HESI Fundamentals

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Sample questions from HESI Fundamentals

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

1. 1.A 72-year-old client on a medical unit received IV morphine 20 minutes ago. The client is difficult to arouse, has shallow respirations at 7/min, and has an oxygen saturation of 84% on room air. Which action should the nurse take first?

   • A.Support ventilation with a bag-mask device and summon emergency assistance.
   • B.Administer prescribed naloxone before beginning respiratory support.
   • C.Apply oxygen by nasal cannula and reassess in 15 minutes.
   • D.Review the medication administration record for previous opioid doses.

   Rationale: Severe hypoventilation requires immediate ventilation support while emergency assistance is summoned. Naloxone is indicated, but preparing it must not delay breathing support. Nasal oxygen alone does not correct inadequate ventilation, and reviewing previous doses delays lifesaving care. The exam takeaway is to treat an immediate breathing threat before investigating its cause.

2. 2.An 81-year-old client admitted to a rehabilitation unit after a hip fracture repeatedly attempts to get out of bed to urinate. The client is oriented, uses a walker, and has a blood pressure of 128/72 mm Hg. Which intervention best reduces fall risk while preserving independence?

   • A.Apply a vest restraint whenever family members leave.
   • B.Keep all four side rails raised throughout the night.
   • C.Offer scheduled toileting and keep the call light and walker within reach.
   • D.Tell the client to remain in bed until the next physical therapy session.

   Rationale: Scheduled toileting addresses the reason for unsafe transfers while accessible equipment supports safe independence. A vest restraint is not justified by these findings and can cause injury. Four raised side rails may function as a restraint, and blanket bed restriction promotes deconditioning without meeting toileting needs. The exam takeaway is to address modifiable fall risks using the least restrictive approach.

3. 3.A 64-year-old client on a medical unit has frequent watery stools after antibiotic treatment, and stool testing confirms Clostridioides difficile. The client is afebrile and hemodynamically stable. Which infection-control plan is most appropriate?

   • A.Use droplet precautions and wear a surgical mask within 3 feet.
   • B.Use contact precautions, dedicated equipment, and soap-and-water handwashing after care.
   • C.Use airborne precautions and place the client in a negative-pressure room.
   • D.Use standard precautions alone once diarrhea decreases.

   Rationale: Contact precautions and dedicated equipment limit environmental transmission, and soap and water physically remove spores. Droplet precautions do not address this organism's primary route of transmission. Airborne isolation is unnecessary, and decreasing diarrhea alone does not justify discontinuing contact precautions. The exam takeaway is to match precautions and hand hygiene to the pathogen.

4. 4.A 29-year-old client in an emergency department has a 3-week cough, night sweats, weight loss, and an upper-lobe infiltrate. The temperature is 38.1 C and oxygen saturation is 95% on room air. Which placement and protective equipment should the nurse select while pulmonary tuberculosis is evaluated?

   • A.A shared room with a surgical mask for staff.
   • B.A private room with gloves only for routine care.
   • C.A positive-pressure room with a surgical mask for staff.
   • D.An airborne infection isolation room with a fit-tested N95 respirator for staff.

   Answer and rationale are in the full material.

5. 5.A 58-year-old client is undergoing a sterile dressing change for an abdominal wound in an outpatient clinic. While opening a supply package, the nurse sees the sterile gauze touch the outer 1-inch border of the sterile field. What should the nurse do?

   • A.Use the gauze because it remained within the edges of the drape.
   • B.Replace the contaminated gauze while preserving the uncontaminated field.
   • C.Pour sterile saline over the gauze before using it.
   • D.Use the gauze only on the incision's surrounding skin.

   Answer and rationale are in the full material.