WorksheetsHESI 3
Total questions: 100
Worksheet time: 55mins
Which electrolyte imbalance is most likely during severe diarrhea in IBD?
Hypermagnesemia
Hyperkalemia
Dehydration with electrolyte loss
High calcium levels
A client with UC is at risk for which long-term complication?
Lung cancer
Colorectal cancer
Kidney cancer
Bladder stones
Which diagnostic test is used to evaluate inflammation in IBD?
ESR and CRP
BNP
Troponin
Hemoglobin A1C
During a UC flare, the nurse should anticipate which bowel pattern?
Watery stool with fat globules
Clay-colored stool
Frequent, bloody diarrhea
Hard pellets
A client with hepatitis develops pruritus. This is caused by:
Low potassium
Accumulation of bile salts
Excess insulin
Elevated platelets
Which symptom indicates that a client with chronic hepatitis may be developing ascites?
In cholecystitis, the gallbladder may become filled with:
Gastric acid
Bile or pus
Stool
Ammonia
A hallmark sign of gallbladder inflammation is:
LUQ pain only
RUQ pain after meals
Black stool
Pain relieved by fatty foods
A client with pancreatitis shows decreased bowel sounds. This may indicate:
Dehydration
Paralytic ileus
High motility
Respiratory alkalosis only
Which position may increase comfort for a client with peritonitis-like pain from pancreatitis?
Supine with legs straight
High Fowler’s only
Knees flexed
Prone with arms above head
Inflammation management includes which pharmacologic category?
Antidepressants
Steroids
Antivirals only
Antiseptics
During acute inflammation, vasodilation causes:
Cool skin
Decreased blood flow
Redness and heat
Loss of all WBC activity
Which finding is consistent with fully developed acute inflammation?
Pale, cool skin
Edema and warmth
Decreased WBC count
A client with mobility limitations is at risk for which complication?
Paralytic ileus and constipation
Lung scarring only
Kidney enlargement
Increased bowel motility
Immobility increases the risk for venous thromboembolism because:
Veins become smaller
Slowed venous return occurs
Arteries constrict excessively
Blood pressure rises
Which order helps prevent VTE in an immobile client?
Restrict fluids
Ambulate 3 times per day
High-sodium diet
Remove SCDs while in bed
In urinary retention, the bladder may appear:
Flat and soft
Distended and palpable
Nonpalpable always
Sunken inward
A UTI in an older adult often presents with:
Severe flank pain only
Confusion or cognitive changes
Vomiting only
High fever exclusively
Which behavior increases risk for UTI?
Voiding after intercourse
Wearing tight, non-breathable underwear
Drinking 2 liters of water daily
Wiping front to back
The best prevention strategy for functional incontinence is:
Timed toileting and easy access to the bathroom
Restrict all fluids
Use of diuretics at night
Avoid mobility aids
Which characteristic differentiates Crohn’s disease from ulcerative colitis?
A) Inflammation limited to mucosal layer
B) Continuous lesions through entire colon
C) “Skip lesions” with segments of normal bowel between diseased areas
D) Diarrhea always without pain
Which bowel disease is limited only to the colon?
Crohn’s disease
Irritable bowel syndrome
Ulcerative colitis
Small bowel obstruction
Which finding is expected in Crohn’s disease due to malabsorption?
Elevated albumin
Weight loss
Bradycardia
Hypernatremia
Which action helps maintain skin integrity for clients with frequent diarrhea?
Avoid cleansing until irritation occurs
Clean with mild soap and water and apply barrier cream
Use hot water to remove stool
Apply rubbing alcohol for dryness
Which action helps prevent worsening of diarrhea?
Increase caffeine
Encourage spicy foods
Encourage adequate hydration
Avoid all fluids
Clients with UC may require which nutritional support during severe exacerbations?
High-fat diet
Parenteral nutrition (TPN)
Low-calorie diet
High-lactose diet
A client with cholecystitis asks what causes their right shoulder pain. The nurse responds:
Gas formation
Referred pain from gallbladder inflammation
Kidney stone radiation
Musculoskeletal strain
Which diagnostic test evaluates gallbladder obstruction?
Chest x-ray
Ultrasound
ECG
CT head
A hallmark manifestation of cholecystitis includes:
Pain relieved by fatty meals
RUQ pain with nausea and vomiting
Severe diarrhea only
Left-sided abdominal pain
A major risk factor for pancreatitis is:
Appendicitis
Gallstones
Pneumonia
Low calcium intake
Which symptom indicates severe acute pancreatitis?
Severe epigastric/LUQ pain radiating to the back
Intermittent mild abdominal cramping
Pain relieved by food
No nausea
The nurse expects which intervention for nausea and vomiting from pancreatitis?
Encourage frequent meals
Insert NG tube to suction
Encourage carbonated drinks
Administer laxatives
Which physical exam finding supports acute inflammation?
Which of the following are classic signs of inflammation?
Pallor
Warmth, redness, swelling
Absent capillary refill
Bradycardia
Systemic inflammatory response may include:
Low WBC count
Fever
Weight gain
Hypersalivation
A client asking why inflammation causes swelling should be told:
It's caused by WBC destruction of tissue
It results from increased capillary permeability
It is due to decreased blood flow
It is caused by muscle breakdown
Which action is included in RICE therapy?
Warm compress immediately
Rest and immobilization
Compression avoided completely
Exercise the area frequently
Which medication type reduces inflammatory pain by lowering prostaglandin levels?
NSAIDs
Antibiotics
Beta-blockers
Antivirals
During inflammation, monocytes become:
Platelets
RBCs
Macrophages
Eosinophils
A neutrophil count with increased “bands” indicates:
Viral infection only
Chronic inflammation
Acute bacterial infection
Low WBC production
A client with decreased mobility is MOST at risk for:
Increased appetite
Venous thromboembolism
High bone density
A client with UC has tachycardia, fever, and severe abdominal pain. Which complication is suspected?
Paralytic ileus
Toxic megacolon
GERD
IBS
Which inflammatory bowel disease complication is more common in Crohn’s than UC?
Fistulas
Bloody diarrhea only
Rectal bleeding
Mucosal-only inflammation
Which nutritional strategy helps clients with IBD maintain hydration?
Avoid drinking fluids
Replace fluid and electrolytes frequently
The nurse monitors a client with UC for dehydration. Which finding is consistent?
Bounding pulses
Poor skin turgor
Hypertension
Peripheral edema
Which lab finding supports the presence of active inflammation?
Low albumin
Elevated ESR/CRP
Low WBC
High platelet count only
Which IBD medication suppresses immune function and decreases inflammation?
Antacids
Corticosteroids
Diuretics
Beta-blockers
Which symptom suggests extraintestinal complications of UC?
A) Eye pain and photophobia
B) Persistent hiccups
Which teaching is MOST important before a client undergoes barium enema testing?
Avoiding milk
Avoiding red meat for 3 days
Eating high fiber
Increasing Vitamin C intake
The nurse instructs a client that Vitamin C should be avoided before a stool occult blood test because it:
Causes diarrhea
Causes false-negative results
Causes false-positive results
Prevents stool formation
A client has right upper quadrant pain, fever, and nausea after eating fried foods. This suggests:
Appendicitis
Cholecystitis
UC flare
Peptic ulcer disease
Which imaging test is most commonly used to diagnose cholecystitis?
(a)
Why is pain in cholecystitis sometimes referred to the right shoulder?
Radiation from a kidney stone
Phrenic nerve irritation (correct)
Pulmonary inflammation
Muscular strain only
Which finding indicates worsening gallbladder disease?
Decreased nausea
Jaundice
Clear yellow urine
Decreased WBC count
A client has pancreatitis. Which assessment finding is expected?
Pain relieved with eating
Severe LUQ pain radiating to back
Bradycardia
No abdominal tenderness
Which electrolyte imbalance may occur in pancreatitis?
(a)
Which electrolyte imbalance is commonly seen in acute pancreatitis?
Hypercalcemia
Hypocalcemia
High sodium
High potassium only
Why is NPO status necessary in acute pancreatitis?
To prevent aspiration
To reduce pancreatic enzyme secretion
To increase metabolic rate
To promote bowel movements
Which intervention supports respiratory function in pancreatitis?
Encourage deep breathing and coughing
Keep client flat in bed
Restrict oxygen therapy
Avoid ambulation
In the inflammatory process, monocytes mature into:
Mast cells
Macrophages
Platelets
Neutrophils
Which characteristic is typical of the acute inflammatory response?
(a)
Which of the following is caused by vasodilation?
A) Vasoconstriction causing pallor
B) Vasodilation causing heat and redness
C) Poor blood flow
D) Tissue cooling
A client's WBC count shows increased neutrophils and bands. This indicates:
Viral infection
Acute bacterial inflammation
Allergic reaction
Parasitic infection
Which manifestation is commonly seen in viral hepatitis during the acute phase?
Pale, frothy stool
Dark urine
Increased appetite
Bradycardia
A client with acute hepatitis reports severe fatigue. What is the priority teaching?
Encourage frequent rest periods throughout the day.
Increase physical activity to build strength.
Limit fluid intake to prevent swelling.
Follow a high-protein diet to speed recovery.
A nurse teaches a client with hepatitis to:
Engage in vigorous exercise
Rest periods between activities
Restrict all fluids
Minimize sleep to stay active
The presence of jaundice indicates impairment in:
Protein metabolism only
Bile excretion
Kidney filtration
Electrolyte absorption
Which hepatitis type requires Hepatitis B to replicate?
Hepatitis A
Hepatitis C
Hepatitis D
Hepatitis E
A nurse teaches a client with hepatitis to avoid alcohol because:
It raises blood pressure
It increases bilirubin excretion
It accelerates liver damage
It prevents bile secretion
Which finding is an early clinical manifestation of acute hepatitis?
Jaundice
Ascites
Splenomegaly
Hepatic encephalopathy
Which of the following is a common symptom of pancreatitis?
Increased energy
Anorexia and nausea
Rapid weight gain
Bright red stool
In pancreatitis, which vital sign change is expected?
Hypertension
Hypotension and tachycardia
Bradycardia and hypertension
Afebrile state
Which complication of pancreatitis is characterized by a fluid-filled cavity?
Duodenal ulcer
Pseudocyst
Viral abscess
Hepatitis encephalopathy
A client with pancreatitis complains that pain worsens after meals. Why?
Pancreatic stimulation increases
Stomach acid decreases
Bile production stops
Enzymes decrease
The MOST important assessment to monitor in pancreatitis is:
Serum amylase and lipase levels
Blood pressure
Urine output
Respiratory rate
Which of the following should be assessed in a client with PUD?
Skin turgor only
Respiratory effort
Finger strength
Visual acuity
A client with PUD reports burning epigastric pain. Which action helps confirm diagnosis?
Endoscopy
Chest x-ray
CT head
Abdominal ultrasound only
Which food type should be avoided by a client with PUD?
Bananas
Pepper and spicy foods
Yogurt
Applesauce
Which medication protects the stomach lining in PUD?
NSAIDs
Sucralfate
Aspirin
Antihistamines
Coffee-ground emesis indicates:
Gastrointestinal bleeding (upper GI bleed)
Viral infection
Gallstones
Pancreatitis
A) Lower GI bleed C) Small bowel obstruction D) Viral infection
Lower GI bleed
Digested blood from upper GI bleed
Small bowel obstruction
Viral infection
Gastric perforation presents with:
Pain relieved by eating
Sudden severe abdominal pain and rigid abdomen
Soft abdomen and diarrhea
Gradual improvement of symptoms
A priority nursing action for suspected perforation is:
Give oral fluids
Insert NG and notify provider
Encourage ambulation
Provide a heating pad to abdomen
What is the purpose of SCDs in immobile clients?
Strengthen leg muscles
Prevent venous stasis and clots
Increase body temperature
Reduce urine output
Which nursing diagnosis is most appropriate for a client with Parkinson-related mobility impairment?
Impaired physical mobility
Risk for infection
Ineffective airway clearance
Disturbed sensory perception
Which of the following is a common nursing diagnosis for a client with Parkinson's disease?
Risk for social isolation
Impaired physical mobility
Ineffective thermoregulation
Impaired gas exchange
A Parkinson’s client with bradykinesia and shuffling gait is at high risk for:
Diarrhea
Falls
Hypertension
Constipation only
What is the safest ambulation pattern for a Parkinson’s client?
Heel-toe walking
Toe-heel walking
Looking down at feet
Taking large steps
Which intervention helps reduce DVT risk in immobile clients?
Restricting all fluids
Ambulating as tolerated
Applying warm compresses to legs
Encouraging prolonged bedrest
Immobility contributes to constipation primarily because:
It increases gastric emptying
It decreases peristalsis
It increases fiber absorption
It increases stool lubrication
Which complication of immobility occurs due to calcium leaving bones?
Muscle hypertrophy
Osteoporosis
Increased bone density
Elevated potassium
Which statement by a client demonstrates understanding of constipation prevention?
I will limit fluids to reduce urgency.
I should increase fiber and water intake.
I should stop walking after meals.
A client experiencing urinary urgency and frequency likely has:
Urethral stenosis
Lower UTI
Cirrhosis
Paralytic ileus
The nurse identifies which client as MOST at risk for a UTI?
The athlete who hydrates well
The client with an indwelling catheter
The client voiding every 4 hours
The client with high fiber intake
Which finding indicates the bladder may not be fully emptying?
Frequent large voids
Dribbling and weak stream
Clear yellow urine
Strong urine odor only
Functional incontinence is best addressed by:
Teaching pelvic floor exercises
Improving environmental access
Increasing caffeine intake
Which instruction is MOST important for preventing CAUTI?
Clamp the catheter at night
Maintain a closed drainage system
Clean catheter tip with alcohol daily
Disconnect tubing before ambulation
Which manifestation is most consistent with upper UTI (pyelonephritis)?
Mild dysuria only
Flank pain and fever
Frequent small voids
Amber urine without odor
Which laboratory finding confirms active inflammation?
Low CRP
Elevated ESR
Low WBC
Low hematocrit
Inflammation causes redness primarily because of:
Loss of skin pigment
Vasodilation
Decreased blood flow
