Nightingale BSN 315 HESI V1

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Sample questions from Nightingale BSN 315 HESI V1

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, a 67-year-old client with pneumonia has a new oxygen requirement and an oxygen saturation of 88% on 2 L/min by nasal cannula. Which client should the charge nurse assess first?

   • A.A 67-year-old with pneumonia whose oxygen saturation has fallen to 88%
   • B.A 54-year-old awaiting discharge teaching after an uncomplicated appendectomy
   • C.A 39-year-old asking when a scheduled dressing change will be completed
   • D.A 72-year-old requesting assistance to the bathroom 2 hours after receiving an opioid

   Rationale: The falling oxygen saturation despite supplemental oxygen signals impaired oxygenation and requires prompt assessment. Discharge teaching and a routine dressing change can wait until the unstable client is addressed. The client requesting bathroom assistance also needs timely attention, but the reported cue does not indicate an immediate threat comparable to hypoxemia. Prioritize changes that threaten airway or breathing.

2. 2.During a home visit, a 78-year-old client with heart failure says, "I cannot afford all these pills, so I take the water pill every other day." The client has gained 2.3 kg (5 lb) in 4 days and has new ankle edema. Which action should the nurse take first?

   • A.Tell the client to take twice the prescribed diuretic dose today
   • B.Document nonadherence and schedule the next visit in 1 month
   • C.Advise the client to stop weighing daily because it causes anxiety
   • D.Ask the client to describe the medication schedule and barriers to obtaining the prescription

   Rationale: The weight gain and edema suggest worsening fluid retention, while the client's statement identifies a cost barrier that needs immediate assessment and care coordination. Doubling a diuretic dose without a prescription is unsafe, and stopping daily weights removes an important way to monitor heart failure. Waiting a month without addressing the change could delay needed treatment. Assess the barrier and promptly communicate the clinical change to the prescriber and appropriate support services.

3. 3.A provider prescribes an invasive procedure for a 16-year-old client who is alert and able to understand the explanation. The parent has signed the consent form, but the client says, "I do not want this done." What is the nurse's best action?

   • A.Ask the parent to persuade the client to cooperate
   • B.Give a sedative so the procedure can be completed safely
   • C.Pause preparation and notify the provider that the client objects
   • D.Proceed because the parent has signed the consent form

   Rationale: The client's objection should be communicated to the provider before the procedure proceeds so that the client's understanding, concerns, and applicable consent requirements can be addressed. A parent's signature does not make it appropriate for the nurse to ignore an alert adolescent's expressed refusal. Pressuring the client or administering a sedative to overcome the objection is coercive and unsafe. The nurse advocates for the client and does not independently resolve legal consent questions.

4. 4.In the pediatric clinic, a parent of a 2-month-old infant has difficulty understanding the discharge instructions for a new medication. The parent speaks limited English, and the infant is stable with a temperature of 37.1 C, HR 132/min, RR 34/min, and SpO2 99% on room air. Which actions should the nurse take to support safe communication and follow-up? Select all that apply.

   • A.Ask the parent to repeat the medication schedule in their own words
   • B.Arrange for a qualified medical interpreter to assist with the teaching
   • C.Use the parent's school-aged child to translate the medication instructions
   • D.Provide written instructions in the parent's preferred language when available
   • E.Document the parent's inability to understand and end the visit without further teaching

   Answer and rationale are in the full material.

5. 5.In the emergency department, a 31-year-old client with a fractured wrist is waiting for radiographs. A second client, age 44, arrives with sudden facial drooping and difficulty speaking that began 20 minutes ago; blood pressure is 168/92 mm Hg and glucose is 112 mg/dL. Which action should the triage nurse take?

   • A.Place the client with speech changes in the waiting area until a bed is available
   • B.Activate the stroke response and expedite assessment of the client with speech changes
   • C.Ask the client with the wrist fracture to assess whether the speech change is new
   • D.Continue with the wrist radiographs because the first client arrived earlier

   Answer and rationale are in the full material.