Hesi Management Exam 2024/2025 With 100% Correct
Answers
In application of the principles of pain treatment, what is the first consideration? - -
The client's perception of pain must be accepted.
The client must be believed, and his or her experience of pain must be acknowledged as
valid. The data gathered via client reports can then be applied to the other options in
developing the treatment plan.
When an analgesic is titrated to manage pain, what is the priority goal? - -Titrate to
the smallest dose that provides relief with the fewest side effects.
The goal is to control pain while minimizing side effects. For severe pain, the medication
can be titrated upward until the pain is controlled. Downward titration occurs when the
pain begins to subside. Adequate dosing is important; however, the concept of controlled
dosing applies more to potent vasoactive drugs.
Which client is at greatest risk for respiratory depression while receiving opioids for
analgesia? - -Child with an arm fracture and cystic fibrosis
At greatest risk are elderly clients, opiate-naive clients, and those with underlying
pulmonary disease. The child has two of the three risk factors.
A client is crying and grimacing but denies pain and refuses pain medication, because "my
sibling is a drug addict and has ruined our lives." What is the priority intervention for this
client? - -Encourage expression of fears and past experiences.
This client has strong beliefs and emotions related to the issue of the sibling's addiction.
First, encourage expression. This indicates to the client that the feelings are real and valid.
It is also an opportunity to assess beliefs and fears. Giving facts and information is
appropriate at the right time. Family involvement is important, but it should be kept in mind
that their beliefs about drug addiction may be similar to those of the client.
The physician has ordered a placebo for a client with chronic pain. You are a newly hired
nurse and you feel very uncomfortable administering the medication. What is the first
action that you should take? - -Contact the charge nurse for advice.
, Hesi Management Exam 2024/2025 With 100% Correct
Answers
Administering placebos is generally considered unethical. Consult the charge nurse as a
resource person who can help you clarify the situation and locate and review the hospital
policy. If the physician is insistent, suggest that he or she could give the placebo. (Note:
Use "could," not "should" when talking to the physician. This provides a small opportunity
to rethink the decision. "Should" is more commanding and elicits a more defensive
response.) While following your own ethical code is correct, you must ensure that the client
is not abandoned and that care continues.
For a cognitively impaired client who cannot accurately report pain, what is the first action
that you should take? - -Obtain baseline behavioral indicators from family members.
Complete information should be obtained from the family during the initial comprehensive
history taking and assessment. If this information is not obtained, the nursing staff will
have to rely on observation of nonverbal behavior and careful documentation to determine
pain and relief patterns.
Which patient is at greatest risk for pancreatic cancer? - -An elderly African-
American man who smokes
Pancreatic cancer is more common in African-Americans, males, and smokers. Other
associated factors include alcohol use, diabetes, obesity, history of pancreatitis, exposure
to organic chemicals, consumption of a high-fat diet, and previous abdominal irradiation.
Patients receiving chemotherapy are at risk for thrombocytopenia related to chemotherapy
or disease processes. Which actions are needed for patients who must be placed on
bleeding precautions? (Select all that apply.) - -Mouthwash should not include
alcohol, because it has a drying action that leaves mucous membranes more vulnerable.
Insertion of suppositories, probes, or tampons into the rectal or vaginal cavity is not
recommended. All other options are appropriate.
For care of a patient who has oral cancer, which task would be appropriate to delegate to
an LPN/LVN? - -Giving antacids and sucralfate suspension as ordered
Giving medications is within the scope of practice of the LPN/LVN. Assisting the patient in
brushing and flossing should be delegated to the UAP. Explaining contraindications is the
responsibility of the RN. Recommendations for saliva substitutes should come from the
physician or pharmacist.
, Hesi Management Exam 2024/2025 With 100% Correct
Answers
When staff assignments are made for the care of patients who are receiving chemotherapy,
what is the major consideration regarding chemotherapeutic drugs? - -During
preparation, drugs may be absorbed through the skin or inhaled.
Chemotherapy drugs should be given by nurses who have received additional training in
how to safely prepare and deliver the drugs and protect themselves and others from
exposure. The other options express concerns, but the general principles of drug
administration apply.
You are monitoring your patient who is at risk for spinal cord compression related to tumor
growth. Which patient statement is most likely to suggest an early manifestation? - -
"Last night my back really hurt, and I had trouble sleeping."
Back pain is an early sign of spinal cord compression occurring in 95% of patients. The
other symptoms are later signs.
You are caring for an older woman with hepatic cancer. The UAP informs you that the
patient's level of consciousness is diminished compared to earlier in the shift. Prioritize the
steps of assessment and intervention related to this patient's change of mental status. -
-Determine level of consciousness and responsiveness, and changes from baseline.
Oxygen should be administered immediately in the presence of respiratory distress or risk
for decreased oxygenation and perfusion. Pulse oximetry can be used for continuous
monitoring. Adequate pulse, blood pressure, and respirations are required for cerebral
perfusion. Increased temperature may signal infection or sepsis. Blood glucose levels
should be checked even if the patient is not diabetic. Severe hypoglycemia should be
immediately treated per protocol. A patent IV line may be needed for delivery of emergency
drugs. Electrolyte and ammonia levels are relevant data for this patient, and abnormalities
in these parameters may be contributing to change in mental status. (Note: Laboratory
results [i.e., electrolytes and ammonia levels] may be concurrently available; however, you
should train yourself to systematically look at data. Look at electrolytes first because these
are more commonly ordered. In some cases, you may actually have to remind the
physician to order the ammonia level if the patient with a hepatic disorder is having a
change in mental status.)
Which two cancer patients could potentially be placed together as roommates? - -A
patient who underwent debulking of a tumor to relieve pressure
A patient who has undergone laminectomy for spinal cord compression
Answers
In application of the principles of pain treatment, what is the first consideration? - -
The client's perception of pain must be accepted.
The client must be believed, and his or her experience of pain must be acknowledged as
valid. The data gathered via client reports can then be applied to the other options in
developing the treatment plan.
When an analgesic is titrated to manage pain, what is the priority goal? - -Titrate to
the smallest dose that provides relief with the fewest side effects.
The goal is to control pain while minimizing side effects. For severe pain, the medication
can be titrated upward until the pain is controlled. Downward titration occurs when the
pain begins to subside. Adequate dosing is important; however, the concept of controlled
dosing applies more to potent vasoactive drugs.
Which client is at greatest risk for respiratory depression while receiving opioids for
analgesia? - -Child with an arm fracture and cystic fibrosis
At greatest risk are elderly clients, opiate-naive clients, and those with underlying
pulmonary disease. The child has two of the three risk factors.
A client is crying and grimacing but denies pain and refuses pain medication, because "my
sibling is a drug addict and has ruined our lives." What is the priority intervention for this
client? - -Encourage expression of fears and past experiences.
This client has strong beliefs and emotions related to the issue of the sibling's addiction.
First, encourage expression. This indicates to the client that the feelings are real and valid.
It is also an opportunity to assess beliefs and fears. Giving facts and information is
appropriate at the right time. Family involvement is important, but it should be kept in mind
that their beliefs about drug addiction may be similar to those of the client.
The physician has ordered a placebo for a client with chronic pain. You are a newly hired
nurse and you feel very uncomfortable administering the medication. What is the first
action that you should take? - -Contact the charge nurse for advice.
, Hesi Management Exam 2024/2025 With 100% Correct
Answers
Administering placebos is generally considered unethical. Consult the charge nurse as a
resource person who can help you clarify the situation and locate and review the hospital
policy. If the physician is insistent, suggest that he or she could give the placebo. (Note:
Use "could," not "should" when talking to the physician. This provides a small opportunity
to rethink the decision. "Should" is more commanding and elicits a more defensive
response.) While following your own ethical code is correct, you must ensure that the client
is not abandoned and that care continues.
For a cognitively impaired client who cannot accurately report pain, what is the first action
that you should take? - -Obtain baseline behavioral indicators from family members.
Complete information should be obtained from the family during the initial comprehensive
history taking and assessment. If this information is not obtained, the nursing staff will
have to rely on observation of nonverbal behavior and careful documentation to determine
pain and relief patterns.
Which patient is at greatest risk for pancreatic cancer? - -An elderly African-
American man who smokes
Pancreatic cancer is more common in African-Americans, males, and smokers. Other
associated factors include alcohol use, diabetes, obesity, history of pancreatitis, exposure
to organic chemicals, consumption of a high-fat diet, and previous abdominal irradiation.
Patients receiving chemotherapy are at risk for thrombocytopenia related to chemotherapy
or disease processes. Which actions are needed for patients who must be placed on
bleeding precautions? (Select all that apply.) - -Mouthwash should not include
alcohol, because it has a drying action that leaves mucous membranes more vulnerable.
Insertion of suppositories, probes, or tampons into the rectal or vaginal cavity is not
recommended. All other options are appropriate.
For care of a patient who has oral cancer, which task would be appropriate to delegate to
an LPN/LVN? - -Giving antacids and sucralfate suspension as ordered
Giving medications is within the scope of practice of the LPN/LVN. Assisting the patient in
brushing and flossing should be delegated to the UAP. Explaining contraindications is the
responsibility of the RN. Recommendations for saliva substitutes should come from the
physician or pharmacist.
, Hesi Management Exam 2024/2025 With 100% Correct
Answers
When staff assignments are made for the care of patients who are receiving chemotherapy,
what is the major consideration regarding chemotherapeutic drugs? - -During
preparation, drugs may be absorbed through the skin or inhaled.
Chemotherapy drugs should be given by nurses who have received additional training in
how to safely prepare and deliver the drugs and protect themselves and others from
exposure. The other options express concerns, but the general principles of drug
administration apply.
You are monitoring your patient who is at risk for spinal cord compression related to tumor
growth. Which patient statement is most likely to suggest an early manifestation? - -
"Last night my back really hurt, and I had trouble sleeping."
Back pain is an early sign of spinal cord compression occurring in 95% of patients. The
other symptoms are later signs.
You are caring for an older woman with hepatic cancer. The UAP informs you that the
patient's level of consciousness is diminished compared to earlier in the shift. Prioritize the
steps of assessment and intervention related to this patient's change of mental status. -
-Determine level of consciousness and responsiveness, and changes from baseline.
Oxygen should be administered immediately in the presence of respiratory distress or risk
for decreased oxygenation and perfusion. Pulse oximetry can be used for continuous
monitoring. Adequate pulse, blood pressure, and respirations are required for cerebral
perfusion. Increased temperature may signal infection or sepsis. Blood glucose levels
should be checked even if the patient is not diabetic. Severe hypoglycemia should be
immediately treated per protocol. A patent IV line may be needed for delivery of emergency
drugs. Electrolyte and ammonia levels are relevant data for this patient, and abnormalities
in these parameters may be contributing to change in mental status. (Note: Laboratory
results [i.e., electrolytes and ammonia levels] may be concurrently available; however, you
should train yourself to systematically look at data. Look at electrolytes first because these
are more commonly ordered. In some cases, you may actually have to remind the
physician to order the ammonia level if the patient with a hepatic disorder is having a
change in mental status.)
Which two cancer patients could potentially be placed together as roommates? - -A
patient who underwent debulking of a tumor to relieve pressure
A patient who has undergone laminectomy for spinal cord compression
