HESI Fundamentals Quizlet

Questions 54

HESI RN

HESI RN Test Bank

HESI Fundamentals Quizlet Questions

Question 1 of 5

The healthcare provider identifies a potential for infection in a client with partial-thickness (second-degree) and full-thickness (third-degree) burns. What intervention has the highest priority in decreasing the client's risk of infection?

Correct Answer: B

Rationale: Proper handwashing technique is crucial in preventing the transmission of infections, especially in clients with burns where the risk of infection is high. It is the most effective intervention to reduce the risk of contamination and promote healing in these clients. While plasma expanders, topical antibacterial creams, and visitor restrictions are important considerations in burn care, meticulous hand hygiene takes precedence in preventing infections.

Question 2 of 5

During a client assessment, the healthcare provider is evaluating cranial nerve function. Which assessment finding suggests that cranial nerve II is intact?

Correct Answer: D

Rationale: The correct answer is D. The ability to read a Snellen chart from 20 feet away indicates intact cranial nerve II (optic nerve). Hearing a whisper (A), identifying an object by touch (B), and shoulder shrugging against resistance (C) are assessments for different cranial nerves.

Question 3 of 5

The client has received a new diagnosis of heart failure, and the nurse is providing dietary management education. Which instruction should the nurse include?

Correct Answer: B

Rationale: Avoiding foods high in sodium (choice B) is essential for clients with heart failure to prevent fluid retention and decrease the strain on the heart. High sodium intake can lead to fluid buildup, exacerbating heart failure symptoms. Increasing potassium intake (choice A) can be harmful in heart failure if not monitored closely. Limiting fluid intake (choice C) may be necessary in some cases, but the specific amount should be individualized based on the client's condition. Increasing vitamin K intake (choice D) is not a primary concern in heart failure management.

Question 4 of 5

A male client is laughing at a television program with his wife when the evening nurse enters the room. He says his foot is hurting and he would like a pain pill. How should the nurse respond?

Correct Answer: A

Rationale: Obtaining a subjective estimate of the pain experience by asking the client to rate his pain helps the nurse determine which pain medication should be administered.

Question 5 of 5

During the admission assessment of a terminally ill male client, he states that he is an agnostic. What is the best nursing action in response to this statement?

Correct Answer: B

Rationale: Documenting the client's statement in the spiritual assessment is the best nursing action in response to his disclosure of being an agnostic. This respects the client's beliefs and preferences, ensuring that care is tailored to his individual needs. It also demonstrates a commitment to providing holistic and patient-centered care.

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