HESI Foundations of Nursing Exam2

Question 7

HESI Foundations of Nursing Exam2. The client taking long-term oral corticosteroids for systematic lupus erythematosus (SLE) is prescribed hydroxychloroquine. The practical nurse (PN) should reinforce which teaching point related to the use of this medication?

• A Perform oral care 2 hours after each dose.
• B Take at least 1 hour before meals.
• C Remain upright for 1 hour after dose.
• D Schedule eye exams every 6 months.

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Question 8

An older adult client is admitted with syncope and laboratory findings reveal a hemoglobin level of 8 g/dL (4.96 mmol/L). The client has a recent history of headaches and frequent falls. Admission prescriptions include continuation of all home medications. Which medication should the practical nurse (PN) withhold until consulting with the charge nurse?

Reference Range: Hemoglobin (Hgb) [12 to 16 g/dL (120 to 160 g/L)]

• A Levothyroxine.
• B Calcium citrate.
• C Aspirin.
• D Docusate sodium. HESI Foundations of Nursing Exam2

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Question 9

A female client with cancer often experiences nausea and vomiting as the result of radiation therapy. The client has a PRN prescription for ondansetron and tells the practical nurse (PN) that she takes the medication as soon as she returns home from her treatment. Which action should the PN take?

• A Instruct the client to take the medication prior to the treatment.
• B Advise the client to try taking the medication before driving home.
• C Offer support and encouragement that this is a temporary effect.
• D Encourage the client to drink plenty of fluids during the treatment.

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Question 10

Which instructions should the practical nurse (PN) reinforce with a client who is prescribed oral diphenhydramine for seasonal allergies? Select all that apply.

• A Contact the healthcare provider if confusion or hypotension occurs.
• B Recognize this drug may cause false negative results in skin allergy tests.
• C Use caution to restrict alcohol intake while taking this drug.
• D Avoid driving or operating machinery after taking this drug.
• E Do not abruptly stop the medication unless advised by healthcare provider.

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Question 11

When a male client tells the nurse that he is feeling nauseated, which PRN medication should the practical nurse (PN) administer?

• A Antiemetic.
• B Emollient.
• C Adsorbent.
• D Laxative.

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Question 12

A client receives a prescription for intravenous (IV) famotidine. Which finding indicates to the practical nurse (PN) the medication is effective? HESI Foundations of Nursing Exam2

• A Decreased in nighttime awakenings.
• B Loss of 3 pounds (1.36 kg) in a month.
• C Positive stool antigen test.
• D Reduced epigastric pain.

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Question 13

The practical nurse (PN) is checking the insulin dose drawn up by another PN and notes that the amount of insulin is 2 units more than the amount indicated for the glucose level written on the client’s medication record. Which action should the PN take?

• A Advise the other PN that the dose of insulin drawn up needs to be reduced by two units.
• B Suggest that the other PN provide a small snack after administering the dose of insulin drawn up.
• C Instruct the other PN to obtain a repeat glucose level before administering the insulin.
• D Remind the other PN to record the discrepancy between the dose on hand and the desired dose.

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Question 14

The practical nurse (PN) is providing care to a client diagnosed with gastroesophageal reflux disease (GERD) who has been prescribed cimetidine. Which is the mechanism of action for this medication?

• A Decreases the rate of gastric emptying.
• B Blocks the secretions of gastric acids.
• C Slows down the prostaglandin synthesis.
• D Neutralizes the gastric secretions.

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Question 15

An adolescent with a history of recurring atopic dermatitis tells the practical nurse (PN) of a desire to play high school football. Which action should the PN take?

• A Describe the problems associated with perspiration for those with atopic dermatitis.
• B Emphasize showering with non-perfumed soaps immediately after practice.
• C Discuss with the coach the client’s skin condition and manifestations.
• D Encourage the client to join the swim team instead of the football team.

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Question 16

The practical nurse (PN) is explaining to a client with inflammatory bowel disease about prednisone. Which information is important for the PN to emphasize?

• A Prednisone must be decreased gradually when discontinuing the medication.
• B Prednisone is a medication that can be taken for the rest of the client’s life.
• C Monthly check ups will be necessary to monitor the serum prednisone level.
• D Intake of green leafy vegetables should be decreased because vitamin K is the antidote for prednisone.

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Question 17

Prior to administering medications to the client, the practical nurse (PN) observes excessive bruising to the extremities. Which medication should the PN withhold until consulting with the charge nurse?

• A Anticoagulant.
• B Antianginal.
• C Antihypertensive.
• D Opioid analgesic.

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Question 18

A client has a prescription for NPH insulin 25 units before breakfast and insulin aspart before meals and hour of sleep per sliding scale. The sliding scale parameters are: 0 units for finger stick glucose less than 170 mg/dL; 5 units for finger stick glucose 171 to 219 mg/dL; 10 units for finger stick glucose 220 to 269 mg/dL; 15 units for finger stick glucose 270 to 300 mg/dL. Call healthcare provider (HCP) for finger stick glucose greater than 300 mg/dL. The client’s 0730 finger stick glucose is 271 mg/dL. Which is the total amount of insulin this client should receive? (Enter numeric value only.)

• 40

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Question 19

The healthcare provider prescribes bismuth subsalicylate, metronidazole, tetracycline, and pantoprazole for a client with an H. pylori infection. Prior to administering the H. pylori treatment regimen, the practical nurse (PN) should review the electronic medical record for which medication? HESI Foundations of Nursing Exam2

• A Famotidine.
• B Ipratropium.
• C Loperamide.
• D Aspirin.

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Question 20

The practical nurse (PN) is preparing to administer a client’s prescribed 0900 dose of one tablet of bisacodyl when the client reports that he has recently expelled three large, semi-formed bowel movements. Which action should the PN take?

• A Administer the bisacodyl with a full glass of water to begin replacement of lost body fluids.
• B Alert the healthcare provider about the diarrhea and hold the scheduled dose of bisacodyl.
• C Consult with the charge nurse about the need to increase the client’s prescribed dose of bisacodyl.
• D Explain to the client how the bisacodyl will help prevent any further episodes of diarrhea.

Question 21

The practical nurse (PN) administers daily doses of lactulose to a client with cirrhosis of the liver and hepatic encephalopathy. To evaluate the client’s therapeutic response to this medication, which intervention should the PN implement? HESI Foundations of Nursing Exam2

• A Monitor serum ammonia results.
• B Assess client’s number of loose stools.
• C Determine family history of alcoholism.
• D Orient the client to the environment.

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Question 22

An older adult is admitted to the hospital because of an adverse drug reaction related to polypharmacy. Which information is most important for the practical nurse (PN) to collect during the admission process?

• A Specific allergic reactions to medications.
• B Obtain a set of baseline vital signs.
• C Pharmaceutical and herbal supplement use.
• D Head-to-toe physical assessment findings.

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Question 23

A client receives a prescription for scopolamine transdermal patch 1 mg every 72 hours. The box is labeled, “Scopolamine Transdermal System, USP 1 mg/3 days.” How many mg should the practical nurse (PN) document for the client who uses the patches for 6 days? (Enter numerical value only.)

• 2

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Question 24

The practical nurse (PN) is reviewing information with a group of high school adolescents about safety associated with traumatic injuries. Which factor causing spinal cord injuries should the PN emphasize to the adolescents?

• A Sports injuries.
• B Violent assault.
• C Falls.
• D Motor vehicle collisions.

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Question 25

The practical nurse (PN) is caring for an adolescent with a body mass index (BMI) above the 95th percentile who has been experiencing increased urination. Which diagnostic test should the PN anticipate?

• A Blood sodium level.
• B Kidney, ureters, and bladder (KUB) x-ray.
• C Serum hemoglobin A1C.
• D Urine human chorionic gonadotropin (hCG).

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Question 26

An hour after receiving the first dose of captopril, a client reports feeling weak and dizzy. Which action is most important for the practical nurse (PN) to perform?

• A Measure the blood pressure.
• B Inquire about development of a cough.
• C Evaluate the pupillary response to light.
• D Review the serum potassium level.

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Question 27

A male client comes to the clinic explaining that he has been feeling weak and fatigued. His daughter reports that he has been taking a high dose systemic corticosteroid, but abruptly stopped taking the medication. Which finding is most important for the practical nurse (PN) to evaluate?

• A Blood pressure.
• B Body weight.
• C Body temperature.
• D Breath sounds.

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Question 28

A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the practical nurse (PN) implement?

• A Administer glucagon intramuscularly.
• B Obtain a fingerstick blood glucose.
• C Perform a neurological exam.
• D Measure the client’s vital signs.

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Question 29

The practical nurse (PN) is caring for a client with deep vein thrombosis (DVT) who is receiving a prescription for rivaroxaban. Which assessment finding should the PN associate as an adverse effect of this medication and report immediately?

• A Genital itching and burning with discharge.
• B Appearance of bruising in arms and legs.
• C Diminished ability to taste and smell food.
• D Hard, dry stools that are difficult to pass.

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Question 30

The practical nurse (PN) has received a new prescription for lisinopril 5 mg PO to be added to a client’s current medication plan of furosemide 60 mg PO twice daily to treat heart failure (HF) and edema. Which action should the PN perform before administering the client’s first dose of lisinopril?

• A Encourage the client to increase fluid intake to prevent hypovolemia related to the medication regime.
• B Obtain the client’s most recent serum potassium, magnesium, sodium, and chloride laboratory levels.
• C Discuss concerns with the charge nurse related to administering the initial dose of lisinopril with a diuretic.
• D Review the new prescription in the client’s electronic medical record (EMR).

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Question 31

When administering NPH insulin, the practical nurse should insert the tip of the needle into which tissue?

• A Adipose.
• B Connective.
• C Dermal.
• D Visceral. HESI Foundations of Nursing Exam2

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Question 32

The charge nurse asks the practical nurse (PN) to administer diphenhydramine 25 mg IM to a client prior to infusing a blood transfusion. Which explanation should the PN offer the client about the purpose of this drug?

• A Promote relaxation of the client during the blood transfusion.
• B Facilitate rapid infusion of the transfusion.
• C Inhibit the antigen-antibody reaction.
• D Minimize symptoms related to any allergic reaction.

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Question 33

When preparing to assist in a scoliosis screening clinic, the practical nurse (PN) should identify which age group will be included in the examinations?

• A Boys aged seven to ten years old.
• B Preschoolers of both genders.
• C Early adolescent girls.
• D Late adolescent boys.

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Question 34

A child who weighs 36 kg receives a prescription for diphenhydramine 25 mg IM every 6 hours. The medication is available as “Diphenhydramine 50 mg/mL vial.” How many mL should the practical nurse (PN) administer with each dose? (Enter numerical value only. If rounding is required, round to the nearest tenth.)

• 0.5

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Question 35

The practical nurse (PN) should reinforce which instruction to help prevent orthostatic hypotension in a client prescribed an antihypertensive medication?

• A Slowly change position when rising from sitting or lying down.
• B Increase the amount of fluids and fiber in the diet.
• C Consume a minimum of two to three liters of fluids each day.
• D Check blood pressure prior to taking any cardiac medication.

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Question 36

The practical nurse (PN) is reinforcing medication instructions to an older client with a new diagnosis of hypothyroidism. Which response by the client demonstrates understanding of how to take levothyroxine?

• A “I will take the medication with a large meal.”
• B “I will take the medication at bedtime.”
• C “I will take the medication on an empty stomach.”
• D “I will take the medication with a glass of milk.”

Question 36

A client who has hypothyroidism is receiving levothyroxine. Which instruction should the practical nurse (PN) reinforce with the client?

• A “I will take the medication with a glass of milk.”
• B “I will take the medication with my breakfast.”
• C “I will take the medication on an empty stomach.” HESI Foundations of Nursing Exam2
• D “I will take the medication at bedtime.”

Question 37

The practical nurse (PN) is teaching a group of adolescents about interpersonal skills and how to deal with bullying. Which strategy should the PN use as the most effective way to teach these skills?

• A Provide a worksheet to complete.
• B Role-playing.
• C Discussing personal experiences.
• D Watching a video on bullying.

Question 38

The practical nurse (PN) is preparing to apply a nitroglycerin transdermal patch. In which order should the PN perform these actions?

1. Inform the client of the purpose of the medication.
2. Put on a clean pair of gloves.
3. Place patch on a new area of cleansed skin.
4. Document the application in the electronic medication record.

Question 39

A client with hyperkalemia receives a prescription for sodium polystyrene sulfonate (Kayexalate) orally. After the first dose, the client has several watery stools. Which action should the practical nurse (PN) take?

• A Notify the healthcare provider immediately.
• B Hold the next dose of the medication.
• C Explain that this is a desired effect of the medication.
• D Administer an antidiarrheal medication.

Question 40

A client who had a myocardial infarction is receiving docusate sodium. Which information should the practical nurse (PN) explain to the client about the purpose of this medication?

• A Prevents changes in the heart rate due to straining.
• B Lowers blood pressure to decrease cardiac workload. HESI Foundations of Nursing Exam2
• C Dissolves any remaining clots in the coronary arteries.
• D Increases the strength of the heart’s contractions.

Question 41

A client with chronic obstructive pulmonary disease (COPD) is using an ipratropium inhaler. Which action by the client indicates that additional teaching is needed?

• A Exhales completely before using the inhaler.
• B Primes the inhaler with 7 pumps.
• C Holds their breath for 10 seconds after inhalation.
• D Rinses their mouth with water after use.

Question 42

A client who is taking apixaban for atrial fibrillation arrives at the clinic for a follow-up visit. Which finding is most important for the practical nurse (PN) to report to the healthcare provider?

• A Occasional headaches.
• B Bruising on the upper arms.
• C Nausea after taking the medication.
• D Prolonged oozing from phlebotomy site. HESI Foundations of Nursing Exam2

Question 43

A client who takes digoxin and furosemide for heart failure tells the practical nurse (PN) that white objects appear to be yellow. Which action should the PN take?

• A Advise the client to have an eye examination.
• B Record the finding in the medical record.
• C Suggest the client stop taking the furosemide.
• D Evaluate the client for digitalis glycoside side effects.

Question 44

The practical nurse (PN) is administering enoxaparin to a client following abdominal surgery. Which finding indicates that the medication was effective?

• A The client’s incision is healing without redness.
• B The client does not develop a deep vein thrombosis (DVT) after abdominal surgery.
• C The client’s hemoglobin remains within normal limits.
• D The client reports minimal pain at the injection site.

Question 45

The practical nurse (PN) is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client with diabetes. Which action should the PN take?

• A Draw up the NPH insulin first, then the regular insulin.
• B Draw up the regular insulin first, then draw the NPH insulin into the same syringe.
• C Administer each insulin injection at a separate site.
• D Mix the two insulins in a vial before drawing into the syringe.

Question 47

A client with gastroesophageal reflux disease (GERD) is prescribed pantoprazole. Which statement by the client indicates that the medication is effective?

• A “After eating my meal, I did not experience any heartburn.”
• B “I am able to sleep through the night without coughing.”
• C “My appetite has increased since I started the medication.”
• D “I have not had any nausea or vomiting lately.”

Question 48

A client with hypothyroidism is being treated with levothyroxine. Which parameter should the practical nurse (PN) monitor to determine if the dosage is too high?

• A Body weight.
• B Appetite.
• C Heart rate.
• D Sleep patterns.

Question 49

A client who has been newly diagnosed with hypertension is being discharged with medication to lower the blood pressure. Which information should the practical nurse (PN) reinforce with the client to help prevent orthostatic hypotension?

• A Avoid overeating or drinking at mealtime.
• B Take the medication with plenty of fluids.
• C Arise slowly from lying, sitting, or standing.
• D Take medication on an empty stomach.

Question 50

The practical nurse (PN) plans to administer an IM injection into the mid anterior thigh. Which muscle group should be identified as the site of administration?

• A Gluteus maximus.
• B Rectus femoris.
• C Gluteus medius.
• D Rectus abdominis.

Question 51

The practical nurse (PN) observes hematuria in the urinary catheter drainage tubing of a client who is receiving IV heparin. Which action should the PN implement first? HESI Foundations of Nursing Exam2

• A Irrigate the urinary catheter with sterile normal saline.
• B Document the finding in the client’s medical record.
• C Check the client’s gums for bleeding.
• D Obtain a urine specimen for urinalysis.

Question 52

A client is prescribed beclomethasone to treat allergic rhinitis. The practical nurse (PN) should reinforce to the client which common effects may develop with this medication? Select all that apply.

• A Hoarseness.
• B Throat irritation.
• C Angioedema.
• D Oral thrush.
• E Dry mouth.

Question 53

The practical nurse (PN) explains the 2-week dosage prescription of prednisone to a client who has poison ivy covering multiple skin surfaces. Which instruction should the PN emphasize about the dosing schedule?

• A Take the prednisone with meals.
• B Return for blood glucose monitoring in one week.
• C Decrease dosage daily as prescribed.
• D Monitor oral temperature daily.

Question 54

The practical nurse (PN) administers exenatide subcutaneous one hour before breakfast to a client with diabetes mellitus. Which action should the PN take to determine if the medication was effective?

• A Monitor the client’s blood glucose levels.
• B Observe for bruising at the injection site.
• C Determine if the client feels nauseated.
• D Document the percentage of diet eaten.

Question 55 of 60

The practical nurse (PN) is caring for an older adult client with multiple comorbidities. Which medication should the PN recognize as increasing the client’s risk for fractures?

• A Amlodipine.
• B Simvastatin.
• C Lansoprazole.
• D Metformin.

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Question 56 of 60

During a health fair at the community center, an attendee asked the practical nurse (PN) for more information about levels of prevention that can protect the client. Which behaviors should the PN give as examples? Select all that apply.

• A Using bicycle helmets.
• B Wearing seatbelts.
• C Vaccinating against measles.
• D Having a mammogram.
• E Skin testing for tuberculosis.

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Question 57 of 60

A client confides to the practical nurse (PN) that the client has been substituting herbal supplements for high blood pressure instead of the prescribed medication. How should the PN respond first?

• A Reinforce that the healthcare provider prescribed the medication for a reason.
• B Ask the client’s reason for choosing to take herbs instead of prescribed drugs.
• C Have the client use their own words to describe complications of high blood pressure.
• D Point out the risks of taking the herbal medications rather than prescribed.

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Question 58 of 60

The practical nurse (PN) is reinforcing instructions about using a metered dose inhaler (MDI) for a client with chronic obstructive pulmonary disease (COPD) who has received a prescription for ipratropium. In which order should the PN describe the instructions to the client? (Arrange each step from 1 to 5 in the correct sequence.)

• 1. Shake inhaler strongly 5 or 6 times, uncap the MDI, and place the spacer onto it.
• 2. Exhale slowly through pursed lips as if blowing out a candle.
• 3. Close mouth over the opening of the MDI spacer aiming at the back of the throat.
• 4. Inhale deeply and slowly while pressing one puff into the spacer.
• 5. Remove the spacer from the mouth and hold the breath for up to 10 seconds.

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Question 59 of 60

A client is learning to self-administer albuterol using a metered dose inhaler. Which information should the practical nurse (PN) include when reinforcing self-care teaching for the client? (Select all that apply.)

• A If two puffs are prescribed, do successive puffs in the same inhalation.
• B Use a spacer to keep canister outlet 2 inches from the lips.
• C Inhale deeply and slowly over 10 seconds.
• D If two puffs are prescribed, perform one puff per inhalation.
• E Hold breath after inhaling medication and exhale slowly.

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Question 60 of 60

Which pediatric client is most likely to experience a disturbed body-image?

• A A 10-year-old with plantar warts.
• B A 12-year-old with bacterial cellulitis.
• C A 16-year-old with a perineal tinea infection.
• D A 14-year-old with acne vulgaris.