HESI Health Assessment Exam 2022/2023 Test Bank 100% Correct & Verified Answers.
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Multiple Choices
For which clinical indicator associated with a complication of portal hypertension would the nurse assess
the client?
A. liver abscess
B. intestinal obstruction
C. perforation of the duodenum
D. hemorrhage from esophageal varices
{{Ans- c.
The increased pressure within the portal circulatory system causes increased pressure in areas of portal systemic
collateral circulation (most importantly, in the distal esophagus and proximal stomach). Hemorrhage is a
possible complication. Liver abscesses may occur as a complication of intestinal infections, not portal
hypertension. Intestinal obstruction may be caused by manipulation of the bowel during surgery, peritonitis,
neurological disorders, or organic obstruction, not portal hypertension. Perforation of the duodenum usually is
caused by peptic ulcers; it is not a direct result of portal hypertension or cirrhosis.
A client with schizophrenia takes ziprasidone. Which conditions in the client may indicate a need to
discontinue the medication? Select all that apply. One, some, or all responses may be correct.
A. leukopenia
B. tachycardia
C. hypokalemia
D. hypomagnesemia
E. prolonged QT interval
{{Ans- a, c, e
Ziprasidone is a second-generation antipsychotic medication indicated for schizophrenia. The medication may
cause leukopenia, hypokalemia, and hypomagnesemia. This medication may cause a prolonged QT interval,
which indicates torsades de pointes. Bradycardia may occur in torsades de pointes but not tachycardia.
A client is prone to hyponatremia. Which factors would the nurse identify that can precipitate
hyponatremia? Select all that apply. One, some, or all responses may be correct.
A. wound drainage
B. diuretic therapy
C. GI suction
D. parenteral infusion of 0.9% sodium chloride
E. inappropriate anti-diuretic hormone (ADH) secretions
{{Ans- a, b, c, e
Wound drainage can result in hyponatremia from loss of sodium ions. Most diuretics interfere with sodium
reabsorption in the nephrons and have the side effect of hyponatremia. Gastrointestinal fluids are rich in sodium
ions, which are lost by GI suction. With the syndrome of inappropriate antidiuretic hormone (SIADH), high levels
of the antidiuretic hormone (ADH) are produced, causing the body to retain water instead of excreting it
normally in the urine. Parenteral infusion of 0.9% sodium chloride, an isotonic solution, should be compatible
with body fluids; if given in excess, it may lead to hypernatremia.
Which statements made by the client identify regulatory functions of the kidney? Select all that apply.
One, some, or all responses may be correct.
A. erythropoiesis
B. acid base balance
C. vitamin D activation
D. blood pressure control
E. fluid and electrolyte balance
{{Ans- b, e
Maintaining the acid-base balance of the body by selectively reabsorbing and secreting certain substances from
the blood is a regulatory function of the kidneys. The kidneys also perform the regulatory function of electrolyte
balance by regulating the reabsorption of certain electrolytes while eliminating others depending on their levels
in the serum. The kidneys perform hormonal function by secreting a hormone called erythropoietin that aids in
synthesis of red blood cells (erythropoiesis). Activation of vitamin D is a hormonal function of the kidneys. The
kidneys perform hormonal function by secreting the hormone renin that assists in blood pressure control.
Which signs would the nurse expect to observe in a client with small ce ll carcinoma of the lung who
develops syndrome of inappropriate antidiuretic hormone (SIADH)? Select all that apply. One, some, or
all responses may be correct.
1 Oliguria
2 Seizures
3 Vomiting
4 Polydipsia
5 Polyphagia
{{Ans- 1, 2, 3
Cancerous cells of small cell lung cancer can produce antidiuretic hormone, which causes fluid retention,
resulting in increased blood volume and decreased urine volume. Fluid retention associated with SIADH can
cause cerebral edema, resulting in confusion and seizures. Fluid retention resulting in hyponatremia causes
nausea and vomiting. The client will have nausea and vomiting, resulting in a decreased oral fluid and food
intake.
Which urinary diagnostic test does not require any dietary or activity restrictions for the clie nt before or
after the test?
1 Renal scan
2 Renal biopsy
3 Renal arteriogram
4 Concentration test
{{Ans- 1
A renal scan does not require any dietary or activity restrictions. A renal biopsy requires bed rest for 24 hours
after the procedure. A renal arteriogram requires the client to maintain bed rest with affected leg straight. A
concentration test requires the client to fast after a given time in the evening.
The nurse identifies that a client's urinary output is less than 40 mL/h over the past 3 hours. Which
action would the nurse take?
1 Assess breath sounds and obtain vital signs.
2 Decrease the intravenous flow rate and increase oral fluids.
3 Insert an indwelling catheter to facilitate emptying of the bladder.
4 Check for dependent edema by assessing the lower extremities
{{Ans- 1
The imbalance in intake and output, with a decreasing urinary output, may indicate kidney failure. The retention
of excess body fluid can precipitate the development of heart failure. Assessing breath sounds and obtaining the
vital signs are necessary when monitoring for these complications. In the presence of hypervolemia, oral and
intravenous fluid intake should be decreased. There are no data to support a problem with the excretion of
urine; the problem is with insufficient production. The insertion of a urinary retention catheter requires a health
care provider's prescription. Checking for dependent edema by assessing the lower extremities is an appropriate
assessment after respirations and vital signs are assessed.
A client had a laparoscopic cholecystectomy. Postoperatively, the client experiences nausea and
vomiting and is admitted overnight for observation and hydration. What would the nurse include in the
teaching plan when preparing this client for discharge? Select all that apply. One, some, or all responses
may be correct.
1 Wash the puncture sites with strong soap and hot water daily.
2 Call the health care provider for a fever of 100°F (37.8°C) or higher more for 2 days.
3 Remove the tape strips over the puncture sites 1 week after surgery.
4 Check the puncture sites daily for redness, tenderness, swelling, heat, or drainage.
5 Ease the discomfort from the gas used to insufflate the abdomen during surgery by applying a heating
pad to the left shoulder.
{{Ans- 2, 4
Which complication is most likely to occur in the immediate postoperative period after a client has had a
splenectomy?
1 Infection
2 Peritonitis
3 Hemorrhage
4 Intestinal obstruction
{{Ans- 3
Because the spleen is highly vascular, hemorrhage may occur in the immediate postoperative period. Although
risk for some types of infection is higher after splenectomy because of lower immunoglobulin levels, risk for
immediate postoperative infection is not higher than usual after splenectomy. Peritonitis is possible after
splenectomy, but it would not be apparent in the immediate postoperative period and is not a common
complication. The incidence of intestinal obstruction is not higher than for other abdominal surgery, and
symptoms would not be apparent in the immediate postoperative period.
A high school student arrives at the local blood drive center to donate blood for the first time. As the
site is being prepared for needle insertion, the student becomes agitated, starts to hyperventilate, and
complains of dizziness and tingling of the hands. Which would the nurse instruct the student to do?
1 Breathe into cupped hands.
2 Pant using rapid, shallow breaths.
3 Use a rapid deep-breathing pattern.
4 Hold the breath for as long as possible.
{{Ans- 1
Breathing into cupped hands allows carbon dioxide to reenter the lungs, which will increase the serum
bicarbonate level, relieving the respiratory alkalosis that is occurring as a result of hyperventilation.
Which major group of substances in human milk are of special importance to the newborn and cannot
be reproduced in a bottle formula?
1 Amino acids
2 Gamma globulins
3 Essential electrolytes
4 Complex carbohydrates
{{Ans- 2
The gamma globulin antibodies in human milk provide the infant with immunity against all or most of the
pathogens that the mother has encountered. Amino acids and essential electrolytes are present in commercial
formulas. Complex carbohydrates are not required by the infant.
Which instruction on infection prevention would the nurse include when providing discharge education
to a client who received a cadaveric renal transplant? Select all that apply. One, some, or all responses
may be correct.
1 Avoid eating from buffets.
2 Obtain annual flu vaccinations.
3 Perform regular hand hygiene.
4 Stay away from crowded areas.
5 Report a temperature greater than 100.5°F.
{{Ans- 1,2,3,4,5
Clients who receive an organ transplant need to take immunosuppressant medications for the rest of their lives
to prevent organ rejection. These medications put the client at increased risk for infection. The nurse would
provide infection prevention teaching to the client after renal transplant, which would include instructions to
avoid eating from buffets, get an annual flu vaccine, practice regular hand hygiene, and avoid crowded areas.
Clients would also be instructed to report a temperature greater than 100.5°F to their health care provider as it
could indicate infection or organ rejection and requires treatment. [Show Less]
