HESI - Medical Surgical Nursing test with
questions & veried answers already graded
A+
When describing patient education approaches, the nurse educator would
explain that informal teaching is an approach that
a. follows formalized plans
b. has standardized content
c. often occurs one-to-one
d. addresses group needs - ANSWER>>C. Informal teaching is
individualized one on one teaching which represents the majority of patient
education done by nurses that occurs when an intervention is explained or
a question is answered. Group needs are often the focus of formal patient
education courses or classes. Informal teaching does not necessarily follow
a specific formalized plan. It may be planned with specific content, but it is
individualized responses to patient needs. Formal teaching involves the use
of a curriculum/course plan with standardized content.
A patient expresses a strong interest in returning to their work, family, and
hobbies after having a stroke. Which theory type would the nurse use to
develop a plan of care for the best results of this patient's motivation style?
a. field
,b. biological
c. cognitive
d. sociologic - ANSWER>>C. Cognitive theorists believe that attention,
relevance, confidence, and satisfaction (ARCS) are the conditions that, when
integrated, motivate someone to learn. Field theorists place significance on
how achievement, power, the need for affiliation, and avoidance motives
influence individual behavior. Sociologic theories are not involved in
motivation.
The nurse is assessing a group of clients. Which clients are at greater risk
for hypothermia or frostbite? (select all that apply)
a. an older woman with hypertension
b. a young man with a body mass index of 42
c. a young many who has just consumed six martinis
d. an older man who smokes a pack of cigarettes a day
e. a young woman who is anorexic
f. a young woman who is diabetic - ANSWER>>C, D, E, F
clients with poor nutrition, fatigue, and multiple chronic illnesses are at
greater risk for hypothermia. Clients who smoke, consume alcohol, or have
impaired peripheral circulation have a higher incidence of frostbite.
Which statement made by a nurse represents the need for further
education regarding pain management in older adult clients?
,a. older adults tend to report pain less often than younger adults
b. older clients usually have more experience with pain than younger clients
c. older adults are at greatest risk for under treated pain
d. older clients have a different pain mechanism and do not feel it as much
- ANSWER>>D
There is no evidence to support the idea that older adult clients perceive
pain any differently than younger clients. The other statements are accurate
regarding older clients and pain.
The nurse is working at a first aid booth for a spring training game on a hot
day. A spectator comes in, reporting that he is not feeling well. Vital signs
are temp 104.1 F, pulse 132 BPM, respirs 26 breaths/min, and blood
pressure 106/66 mm Hg. He trips over his feet as the nurse leads him to a
cot. What is the priory action of the nurse?
a. admin tylenol 650 mg orally
b. encourage rest, and reassess in 15 minutes
c. sponge the victim with cool water and remove his shirt
d. encourage drinking of cool water or sports drink - ANSWER>>C
The spectator shows signs of heat stroke, which is a medical emergency.
The spectator should be transported to the ED ASAP. The nurs should take
actions to lower his body temp in teh meantime by removing his shirt and
, sponging his body with cool water. Lowering body temp by drinking cool
fluids or taking acetaminophen is not as effective in an emergency
situation. The client needs to be cooled quickly and is a priority for
treatment
The client is receiving an IV of 60 mEq of potassium chloride ina 1000 mL
solution of dextrose 5% in 0.45% saline. The client states that the area
around the IV site burns. What intervention does the nurse perform first?
a. assess for a blood return
b. notify the physician
c. document the finding
d. stop the IV infusion - ANSWER>>D
Potassium is a severe tissue irritant. The safest action is to discontinue the
solution that contains the potassium and discontinue the IV altogether, in
which case the client would need another site started. Assessing for a blood
return may or may not be successful. The solution could be diluted (less
potassium) and the rate could be slowed once it is determined that the
needle is in the vein.
A nurse is caring for an older adult client who lives alone. Which economic
situation presents the most serious problem for this client?
a. costs of creating a living will
b. stock market fluctuations
questions & veried answers already graded
A+
When describing patient education approaches, the nurse educator would
explain that informal teaching is an approach that
a. follows formalized plans
b. has standardized content
c. often occurs one-to-one
d. addresses group needs - ANSWER>>C. Informal teaching is
individualized one on one teaching which represents the majority of patient
education done by nurses that occurs when an intervention is explained or
a question is answered. Group needs are often the focus of formal patient
education courses or classes. Informal teaching does not necessarily follow
a specific formalized plan. It may be planned with specific content, but it is
individualized responses to patient needs. Formal teaching involves the use
of a curriculum/course plan with standardized content.
A patient expresses a strong interest in returning to their work, family, and
hobbies after having a stroke. Which theory type would the nurse use to
develop a plan of care for the best results of this patient's motivation style?
a. field
,b. biological
c. cognitive
d. sociologic - ANSWER>>C. Cognitive theorists believe that attention,
relevance, confidence, and satisfaction (ARCS) are the conditions that, when
integrated, motivate someone to learn. Field theorists place significance on
how achievement, power, the need for affiliation, and avoidance motives
influence individual behavior. Sociologic theories are not involved in
motivation.
The nurse is assessing a group of clients. Which clients are at greater risk
for hypothermia or frostbite? (select all that apply)
a. an older woman with hypertension
b. a young man with a body mass index of 42
c. a young many who has just consumed six martinis
d. an older man who smokes a pack of cigarettes a day
e. a young woman who is anorexic
f. a young woman who is diabetic - ANSWER>>C, D, E, F
clients with poor nutrition, fatigue, and multiple chronic illnesses are at
greater risk for hypothermia. Clients who smoke, consume alcohol, or have
impaired peripheral circulation have a higher incidence of frostbite.
Which statement made by a nurse represents the need for further
education regarding pain management in older adult clients?
,a. older adults tend to report pain less often than younger adults
b. older clients usually have more experience with pain than younger clients
c. older adults are at greatest risk for under treated pain
d. older clients have a different pain mechanism and do not feel it as much
- ANSWER>>D
There is no evidence to support the idea that older adult clients perceive
pain any differently than younger clients. The other statements are accurate
regarding older clients and pain.
The nurse is working at a first aid booth for a spring training game on a hot
day. A spectator comes in, reporting that he is not feeling well. Vital signs
are temp 104.1 F, pulse 132 BPM, respirs 26 breaths/min, and blood
pressure 106/66 mm Hg. He trips over his feet as the nurse leads him to a
cot. What is the priory action of the nurse?
a. admin tylenol 650 mg orally
b. encourage rest, and reassess in 15 minutes
c. sponge the victim with cool water and remove his shirt
d. encourage drinking of cool water or sports drink - ANSWER>>C
The spectator shows signs of heat stroke, which is a medical emergency.
The spectator should be transported to the ED ASAP. The nurs should take
actions to lower his body temp in teh meantime by removing his shirt and
, sponging his body with cool water. Lowering body temp by drinking cool
fluids or taking acetaminophen is not as effective in an emergency
situation. The client needs to be cooled quickly and is a priority for
treatment
The client is receiving an IV of 60 mEq of potassium chloride ina 1000 mL
solution of dextrose 5% in 0.45% saline. The client states that the area
around the IV site burns. What intervention does the nurse perform first?
a. assess for a blood return
b. notify the physician
c. document the finding
d. stop the IV infusion - ANSWER>>D
Potassium is a severe tissue irritant. The safest action is to discontinue the
solution that contains the potassium and discontinue the IV altogether, in
which case the client would need another site started. Assessing for a blood
return may or may not be successful. The solution could be diluted (less
potassium) and the rate could be slowed once it is determined that the
needle is in the vein.
A nurse is caring for an older adult client who lives alone. Which economic
situation presents the most serious problem for this client?
a. costs of creating a living will
b. stock market fluctuations
