HESI Fundamentals 2023/2024 exam Review

HESI Fundamentals 2023/2024 exam Review During a routine assessment, an obese 50-year-old client states, "I feel so unlovable because of my weight." Which is the best response by the nurse? A. Reassure the client that many obese people have concerns about sex. B. Remind the client that sexual relationships need not be affected by obesity. C. Determine the frequency of sexual intercourse. D. Ask the client to talk about specific concerns. Option D provides an opportunity for the client to verbalize concerns and provides the nurse with more assessment data. Options A and B may not be related to the current concern, assume that obesity is the problem, and are communication blocks. Option C may be appropriate after discussing the stated concerns. In assisting an older adult client prepare to take a tub bath, which nursing action is most important? A. Check the bath water temperature. B. Shut the bathroom door. C. Ensure that the client has voided. D. Provide extra towels. To prevent burns or excessive chilling, the nurse must check the bath water temperature. Options B, C, and D promote comfort and privacy and are important interventions but are of less priority than promoting safety. A nurse is working in an occupational health clinic when an employee walks in and states, "I was walking outside and I believe I was just struck by lightning." The client is alert but reports feeling faint. Which assessment will the nurse perform first? A. Pulse characteristics B. Open airway C. Entrance and exit wounds D. Cervical spine injury Lightning is a jolt of electrical current and can produce a "natural" defibrillation, so assessment of the pulse rate and regularity is a priority. Because the client is talking, he has an open airway so that assessment is not necessary. Assessing for options C and D should occur after assessing for adequate circulation. The nurse is evaluating the chart of a client scheduled for surgery in 1 hour. When viewing the consent form, the nurse notes the surgeon’s signature, but not the client’s signature. What steps must the nurse take? (Select all that apply.) A. Call the surgeon. B. Ask the client, “Did your surgeon explain the procedure to you?” C. Have the client’s spouse sign the form. D. Ask the client, “Do you have any questions?” E. Witness the signature. F. Obtain the consent. Correct Answer: B,D,E It is the surgeon’s responsibility to review the procedure with the client until the client has no further questions. The nurse can verify the review by the surgeon and ask if the client has any further questions. If the client has questions, the nurse must call in the surgeon. When the nurse signs the consent form, the nurse is witnessing the signature only.