physical therapy evaluation
   • C.Administer the prescribed oral analgesic
   • D.Activate the rapid response team

   Rationale: The BP decline to 84/48 mm Hg, HR increase to 124/min, new confusion, and sharply reduced urine output indicate shock and require immediate escalation. Physical therapy is inappropriate during instability, and oral analgesia does not address impaired perfusion. Waiting 2 hours risks further deterioration. Trend recognition should trigger emergency action rather than routine postoperative care.

3. 3.On a rehabilitation unit, an RN plans care for a stable 76-year-old recovering from a hip fracture. The client is alert, has BP 128/74 mm Hg, and has an established walker-assisted mobility plan. Which tasks may the RN delegate to trained assistive personnel? Select all that apply.

   • A.Teach the client how to use the walker
   • B.Obtain routine vital signs and report values outside assigned parameters
   • C.Record food and fluid intake
   • D.Assist the client to the bathroom using the established mobility plan
   • E.Determine whether new calf pain suggests a complication

   Rationale: Assistance with established mobility, intake recording, and routine vital signs are predictable tasks appropriate for trained assistive personnel. Evaluating new calf pain requires nursing assessment because it could indicate venous thrombosis. Initial walker teaching requires a licensed clinician rather than delegation of nursing judgment. The RN remains responsible for supervision and follow-up of reported findings.

4. 4.Before transport to the operating room, a 51-year-old client states, 'I signed the consent, but I still do not understand why my thyroid must be removed.' The client has not received sedation. What should the RN do?

   • A.Ask the spouse to confirm that surgery is necessary
   • B.Explain the surgical risks and obtain a new signature
   • C.Notify the surgeon and pause transport until questions are addressed
   • D.Proceed because the signed form documents informed consent

   Answer and rationale are in the full material.

5. 5.In an outpatient infusion center, a 44-year-old client with severe anemia declines a prescribed blood transfusion for religious reasons. The client is alert, explains the consequences of refusal, and has BP 118/70 mm Hg. Which response is appropriate?

   • A.Respect the refusal and notify the provider to discuss alternatives
   • B.Request a psychiatric evaluation solely because treatment was refused
   • C.Administer blood if the hemoglobin falls below the facility threshold
   • D.Ask the family to override the refusal

   Answer and rationale are in the full material.