Module 5: Management of Care [HESI] questions
and answers 2024\2025 A+ Grade
A registered nurse (RN) must determine how best to assign co-workers (another RN and one licensed
practical nurse [LPN]) to provide care to a group of clients. Which of the following is the best
assignment?
- correct answer The RN is assigned to care for a woman with newly diagnosed leukemia who has a
newborn at home.
Rationale: To determine what may and may not be delegated to the various co-worker, the RN making
the assignment must take into account several factors: the level of care required by each client, both
immediately and in the future; the competencies possessed by the co-workers; and the legal limitations
on the practice of those co-workers. Self administration of insulin and discharge instructions on dressing
changes and medications require teaching, a professional responsibility that the RN may not delegate to
anyone except another RN.
A man who is visiting his wife in a LT care facility for people with Alzheimer's disease collapses and is
transported to a hospital. The client remains unconscious, and testing reveals that he has cancer that
has metastasized to bone, brain, and liver. The nursing staff at wife's care facility report to the hospital
physician that the client has no other family members and that his wife is mentally incompetent. What
information regarding DNR orders does the nurse remember?
- correct answer That a DNR order may be written by a client's physician.
Rationale: In a situation in which a client has no family members who can provide permission for
treatment, the physician may write a DNR order if he or she is reasonably and medically certain that
resuscitation would be futile.
A registered nurse (RN) is supervising a nursing assistant ambulating a client with right-sided weakness.
The RN would conclude that the nursing assistant is performing the procedure incorrectly after
observing that the nursing assistant
- correct answer Stands behind the client
,Rationale: When walking with a client, the nurse should stand on the affected side and grasp the
security belt in the mid-spine area of the small of the client's back. The nurse should position the free
hand at the shoulder area so that the client may be pulled toward the nurse in the event that there is a
forward fall. The client is instructed to look up and outward rather than at his or her feet.
A nurse manager has announced a change to computerized documentation of nursing care. A licensed
practical nurse (LPN) on the team, resistant to the change, is not taking an active part in facilitating
implementation of the new procedure. Which of the following strategies would be the best approach to
dealing with the conflict?
- correct answer Confronting the LPN and encouraging him to express his feelings regarding the change
Rationale: Confrontation is an important strategy in dealing with resistance. Face-to-face meetings to
confront the issue at hand allow verbalization of feelings, identification of problems and issues, and
development of strategies to solve the problem.
A nurse and a nursing assistant enter a client's room to provide care and find the client lying on the
floor. The nurse should first
- correct answer Check the client's LOC and VS
Rationale: When a client sustains a fall, the nurse must first assess the client. The nurse should check the
client's level of consciousness and vital signs and look for any bruises or injuries sustained in the fall.
A nurse is taking a morning break with the unit secretary in the nurses' lounge. The unit secretary says
to the nurse, "I read in Mr. Gage's medical record that he has gonorrhea." How should the nurse
respond to the secretary?
- correct answer "We can't discuss a client's medical condition."
Rationale: A client's medical condition is confidential and should never be discussed with anyone other
than the client and the client's HCP.
A married couple is attending a hospital program about in vitro fertilization. During the program, a crew
from a local television station arrives to film the proceedings because the station is publicizing a series
on hospital services. The nurse conducting the program should
- correct answer Explain to the television crew that videotaping is not allowed.
, Rationale: Privacy is a client's right to be free from unwanted intrusion into his or her private affairs.
Videotaping constitutes an invasion of a client's privacy, and written permission is required from the
client for an action such as photographing or videotaping. Therefore the nurse must explain to the
television crew that videotaping is not allowed.
A nurse on the day shift is assigned to care for four clients. List the clients in order of priority for nurse.
- correct answer A client with asthma who had shortness of breath during the night
A client scheduled to have a chest x-ray at 9 am
A client scheduled for an echocardiogram at 10 am
A client with pneumonia who is scheduled for discharge home
Rationale: Airway is always the priority, so the nurse would first assess the client with asthma who had
shortness of breath during the night. The nurse would next assess the client scheduled for a chest x-ray,
because the x-ray is scheduled at 9 am and the nurse would want to gather data about the client before
the client leaves the nursing unit. Next the nurse would assess the client scheduled for an
echocardiogram at 10 am, and finally the nurse would care for the client scheduled for discharge. The
client being discharged will have needs that must be addressed, but there is nothing in the question to
indicate that the client must have his or her discharge needs addressed by a specific time.
An emergency department nurse is performing an assessment of a client who has sustained
circumferential burns of both legs. What should the nurse assess first?
- correct answer Peripheral Pulses
Rationale: The client who has sustained circumferential burns to the extremities is at risk for altered
peripheral circulation. The priority assessment is to check the peripheral pulses to ensure that
circulation is adequate. Although the heart rate and BP would also be assessed, the priority with a
circumferential extremity burn is the assessment of peripheral pulses.
A registered nurse (RN) is planning client assignments for the day. Which clients should the nurse assign
to a nursing assistant (unlicensed assistive personnel)? Select all that apply.
- correct answer A client who requires transport to the radiology department in a wheelchair
and answers 2024\2025 A+ Grade
A registered nurse (RN) must determine how best to assign co-workers (another RN and one licensed
practical nurse [LPN]) to provide care to a group of clients. Which of the following is the best
assignment?
- correct answer The RN is assigned to care for a woman with newly diagnosed leukemia who has a
newborn at home.
Rationale: To determine what may and may not be delegated to the various co-worker, the RN making
the assignment must take into account several factors: the level of care required by each client, both
immediately and in the future; the competencies possessed by the co-workers; and the legal limitations
on the practice of those co-workers. Self administration of insulin and discharge instructions on dressing
changes and medications require teaching, a professional responsibility that the RN may not delegate to
anyone except another RN.
A man who is visiting his wife in a LT care facility for people with Alzheimer's disease collapses and is
transported to a hospital. The client remains unconscious, and testing reveals that he has cancer that
has metastasized to bone, brain, and liver. The nursing staff at wife's care facility report to the hospital
physician that the client has no other family members and that his wife is mentally incompetent. What
information regarding DNR orders does the nurse remember?
- correct answer That a DNR order may be written by a client's physician.
Rationale: In a situation in which a client has no family members who can provide permission for
treatment, the physician may write a DNR order if he or she is reasonably and medically certain that
resuscitation would be futile.
A registered nurse (RN) is supervising a nursing assistant ambulating a client with right-sided weakness.
The RN would conclude that the nursing assistant is performing the procedure incorrectly after
observing that the nursing assistant
- correct answer Stands behind the client
,Rationale: When walking with a client, the nurse should stand on the affected side and grasp the
security belt in the mid-spine area of the small of the client's back. The nurse should position the free
hand at the shoulder area so that the client may be pulled toward the nurse in the event that there is a
forward fall. The client is instructed to look up and outward rather than at his or her feet.
A nurse manager has announced a change to computerized documentation of nursing care. A licensed
practical nurse (LPN) on the team, resistant to the change, is not taking an active part in facilitating
implementation of the new procedure. Which of the following strategies would be the best approach to
dealing with the conflict?
- correct answer Confronting the LPN and encouraging him to express his feelings regarding the change
Rationale: Confrontation is an important strategy in dealing with resistance. Face-to-face meetings to
confront the issue at hand allow verbalization of feelings, identification of problems and issues, and
development of strategies to solve the problem.
A nurse and a nursing assistant enter a client's room to provide care and find the client lying on the
floor. The nurse should first
- correct answer Check the client's LOC and VS
Rationale: When a client sustains a fall, the nurse must first assess the client. The nurse should check the
client's level of consciousness and vital signs and look for any bruises or injuries sustained in the fall.
A nurse is taking a morning break with the unit secretary in the nurses' lounge. The unit secretary says
to the nurse, "I read in Mr. Gage's medical record that he has gonorrhea." How should the nurse
respond to the secretary?
- correct answer "We can't discuss a client's medical condition."
Rationale: A client's medical condition is confidential and should never be discussed with anyone other
than the client and the client's HCP.
A married couple is attending a hospital program about in vitro fertilization. During the program, a crew
from a local television station arrives to film the proceedings because the station is publicizing a series
on hospital services. The nurse conducting the program should
- correct answer Explain to the television crew that videotaping is not allowed.
, Rationale: Privacy is a client's right to be free from unwanted intrusion into his or her private affairs.
Videotaping constitutes an invasion of a client's privacy, and written permission is required from the
client for an action such as photographing or videotaping. Therefore the nurse must explain to the
television crew that videotaping is not allowed.
A nurse on the day shift is assigned to care for four clients. List the clients in order of priority for nurse.
- correct answer A client with asthma who had shortness of breath during the night
A client scheduled to have a chest x-ray at 9 am
A client scheduled for an echocardiogram at 10 am
A client with pneumonia who is scheduled for discharge home
Rationale: Airway is always the priority, so the nurse would first assess the client with asthma who had
shortness of breath during the night. The nurse would next assess the client scheduled for a chest x-ray,
because the x-ray is scheduled at 9 am and the nurse would want to gather data about the client before
the client leaves the nursing unit. Next the nurse would assess the client scheduled for an
echocardiogram at 10 am, and finally the nurse would care for the client scheduled for discharge. The
client being discharged will have needs that must be addressed, but there is nothing in the question to
indicate that the client must have his or her discharge needs addressed by a specific time.
An emergency department nurse is performing an assessment of a client who has sustained
circumferential burns of both legs. What should the nurse assess first?
- correct answer Peripheral Pulses
Rationale: The client who has sustained circumferential burns to the extremities is at risk for altered
peripheral circulation. The priority assessment is to check the peripheral pulses to ensure that
circulation is adequate. Although the heart rate and BP would also be assessed, the priority with a
circumferential extremity burn is the assessment of peripheral pulses.
A registered nurse (RN) is planning client assignments for the day. Which clients should the nurse assign
to a nursing assistant (unlicensed assistive personnel)? Select all that apply.
- correct answer A client who requires transport to the radiology department in a wheelchair
