HESI BSN 315

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Sample questions from HESI BSN 315

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

1. 1.During morning rounds on a surgical unit, a 67-year-old client reports feeling unusually weak. Refer to the client's chart. Which action should the RN take first?

   • A.Assist the client to a chair to improve ventilation
   • B.Reassess the dressing and vital signs in 30 minutes
   • C.Request a prescription for an oral iron supplement
   • D.Activate the rapid response team and remain with the client

   Rationale: The falling BP, rising HR, increasing bloody drainage, and hemoglobin decrease from 12.1 to 8.4 g/dL indicate possible postoperative hemorrhage with shock. Activating the rapid response team brings immediate assistance while the RN remains available to support circulation and breathing. Oral iron does not correct acute circulatory compromise, and moving the client to a chair can worsen hypotension. Waiting 30 minutes delays treatment of an unstable client.

2. 2.On a rehabilitation unit, a 42-year-old client with a healed hip incision is scheduled for discharge tomorrow. Which task is appropriate for the RN to delegate to experienced unlicensed assistive personnel?

   • A.Determine whether the client can safely use stairs at home
   • B.Measure and record intake and output
   • C.Evaluate the client's understanding of fall precautions
   • D.Reinforce a newly developed anticoagulant teaching plan

   Rationale: Measuring and recording intake and output is a routine task that does not require nursing judgment. Determining stair safety and evaluating understanding require professional assessment. Anticoagulant education should be performed by licensed nursing personnel rather than assigned to unlicensed assistive personnel. Delegate predictable tasks while retaining assessment, teaching, and evaluation responsibilities.

3. 3.Before surgery in an ambulatory center, a 58-year-old client tells the RN, 'I signed the consent, but I still do not understand why I need this procedure.' No sedating medication has been given. Which actions should the RN take? Select all that apply.

   • A.Verify that the client's decision is voluntary
   • B.Tell the client the signed form prevents withdrawal of consent
   • C.Delay administration of the prescribed preoperative sedative
   • D.Notify the surgeon that the client needs additional explanation
   • E.Explain the procedure's material risks in place of the surgeon

   Rationale: The surgeon must address unanswered questions about the procedure, and delaying sedation preserves the client's ability to participate in informed decision-making. Verifying that the decision is voluntary is part of the nurse's advocacy role. The RN may reinforce information but should not substitute for the surgeon's required discussion of material risks. A client may withdraw consent even after signing the form.

4. 4.At a community hospital, a 35-year-old client with decision-making capacity refuses a prescribed blood transfusion for religious reasons. Hemoglobin is 6.9 g/dL, BP is 112/68 mm Hg, and HR is 96 beats/min. Which response best supports the client's rights?

   • A.Document the refusal and collaborate on acceptable alternatives
   • B.Explain that refusal requires immediate discharge
   • C.Ask a family member to authorize the transfusion
   • D.Administer the transfusion because the hemoglobin is critically low

   Answer and rationale are in the full material.

5. 5.Following a stroke, a 76-year-old client on a medical unit coughs after drinking water and has a wet-sounding voice. SpO2 is 96% on room air. Which interprofessional referral is the priority?

   • A.Social work for transportation assistance
   • B.Physical therapy for gait training
   • C.Speech-language pathology for swallowing evaluation
   • D.Occupational therapy for dressing adaptations

   Answer and rationale are in the full material.