NSG 123 HESI Study Guide

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Sample questions from NSG 123 HESI Study Guide

This material has 24 questions with answers and rationales. Here are the first 5.

1. 1.An RN is caring for four clients on a medical-surgical unit with an experienced unlicensed assistive personnel (UAP). Which task is appropriate for the RN to delegate to the UAP?

   • A.Evaluate pain relief after a client receives IV morphine.
   • B.Obtain a daily weight for a stable client with heart failure.
   • C.Teach a client with pneumonia how to use an incentive spirometer.
   • D.Assess dizziness in a client walking for the first time after surgery.

   Rationale: Obtaining a daily weight for a stable client is a routine task that can be delegated with instructions to report the result. Evaluating a medication response, providing initial teaching, and assessing new postoperative dizziness require nursing judgment and must remain with the RN.

2. 2.An older adult admitted with pneumonia becomes restless and confused. Respirations are 32/min, oxygen saturation is 84% on room air, and blood pressure is 128/74 mm Hg. Which action should the nurse take first?

   • A.Complete a focused neurologic assessment.
   • B.Administer the prescribed IV antibiotic.
   • C.Apply supplemental oxygen per protocol.
   • D.Obtain a sputum specimen for culture.

   Rationale: Severe hypoxemia with new confusion indicates impaired oxygenation and requires immediate supplemental oxygen, prompt reassessment, and escalation of care. A neurologic assessment is relevant but must not delay oxygen. Antibiotics treat the infection but do not immediately correct hypoxemia. Collecting sputum is lower priority than stabilizing breathing.

3. 3.A bedbound client has frequent liquid stools and suspected Clostridioides difficile infection. The sacral skin is intact but reddened and blanches with pressure. Which care plan is most appropriate?

   • A.Use contact precautions, wash hands with soap and water after care, and provide moisture protection and repositioning.
   • B.Use droplet precautions, wash hands with soap and water after care, and cover the sacrum with dry gauze.
   • C.Use contact precautions, use alcohol hand rub alone after care, and massage the reddened sacrum.
   • D.Use standard precautions alone, apply moisture barrier, and reposition only when the client reports discomfort.

   Rationale: Suspected C. difficile requires contact precautions; soap and water physically remove spores. Moisture protection and individualized repositioning reduce skin injury. Droplet precautions do not address fecal-contact transmission, and dry gauze does not adequately manage moisture. Alcohol hand rub alone is not effective against spores, and massage may injure vulnerable tissue. Standard precautions alone and waiting for discomfort provide inadequate protection.

4. 4.A client with diabetic ketoacidosis has received initial isotonic IV fluids. Current laboratory results show glucose 486 mg/dL, potassium 2.9 mEq/L, and arterial pH 7.22. A continuous IV regular insulin infusion is prescribed. Which action should the nurse take before starting the infusion?

   • A.Start the insulin infusion and recheck potassium in 4 hours.
   • B.Replace isotonic fluid with dextrose-containing fluid.
   • C.Administer IV sodium bicarbonate to correct the pH.
   • D.Hold insulin and contact the prescriber for potassium replacement.

   Answer and rationale are in the full material.

5. 5.A postoperative client receiving packed red blood cells develops chills, lower back pain, and shortness of breath 15 minutes after the transfusion begins. Temperature rises from 37.1 C to 38.6 C, and blood pressure falls from 122/76 to 88/50 mm Hg. Which action should the nurse take first?

   • A.Slow the transfusion and reassess the vital signs in 5 minutes.
   • B.Stop the transfusion and maintain IV access with normal saline through new tubing.
   • C.Administer the prescribed antipyretic and continue the transfusion.
   • D.Collect a urine specimen before interrupting the transfusion.

   Answer and rationale are in the full material.