Questions 9

HESI RN

HESI RN Test Bank

HESI Fundamentals Questions

Question 1 of 5

The healthcare provider obtains a BP reading of 100/88 in the right arm of a client whose blood pressure is typically 120/60 in the same arm. What action should the healthcare provider implement first?

Correct Answer: B

Rationale: The healthcare provider should first retake the blood pressure in the right arm, deflating the cuff slowly, because a low systolic and high diastolic blood pressure measurement is often the result of deflating the cuff too rapidly. Taking the BP in the same arm ensures consistency and accuracy of the measurement.

Question 2 of 5

When suctioning a tracheostomy, which action is most appropriate for the nurse to take?

Correct Answer: B

Rationale: When suctioning a tracheostomy, it is crucial to use sterile technique to prevent infections. Turning off the suction as the catheter is introduced is important to avoid trauma and injury to the tracheal walls. This technique helps maintain the integrity of the tracheostomy site and ensures proper care for the patient.

Question 3 of 5

The healthcare provider attaches a pulse oximeter to a client's fingers and obtains an oxygen saturation reading of 91%. Which assessment finding most likely contributes to this reading?

Correct Answer: B

Rationale: Edema in the fingers and hands can impede the proper functioning of the pulse oximeter, leading to a falsely low oxygen saturation reading. Edema alters the transmission of light through the tissues, affecting the accuracy of the measurement. Therefore, the presence of edema in the fingers and hands is the most likely factor contributing to the low oxygen saturation reading of 91%.

Question 4 of 5

What is the most important instruction for the nurse to provide to a 65-year-old client who attends an adult daycare program, is wheelchair-mobile, and has redness in the sacral area?

Correct Answer: B

Rationale: For a client with redness in the sacral area, the most critical instruction is to change positions in the chair at least every hour. This is crucial to prevent pressure ulcers, which can develop due to prolonged pressure on the skin and underlying tissues. Regular position changes help relieve pressure on vulnerable areas, promoting circulation and reducing the risk of skin breakdown and pressure ulcer formation.

Question 5 of 5

A client is scheduled for a colonoscopy. What instruction should the nurse provide to prepare the client for the procedure?

Correct Answer: A

Rationale: The correct instruction for preparing a client for a colonoscopy is to drink clear liquids for 24 hours before the procedure. This step helps to ensure the bowel is adequately cleared for the colonoscopy, allowing for better visualization and examination of the colon.

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