Hesi Fundamental QUESTIONS AND ANSWERS

A nurse is teaching staff members about the legal terminology used in child abuse. What definition of battery should the nurse include in the teaching? 1 Maligning a person's character while threatening to do bodily harm. 2 A legal wrong committed by one person against property of another. Correct3 The application of force to another person without lawful justification. 4 Behaving in a way that a reasonable person with the same education would not. Battery means touching in an offensive manner or actually injuring another person. Battery refers to actual bodily harm rather than threats of physical or psychological harm. Battery refers to harm against persons instead of property. Behaving in a way that a reasonable person with the same education would not is the definition of negligence. 65%of students nationwide answered this question correctly. View Topics 1 Confidence: Nailed it Stats Issue with this question? 3. Which nursing interventions require a nurse to wear gloves? (Select all that apply.) 1 Giving a back rub. Correct2 Cleaning a newborn immediately after delivery. Correct3 Emptying a portable wound drainage system. 4 Interviewing a client in the emergency department. 5 Obtaining the blood pressure of a client who is human immunodeficiency virus (HIV) positive Personal protective equipment (PPE) should be used because the newborn is covered with amniotic fluid and maternal blood. PPE should be used because the nurse may be exposed to blood and fluid that are contained in the portable wound drainage system. PPE is not required for a back rub; there is no indication that the nurse is in contact with body secretions. PPE is not necessary when conducting an interview because it is unlikely that the nurse will come in contact with the client's body fluids. PPE is not necessary when obtaining the blood pressure of a client, even if the client is HIV positive. 60%of students nationwide answered this question correctly. View Topics 1 Confidence: Nailed it Stats Issue with this question? 4. A nurse is caring for a client with hemiplegia who is frustrated. How can the nurse motivate the client toward independence? 1 Establish long-range goals for the client. 2 Identify errors that the client can correct. Correct3 Reinforce success in tasks accomplished. 4 Demonstrate ways to promote self-reliance. Success is a basic motivation for learning. People receive satisfaction when a goal is reached. Progress toward long-range goals often is not apparent readily and may be discouraging. Constructive criticism is an important aspect of client teaching, but if it is not tempered with praise, it is discouraging. Demonstrating ways to promote self-reliance is an important part of teaching, but it probably will not motivate the client. 65%of students nationwide answered this question correctly. View Topics 1 Confidence: Pretty sure Stats Issue with this question? 5. A health care provider prescribes a standard walker (pick-up walker with rubber tips on all four legs). The nurse identifies what clinical findings that indicate the client is capable of using a standard walker? 1 Weak upper arm strength and impaired stamina 2 Weight bearing as tolerated and unilateral paralysis 3 Partial weight bearing on the affected extremity and kyphosis Correct4 Strong upper arm strength and non–weight bearing on the affected extremity A walker with four rubber tips on the legs requires more upper body strength than a rolling walker. A client who is non–weight bearing on the affected extremity is able to use a standard walker. A rolling walker is more appropriate for a client with weak upper arm strength and impaired stamina who is less able to lift up and move a walker with four rubber tips. A client with unilateral paralysis is not a candidate for a standard walker; the client must be able to grip and lift the walker with both upper extremities and move the walker forward. A rolling walker is more appropriate for this client. A client with kyphosis is less able to lift up and move a walker with four rubber tips. 62%of students nationwide answered this question correctly. View Topics 1 Confidence: Pretty sure Stats Issue with this question? 6. To prevent footdrop in a client with a leg cast, the nurse should: 1 Encourage complete bed rest to promote healing of the foot. 2 Place the foot in traction. Correct3 Support the foot with 90 degrees of flexion. 4 Place an elastic stocking on the foot to provide support. To prevent footdrop (plantar flexion of the foot due to weakness or paralysis of the anterior muscles of the lower leg) in a client with a cast, the foot should be supported with 90 degrees of flexion. Bed rest can cause footdrop, and 45 degrees is not enough flexion to prevent footdrop . Applying an elastic stocking for support also will not prevent footdrop; a firmer support is required. Test-Taking Tip: On a test day, eat a normal meal before going to school. If the test is late in the morning, take a high-protein snack with you to eat 20 minutes before the examination. The brain works best when it has the glucose necessary for cellular function. 64%of students nationwide answered this question correctly. View Topics 1 Confidence: Nailed it Stats Issue with this question? 7. What should the nurse include in dietary teaching for a client with a colostomy? 1 Liquids should be limited to 1 L per day. 2 Non-digestible fiber and fruits should be eliminated. 3 A formed stool is an indicator of constipation. Correct4 The diet should be adjusted to include foods that result in manageable stools. Each person will need to experiment with diet after a colostomy to determine what foods are best tolerated and also produce stools that are manageable, depending on the type of colostomy. Liquids are typically not limited unless there is a specific reason such as cardiac or renal disease. Food high in fiber such as fruit should be included in the diet as tolerated. Depending on the type of colostomy and the diet, a formed stool is acceptable and does not indicate a constipating diet. STUDY TIP: Remember that intelligence plays a vital role in your ability to learn. However, being smart involves more than just intelligence. Being practical and applying common sense are also part of the learning experience. 66%of students nationwide answered this question correctly. View Topics 1 Confidence: Nailed it Stats Issue with this question? 9. A client with respiratory difficulties asks why the percussion procedure is being performed. The nurse explains that the primary purpose of percussion is to: 1 Relieve bronchial spasm. 2 Increase depth of respirations. Correct3 Loosen pulmonary secretions. 4 Expel carbon dioxide from the lungs. Percussion (chest physiotherapy) loosens pulmonary secretions by mechanical means. This is accomplished by vibrations over the lung fields on the client's posterior, anterior, and lateral chest. Percussion does not relieve bronchial spasms. Once pulmonary secretions are loosened by percussion and the client has a clearer airway, the depth of respirations may increase and facilitate removal of carbon dioxide from the lungs. 70%of students nationwide answered this question correctly. View Topics 1 Confidence: Pretty sure Stats Issue with this question? 10. A 2-year-old child admitted with a diagnosis of pneumonia was administered antibiotics, fluids, and oxygen. The child's temperature increased until it reached 103° F. When notified, the health care provider determined that there was no need to change treatment, even though the child had a history of febrile seizures. Although concerned, the nurse took no further action. Later, the child had a seizure that resulted in neurological impairment. Legally, who is responsible for the child's injury? 1 Health care provider, because this decision took precedence over the nurse's concern 2 Health care provider, because of total responsibility for the child's health and treatment regimen Correct3 Nurse, because failure to further question the health care provider about the child's status placed the child at r