Hesi Management Exam Questions with Certified
Solutions.
Terms in this set (84)
In application of the The client's perception of pain must be accepted.
principles of pain treatment,
what is the first
The client must be believed, and his or her experience of pain
consideration?
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 Titrate to the smallest dose that provides relief with the
to manage pain, what is the fewest side effects.
priority goal?
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.
Child with an arm fracture and cystic fibrosis
Which client is at greatest
risk for respiratory
At greatest risk are elderly clients, opiate-naive clients, and
depression while receiving
opioids for analgesia? those with underlying pulmonary disease.
The child has two of the three risk factors.
,A client is crying and Encourage expression of fears and past experiences.
grimacing but denies pain
and refuses pain medication,
This client has strong beliefs and emotions related to the
because "my sibling is a drug
issue of the sibling's addiction. First, encourage expression.
addict and has ruined our
This indicates to the client that the feelings are real and
lives." What is the priority
valid. It is also an opportunity to assess beliefs and fears.
intervention for this client?
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 Contact the charge nurse for advice.
placebo for a client with
chronic pain. You are a newly
Administering placebos is generally considered unethical.
hired nurse and you feel very
Consult the charge nurse as a resource person who can help
uncomfortable administering
you clarify the situation and locate and review the hospital
the medication. What is the
policy. If the physician is insistent, suggest that he or she
first action that you should
could give the placebo. (Note: Use "could," not "should"
take?
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.
Obtain baseline behavioral indicators from family members.
For a cognitively impaired Complete information should be obtained from the family
client who cannot accurately during the initial comprehensive history taking and
report pain, what is the first assessment. If this information is not obtained, the nursing
action that you should take? staff will have to rely on observation of nonverbal behavior
and careful documentation to determine pain and relief
patterns.
,Which patient is at greatest An elderly African-American man who smokes
risk for pancreatic cancer?
Pancreatic cancer is more common in AfricanAmericans,
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 Mouthwash should not include alcohol, because it has a
chemotherapy are at risk for drying action that leaves mucous membranes more
vulnerable. Insertion of suppositories, probes, or tampons
thrombocytopenia related to
into the rectal or vaginal cavity is not recommended. All
chemotherapy or disease other options are appropriate.
processes. Which actions are
needed for patients who
must be placed on bleeding
precautions? (Select all
that apply.)
For care of a patient who has Giving antacids and sucralfate suspension as ordered
oral cancer, which task would
be appropriate to delegate to
Giving medications is within the scope of practice of the
an LPN/LVN?
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.
During preparation, drugs may be absorbed through the skin
When staff assignments are or inhaled.
made for the care of patients
who are receiving
chemotherapy, what is the Chemotherapy drugs should be given by nurses who have
major consideration received additional training in how to safely prepare and
regarding chemotherapeutic deliver the drugs and protect themselves and others from
drugs? exposure. The other options express concerns, but the general
principles of drug administration apply.
, You are monitoring your "Last night my back really hurt, and I had trouble sleeping."
patient who is at risk for
spinal cord compression
Back pain is an early sign of spinal cord compression
related to tumor growth.
occurring in 95% of patients. The other symptoms are later
Which patient statement is
signs.
most likely to suggest an
early manifestation?
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
You are caring for an older
perfusion. Increased temperature may signal infection or
woman with hepatic cancer.
sepsis. Blood glucose levels should be checked even if the
The UAP informs you that
patient is not diabetic. Severe hypoglycemia should be
the patient's level of
immediately treated per protocol. A patent IV line may be
consciousness is diminished
needed for delivery of emergency drugs. Electrolyte and
compared to earlier in the
ammonia levels are relevant data for this patient, and
shift. Prioritize the steps of
abnormalities in these parameters may be contributing to
assessment and intervention
change in mental status. (Note: Laboratory results [i.e.,
related to this patient's
electrolytes and ammonia levels] may be concurrently
change of mental status.
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.)
Solutions.
Terms in this set (84)
In application of the The client's perception of pain must be accepted.
principles of pain treatment,
what is the first
The client must be believed, and his or her experience of pain
consideration?
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 Titrate to the smallest dose that provides relief with the
to manage pain, what is the fewest side effects.
priority goal?
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.
Child with an arm fracture and cystic fibrosis
Which client is at greatest
risk for respiratory
At greatest risk are elderly clients, opiate-naive clients, and
depression while receiving
opioids for analgesia? those with underlying pulmonary disease.
The child has two of the three risk factors.
,A client is crying and Encourage expression of fears and past experiences.
grimacing but denies pain
and refuses pain medication,
This client has strong beliefs and emotions related to the
because "my sibling is a drug
issue of the sibling's addiction. First, encourage expression.
addict and has ruined our
This indicates to the client that the feelings are real and
lives." What is the priority
valid. It is also an opportunity to assess beliefs and fears.
intervention for this client?
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 Contact the charge nurse for advice.
placebo for a client with
chronic pain. You are a newly
Administering placebos is generally considered unethical.
hired nurse and you feel very
Consult the charge nurse as a resource person who can help
uncomfortable administering
you clarify the situation and locate and review the hospital
the medication. What is the
policy. If the physician is insistent, suggest that he or she
first action that you should
could give the placebo. (Note: Use "could," not "should"
take?
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.
Obtain baseline behavioral indicators from family members.
For a cognitively impaired Complete information should be obtained from the family
client who cannot accurately during the initial comprehensive history taking and
report pain, what is the first assessment. If this information is not obtained, the nursing
action that you should take? staff will have to rely on observation of nonverbal behavior
and careful documentation to determine pain and relief
patterns.
,Which patient is at greatest An elderly African-American man who smokes
risk for pancreatic cancer?
Pancreatic cancer is more common in AfricanAmericans,
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 Mouthwash should not include alcohol, because it has a
chemotherapy are at risk for drying action that leaves mucous membranes more
vulnerable. Insertion of suppositories, probes, or tampons
thrombocytopenia related to
into the rectal or vaginal cavity is not recommended. All
chemotherapy or disease other options are appropriate.
processes. Which actions are
needed for patients who
must be placed on bleeding
precautions? (Select all
that apply.)
For care of a patient who has Giving antacids and sucralfate suspension as ordered
oral cancer, which task would
be appropriate to delegate to
Giving medications is within the scope of practice of the
an LPN/LVN?
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.
During preparation, drugs may be absorbed through the skin
When staff assignments are or inhaled.
made for the care of patients
who are receiving
chemotherapy, what is the Chemotherapy drugs should be given by nurses who have
major consideration received additional training in how to safely prepare and
regarding chemotherapeutic deliver the drugs and protect themselves and others from
drugs? exposure. The other options express concerns, but the general
principles of drug administration apply.
, You are monitoring your "Last night my back really hurt, and I had trouble sleeping."
patient who is at risk for
spinal cord compression
Back pain is an early sign of spinal cord compression
related to tumor growth.
occurring in 95% of patients. The other symptoms are later
Which patient statement is
signs.
most likely to suggest an
early manifestation?
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
You are caring for an older
perfusion. Increased temperature may signal infection or
woman with hepatic cancer.
sepsis. Blood glucose levels should be checked even if the
The UAP informs you that
patient is not diabetic. Severe hypoglycemia should be
the patient's level of
immediately treated per protocol. A patent IV line may be
consciousness is diminished
needed for delivery of emergency drugs. Electrolyte and
compared to earlier in the
ammonia levels are relevant data for this patient, and
shift. Prioritize the steps of
abnormalities in these parameters may be contributing to
assessment and intervention
change in mental status. (Note: Laboratory results [i.e.,
related to this patient's
electrolytes and ammonia levels] may be concurrently
change of mental status.
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.)
