MEDICAL SURGICAL
NURSING
CONCEPTS FOR
INTERPROFESSIONAL
COLLABORATIVE CARE
(HESI)
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 - CORRECT 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 aoften athe
afocus aof aformal apatient aeducation acourses aor aclasses. aInformal ateaching adoes anot
anecessarily afollow aa aspecific aformalized aplan. aIt amay abe aplanned awith aspecific acontent,
abut ait ais aindividualized aresponses ato apatient aneeds. aFormal ateaching ainvolves athe ause
aof aa acurriculum/course aplan awith astandardized acontent.
A apatient aexpresses aa astrong ainterest ain areturning ato atheir awork, afamily, aand ahobbies
aafter ahaving aa astroke. aWhich atheory atype awould athe anurse ause ato adevelop aa aplan aof
acare afor athe abest aresults aof athis apatient's amotivation astyle?
a. field
b. biological
c. cognitive
,d. sociologic a- aCORRECT aANSWER a-C. aCognitive atheorists abelieve athat aattention,
arelevance, aconfidence, aand asatisfaction a(ARCS) aare athe aconditions athat, awhen
aintegrated, amotivate asomeone ato alearn. aField atheorists aplace asignificance aon ahow
aachievement, apower, athe aneed afor aaffiliation, aand aavoidance amotives ainfluence aindividual
abehavior. aSociologic atheories aare anot ainvolved ain amotivation.
The anurse ais aassessing aa agroup aof aclients. aWhich aclients aare aat agreater arisk afor
ahypothermia aor afrostbite? a(select aall athat aapply)
a. an aolder awoman awith ahypertension
b. a ayoung aman awith aa abody amass aindex aof a42
c. a ayoung amany awho ahas ajust aconsumed asix amartinis
d. an aolder aman awho asmokes aa apack aof acigarettes aa aday
e. a ayoung awoman awho ais aanorexic
f. a ayoung awoman awho ais adiabetic a- aCORRECT aANSWER a-C, aD, aE, aF
clients awith apoor anutrition, afatigue, aand amultiple achronic aillnesses aare aat agreater arisk afor
ahypothermia. aClients awho asmoke, aconsume aalcohol, aor ahave aimpaired aperipheral
acirculation ahave aa ahigher aincidence aof afrostbite.
Which astatement amade aby aa anurse arepresents athe aneed afor afurther aeducation aregarding
apain amanagement ain aolder aadult aclients?
a. older aadults atend ato areport apain aless aoften athan ayounger aadults
b. older aclients ausually ahave amore aexperience awith apain athan ayounger aclients
c. older aadults aare aat agreatest arisk afor aunder atreated apain
d. older aclients ahave aa adifferent apain amechanism aand ado anot afeel ait aas amuch a- aCORRECT
aANSWER a-D
There ais ano aevidence ato asupport athe aidea athat aolder aadult aclients aperceive apain aany
adifferently athan ayounger aclients. aThe aother astatements aare aaccurate aregarding aolder
aclients aand apain.
,The anurse ais aworking aat aa afirst aaid abooth afor aa aspring atraining agame aon aa ahot aday. aA
aspectator acomes ain, areporting athat ahe ais anot afeeling awell. aVital asigns aare atemp a104.1 aF,
apulse a132 aBPM, arespirs a26 abreaths/min, aand ablood apressure a106/66 amm aHg. aHe atrips
aover ahis afeet aas athe anurse aleads ahim ato aa acot. aWhat ais athe apriory aaction aof athe anurse?
a. admin atylenol a650 amg aorally
b. encourage arest, aand areassess ain a15 aminutes
c. sponge athe avictim awith acool awater aand aremove ahis ashirt
d. encourage adrinking aof acool awater aor asports adrink a- aCORRECT aANSWER a-C
The aspectator ashows asigns aof aheat astroke, awhich ais aa amedical aemergency. aThe
aspectator ashould abe atransported ato athe aED aASAP. aThe anurs ashould atake aactions ato
alower ahis abody atemp ain ateh ameantime aby aremoving ahis ashirt aand asponging ahis abody
awith acool awater. aLowering abody atemp aby adrinking acool afluids aor ataking aacetaminophen
ais anot aas aeffective ain aan aemergency asituation. aThe aclient aneeds ato abe acooled aquickly
aand ais aa apriority afor atreatment
The aclient ais areceiving aan aIV aof a60 amEq aof apotassium achloride aina a1000 amL asolution
aof adextrose a5% ain a0.45% asaline. aThe aclient astates athat athe aarea aaround athe aIV asite
aburns. aWhat aintervention adoes athe anurse aperform afirst?
a. assess afor aa ablood areturn
b. notify athe aphysician
c. document athe afinding
d. stop athe aIV ainfusion a- aCORRECT aANSWER a-D
Potassium ais aa asevere atissue airritant. aThe asafest aaction ais ato adiscontinue athe asolution
athat acontains athe apotassium aand adiscontinue athe aIV aaltogether, ain awhich acase athe
aclient awould aneed aanother asite astarted. aAssessing afor aa ablood areturn amay aor amay anot
abe asuccessful. aThe asolution acould abe adiluted a(less apotassium) aand athe arate acould abe
aslowed aonce ait ais adetermined athat athe aneedle ais ain athe avein.
, A anurse ais acaring afor aan aolder aadult aclient awho alives aalone. aWhich aeconomic asituation
apresents athe amost aserious aproblem afor athis aclient?
a. costs aof acreating aa aliving awill
b. stock amarket afluctuations
c. increased aprovider abenefits
d. social asecurity aas athe abasis aof aincome a- aCORRECT aANSWER a-D
Older aadults aon afixed aincomes aare aunable ato aadjust atheir aincome ato ameet arising acosts
aassociated awith ameeting abasic aneeds
Controlling apain ais aimportant ato apromoting awellness. aUnrelieved apain ahas abeen aassociated
awith
a. prolonged astress aresponse aand aa acascade aof aharmful aeffects asystem awide.
b. decreased atumor agrowth aand alongevity
c. large atidal avolumes aand adecreased alung acapacity
d. decreased acarbohydrate, aprotein, aand afat adestruction a- aCORRECT aANSWER a-A
Pain atriggers aa anumber aof aphysiologic astress aresponses ain athe ahuman abody. aUnrelieved
apain acan aprolong athe astress aresponse aand aproduce aa acascade aof aharmful aeffects ain aall
abody asystems. aThe astress aresponse acauses athe aendocrine asystem ato arelease aexcessive
aamounts aof ahormones, asuch aas acortisol, acatecholamines, aand aglucagon. aInsulin aand
atestosterone alevels adecrease. aIncreased aendocrine aactivity ain aturn ainitiates aa anumber aof
ametabolic aprocesses, ain aparticular, aaccelerated acarbohydrate, aprotein, aand afat
adestruction, awhcih acan aresult ain aweight aloss, atachycardia, aincreased arespiratory arate,
ashock, aand aeven adeath. aThe aimmune asystem ais aalso aaffected aby apain aas ademonstrated
aby aresearch ashowing aa alink abetween aunrelieved apain aand aa ahigher aincidence aof
anosocomial ainfections aand aincreased atumor agrowth. aLarge atidal avolumes aare anot
aassociated awith apain awhile adecreased alung acapacity ais aassociated awith aunrelieved apain.
aDecreased atumor agrowth aand alongevity aare anot aassociated awith aunrelieved apain.
aDecreased acarbs, aprotein, aand afat aare anot aassociated awith apain aor astress aresponse.
NURSING
CONCEPTS FOR
INTERPROFESSIONAL
COLLABORATIVE CARE
(HESI)
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 - CORRECT 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 aoften athe
afocus aof aformal apatient aeducation acourses aor aclasses. aInformal ateaching adoes anot
anecessarily afollow aa aspecific aformalized aplan. aIt amay abe aplanned awith aspecific acontent,
abut ait ais aindividualized aresponses ato apatient aneeds. aFormal ateaching ainvolves athe ause
aof aa acurriculum/course aplan awith astandardized acontent.
A apatient aexpresses aa astrong ainterest ain areturning ato atheir awork, afamily, aand ahobbies
aafter ahaving aa astroke. aWhich atheory atype awould athe anurse ause ato adevelop aa aplan aof
acare afor athe abest aresults aof athis apatient's amotivation astyle?
a. field
b. biological
c. cognitive
,d. sociologic a- aCORRECT aANSWER a-C. aCognitive atheorists abelieve athat aattention,
arelevance, aconfidence, aand asatisfaction a(ARCS) aare athe aconditions athat, awhen
aintegrated, amotivate asomeone ato alearn. aField atheorists aplace asignificance aon ahow
aachievement, apower, athe aneed afor aaffiliation, aand aavoidance amotives ainfluence aindividual
abehavior. aSociologic atheories aare anot ainvolved ain amotivation.
The anurse ais aassessing aa agroup aof aclients. aWhich aclients aare aat agreater arisk afor
ahypothermia aor afrostbite? a(select aall athat aapply)
a. an aolder awoman awith ahypertension
b. a ayoung aman awith aa abody amass aindex aof a42
c. a ayoung amany awho ahas ajust aconsumed asix amartinis
d. an aolder aman awho asmokes aa apack aof acigarettes aa aday
e. a ayoung awoman awho ais aanorexic
f. a ayoung awoman awho ais adiabetic a- aCORRECT aANSWER a-C, aD, aE, aF
clients awith apoor anutrition, afatigue, aand amultiple achronic aillnesses aare aat agreater arisk afor
ahypothermia. aClients awho asmoke, aconsume aalcohol, aor ahave aimpaired aperipheral
acirculation ahave aa ahigher aincidence aof afrostbite.
Which astatement amade aby aa anurse arepresents athe aneed afor afurther aeducation aregarding
apain amanagement ain aolder aadult aclients?
a. older aadults atend ato areport apain aless aoften athan ayounger aadults
b. older aclients ausually ahave amore aexperience awith apain athan ayounger aclients
c. older aadults aare aat agreatest arisk afor aunder atreated apain
d. older aclients ahave aa adifferent apain amechanism aand ado anot afeel ait aas amuch a- aCORRECT
aANSWER a-D
There ais ano aevidence ato asupport athe aidea athat aolder aadult aclients aperceive apain aany
adifferently athan ayounger aclients. aThe aother astatements aare aaccurate aregarding aolder
aclients aand apain.
,The anurse ais aworking aat aa afirst aaid abooth afor aa aspring atraining agame aon aa ahot aday. aA
aspectator acomes ain, areporting athat ahe ais anot afeeling awell. aVital asigns aare atemp a104.1 aF,
apulse a132 aBPM, arespirs a26 abreaths/min, aand ablood apressure a106/66 amm aHg. aHe atrips
aover ahis afeet aas athe anurse aleads ahim ato aa acot. aWhat ais athe apriory aaction aof athe anurse?
a. admin atylenol a650 amg aorally
b. encourage arest, aand areassess ain a15 aminutes
c. sponge athe avictim awith acool awater aand aremove ahis ashirt
d. encourage adrinking aof acool awater aor asports adrink a- aCORRECT aANSWER a-C
The aspectator ashows asigns aof aheat astroke, awhich ais aa amedical aemergency. aThe
aspectator ashould abe atransported ato athe aED aASAP. aThe anurs ashould atake aactions ato
alower ahis abody atemp ain ateh ameantime aby aremoving ahis ashirt aand asponging ahis abody
awith acool awater. aLowering abody atemp aby adrinking acool afluids aor ataking aacetaminophen
ais anot aas aeffective ain aan aemergency asituation. aThe aclient aneeds ato abe acooled aquickly
aand ais aa apriority afor atreatment
The aclient ais areceiving aan aIV aof a60 amEq aof apotassium achloride aina a1000 amL asolution
aof adextrose a5% ain a0.45% asaline. aThe aclient astates athat athe aarea aaround athe aIV asite
aburns. aWhat aintervention adoes athe anurse aperform afirst?
a. assess afor aa ablood areturn
b. notify athe aphysician
c. document athe afinding
d. stop athe aIV ainfusion a- aCORRECT aANSWER a-D
Potassium ais aa asevere atissue airritant. aThe asafest aaction ais ato adiscontinue athe asolution
athat acontains athe apotassium aand adiscontinue athe aIV aaltogether, ain awhich acase athe
aclient awould aneed aanother asite astarted. aAssessing afor aa ablood areturn amay aor amay anot
abe asuccessful. aThe asolution acould abe adiluted a(less apotassium) aand athe arate acould abe
aslowed aonce ait ais adetermined athat athe aneedle ais ain athe avein.
, A anurse ais acaring afor aan aolder aadult aclient awho alives aalone. aWhich aeconomic asituation
apresents athe amost aserious aproblem afor athis aclient?
a. costs aof acreating aa aliving awill
b. stock amarket afluctuations
c. increased aprovider abenefits
d. social asecurity aas athe abasis aof aincome a- aCORRECT aANSWER a-D
Older aadults aon afixed aincomes aare aunable ato aadjust atheir aincome ato ameet arising acosts
aassociated awith ameeting abasic aneeds
Controlling apain ais aimportant ato apromoting awellness. aUnrelieved apain ahas abeen aassociated
awith
a. prolonged astress aresponse aand aa acascade aof aharmful aeffects asystem awide.
b. decreased atumor agrowth aand alongevity
c. large atidal avolumes aand adecreased alung acapacity
d. decreased acarbohydrate, aprotein, aand afat adestruction a- aCORRECT aANSWER a-A
Pain atriggers aa anumber aof aphysiologic astress aresponses ain athe ahuman abody. aUnrelieved
apain acan aprolong athe astress aresponse aand aproduce aa acascade aof aharmful aeffects ain aall
abody asystems. aThe astress aresponse acauses athe aendocrine asystem ato arelease aexcessive
aamounts aof ahormones, asuch aas acortisol, acatecholamines, aand aglucagon. aInsulin aand
atestosterone alevels adecrease. aIncreased aendocrine aactivity ain aturn ainitiates aa anumber aof
ametabolic aprocesses, ain aparticular, aaccelerated acarbohydrate, aprotein, aand afat
adestruction, awhcih acan aresult ain aweight aloss, atachycardia, aincreased arespiratory arate,
ashock, aand aeven adeath. aThe aimmune asystem ais aalso aaffected aby apain aas ademonstrated
aby aresearch ashowing aa alink abetween aunrelieved apain aand aa ahigher aincidence aof
anosocomial ainfections aand aincreased atumor agrowth. aLarge atidal avolumes aare anot
aassociated awith apain awhile adecreased alung acapacity ais aassociated awith aunrelieved apain.
aDecreased atumor agrowth aand alongevity aare anot aassociated awith aunrelieved apain.
aDecreased acarbs, aprotein, aand afat aare anot aassociated awith apain aor astress aresponse.
