HESI Adult Health 2 D446

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Sample questions from HESI Adult Health 2 D446

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, report identifies four clients. Which client should the nurse assess first?

   • A.A 44-year-old reporting incisional pain of 7 on a 0-to-10 scale
   • B.A 76-year-old awaiting discharge instructions after an uncomplicated procedure
   • C.A 52-year-old with diabetes whose premeal blood glucose is 248 mg/dL
   • D.A 68-year-old with pneumonia whose oxygen saturation decreased from 95% to 89% on 2 L/min by nasal cannula

   Rationale: The client with pneumonia has worsening oxygenation despite supplemental oxygen, which can signal respiratory deterioration and requires immediate assessment. Hyperglycemia, pain, and discharge teaching need attention but are not as urgent as impaired oxygenation. Prioritize threats to airway and breathing before less acute needs.

2. 2.In a rehabilitation unit, an RN is assigning tasks to a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP). Which task is appropriate to delegate to the UAP?

   • A.Teach a client how to use an incentive spirometer
   • B.Obtain routine vital signs for a stable client 2 days after hip surgery
   • C.Evaluate a client's understanding of new anticoagulant instructions
   • D.Assess a newly admitted client's pain and response to analgesia

   Rationale: Obtaining routine vital signs for a stable client is a predictable task that can be delegated to a UAP, with the RN responsible for interpreting and acting on the results. Initial assessment, teaching, and evaluation require nursing judgment and remain the RN's responsibility. Match delegation to client stability, task predictability, and staff competency.

3. 3.A client states, "I do not want the blood transfusion that my provider recommended." Which response by the nurse is most appropriate?

   • A."Tell me what concerns you most about receiving the transfusion."
   • B."I will ask your family to persuade you to accept the transfusion."
   • C."Your provider would not recommend it unless it were necessary."
   • D."You must sign the refusal form before I can discuss your concerns."

   Rationale: Inviting the client to explain concerns supports informed, voluntary decision-making and helps identify questions that may need clarification. Appealing to the provider's authority or family pressure can undermine autonomy, and a form should not replace a meaningful discussion. The capable client has the right to refuse treatment.

4. 4.Refer to the client's chart. Which actions should the nurse take now? Select all that apply.

   • A.Position the client upright to ease breathing
   • B.Review the client's respiratory status and response after interventions
   • C.Apply oxygen as prescribed and reassess the client's oxygenation
   • D.Wait 30 minutes and repeat the oxygen saturation before intervening
   • E.Notify the rapid response team about the worsening respiratory status

   Answer and rationale are in the full material.

5. 5.The provider prescribes a medication dose that is substantially higher than the usual dose listed in the facility reference. The client is stable, and the medication has not been given. What should the nurse do first?

   • A.Ask another nurse to cosign the medication administration
   • B.Administer the dose and monitor the client closely
   • C.Hold the medication and clarify the prescription with the prescriber
   • D.Give half the prescribed dose and document the change

   Answer and rationale are in the full material.