Virginia HESI Level 4 Practice Test

These questions are part of the practice quiz. Start practicing

• When faced with an ethical dilemma, which resource should the nurse utilize?
• Which organ is primarily responsible for filtering blood and forming urine?
• What is the purpose of using a scoliometer in scoliosis screening?
• In a large community disaster triage scenario, what action should the nurse implement first when encountering a blast victim?
• What is the role of the sinoatrial (SA) node?
• Which device is used to monitor intracranial pressure in ICU patients?
• In hyponatremia, which electrolyte is low?
• Which statement best describes the primary action of insulin on blood glucose?
• Which sentence demonstrates correct pronoun-antecedent agreement with 'each'?
• The nurse neglects to record the home care client’s daily dressing change in the medical record. Which action should the nurse anticipate?
• Which step in the scientific method involves testing a hypothesis under controlled conditions?
• If a patient weighs 70 kg and the medication dose is 5 mg/kg, what is the total dose?
• In monitoring sepsis treatment, which lactate trend indicates improvement?
• In the sentence 'The new policy will have a ___ on the schedule,' which word completes the sentence correctly?
• A client reports shortness of breath and chest pressure radiating down the left arm. ECG shows ST segment elevation in leads II, III, aVF, and V4R. Which action should the nurse implement first?
• Which ethical principle emphasizes patient autonomy and informed consent?
• The RN is assisting with the removal of a chest tube. After the removal, which intervention has the highest priority to anticipate?
• What is the normal fasting blood glucose range for adults?
• For a patient with fever, crackles throughout the lungs, and edema, which diagnostic procedure should the nurse prepare to do first?
• Convert the concentration of dispensed dopamine to mcg/mL given 800 mg in 500 mL.
• The nurse is requesting several days off from work during a period of anticipated high acuity client census. Which approach should the nurse use when speaking with the nurse manager?
• A bacterial cell that lacks a nucleus is called what?
• Which muscle is the primary muscle of respiration?
• If a recipe is reduced by 25%, what percent of the original amount remains?
• Which value best represents a typical normal resting heart rate for adults?
• What is the primary function of mitochondria?
• Which condition is characterized by edema and heavy proteinuria often requiring sodium restriction?
• Which statement about line charts and bar charts is true?
• Which intervention best minimizes stimulation of the pancreas in acute pancreatitis?
• Which type of needle is used to access an implanted infusion port?
• Which type of reasoning involves applying general rules to specific cases?
• A client with chronic Hepatitis C virus infection is scheduled for a liver biopsy. Which intervention should the nurse perform after the procedure?
• Which sentence uses correct comma placement?
• Convert 2.5 liters to milliliters.
• Which body system regulates hormonal activity via glands?
• The epidermis contains melanocytes. Which skin layer is primarily responsible for this?
• Root 'cardi-' relates to which organ?
• A patient’s SpO2 declines from 98% to 90% with increased work of breathing over an hour. Which assessment conclusion is most justified?
• Which statement about the renal system is true?
• Which medications are typically administered during an episode of acute respiratory distress?
• Which formula correctly converts Fahrenheit to Celsius?
• If scoliosis is suspected after initial screening, which action is most appropriate next?
• A client is in cardiac arrest with resuscitation ongoing; the spouse arrives and asks to stay with the client. What action should the nurse implement?
• What action should the nurse implement when accessing an implanted infusion port for a client who receives long-term IV medications?
• In SBAR, which component corresponds to the statement 'The client is reporting pain radiating down the left arm'?
• What is the normal adult Hb range for women?
• What is the decimal equivalent of 3/4?
• Which finding should the nurse report to the healthcare provider for a client with a circumferential extremity burn?
• Which dietary approach is typically used initially for a patient with acute pancreatitis?
• What is the best way for the nurse to introduce the idea of obtaining a computer system for the clinic?
• Which finding would prompt intubation in a patient with head injury?
• A client is comatose 24 hours after cardiac arrest. Which physical finding best predicts a poor outcome?
• Which lab value is the most reliable indicator of kidney function?
• In cellular respiration, which molecule is the final electron acceptor?
• Drip rate is 40 mL/hour for 3.5 hours. What is the total volume to be infused?
• Which sentence uses correct capitalization and punctuation?
• Iatrogenic refers to something that is:
• For a patient with nephrotic syndrome presenting with pitting edema, which dietary modification is appropriate?
• What is the primary purpose of a chest drainage system attached to a chest tube?
• Which statement is true about energy yield per gram for macronutrients?
• An older client is transferred to a telemetry unit after placement of a pacemaker. What action should the RN take first?
• In monitoring sepsis, which value is most useful to assess perfusion status?
• What is the typical resting heart rate range for adults?
• The nervous system includes which structures?
• During induction for intubation using IV sedative and paralytic, which sequence should the nurse implement?
• Which occupational hazard could quickly become a national problem for nurses working in acute care settings?
• A client suspected of poisoning presents with symmetric, descending flaccid paralysis, blurred vision, diplopia, and dry mouth. The nurse should consider these findings consistent with which bioterrorism agent?
• Which sentence uses proper capitalization?
• A brief excerpt states, 'The nurse emphasized hand hygiene to prevent infections.' What is the main idea?
• Which protein provides a structural framework in connective tissue?
• Which organ is primarily responsible for filtering blood and forming urine?
• In the management of acute pancreatitis, which statement best justifies keeping the patient NPO?
• Surgical correction of a ventricular septal defect is designed to achieve which outcome?
• Identify the sentence with correct use of quotation marks.
• Which sentence demonstrates proper quotation marks and punctuation?
• Mitosis yields two genetically identical diploid daughter cells.
• Which structure is part of the lower respiratory tract?
• Which bone is located in the upper limb?
• Which word most nearly means 'persistent' in a medical context?
• A client returns to the ICU after having a permanent pacemaker inserted. Which finding should the nurse observe for during the immediate hours after insertion?
• What is the primary purpose of checklists in clinical handoffs?
• A patient needs 1.25 g of a drug with a concentration of 250 mg/mL. How many milliliters should be administered?
• In the patient described with sepsis features (fever, tachycardia, hypotension), which finding most strongly indicates the need for urgent fluid resuscitation?
• Which vitamin is fat-soluble?
• If a drip rate is 60 mL/hour for 2.5 hours, what is the total volume?
• A medication order is 500 mg every 8 hours. How many milligrams are administered in 24 hours?
• Convert 154 lb to kilograms using 1 kg = 2.2046 lb. Round to the nearest tenth.
• A client's blood pressure drops suddenly from 160/90 mmHg to 60/40 mmHg minutes after the nurse administers a 0.3 mg sublingual dose of nitroglycerin for chest pain. The client reports crushing chest pain, severe nausea, dizziness, and left arm numbness. Which intervention should the nurse implement?
• If a dose is administered every 8 hours for 24 hours, how many doses are given?
• Which ethical principle emphasizes patient independence and decision-making authority?
• Which storage condition helps preserve most biological samples during transport?
• Using the SBAR technique to communicate with the healthcare provider, which statement best conveys information about the client’s situation?
• In the circulatory system, which vessel carries oxygenated blood away from the heart?
• Which task should the nurse delegate to an experienced unlicensed assistive personnel (UAP)?
• Which sequence correctly describes how a nurse screens for scoliosis?
• In DNA base pairing, which base pairs with adenine?
• Which description matches the term in vitro?
• In a client with a circumferential burn, which finding indicates potential compartment syndrome and should be reported?
• Before visiting a new home care client, what action should the nurse take first?
• Vertebrae belong to which skeletal division?
• Which sentence demonstrates correct pronoun-antecedent agreement?
• A nurse advocates for a patient’s wishes in care decisions. What principle does this demonstrate?
• Which chamber receives oxygenated blood from the lungs?
• Which strategy best helps identify the main idea in a paragraph?
• Which body system coordinates internal communication and responses to stimuli?
• A patient weighing 15 kg requires 2 mg/kg. What is the total dose?
• Which organ filters the blood and forms urine?
• The autonomic nervous system regulates which type of actions?
• Which factor most affects the accuracy of eGFR calculations?
• Which suffix denotes inflammation?
• Convert 1.25 L to milliliters.
• Which component is part of the lower respiratory tract?
• A patient with multiple traumatic injuries has a Glasgow Coma Scale of 6. Which intervention should the nurse prepare for?
• Which statement best describes a buffer's purpose?
• What is the primary purpose of a nursing care plan?
• Gastrografin is used in imaging to evaluate which postoperative complication?
• Which sentence correctly distinguishes its from it's?
• Which term describes inflammation of the stomach?
• A patient has a high WBC count and fever; what is most likely?
• In a patient with traumatic brain injury, which finding is most important for the nurse to assess further?
• Which value is most useful to monitor the effectiveness of sepsis therapy in terms of perfusion?
• The healthcare provider prescribes furosemide (Lasix) 15 mg IV STAT for a client. On hand is an ampoule labeled, furosemide (Lasix) 20 mg/2ml. How many milliliters should the nurse administer?
• Which finding in an elderly patient requires the most immediate follow-up?
• Which math topic is essential for nursing dosage calculations?
• When assessing a client with dyspnea, the nurse hears an audible inspiratory crowing sound. Which lung sound should the nurse document?
• A medication order reads 0.75 mg. If the vial contains 0.25 mg/mL, how many milliliters should be administered?
• Which is an example of a run-on sentence?
• A postoperative client develops sudden shortness of breath, chest pain, and anxiety. Oxygen saturation drops to 86%. Which condition should the nurse suspect first?
• In a patient with sepsis who is receiving broad-spectrum IV antibiotics, which laboratory value best indicates that the treatment is effective?
• Which sentence uses parallel structure?
• A client experiencing cardiogenic shock receives a prescription for an IV infusion of milrinone (Primacor) 10 mg in 100 ml at a rate of 46 mcg/min. The nurse should program the infusion pump to deliver how many ml/hour?
• Which statement best explains why NPO status is used in acute pancreatitis?
• Which sentence shows correct possessive apostrophe usage?
• What is the primary method used to ensure correct unit dosing in calculations?
• How many 8-hour intervals are there in 24 hours?
• A client weighing 86 kg is receiving dopamine at 8 mcg/kg/min. The drug is dispensed as dopamine 800 mg/500 mL. The nurse should program the infusion pump to deliver how many mL/hour?
• A client arrives with asymmetrical chest wall expansion during respiration after a motor vehicle collision. What action should the nurse implement next?
• After a Whipple procedure, which diagnostic test should the nurse prepare to confirm an anastomotic leak?
• An 8-month-old with patent ductus arteriosus arrives for a follow-up. Which finding should the nurse document in the medical record?
• What is the major function of the renal system?
• In sepsis treatment evaluation, which finding most strongly indicates improvement in tissue perfusion after antibiotics are started?
• Which bone is part of the axial skeleton?
• Convert 750 mL to liters.
• What is the primary metabolic action of insulin?
• Which imaging modality is most appropriate to confirm scoliosis after screening suggests curvature?
• In preparing for home oral feeding for a ventilator-dependent child, which sequence of actions should the nurse take?
• Which statement best describes why maintaining NPO status is important in acute pancreatitis management?
• If a nurse notes that a procedure was tolerated without complications, what does this indicate?
• Which laboratory value trend is most closely associated with tissue perfusion status in sepsis?
• When evaluating a laboratory report, which skill is essential?
• Which laboratory marker best validates myocardial damage that occurred several days earlier?
• For a dopamine infusion ordered at 8 mcg/kg/min for an 86 kg patient with a concentration of 1600 mcg/mL, what is the dose in mcg/min?
• In pharmacology, which statement best defines a drug's half-life?
• In sepsis, the term 'systemic inflammatory response' refers to which concept?
• Which statement correctly identifies the role of collagen in connective tissue?
• Which term describes a drug that kills bacteria?
• Round 3.456 cm to the nearest tenth.
• Who should be the primary audience for a formal proposal to implement a new computer system in a clinic?
• The phenomenon where allele frequencies change due to random sampling, more pronounced in small populations, is called what?
• Which term describes a tumor that does not invade or metastasize?
• Convert 3/4 to a decimal.
• What is the normal adult Hb range for men?
• What is the normal adult respiratory rate range?
• Which organ is part of the urinary system?
• A medication order is 0.5 mg/kg for a 60 kg patient. What is the total dose in milligrams?
• Which of the following is an involuntary action regulated by the autonomic nervous system?
• In a solution with 4 parts solvent to 1 part solute, what percent of the solution is solute?
• A client who recently had a permanent pacemaker insertion is in the immediate post-op period. Which finding should the nurse observe?
• In DNA base pairing, which base pairs with cytosine?
• Which expression correctly converts a dose from mcg/kg/min to mcg/min when weight is W kg?
• A client reports to the nurse feeling achy and weak, being tired and coughing all the time, frequent headaches and night sweats. Which diagnostic procedure should the nurse prepare to do first?
• A patient with an intraventricular catheter monitoring device for increased ICP has an ICP reading of 15 mm Hg. This indicates what outcome?
• What action is essential to preventing medication errors in clinical practice?
• A patient has a BMI of 32.0. Which category does this fall into?
• Convert 7 mg to micrograms.
• Convert 0.75 L to milliliters.
• What is the primary purpose of reading comprehension on the HESI Level 4 exam?
• A client on a ventilator demonstrates a tracheal shift to the right, decreased breath sounds on the left, tachycardia, and hypotension. What action should the nurse implement first?
• A diagnostic test for suspected myasthenia gravis uses edrophonium chloride (Tensilon). What is the expected outcome after administration?
• Which type of chart is best for showing data trends over time?
• In a passage where the author's tone shifts from optimistic to skeptical, which question helps detect tone?
• Using the same parameters as above (8 mcg/kg/min, 86 kg, 1600 mcg/mL), what is the infusion rate in mL/hour?
• Which concept is described by the maintenance of stable internal conditions despite changes in the external environment?
• Which energy-carrying molecule is produced by mitochondria during cellular respiration?
• A short passage states that prevention depends on early detection. What is the main idea?
• Which description best matches the major role of the renal system?
• Which tool is used to measure abnormal degrees of lateral spinal curvature during scoliosis screening?
• An IV infusion of Inocor is prescribed as a 0.1 g/100 mL solution to run at 400 mcg/min. The rate should be set to how many mL per hour?
• Which vessel carries blood away from the heart?
• Which term refers to the study of the origin and history of words?
• A patient with a history of heroin and alcohol abuse has right arm cellulitis with a puncture wound. Vitals show tachycardia, fever, hypotension. Which intervention should the nurse implement first?
• During scoliosis screening, which component of the Adam’s forward bend test is included?
• What action should the nurse take first when a patient reports acute chest pain after a PTCA?
• Which macromolecule is the primary source of long-term energy storage?
• Which sentence uses correct grammar and punctuation?
• Which postoperative condition should be considered first in a patient who develops sudden dyspnea and chest pain with a drop in SpO2 to 86%?
• What is the normal pH range for human blood?
• Genetic drift is influenced most by population size; which scenario increases its impact?
• Which organ is part of the nervous system?
• If a patient’s chart shows chronic miscommunication between patient and staff leading to errors, what practice best reduces risk?
• After a right thoracotomy for removal of lung lobes, two chest tubes are attached to a chest drainage system to re-establish negative pleural pressure. Which finding provides the earliest indication that the chest tube may be displaced?
• What is the most appropriate initial action when a patient is hypoxemic?
• Antonym of benign in medical terms?
• A buffer typically consists of which components?
• In medication orders, what does the abbreviation PRN indicate?
• Which strategy has shown to be the most effective way for nurse leaders to manage conflict?
• What is the difference between bacteriostatic and bactericidal antibiotics?
• Which infection control practices are essential to prevent the spread of pathogens?
• A solution is prepared with a 1:2 dilution (1 part solute to 2 parts solvent). What fraction of the final solution is solute?
• Which statement best describes the role of Gastrografin in GI imaging after abdominal surgery?
• A medication order is 0.5 mg/kg for a 40 kg patient. What is the total dose in milligrams?
• Which statement about fat-soluble vitamins is true?
• Which macronutrient provides the most energy per gram?
• When reviewing a lab result, which aspect helps ensure accuracy of interpretation?
• Which term describes a condition caused by medical treatment or intervention?
• Prefix 'brady-' means which of the following?
• Septic shock is best explained by which mechanism?
• A client has a prescription for inamrinone (Inocor) 0.75 mg/kg IV bolus to be delivered over 3 minutes. The client weighs 80 kg. Inamrinone is available for injection 100 mg/20 ml. How many ml of inamrinone should the nurse administer?
• Which statement best describes the clinical significance of a drug's half-life?
• Which statement best distinguishes anatomy from physiology?
• In a patient with a cuffed tracheostomy, which sign indicates the client may tolerate cuff deflation for speaking and swallowing?
• A patient presents with fever, tachycardia, hypotension, and confusion. Which interpretation best explains these findings?
• Which macromolecule provides the primary source of long-term energy?
• Suffix '-itis' denotes which of the following?
• A cuffed tracheostomy tube is in place and the patient is breathing spontaneously. To evaluate if the client can tolerate cuff deflation to promote speaking and swallowing, what action should the nurse implement?
• In a solution, 4 parts solvent to 1 part solute are present. What percent of the solution is solute?
• Which strategy helps identify supporting details in a passage?
• A patient requires an IV flow rate of 120 mL per hour for 8 hours. What is the total volume?
• A client with acute pancreatitis reports severe epigastric pain radiating to the back. Which nursing intervention has the highest priority?
• Which base pairing is correct in DNA?
• In a 1:2 dilution, what fraction of the final solution is solvent?
• Which laboratory trend best indicates improving tissue perfusion in a patient with sepsis receiving antibiotics?
• A conscious, alert patient experiences telemetry alarms. What action should the nurse implement first when this rhythm occurs?
• Which precaution is appropriate for a patient with a contagious respiratory infection transmitted via droplets?
• Which sentence demonstrates correct subject-verb agreement?
• List the typical sequence of steps in the scientific method in order.
• In reading passages, what does an 'inference' refer to?
• The healthcare provider prescribed propofol IV and succinylcholine IV for a client being prepared for intubation. Which action should the nurse implement to assist during administration of these two drugs?
• The registered nurse is assisting with the removal of a chest tube. Which intervention has the highest priority and should be anticipated by the RN after the removal of the chest tube?
• Which action should the nurse take first before visiting a new home care client?