HESI Subject Exams

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Sample questions from HESI Subject Exams

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

   • A.A 68-year-old client with heart failure who gained 1 kg in 24 hours and has bilateral ankle edema
   • B.A 54-year-old client 2 hours after thyroidectomy who has new inspiratory stridor
   • C.A 76-year-old client with a hip fracture who reports pain of 8 on a 0-to-10 scale
   • D.A 42-year-old client with pneumonia whose temperature is 38.2 C (100.8 F) after acetaminophen

   Rationale: New inspiratory stridor after thyroidectomy can indicate airway obstruction from swelling or bleeding and requires immediate assessment and intervention. The weight gain and edema require prompt follow-up, but do not indicate an immediate airway threat. The fever and severe pain also need care, but airway compromise takes priority. Use airway, breathing, and circulation to prioritize acute changes.

2. 2.In a long-term care facility, an RN is assigning care for the morning. Which task is appropriate to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Obtain routine vital signs for a stable resident with hypertension
   • B.Evaluate whether a prescribed pain medication relieved a resident's pain
   • C.Assess a resident who reports new shortness of breath
   • D.Teach a resident how to use a walker after hip surgery

   Rationale: Obtaining routine vital signs for a stable resident is a predictable task that can be delegated to a trained UAP, with the RN responsible for interpreting and following up on the results. Assessment of new shortness of breath requires nursing judgment. Teaching walker use and evaluating a medication response are also RN responsibilities. Delegate tasks, not assessment, teaching, or evaluation.

3. 3.The provider prescribes a medication for a 39-year-old client admitted to an inpatient unit. The client says, 'I do not understand why I need this drug.' The medication is due now. What should the nurse do first?

   • A.Explain the medication's purpose and ask the client to sign the consent form
   • B.Ask a family member to explain the medication to the client
   • C.Administer the medication and provide teaching during the next medication pass
   • D.Hold the medication and contact the provider to answer the client's questions

   Rationale: The client needs adequate information to make an informed decision, and the prescribing provider is responsible for explaining the treatment, risks, and benefits. The nurse should hold the medication while clarifying the client's questions with the provider. A family member cannot replace the provider's explanation, and administering the medication before the concern is resolved disregards the client's right to participate in care. The nurse supports informed decision-making without pressuring the client to agree.

4. 4.Refer to the client's chart. Which actions should the nurse take now for the 6-year-old client? Select all that apply.

   • A.Wait 30 minutes after the next scheduled bronchodilator before reporting the findings
   • B.Place the client supine and encourage oral fluids
   • C.Prepare for escalation of respiratory support while staying with the client
   • D.Apply oxygen as prescribed and maintain continuous pulse oximetry
   • E.Notify the rapid response team and provider about the worsening respiratory status

   Answer and rationale are in the full material.

5. 5.During a home visit, a public health nurse finds that an 81-year-old client who lives alone has missed two follow-up appointments and has not obtained a newly prescribed anticoagulant. The client says transportation is unreliable. Which action best addresses the immediate barrier to the plan of care?

   • A.Ask the client's neighbor to pick up the medication without the client's permission
   • B.Tell the client that medication adherence is a personal responsibility
   • C.Arrange a referral to transportation or community support services with the client's agreement
   • D.Document the missed appointments and end the visit

   Answer and rationale are in the full material.