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HESI 366 Practice Test

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  • Which parameter should be monitored in the infant with a large VSD to assess for heart failure?
  • A client with a new colostomy asks about the purpose of colostomy irrigation. How should the nurse describe it?
  • Which rehabilitation professional is primarily responsible for improving communication and language skills after stroke?
  • Which statement best describes the effect of daily exercise on sleep for someone aiming to lose weight?
  • A client with syphilis reports unprotected sex. Which response should the nurse provide regarding reinfection?
  • What is the purpose of continuous bladder irrigation after TURP?
  • To evaluate the effectiveness of an antibiotic prescribed for a respiratory tract infection, which laboratory value should be monitored?
  • Which acid-base disturbance is present with pH 7.26 and PaCO2 68 mm Hg in a ventilated patient?
  • What is the primary correct purpose of the synchronization mode in synchronized cardioversion?
  • Which child is most susceptible to lead poisoning during intake interviews?
  • A patient presents with facial droop, garbled speech, and a history of hypertension. These findings are most consistent with which condition?
  • A male client who is overweight discusses monitoring the glycemic index to ensure an adequate intake of vitamins and nutrients while trying to lose weight. Which action should the nurse implement?
  • An older adult client is having photocoagulation for macular degeneration. Which intervention should the nurse implement during postprocedure care in the outpatient surgical unit?
  • Which PPE combination is appropriate for close contact when caring for a client with a respiratory infection on droplet precautions?
  • Which domain is not typically used to measure client outcomes in rehabilitation?
  • A client began an exercise program to lose weight to improve sleep but reports it still takes at least two hours to fall asleep. Which action should the nurse implement?
  • An adolescent in the ED with fever and persistent right lower quadrant abdominal pain is anxious, fearful, and hyperventilating. The nurse anticipates which acid-base imbalance?
  • An infant with trisomy 21 and a large ventricular septal defect requires monitoring. Which actions are prioritized for detecting potential heart failure?
  • Which finding in a patient with acute neurologic symptoms best indicates a stroke and requires immediate evaluation?
  • A client returns from lumbar spinal surgery with a dressing that has clear fluid leaking. Which action should the nurse implement immediately?
  • A postpartum client who is bottle feeding develops breast engorgement. What is the best recommendation?
  • Which statement best explains how foods rich in Vitamin K affect warfarin therapy?
  • Following a bone marrow biopsy in a patient with thrombocytopenia, which site requires close inspection for bleeding?
  • In a patient with chronic kidney disease who has an arteriovenous fistula in the left forearm, which observation most suggests the fistula is patent?
  • When performing venipuncture in an older adult, which technique helps reduce vessel trauma?
  • How many aspirin tablets are needed for a 650 mg dose if each tablet is 325 mg?
  • In acetaminophen overdose management, if an N-acetylcysteine oral dose is vomited within 1 hour of administration, what should the nurse do?
  • Which monitoring is essential for a patient who is on haloperidol and lithium to minimize risk?
  • A UAP requests a change in assignment because she has not yet been fitted for a particulate filter mask while caring for a client on droplet precautions. Which action should the nurse take?
  • For a client diagnosed with psoriasis, which behavior by the nurse addresses the client's psychosocial need for acceptance?
  • In discharge teaching after a liver transplant, which instruction is most important to include?
  • What is the most important action for a school nurse to implement for student safety?
  • Which single finding would most strongly indicate the infant’s condition is improving?
  • A nurse is evaluating a tertiary prevention program for clients with cardiovascular disease implemented in a rural health clinic. Which outcome indicates the program is effective?
  • A nurse prepares to administer 1.6 mL of medication intramuscularly to a 4-month-old infant. Which action should the nurse include?
  • A client is receiving IV fluids by gravity infusion and exhibits signs of fluid volume overload. When assessing the IV delivery system, where should the nurse assess first?
  • Leaving an older adult in a public space is categorized as which form of elder mistreatment?
  • A postoperative patient with a ureteroileostomy following bladder cancer presents with which finding requires immediate reporting to the healthcare provider?
  • The second step in the escalation process for concerns about a colleague's behavior during invasive procedures is:
  • A T-score is used to compare bone density to which reference?
  • Which observation would most readily indicate patency of an arteriovenous fistula in a dialysis patient?
  • A toddler is being followed up after corticosteroid treatment for minimal change nephrotic syndrome (MCNS). Which finding is an early sign of relapse?
  • A patient has a T-score of -2.8. This finding indicates which condition?
  • In the described toddler with URI symptoms, which symptom is notably absent?
  • After a postoperative admission, a client with type 2 diabetes mellitus has a blood glucose level of 750 mg/dL. Which assessment should be the priority?
  • A client with influenza needs assistance to transfer to the bedside commode. The UAP dons gloves and a gown to assist. What action should the nurse take next to ensure proper infection control?
  • Which nursing action is an example of therapeutic communication?
  • Which instruction should the nurse provide to the parent after the Haemophilus influenzae type b vaccine?
  • When educating parents about home phototherapy for a 4-day-old with a bilirubin level of 19 mg/dL, which instruction should be included?
  • When an HCP instructs the nurse to administer a dosage that cannot be programmed into the pump, what action should the nurse take?
  • For acquired aplastic anemia, which treatment option offers the best prognosis?
  • Which symptom pattern is most consistent with a gastric ulcer and should prompt a full physical evaluation?
  • For a migraine patient awaiting the effect of sumatriptan, which environmental modification is appropriate to help reduce sensory stimulation?
  • A client with sudden visual changes is evaluated for ischemic CVA. Which initial nursing action is most appropriate?
  • An older adult with Type 2 diabetes reports leg pain when walking that is relieved by rest. Which behavior indicates understanding of treatment to promote more effective arterial circulation?
  • To assess outcomes after rehabilitation, which information should the nurse consider?
  • A patient previously treated for herpes zoster now reports trunk pain at the site of prior lesions. What is the nurse’s first step?
  • In a client with bipolar disorder experiencing a manic episode who is being treated with haloperidol and lithium, which action should the nurse take to minimize risk?
  • In the SBAR communication framework, which component conveys the clinical assessment and interpretation of the situation?
  • A client with a prescription for do-not-resuscitate (DNR) begins to manifest signs of impending death. After notifying the family, what is the priority action the nurse should implement?
  • Which action is appropriate for this client?
  • Which environmental factor is most significant when planning care for a client with osteomalacia?
  • The care team on a medical-surgical unit is delegating tasks to a practical nurse and an unlicensed assistive personnel. Which activity should be delegated to the UAP?
  • An adult client with maxillofacial surgery pain is prescribed acetaminophen and codeine phosphate oral solution. The solution contains 120 mg acetaminophen and 12 mg codeine per 5 mL, and the dose is 25 mL every 6 hours PRN. How many milligrams of codeine are in one dose?
  • Which option is an example of nontherapeutic communication?
  • In a community clinic with limited English proficiency, which action best ensures accurate understanding of health information?
  • A nurse is caring for a group of clients with the help of a practical nurse (PN). Which nursing action is appropriate to assign to the PN?
  • Which finding would indicate the patient with COPD on supplemental oxygen is not adequately oxygenated?
  • Before undergoing an intravenous pyelogram, the most important information for the nurse to gather is whether the patient has an allergy to shellfish.
  • Which nursing intervention is indicated for the second stage of labor?
  • A patient recently underwent lung tumor removal and has a chest drainage system with multiple chambers. If the second chamber reads 850 mL, which description correctly identifies this finding?
  • Depression or withdrawn behavior is typically categorized as which form of elder mistreatment?
  • During the initial mental health assessment, which information should the nurse consider as relevant?
  • A client has an elevated serum bilirubin level. Which assessment action should the nurse include?
  • Which professional focuses on activities of daily living and fine motor skills during stroke recovery?
  • Which antidote is used for acetaminophen overdose?
  • When evaluating outcomes in rehabilitation, which sources of information should be considered?
  • Which finding requires immediate follow-up by the nurse? (Choose the most urgent)
  • Which problem reported by a client taking lovastatin requires the most immediate follow-up by the nurse?
  • In a pediatric patient, calculate the per-dose volume for a methylprednisolone dose of 0.5 mg/kg/day for a 25 kg child, given in two divided doses daily, with a 20 mg/mL vial. What is the per-dose volume rounded to the nearest tenth of a milliliter?
  • A client with Alzheimer's disease is taking trazodone; the caregiver reports mood and sleep have improved but there is no change in cognitive ability. How should the nurse respond?
  • Nurses on a surgical unit are concerned about a healthcare provider's treatment of clients during invasive procedures. What is the first action the nurses should take to resolve this problem?
  • Which action is most appropriate when a patient with a respiratory infection has a negative COVID-19 test result but later develops fever and cough?
  • Which intervention is appropriate to include in the client's plan of care?
  • What is the most direct method to evaluate pain quality in a patient experiencing a migraine?
  • A TURP patient experiences bladder spasms. Which nursing action should be taken?
  • A diverse population with limited English proficiency: which action should the nurse use to meet needs? (best single choice)
  • A school nurse is assessing a 5-year-old with recurrent joint pain and bruising. Which action should the nurse take first?
  • In the PACU, a client who has had a hypophysectomy for Cushing's disease requires which intervention to be most important in the plan of care?
  • The healthcare provider prescribes cefazolin 800 mg IM every 6 hours. The vial is labeled Cefazolin 1 gram, and reconstitution states: For IM use, add 2.5 mL sterile water to obtain 3.0 mL total. How many mL should be administered?
  • A 3-month-old is recovering from a pyloromyotomy and shows signals of pain. Which finding is most indicative of pain in this infant?
  • When establishing peripheral IV access for an older adult, which action should the nurse implement?
  • When elder mistreatment is suspected, the nurse should report findings to which agency?
  • Which parameter is explicitly listed as a monitorable concern after retinal detachment surgery?
  • When providing care to a patient with influenza, which precaution is essential for close contact?
  • The statement 'Client symptoms are indicators of depression' most closely represents which concept?
  • Which fever-management action is appropriate for a febrile patient?
  • In evaluating a 21-year-old patient with fatigue and missing labs, which priority area should the nurse assess to help avoid misdiagnosis before referring to the PCP?
  • Untreated pressure injuries are most consistent with which elder mistreatment category?
  • The nurse explains that sertraline can cause dry mouth. Which combination of education points is appropriate?
  • Which intervention best promotes safety for a patient at risk for falls in the hospital setting?
  • A child weighing 25 kg is prescribed methylprednisolone 0.5 mg/kg/day to be given IM in divided doses every 12 hours. The medication is in a 20 mg/mL vial. How many mL should be given with each dose?
  • The nurse is planning care for a client with chronic kidney disease who is anuric and undergoes hemodialysis three times weekly. Which intervention belongs in the plan of care?
  • After taking SMZ-TMP, a patient experiences a burning sensation. Which assessment should the nurse perform to evaluate a possible adverse reaction?
  • An older adult client is being reported to the healthcare provider using SBAR because of increasing confusion. In this SBAR communication, what is the Situation?
  • To evaluate the effectiveness of a telehealth program designed for clients with chronic conditions, which method should the nurse use to assess impact on outcomes?
  • A patient arrives postoperatively with clear fluid present on the lumbar dressing. Which action should be performed first?
  • Why is avoiding crowds important after a liver transplant?
  • Which statement accurately reflects the required action when elder mistreatment is suspected?
  • Fifteen minutes after receiving sulfamethoxazole-trimethoprim, a client reports a burning sensation in multiple areas. What intervention is most important?
  • A patient with diabetic peripheral neuropathy on pregabalin for 4 days shows improvement. Which finding indicates effectiveness?
  • Oversedation is most closely associated with which category of elder mistreatment?
  • Which nutrient interacts with warfarin and requires monitoring of dietary intake?
  • Which rehabilitation professional is most focused on improving mobility and gait after a stroke?
  • Which time window is critical for initiating thrombolytic therapy in ischemic stroke?
  • A toddler with URI symptoms and fever has a throat culture with no growth. During discharge education, which instruction should the nurse include?
  • A client on ramelteon reports several side effects. Which side effect should be reported to the healthcare provider?
  • If cefazolin dose is reduced to 400 mg using the same concentration (1 gram per 3 mL), what volume should be administered?
  • Among four clients with increased pain, which requires immediate intervention by the nurse?
  • In a postoperative patient after abdominal hysterectomy, which task is appropriate to delegate to the PN?
  • Which intervention is appropriate as an initial step when elder mistreatment is suspected?
  • During tissue plasminogen activator (tPA) administration for acute ischemic stroke, which action should the nurse prioritize?
  • An older adult patient is upset after waking in a bed that is wet and has a strong urine odor. Which immediate nursing action is appropriate?
  • An admission assessment for a patient with bipolar disorder includes signs of boundary testing when the patient undresses during the interview. What is the most appropriate initial nursing action?
  • When counseling a client about glycemic index in dietary planning, what should the nurse emphasize?
  • Discharge instruction for gout with colchicine and ibuprofen should include which dietary modification?
  • During a visual screening of older adults, which finding should the nurse report immediately to the healthcare provider?
  • Several weeks before scheduled thyroid surgery, a client is prescribed methimazole. The nurse should instruct the client to perform which daily self-assessment?
  • An older adult with emphysema returns from physical therapy with oxygen at 3 L/min and SpO2 88%. Which intervention should the nurse implement?
  • In a patient with pleural effusion and heart failure, which intervention best reduces cardiac workload?
  • A liter of normal saline is prescribed to infuse at 1.5 mL/kg/hr. The patient weighs 176 pounds. What infusion rate should be set on the pump in mL/hr?
  • Which symptom is commonly associated with retinal detachment and requires urgent evaluation?
  • Which statements by the client indicate depression is improving?
  • For a child with sickle cell disease, which sign most strongly indicates a life-threatening complication requiring urgent care?
  • Which of the following is NOT appropriate for this client?
  • Which intervention is appropriate to prevent spread of symptoms until a specific day?
  • An older adult with pneumonia and COPD is weak after prolonged endotracheal intubation with mechanical ventilation. Which single action should the nurse implement first?
  • During bedside wound debridement for a mildly confused client with a sterile field, which safety intervention should the nurse implement?
  • Which food should the nurse encourage a patient on a postoperative full liquid diet to eat?
  • A client on mechanical ventilation has pH 7.26, PaCO2 68 mm Hg, PaO2 92 mm Hg. What action should the nurse take?
  • What is the primary purpose of the drip chamber in an IV setup?
  • A client with atrial fibrillation has a new prescription for extended-release diltiazem. Which nursing instruction is most important to emphasize?
  • In an infant with trisomy 21 and a large VSD, which tests would be appropriate to evaluate the potential for heart failure?
  • To assess the quality of the client’s pain from recurring migraine headaches, which approach should the nurse use?
  • When discussing caregiver stress with the client's daughter, which statements should the nurse include?
  • A client is admitted with Wernicke's encephalopathy. Which assessment finding should the nurse use when developing the plan of care?
  • A patient is to receive 1 liter of lactated Ringer's solution over 8 hours. What should the infusion pump be programmed to deliver in mL per hour?
  • What is the most important information to teach a client newly diagnosed with type 1 diabetes?
  • In suspected cerebrovascular accident with facial paralysis and left-sided weakness, a spouse tries to give the patient water. What action should the nurse take first?
  • Which statement by a client with an impulse control disorder indicates effective coping?
  • Two critical care clients are under the nurse’s care. Which intervention should be implemented first?
  • Red spots with a bluish center are most likely to indicate which disease?
  • In a community with a large uninsured population, which barrier to accessing quality healthcare is most directly linked to cost?
  • During a community health event offering bone density screening, which condition would be most concerning and require immediate reporting to the nurse?
  • Small spots with bluish white center are characteristic of which disease?
  • A child with acquired aplastic anemia has the best prognosis with which treatment regimen?
  • A client with a history of bilateral adrenalectomy presents with a weak, irregular pulse and hypotension. Which assessment finding warrants immediate intervention?
  • An 11-month-old child presents to the emergency department with fever, cough, and a recent rash. Which findings should the nurse report to the healthcare professional?
  • The final step in the escalation process described for concerns about a colleague's behavior is:
  • What is the most appropriate initial nursing action when a patient with TURP reports bladder spasms?
  • A pregnant client’s prenatal immunization history is reviewed. Which immunization should the nurse instruct the client to receive after pregnancy?
  • A client with leukemia receiving myelosuppressive chemotherapy has a platelet count of 25,000/mm3. Which intervention is most important to include in the plan of care?
  • In a toddler with MCNS, which finding indicates an early relapse after corticosteroid treatment?
  • The nurse applies gloves and a face mask to perform a morning assessment of a client on droplet precautions. A small amount of mucous lands on the nurse's face mask. After removing the contaminated mask, what is the appropriate next action?
  • A client with leukemia undergoes a bone marrow biopsy. If thrombocytopenia is present, which nursing assessment is most important after the procedure?
  • A liter of normal saline to infuse over 4 hours requires what rate in mL/hour?
  • Which statement correctly matches the clinical role with its typical focus?
  • During a dressing change, purulent drainage is observed at the wound site. Before reporting this to the healthcare provider, which laboratory value should the nurse review first?
  • Which findings are consistent with elder mistreatment?
  • In elder mistreatment case study, bruises in various stages of healing indicate which form of abuse?
  • Which intervention is most important in the plan of care for a client who is 12 hours post-thyroidectomy?
  • When monitoring a TURP patient with a continuous bladder irrigation, which finding indicates a potential catheter obstruction?
  • A patient reports fatigue and has missed several days of work in two weeks. Which diagnosis is most supported by these symptoms?
  • In the toddler with URI, which test result was negative?
  • The charge nurse is assigning one practical nurse (PN) and three registered nurses (RN) to neurologically compromised clients. Which client change is best to assign to the PN?
  • A client reports possible stomach ulcer with heartburn and a dull gnawing pain relieved by eating. What is the best nursing response?
  • Postoperative care for a patient who recently had a hypophysectomy should include which head-of-bed position to help prevent complications?
  • When giving sumatriptan 25 mg orally for a migraine, a patient reports the medication takes about 45 minutes to work. Which intervention should the nurse implement until the medication is effective?
  • What is the optimal nursing action to support airway clearance for a patient after pneumonia and COPD with recent extubation?
  • Four days after exposure to COVID-19, a client has a negative test result. Eight days later, the client develops fever, fatigue, and cough. What is the most important action for the nurse to take?
  • What is the primary purpose of colostomy irrigation?
  • A client with atrial fibrillation is scheduled for an elective cardioversion. Which action is most important before deploying the current?
  • An impaired nurse requests return to duty after mandatory counseling. What action by the charge nurse is best?
  • An intravenous pyelogram visualizes which structures?
  • The nurse is the team leader for a client in cardiopulmonary arrest. Compressions are 120/min with two one-second bag-valve-mask ventilations. There is visible rise and fall of the chest with ventilations. The patient remains cyanotic and no pulse is palpable with compressions. Which action should the team implement next?
  • While admitting a female client with bipolar disorder, the client begins to take off her clothes and throw them around the room. What action should the nurse take first?
  • Which action is appropriate to fever management when considering tepid baths?
  • A 75-year-old female presents with visual changes. Which condition is most consistent with this presentation and requires urgent management?
  • Which situation indicates a need for the nurse to discuss mitten restraints with the healthcare provider?
  • Which action best supports safety by reducing the risk of falls for hospitalized patients?
  • Entering the room of a sedated postoperative client, which assessment requires immediate intervention?
  • Which of the following is NOT appropriate for this client?
  • In a postoperative patient with signs of infection, which laboratory value is most useful to assess the body's acute inflammatory response?
  • Which lunch choice indicates that the patient’s diet teaching for wound healing was effective after leg wound treatment?
  • Which symptom is commonly associated with hypoglycemia in a person with type 1 diabetes?
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