HESI RN 2024 EXIT EXAM QUESTIONS
WITH COMPLETE ANSWERS
When zzpreparing zzto zzadminister zza zzprescribed zzmedication zzto zza zzhomeless zzclient
zzat zza zzcommunity zzpsychiatric zzclinic. zzThe zzclient zztells zzthe zznurse zzthat zzthe
zzusual zzdosage zztaken zzis zzdifferent zzfrom zzthe zzdose zzthe zznurse zzis zzgiving.
zzWhich zzaction zzshould zzthe zznurse zztake? zz
A) zzInform zzthe zzclient zzthat zzhe zzmay zzrefuse zzthe zzmedication zzand zzdocument
zzwhether zzor zznot zzthe zzclient zztakes zzit. zz
B) zzWithhold zzthe zzmedication zzuntil zzthe zzdosage zzcan zzbe zzconfirmed. zz
C) zzExplain zzto zzthe zzclient zzthat zzthe zzdosage zzhas zzbeen zzchanged. zz
D) zzTell zzthe zzclient zzto zztake zzthe zzmedication zzthen zzverify zzthe zzdosage zzat zzthe
zznext zzhealthcare zzteam zzmeeting. zz- zzANS-B) zzWithhold zzthe zzmedication zzuntil zzthe
zzdosage zzcan zzbe zzconfirmed.
The zzcharge zznurse zzis zzmaking zzassignments zzfor zzone zzpractical zznurse zzand
zzthree zzregistered zznurses zzwho zzare zzcaring zzfor zzneurologically zzcompromised
zzclients. zzWhich zzclient zzwith zzwhich zzchange zzin zzstatus zzis zzbest zzto zzassign zzto
zzthe zzPN? zz
A) zzSubdural zzhematoma zzwhose zzblood zzpressure zzchanged zzfrom zz150/80 zzto
zz170/60.
B) zzViral zzmeningitis zzwhose zztemperature zzchange zzfrom zz101 zzS zzto zz102F. zz
C) zzDiabetic zzketo zzacidosis zzwho zzis zzGlasgow zzcoma zzscale zzscore zzchanged
zzfrom zz10 zzto zz7. zz
D) zzMyxedema, zzwhose zzblood zzpressure zzchange zzfrom zz80/50 zzto zz70/40. zz- zzANS-
B) zzViral zzmeningitis zzwhose zztemperature zzchange zzfrom zz101 zzS zzto zz102F.
The zznurse zzis zzcaring zzfor zza zzclient zzwith zzpneumonia zzwho zznow zzdevelops zzinitial
zzsigns zzof zzseptic zzshock zzand zzmulti zzorgan zzfailure. zzThe zzhealthcare zzprovider
zzprescribes zza zzsepsis zzprotocol. zzWhich zzintervention zzis zzmost zzimportant zzfor zzthe
zznurse zzto zzinclude zzin zzthe zzplan zzof zzcare? zz
,A) zzMaintain zzstrict zzintake zzand zzoutput. zz
B) zzKeep zzhead zzof zzbed zzraised zz45°. zz
C) zzExcess zzwarmth zzof zzextremities. zz
D) zzMonitor zzblood zzglucose zzlevel. zz- zzANS-A) zzMaintain zzstrict zzintake zzand
zzoutput.
And zzadolescent zzclient zzis zzadmitted zzto zzthe zzhospital zzbecause zzof zzwriting zza
zzsuicide zznote zzto zza zzteacher zzat zzschool. zzOn zzthe zzsecond zzday zzof
zzhospitalization, zzthe zznurse zzasked zzthe zzclient zzto zzmeet zzwith zzthe zztreatment
zzteam. zzAfter zzthe zzteam zzmeeting, zzthe zzclient zzleaves zzin zztears zzand zzgoes zzto
zztheir zzroom. zzWhich zznursing zzintervention zzis zzbest? zz
A) zzLet zzthe zzclient zzrest zzquietly zzin zztheir zzroom zzfor zza zzwhile. zz
B) zzExplore zzthe zzclients zzgoals zzand zzdesire zzfor zztreatment. zz
C) zzAsk zzthe zztreatment zzteam zzabout zzthe zzclients zzbehavior. zz
D) zzGo zzto zzthe zzclients zzroom zzand zzask zzwhat zzhappened. zz- zzANS-D) zzGo zzto
zzthe zzclients zzroom zzand zzask zzwhat zzhappened.
The zzhealthcare zzprovider zzprescribes zzdalteparin zz200 zzunits zzper zzkilogram
zzsubcutaneous zzonce zza zzday zzfor zza zzclient zzwho zzweighs zz154 zzpounds. zzThe
zzmedication zzis zzavailable zzand zz25,000 zzunits zzper zzmilliliter zzvial. zzHow zzmany
zzmilliliters zzshould zzthe zznurse zzadminister? zz(Enter zznumerical zzvalue zzonly. zzIf
zzrounding zzis zzrequired, zzround zzto zzthe zznearest zz10th.) zz- zzANS-0.6
NGN: zzThe zzclient zzis zza zz49-year-old zzmale zzwho zzreports zzflu zzlike zzsymptoms
zzincluding zzfever zzand zzchest zzcongestion zzfor zzfour zzdays. zzHe zzcame zzto zzthe
zzemergency zzdepartment zzlast zznight zzwhen zzhe zzwas zzhaving zzmore zzdifficulty
zzbreathing zzhe zzhas zza zzhistory zzof zz1/2 zzpack zza zzday zzcigarette zzsmoking zzfor zz20
zzyears. zzHe zzhas zzno zzsignificant zzmedical zzor zzsurgical zzhistory. zz
Which zztwo zzorders zzshould zzthe zznurse zzcomplete zzfirst? zz
A) zzSputum zzculture. zz
B) zzStart zzoxygen zz3 zzL zzper zzminute zzvia zznasal zzcannula. zz
C) zzPlace zzthe zzclient zzon zza zzcardio zzrespiratory zzmonitor. zz
D) zzChest zzx-ray. zz
E) zzAcetominophen zz350 zzmg zzPO zzevery zzsix zzhours zzfor zztemperature zzcontrol. zz
F) zzRun zz0.9% zzsodium zzchloride zzIV zzinfusion zzat zz150 zzmL zzper zzhour. zz
G) zzStart zzperipheral zzIV. zz
H) zzNPO. zz- zzANS-B) zzStart zzoxygen zz3 zzL zzper zzminute zzvia zznasal zzcannula. zz
C) zzPlace zzthe zzclient zzon zza zzcardio zzrespiratory zzmonitor.
NGN: zz0330: zzplace zzthe zzclient zzon zza zzcardio zzrespiratory zzmonitor, zzNPO, zzsputum
zzculture, zzstart zza zzperipheral zzIV zzinfusion, zzstart zzoxygen zz3 zzL zzper zzminute zzvia
zznasal zzcannula, zzbegin zz0.9% zzsodium zzchloride zzIV zzinfusion zzat zz150 zzmL zzper
zzhour, zzacetaminophen zz350 zzmg zzPO zzevery zzsix zzhours zzfor zztemperature.
,To zzstart zzthe zzclient zzon zzoxygen zzas zzordered zzwhich zzitems zzshould zzthe zznurse
zzcollects zzfrom zzthe zzsupply zzroom? zzSATA zz
A) zzhumidifier zzbottle. zz
B)Suction zzcanister. zz
C)Sterile zzwater. zz
D) zzNasal zzcannula. zz
E) zzFlow zzmeter. zz
F) zzLambs zzwool. zz
G) zzTape. zz- zzANS-D) zzNasal zzcannula. zz
E) zzFlow zzmeter.
NGN: zzstates, zzI zzam zzfeeling zzextremely zzanxious zzright zznow. zzThe zzclient zzhas
zzdecreased zzbreath zzsounds zzin zzthe zzleft zzlower zzlow. zzHis zzmucus zzmembranes
zzare zzdry. zzHe zzhas zza zzproductive zzcough zzwith zzthick, zzyellow zzsecretions. zzHis
zzcapillary zzrefill zzis zzfour zzseconds. zzVital zzsigns, zztemperature zz100.2. zzHeart zzrate
zz101 zzbpm, zzrespiratory zzrate zz28 zzbreaths zzper zzminute, zzblood zzpressure zz145/89,
zzoxygen zzsaturation zz90% zzon zzroom zzair.
(for zzeach zzbody zzsystem zzclick zzto zzspecify zzthe zzassessment zzfindings zzthat
zzindicates zzhypoxia)
Cardiovascular: zzheart zzrate zz100 zzbpm, zzcapillary zzrefill zzfor zzseconds, zzblood
zzpressure zz145/89.
Neurological: zzanxious, zzawake zzand zzalert, zzrestless.
Respiratory: zzoxygen zzsaturation zz90% zzon zzroom zzair, zzrespiratory zzrate zz28 zzbpm,
zzproductive zzcough. zz- zzANS-Cardiovascular: zzcapillary zzrefill zzfor zzseconds, zzblood
zzpressure zz145/89.
Neurological: zzanxious, zzrestless.
Respiratory: zzoxygen zzsaturation zz90% zzon zzroom zzair, zzrespiratory zzrate zz28 zzbpm.
NGN: zzThe zzclient zzis zza zz49-year-old zzmale zzwho zzreports zzflu zzlike zzsymptoms
zzincluding zzfever zzand zzchest zzcongestion zzfor zzfour zzdays. zzHe zzcame zzto zzthe
zzemergency zzdepartment zzlast zznight zzwhen zzhe zzwas zzhaving zzmore zzdifficulty
zzbreathing zzhe zzhas zza zzhistory zzof zz1/2 zzpack zza zzday zzcigarette zzsmoking zzfor zz20
zzyears. zzHe zzhas zzno zzsignificant zzmedical zzor zzsurgical zzhistory. zz
The zznurse zzshould zzplace zzthe zzclient zzin zza zz_______________ zzposition zzto
zzpromote zz_____________. zz- zzANS-Semi-Fowler zz, zzlung zzexpansion.
NGN: zzOrders: zz0330: zzplace zzthe zzclient zzon zza zzcardio zzrespiratory zzmonitor,
zzNPO, zzsputum zzculture, zzstart zza zzPIV, zzstart zzoxygen zz3L zzvia zznasal zzcannula,
zznormal zzsaline zz150 zzML zzper zzhour, zzacetaminophen zz350mg zzPO zzevery zzsix
zzhours zzfor zztemp zzgreater zzthan zz101F, zzchest zzx-ray.
0500: zzOxygen zz8Lvia zzsimple zzfacemask, zztitrate zzto zzkeep zzoxygen zzsaturation
zzgreater zzthan zz94%.
, (mark zzwhether zzthe zzstatements zzby zzthe zznew zzgrad zznurse zzindicate
zzunderstanding zzor zzno zzunderstanding zzof zzthe zzuse zzof zzfacemask zzin zzthe zzcare
zzof zzthis zzclient)
-I zzshould zzclean zzthe zzfacemask zzonce zzper zzshift.
-The zzclient zzshould zztake zza zz1 zzto zz2 zzminute zzbreak zzfrom zzthe zzfacemask zzeach
zzhour.
-I zzshould zzput zzgauze zzunder zzthe zzelastic zzstraps zzover zzthe zzears.
-I zzcan zzadjust zzthe zzoxygen zzlevel zzon zzthe zzflow zzmeter zzto zzkeep zzthe zzclients
zzoxygen zzsaturation zzgreater zzthan zz94%.
-The zzmask zzshould zzcover zzonly zzthe zzmouth zzand zzleave zzthe zznose zzopen zzfor
zzexpiration.
-I zzshould zzplace zzthe zzmask zzfirst zzover zzthe zznose zzand zzthen zzcover zzthe zzmouth.
zz- zzANS--I zzshould zzclean zzthe zzfacemask zzonce zzper zzshift. zz(UNDERSTANDING)
-The zzclient zzshould zztake zza zz1 zzto zz2 zzminute zzbreak zzfrom zzthe zzfacemask zzeach
zzhour. zz(NOT zzUNDERSTANDING)
-I zzshould zzput zzgauze zzunder zzthe zzelastic zzstraps zzover zzthe zzears. zz(NOT
zzUNDERSTANDING zz????)
-I zzcan zzadjust zzthe zzoxygen zzlevel zzon zzthe zzflow zzmeter zzto zzkeep zzthe zzclients
zzoxygen zzsaturation zzgreater zzthan zz94%. zz(UNDERSTANDING)
-The zzmask zzshould zzcover zzonly zzthe zzmouth zzand zzleave zzthe zznose zzopen zzfor
zzexpiration. zz(NOT zzUNDERSTANDING)
-I zzshould zzplace zzthe zzmask zzfirst zzover zzthe zznose zzand zzthen zzcover zzthe zzmouth.
zz(UNDERSTANDING)
NGN: zzNurses zzNotes: zz0400, zzthe zzclient zzis zzawake zzand zzalert zzbut zzrestless. zzHe
zzstates zzI zzam zzfeeling zzextremely zzanxious zzright zznow. zzThe zzclient zzhas
zzdecreased zzbreath zzsounds zzin zzthe zzleft zzlower zzlobe. zzHis zzmucus zzmembranes
zzare zzdry. zzHe zzhas zza zzproductive zzcough zzwith zzthick, zzyellow zzsecretions. zzHis
zzcapillary zzrefill zzis zzfour zzseconds. zzHeart zzrate zz101 zzBPM, zzoxygen zzsaturation
zz90%. zzBlood zzpressure zz145/89, zztemperature zz100.2 zzF, zzrespiratory zzrate zz28
zzBPM. zz
0500: zzPlacedthe zzclient zzin zzsemi-Fowlers zzposition. zzNo zzimprovement zzin zzoxygen
zzsaturation zzon zz3L zznasal zzcannula...
(Which zzare zzthe zzthree zzmost zzimportant zzgoals?)
A) zzThe zzclient zzwill zzremain zzfree zzof zzskin zzbreakdown.
B) zzThe zzclient zzwill zzhave zzquit zzsmoking.
C) zzThe zzclient zzwill zzbe zzafebrile zzfor zz24 zzhours.
D) zzThe zzclient zzwill zzmaintain zzoxygen zzsaturation zzof zz96% zzwithout zzsupplemental
zzoxygen.
E) zzThe zzclient zzwill zzreport zzpain zzless zzthan zz3/10. zz- zzANS-B) zzThe zzclient zzwill
zzhave zzquit zzsmoking.
C) zzThe zzclient zzwill zzbe zzafebrile zzfor zz24 zzhours.
E) zzThe zzclient zzwill zzreport zzpain zzless zzthan zz3/10.
WITH COMPLETE ANSWERS
When zzpreparing zzto zzadminister zza zzprescribed zzmedication zzto zza zzhomeless zzclient
zzat zza zzcommunity zzpsychiatric zzclinic. zzThe zzclient zztells zzthe zznurse zzthat zzthe
zzusual zzdosage zztaken zzis zzdifferent zzfrom zzthe zzdose zzthe zznurse zzis zzgiving.
zzWhich zzaction zzshould zzthe zznurse zztake? zz
A) zzInform zzthe zzclient zzthat zzhe zzmay zzrefuse zzthe zzmedication zzand zzdocument
zzwhether zzor zznot zzthe zzclient zztakes zzit. zz
B) zzWithhold zzthe zzmedication zzuntil zzthe zzdosage zzcan zzbe zzconfirmed. zz
C) zzExplain zzto zzthe zzclient zzthat zzthe zzdosage zzhas zzbeen zzchanged. zz
D) zzTell zzthe zzclient zzto zztake zzthe zzmedication zzthen zzverify zzthe zzdosage zzat zzthe
zznext zzhealthcare zzteam zzmeeting. zz- zzANS-B) zzWithhold zzthe zzmedication zzuntil zzthe
zzdosage zzcan zzbe zzconfirmed.
The zzcharge zznurse zzis zzmaking zzassignments zzfor zzone zzpractical zznurse zzand
zzthree zzregistered zznurses zzwho zzare zzcaring zzfor zzneurologically zzcompromised
zzclients. zzWhich zzclient zzwith zzwhich zzchange zzin zzstatus zzis zzbest zzto zzassign zzto
zzthe zzPN? zz
A) zzSubdural zzhematoma zzwhose zzblood zzpressure zzchanged zzfrom zz150/80 zzto
zz170/60.
B) zzViral zzmeningitis zzwhose zztemperature zzchange zzfrom zz101 zzS zzto zz102F. zz
C) zzDiabetic zzketo zzacidosis zzwho zzis zzGlasgow zzcoma zzscale zzscore zzchanged
zzfrom zz10 zzto zz7. zz
D) zzMyxedema, zzwhose zzblood zzpressure zzchange zzfrom zz80/50 zzto zz70/40. zz- zzANS-
B) zzViral zzmeningitis zzwhose zztemperature zzchange zzfrom zz101 zzS zzto zz102F.
The zznurse zzis zzcaring zzfor zza zzclient zzwith zzpneumonia zzwho zznow zzdevelops zzinitial
zzsigns zzof zzseptic zzshock zzand zzmulti zzorgan zzfailure. zzThe zzhealthcare zzprovider
zzprescribes zza zzsepsis zzprotocol. zzWhich zzintervention zzis zzmost zzimportant zzfor zzthe
zznurse zzto zzinclude zzin zzthe zzplan zzof zzcare? zz
,A) zzMaintain zzstrict zzintake zzand zzoutput. zz
B) zzKeep zzhead zzof zzbed zzraised zz45°. zz
C) zzExcess zzwarmth zzof zzextremities. zz
D) zzMonitor zzblood zzglucose zzlevel. zz- zzANS-A) zzMaintain zzstrict zzintake zzand
zzoutput.
And zzadolescent zzclient zzis zzadmitted zzto zzthe zzhospital zzbecause zzof zzwriting zza
zzsuicide zznote zzto zza zzteacher zzat zzschool. zzOn zzthe zzsecond zzday zzof
zzhospitalization, zzthe zznurse zzasked zzthe zzclient zzto zzmeet zzwith zzthe zztreatment
zzteam. zzAfter zzthe zzteam zzmeeting, zzthe zzclient zzleaves zzin zztears zzand zzgoes zzto
zztheir zzroom. zzWhich zznursing zzintervention zzis zzbest? zz
A) zzLet zzthe zzclient zzrest zzquietly zzin zztheir zzroom zzfor zza zzwhile. zz
B) zzExplore zzthe zzclients zzgoals zzand zzdesire zzfor zztreatment. zz
C) zzAsk zzthe zztreatment zzteam zzabout zzthe zzclients zzbehavior. zz
D) zzGo zzto zzthe zzclients zzroom zzand zzask zzwhat zzhappened. zz- zzANS-D) zzGo zzto
zzthe zzclients zzroom zzand zzask zzwhat zzhappened.
The zzhealthcare zzprovider zzprescribes zzdalteparin zz200 zzunits zzper zzkilogram
zzsubcutaneous zzonce zza zzday zzfor zza zzclient zzwho zzweighs zz154 zzpounds. zzThe
zzmedication zzis zzavailable zzand zz25,000 zzunits zzper zzmilliliter zzvial. zzHow zzmany
zzmilliliters zzshould zzthe zznurse zzadminister? zz(Enter zznumerical zzvalue zzonly. zzIf
zzrounding zzis zzrequired, zzround zzto zzthe zznearest zz10th.) zz- zzANS-0.6
NGN: zzThe zzclient zzis zza zz49-year-old zzmale zzwho zzreports zzflu zzlike zzsymptoms
zzincluding zzfever zzand zzchest zzcongestion zzfor zzfour zzdays. zzHe zzcame zzto zzthe
zzemergency zzdepartment zzlast zznight zzwhen zzhe zzwas zzhaving zzmore zzdifficulty
zzbreathing zzhe zzhas zza zzhistory zzof zz1/2 zzpack zza zzday zzcigarette zzsmoking zzfor zz20
zzyears. zzHe zzhas zzno zzsignificant zzmedical zzor zzsurgical zzhistory. zz
Which zztwo zzorders zzshould zzthe zznurse zzcomplete zzfirst? zz
A) zzSputum zzculture. zz
B) zzStart zzoxygen zz3 zzL zzper zzminute zzvia zznasal zzcannula. zz
C) zzPlace zzthe zzclient zzon zza zzcardio zzrespiratory zzmonitor. zz
D) zzChest zzx-ray. zz
E) zzAcetominophen zz350 zzmg zzPO zzevery zzsix zzhours zzfor zztemperature zzcontrol. zz
F) zzRun zz0.9% zzsodium zzchloride zzIV zzinfusion zzat zz150 zzmL zzper zzhour. zz
G) zzStart zzperipheral zzIV. zz
H) zzNPO. zz- zzANS-B) zzStart zzoxygen zz3 zzL zzper zzminute zzvia zznasal zzcannula. zz
C) zzPlace zzthe zzclient zzon zza zzcardio zzrespiratory zzmonitor.
NGN: zz0330: zzplace zzthe zzclient zzon zza zzcardio zzrespiratory zzmonitor, zzNPO, zzsputum
zzculture, zzstart zza zzperipheral zzIV zzinfusion, zzstart zzoxygen zz3 zzL zzper zzminute zzvia
zznasal zzcannula, zzbegin zz0.9% zzsodium zzchloride zzIV zzinfusion zzat zz150 zzmL zzper
zzhour, zzacetaminophen zz350 zzmg zzPO zzevery zzsix zzhours zzfor zztemperature.
,To zzstart zzthe zzclient zzon zzoxygen zzas zzordered zzwhich zzitems zzshould zzthe zznurse
zzcollects zzfrom zzthe zzsupply zzroom? zzSATA zz
A) zzhumidifier zzbottle. zz
B)Suction zzcanister. zz
C)Sterile zzwater. zz
D) zzNasal zzcannula. zz
E) zzFlow zzmeter. zz
F) zzLambs zzwool. zz
G) zzTape. zz- zzANS-D) zzNasal zzcannula. zz
E) zzFlow zzmeter.
NGN: zzstates, zzI zzam zzfeeling zzextremely zzanxious zzright zznow. zzThe zzclient zzhas
zzdecreased zzbreath zzsounds zzin zzthe zzleft zzlower zzlow. zzHis zzmucus zzmembranes
zzare zzdry. zzHe zzhas zza zzproductive zzcough zzwith zzthick, zzyellow zzsecretions. zzHis
zzcapillary zzrefill zzis zzfour zzseconds. zzVital zzsigns, zztemperature zz100.2. zzHeart zzrate
zz101 zzbpm, zzrespiratory zzrate zz28 zzbreaths zzper zzminute, zzblood zzpressure zz145/89,
zzoxygen zzsaturation zz90% zzon zzroom zzair.
(for zzeach zzbody zzsystem zzclick zzto zzspecify zzthe zzassessment zzfindings zzthat
zzindicates zzhypoxia)
Cardiovascular: zzheart zzrate zz100 zzbpm, zzcapillary zzrefill zzfor zzseconds, zzblood
zzpressure zz145/89.
Neurological: zzanxious, zzawake zzand zzalert, zzrestless.
Respiratory: zzoxygen zzsaturation zz90% zzon zzroom zzair, zzrespiratory zzrate zz28 zzbpm,
zzproductive zzcough. zz- zzANS-Cardiovascular: zzcapillary zzrefill zzfor zzseconds, zzblood
zzpressure zz145/89.
Neurological: zzanxious, zzrestless.
Respiratory: zzoxygen zzsaturation zz90% zzon zzroom zzair, zzrespiratory zzrate zz28 zzbpm.
NGN: zzThe zzclient zzis zza zz49-year-old zzmale zzwho zzreports zzflu zzlike zzsymptoms
zzincluding zzfever zzand zzchest zzcongestion zzfor zzfour zzdays. zzHe zzcame zzto zzthe
zzemergency zzdepartment zzlast zznight zzwhen zzhe zzwas zzhaving zzmore zzdifficulty
zzbreathing zzhe zzhas zza zzhistory zzof zz1/2 zzpack zza zzday zzcigarette zzsmoking zzfor zz20
zzyears. zzHe zzhas zzno zzsignificant zzmedical zzor zzsurgical zzhistory. zz
The zznurse zzshould zzplace zzthe zzclient zzin zza zz_______________ zzposition zzto
zzpromote zz_____________. zz- zzANS-Semi-Fowler zz, zzlung zzexpansion.
NGN: zzOrders: zz0330: zzplace zzthe zzclient zzon zza zzcardio zzrespiratory zzmonitor,
zzNPO, zzsputum zzculture, zzstart zza zzPIV, zzstart zzoxygen zz3L zzvia zznasal zzcannula,
zznormal zzsaline zz150 zzML zzper zzhour, zzacetaminophen zz350mg zzPO zzevery zzsix
zzhours zzfor zztemp zzgreater zzthan zz101F, zzchest zzx-ray.
0500: zzOxygen zz8Lvia zzsimple zzfacemask, zztitrate zzto zzkeep zzoxygen zzsaturation
zzgreater zzthan zz94%.
, (mark zzwhether zzthe zzstatements zzby zzthe zznew zzgrad zznurse zzindicate
zzunderstanding zzor zzno zzunderstanding zzof zzthe zzuse zzof zzfacemask zzin zzthe zzcare
zzof zzthis zzclient)
-I zzshould zzclean zzthe zzfacemask zzonce zzper zzshift.
-The zzclient zzshould zztake zza zz1 zzto zz2 zzminute zzbreak zzfrom zzthe zzfacemask zzeach
zzhour.
-I zzshould zzput zzgauze zzunder zzthe zzelastic zzstraps zzover zzthe zzears.
-I zzcan zzadjust zzthe zzoxygen zzlevel zzon zzthe zzflow zzmeter zzto zzkeep zzthe zzclients
zzoxygen zzsaturation zzgreater zzthan zz94%.
-The zzmask zzshould zzcover zzonly zzthe zzmouth zzand zzleave zzthe zznose zzopen zzfor
zzexpiration.
-I zzshould zzplace zzthe zzmask zzfirst zzover zzthe zznose zzand zzthen zzcover zzthe zzmouth.
zz- zzANS--I zzshould zzclean zzthe zzfacemask zzonce zzper zzshift. zz(UNDERSTANDING)
-The zzclient zzshould zztake zza zz1 zzto zz2 zzminute zzbreak zzfrom zzthe zzfacemask zzeach
zzhour. zz(NOT zzUNDERSTANDING)
-I zzshould zzput zzgauze zzunder zzthe zzelastic zzstraps zzover zzthe zzears. zz(NOT
zzUNDERSTANDING zz????)
-I zzcan zzadjust zzthe zzoxygen zzlevel zzon zzthe zzflow zzmeter zzto zzkeep zzthe zzclients
zzoxygen zzsaturation zzgreater zzthan zz94%. zz(UNDERSTANDING)
-The zzmask zzshould zzcover zzonly zzthe zzmouth zzand zzleave zzthe zznose zzopen zzfor
zzexpiration. zz(NOT zzUNDERSTANDING)
-I zzshould zzplace zzthe zzmask zzfirst zzover zzthe zznose zzand zzthen zzcover zzthe zzmouth.
zz(UNDERSTANDING)
NGN: zzNurses zzNotes: zz0400, zzthe zzclient zzis zzawake zzand zzalert zzbut zzrestless. zzHe
zzstates zzI zzam zzfeeling zzextremely zzanxious zzright zznow. zzThe zzclient zzhas
zzdecreased zzbreath zzsounds zzin zzthe zzleft zzlower zzlobe. zzHis zzmucus zzmembranes
zzare zzdry. zzHe zzhas zza zzproductive zzcough zzwith zzthick, zzyellow zzsecretions. zzHis
zzcapillary zzrefill zzis zzfour zzseconds. zzHeart zzrate zz101 zzBPM, zzoxygen zzsaturation
zz90%. zzBlood zzpressure zz145/89, zztemperature zz100.2 zzF, zzrespiratory zzrate zz28
zzBPM. zz
0500: zzPlacedthe zzclient zzin zzsemi-Fowlers zzposition. zzNo zzimprovement zzin zzoxygen
zzsaturation zzon zz3L zznasal zzcannula...
(Which zzare zzthe zzthree zzmost zzimportant zzgoals?)
A) zzThe zzclient zzwill zzremain zzfree zzof zzskin zzbreakdown.
B) zzThe zzclient zzwill zzhave zzquit zzsmoking.
C) zzThe zzclient zzwill zzbe zzafebrile zzfor zz24 zzhours.
D) zzThe zzclient zzwill zzmaintain zzoxygen zzsaturation zzof zz96% zzwithout zzsupplemental
zzoxygen.
E) zzThe zzclient zzwill zzreport zzpain zzless zzthan zz3/10. zz- zzANS-B) zzThe zzclient zzwill
zzhave zzquit zzsmoking.
C) zzThe zzclient zzwill zzbe zzafebrile zzfor zz24 zzhours.
E) zzThe zzclient zzwill zzreport zzpain zzless zzthan zz3/10.
