NSG520 HESI Exam 2

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Sample questions from NSG520 HESI Exam 2

This material has 75 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift in a community hospital, a 76-year-old client with heart failure, chronic kidney disease, and atrial fibrillation is due for digoxin. The client reports nausea and blurred vision; the apical pulse is 54/min, and the potassium is 3.1 mEq/L. Which action should the nurse take first?

   • A.Administer a potassium supplement from the unit supply and give the digoxin
   • B.Give the prescribed digoxin with food to reduce nausea
   • C.Ask the unlicensed assistive personnel to recheck the apical pulse in 1 hour
   • D.Withhold the digoxin and notify the provider of the findings

   Rationale: Withholding digoxin and promptly notifying the provider is the safest action because bradycardia, visual changes, nausea, and hypokalemia suggest possible digoxin toxicity. Giving the dose could worsen dysrhythmia risk, and waiting an hour to recheck delays needed evaluation. The nurse should not independently administer an unprescribed potassium supplement; the exam takeaway is to hold a potentially toxic medication and escalate concerning assessment and laboratory findings.

2. 2.During a home visit, a 29-year-old client at 32 weeks of pregnancy reports a severe headache and seeing spots. Blood pressure is 168/110 mm Hg, and the client says fetal movement has decreased since morning. Which action should the nurse take?

   • A.Schedule an urgent clinic appointment for later today and advise avoiding bright light
   • B.Arrange immediate transport to the hospital and communicate the maternal and fetal concerns
   • C.Ask the client to drink water and count fetal movements for 2 hours before deciding
   • D.Instruct the client to lie on the left side and call back in 1 hour with a repeat blood pressure

   Rationale: Severe-range blood pressure with headache and visual symptoms can indicate preeclampsia with severe features, while decreased fetal movement adds urgency; immediate hospital assessment is needed. A period of home monitoring or hydration delays evaluation of potentially life-threatening maternal and fetal complications. A later clinic appointment is not an adequate response to these findings; prioritize emergency escalation and a safe transfer.

3. 3.Refer to the client's chart. Which action should the nurse take first?

   • A.Ask the client to walk to the bathroom to assess whether dizziness improves
   • B.Administer an oral iron dose and reassess the blood pressure in 30 minutes
   • C.Stop the infusion, maintain access with normal saline using new tubing, and notify the provider
   • D.Continue the infusion at a slower rate while obtaining a repeat blood count

   Rationale: The client has new hypotension and tachycardia during a blood transfusion, with a concurrent temperature rise and chills, so a transfusion reaction must be treated as an emergency. The time-linked change from 0800 to 0830 supports stopping the blood product immediately; new saline tubing maintains IV access without continuing the suspected trigger. Slowing the infusion, ambulating a hypotensive client, or delaying action for oral iron does not address the acute reaction.

4. 4.A 7-year-old client is admitted to a pediatric unit with fever and suspected meningococcal meningitis. The client is receiving droplet precautions and has a new order for IV antibiotics. Which actions should the charge nurse include in the plan of care? Select all that apply.

   • A.Verify that blood cultures are obtained as ordered before the first antibiotic dose if this does not delay urgent treatment
   • B.Assign a nurse who is competent in pediatric IV medication administration
   • C.Have the unlicensed assistive personnel independently assess the client's level of consciousness every 15 minutes
   • D.Place the client in a negative-pressure room for airborne isolation
   • E.Ensure staff wear a surgical mask on room entry according to facility policy

   Answer and rationale are in the full material.

5. 5.In a long-term care facility, an 83-year-old resident with moderate dementia is scheduled for a procedure under sedation. The resident's adult child asks the nurse to sign the consent form because the resident 'doesn't understand anything.' The resident is awake, recognizes the procedure's purpose, and asks whether it will hurt. What should the nurse do?

   • A.Assess and support the resident's decision-making participation, and ask the procedural provider to explain risks, benefits, and alternatives
   • B.Have the adult child sign immediately because dementia automatically removes decision-making capacity
   • C.Ask the nurse manager to sign the form as a witness and proceed with transport
   • D.Give a sedative to reduce distress, then obtain consent from the resident

   Answer and rationale are in the full material.