HESI RN
HESI Fundamentals Practice Test
1. The healthcare professional in the emergency department observes a colleague viewing the electronic health record (EHR) of a client who holds an elected position in the community. The client is not a part of the colleague’s assignment. Which action should the healthcare professional implement?
- A. Communicate the colleague’s actions to the unit charge nurse
- B. Send an email to facility administration reporting the action
- C. Write an anonymous complaint to a professional website
- D. Post a comment about the action on a staff discussion board
Correct answer: A
Rationale: Observing a colleague accessing a patient's EHR without a legitimate reason is a violation of HIPAA, which protects patient confidentiality. The appropriate action in this scenario is to communicate the colleague’s actions to the unit charge nurse immediately. The charge nurse can then address the issue internally and ensure that patient privacy is maintained. Reporting the incident through the appropriate channels within the healthcare facility is the most effective and professional way to handle such breaches of patient confidentiality. Choices B, C, and D are incorrect because they do not involve addressing the issue internally within the healthcare facility. Reporting such incidents internally is essential to ensure that patient privacy is protected, and the matter is handled appropriately by healthcare authorities.
2. After hemodialysis, a client with a history of chronic renal failure has just returned to the unit. What is the most important assessment for the nurse to make?
- A. Auscultate the client's lung sounds.
- B. Assess the client's blood pressure.
- C. Monitor the client's weight.
- D. Check the client's fistula for bruit and thrill.
Correct answer: D
Rationale: The most crucial assessment for the nurse to make after hemodialysis in a client with chronic renal failure is to check the client's fistula for bruit and thrill (D). This assessment is essential to ensure the patency of the fistula and adequate blood flow. Auscultating lung sounds (A), assessing blood pressure (B), and monitoring weight (C) are important assessments but are secondary to evaluating the fistula. Checking the fistula is vital as it directly impacts the effectiveness of the client's dialysis treatment and the patency of the vascular access, ensuring successful dialysis sessions.
3. A client with a diagnosis of asthma is receiving albuterol (Proventil) via a metered-dose inhaler (MDI). Which assessment finding indicates that the medication is effective?
- A. Increased oxygen saturation.
- B. Decreased respiratory rate.
- C. Absence of audible wheezing.
- D. Improved exercise tolerance.
Correct answer: A
Rationale: Increased oxygen saturation (A) is the most direct indicator of the effectiveness of albuterol (Proventil) in improving breathing. Oxygen saturation reflects the amount of oxygen in the blood, showing that the albuterol is helping with air exchange in the lungs. While decreased respiratory rate (B), absence of audible wheezing (C), and improved exercise tolerance (D) are positive outcomes, they are secondary to oxygen saturation. Oxygen saturation directly reflects the improvement in the client's respiratory status and the effectiveness of the medication.
4. Mr. Landon is scheduled to undergo a tracheostomy. Which nursing action is essential during tracheal suctioning?
- A. Using a water-soluble lubricant.
- B. Administering 100% oxygen before and after suctioning.
- C. Ensuring that the suction catheter is open during insertion.
- D. Assisting the client to assume a semi-Fowler's position during suctioning.
Correct answer: B
Rationale: Administering 100% oxygen before and after suctioning is crucial to prevent hypoxia, which can occur during tracheal suctioning. Hypoxia can lead to serious complications, making the provision of oxygen essential in maintaining adequate oxygenation levels for the patient undergoing tracheal suctioning. Choice A is incorrect because using a water-soluble lubricant is not directly related to the essential nursing action during tracheal suctioning. Choice C is incorrect as ensuring that the suction catheter is open during insertion is a basic requirement and not the essential action for oxygenation. Choice D is incorrect because assisting the client to assume a semi-Fowler's position is beneficial for comfort and airway alignment but is not as crucial as administering oxygen to prevent hypoxia.
5. A high school senior is complaining of a persistent cough and admits to smoking 10 to 15 cigarettes daily for the past year. He is convinced that he is hopelessly addicted to tobacco since he tried unsuccessfully to quit smoking last week. Which intervention is best for the nurse to implement?
- A. Encourage the student to associate with non-smokers only while attempting to stop smoking.
- B. Tell the student that he is still young and should continue trying various smoking cessation methods.
- C. Describe cigarette smoking as a habit that requires a strong will to overcome its addictiveness.
- D. Provide the student with the latest research data describing the long-term effects of tobacco use.
Correct answer: A
Rationale: Adolescents are particularly influenced by peers, so associating with non-smokers may help the student quit smoking. By being surrounded by non-smokers, the student is less likely to feel pressured to smoke and may be encouraged to adopt healthier behaviors. This intervention leverages the power of social influence to support smoking cessation efforts and create a more conducive environment for the student to quit smoking. Choices B, C, and D do not address the social aspect of smoking behavior and the influence of peers on smoking habits, making them less effective interventions in this case.
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