2350C HESI

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Sample questions from 2350C HESI

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, the charge nurse receives report on four clients. Which client should the charge nurse assess first?

   • A.A 68-year-old client with chronic heart failure who has gained 1 kg in 24 hours, has 2+ ankle edema, and is comfortable on room air with SpO2 94%
   • B.A 46-year-old client with pancreatitis who reports pain of 8/10 and has a heart rate of 108/min after walking to the bathroom
   • C.A 54-year-old client 6 hours after thyroidectomy who reports tingling around the mouth and has a respiratory rate of 22/min
   • D.A 73-year-old client with pneumonia whose temperature is 38.2 C, heart rate is 104/min, and SpO2 is 92% on 2 L/min by nasal cannula

   Rationale: Perioral tingling after thyroidectomy can signal acute hypocalcemia, which may progress to laryngospasm and airway compromise. The client needs immediate assessment for additional signs such as stridor and a focused airway evaluation; the other clients have concerning but less immediately life-threatening findings. The heart failure client needs fluid-status follow-up, the client with pneumonia needs ongoing respiratory monitoring, and the client with pancreatitis needs pain management after assessment.

2. 2.During a home visit, a 79-year-old client with type 2 diabetes has a fasting glucose of 58 mg/dL, is alert, and can swallow; the client says, "I took my insulin but skipped breakfast." The client's blood pressure is 138/76 mm Hg and pulse is 84/min. Which action should the nurse take first?

   • A.Ask the family to administer the client's usual insulin dose tomorrow
   • B.Give 15 g of a rapid-acting oral carbohydrate and recheck glucose in 15 minutes
   • C.Document the skipped meal and arrange a nutrition referral
   • D.Call the client's prescriber to request a lower insulin dose for the next morning

   Rationale: The client has symptomatic-risk hypoglycemia and can safely swallow, so immediate treatment with a rapid-acting carbohydrate takes priority. Rechecking in 15 minutes evaluates whether the intervention worked. A dose change and nutrition referral may be appropriate after the acute low glucose is corrected, while asking family to give an unchanged dose without a meal plan risks another episode.

3. 3.Refer to the client's chart. Which actions should the nurse take now in response to the client's changing condition? Select all that apply.

   • A.Notify the provider and blood bank of the suspected transfusion reaction
   • B.Restart the transfusion at a slower rate after the client's temperature decreases
   • C.Administer an antipyretic and continue the transfusion while monitoring
   • D.Send the blood bag and tubing to the blood bank according to facility policy
   • E.Obtain ordered blood and urine specimens for a reaction workup
   • F.Stop the transfusion immediately and maintain IV access with normal saline using new tubing

   Rationale: The temperature rise from 37.1 C to 38.4 C, new chills, and flank discomfort during the transfusion require stopping the blood and preserving IV access with normal saline through new tubing. The provider and blood bank must be notified, and the blood bag and tubing are returned per policy while ordered specimens are obtained. Restarting the unit after the fever falls or continuing it with an antipyretic could worsen a potentially serious reaction.

4. 4.A provider prescribes IV potassium chloride for a 31-year-old client with vomiting and a potassium level of 2.8 mEq/L. The client is on a general medical unit, has a patent peripheral IV, and has a heart rate of 92/min with stable blood pressure. Which action should the nurse take?

   • A.Clarify the prescription if it does not specify dilution and an infusion rate, and use an infusion pump
   • B.Ask an experienced nursing assistant to monitor the client during the infusion
   • C.Hold the potassium until the client develops a dysrhythmia
   • D.Administer the potassium by IV push to correct the level promptly

   Answer and rationale are in the full material.

5. 5.In a long-term care facility, an 84-year-old resident with dementia is found on the floor beside the bed after an unwitnessed fall. The resident is awake, has a 2-cm scalp laceration, and has a blood pressure of 146/82 mm Hg, pulse of 88/min, and respirations of 18/min. The medication record shows warfarin use. What should the nurse do first?

   • A.Help the resident back to bed and perform neurologic checks at the next scheduled interval
   • B.Complete an incident report before notifying the provider
   • C.Ask the resident's family to decide whether emergency evaluation is needed
   • D.Assess for injury and neurologic changes, maintain cervical precautions as indicated, and obtain urgent medical evaluation

   Answer and rationale are in the full material.