NU371 HESI Case Study: Suicide, A Sentinel Event
Questions and Answers
Meet the Client - ANSWER -The client has a) Being retired from the military.
a 45-year history of smoking one pack a day of b) The realization of growing older.
cigarettes. He admits he has had a productive c) Inability to attend church regularly.
cough, hoarseness, and a hard time breathing. d) Becoming widowed within the past year. -
He attributes these symptoms to his age. He ANSWER -d) Becoming widowed within the
describes waking up three to four times at night past year.
with coughing and difficulty breathing. He states -
that he has lost weight, but thinks it is because The combinations of sadness, loneliness from
he isn't really hungry anymore. He talks about losing a loved one in widowhood, and
being unusually tired lately and mentions that hopelessness leads to social withdrawal. Those
sometimes doesn't have enough energy to get feelings place an older adult at greater risk of
from the bedroom to the kitchen. The client also suffering from major depression because older
says he drinks nutrition shakes for meals adults are reluctant to adapt to changes.
because they are easy to prepare and they taste
good. The client's medical history includes
insulin-dependent type II diabetes mellitus. He
says that what bothers him the most is that he Physical Assessment - ANSWER -The
has difficulty concentrating. He compares it to client is alert and oriented to time and place. He
"suffering from some sort of brain fog." is a pale, thin male, with shallow respirations. He
exhibits some nasal flaring, mild intercostal
retractions, and a productive cough. He leans
forward as he sits in a tripod position. Upon
As the nurse documents the client's assessment, auscultation, the nurse notices wheezing to the
the nurse is correct to question which activity of a right side and diminished breath sounds to the
client with type II diabetes mellitus? (Select all left side, and his heart rate is slightly elevated.
that apply. One, some, or all options may be Visual inspection of the client reveals a barrel
correct.) chest, mild clubbing of the fingers, and cyanosis
a) Client's frequency for checking blood glucose. to the nail beds. His skin is very warm and dry to
b) Quantity of Ensure taken per day. the touch, and an examination reveals decreased
c) Reason for lack of appetite. skin turgor, and a stage II decubitus ulcer in the
d) Amount of water and other fluids taken daily. sacral area that scored a 14 on the Braden scale.
e) Last blood glucose result obtained by client. - The client has mild swelling of the feet and he
ANSWER -a) Client's frequency for reports limited mobility related to feeling weak.
checking blood glucose. He denies allergies to medication or food and
b) Quantity of Ensure taken per day. denies any pain. He does not have advance
c) Reason for lack of appetite. directives.
d) Amount of water and other fluids taken daily.
VITAL SIGNS - ANSWER -T 101.5° F
The client mentions that he feels "blue" lately (38.6° C), HR 110 beats/min, R 20 breaths/min,
because his wife died one year ago, and his BP 150/90 mmHg, blood glucose 200, O2
children live out of state and seldom visit. The saturation 88% on room air
nurse knows that the greatest risk for major
depression includes which event?
, NU371 HESI Case Study: Suicide, A Sentinel Event
Questions and Answers
surgery. As a result of the many treatment and
approaches to diabetes, it is important for the
MEDICATIONS - ANSWER -albuterol and nurse to clarify the drug and intravenous fluid
ipratropium bromide, meter dose inhalers prescriptions with the HCP.
diltiazem
furosemide
aspirin 81 mg
metformin The HCP prescribes 1000 mL normal saline
regular insulin (sliding scale) 0.45% with 20 mEq/L potassium chloride (KCl) to
enoxaparin sodium infuse at 125 mL/hr. The nurse calculates that it
will take how many hours for the infusion to be
complete? (Enter numeric value only. If rounding
is required, round to the whole number.) -
PRESCRIPTIONS - ANSWER -The nurse ANSWER -1 hr/125 mL X 1,000 =
follows the healthcare provider's (HCP) 1,000/125 = 8 hours
prescriptions for treatment of exacerbation of
chronic obstructive pulmonary disease (COPD)
Obtain ABG, CBC with diff, chemistry 7, blood
cultures (BC), urinanalysis (UA) The client is febrile with temperature of 101.5°F
PA and lateral chest x-ray (38.6°C). Based on this information, which
Consult PT/OT for wound care intervention should the nurse implement first?
Start sequential compression device (SCD) a) Contact the lab and request blood cultures be
Establish intravenous access (saline lock) drawn.
b) Administer acetaminophen per hospital
protocol.
c) Contact the HCP for a prescription for an
The HCP prescribes 1000 mL dextrose 5% with antibiotic.
normal saline 0.9% and 20 mEq/L potassium d) Retake temperature with a tympanic
chloride (KCl) to infuse at 100 mL/hr. The nurse thermometer. - ANSWER -a) Contact the
is correct to question which additive to this lab and request blood cultures be drawn.
infusion prescription? -
a) Normal saline (NS) and Potassium chloride Blood culture specimens are always drawn
(KCl). before giving acetaminophen or starting antibiotic
b) Normal saline (NS). therapy because the antibiotic usually interferes
c) Dextrose (D5). with the organism's growth in the laboratory.
d) Potassium chloride (KCl). - ANSWER -c)
Dextrose (D5).
-
Solutions that contain dextrose are not The HCP prescribes clindamycin 900 mg in 100
recommended for client with diabetes because mL over 30 minutes. The IV tubing drop factor is
they can result in the rise of insulin, which will 15 gtt/mL. The nurse should regulate the IV to
cause a decreased level of potassium in the deliver how many drops per minute? (Enter
blood. Dextrose may be prescribed for a client numeric value only. If rounding is required, round
with diabetes to prevent low blood sugar during to the nearest whole number.) - ANSWER -
Questions and Answers
Meet the Client - ANSWER -The client has a) Being retired from the military.
a 45-year history of smoking one pack a day of b) The realization of growing older.
cigarettes. He admits he has had a productive c) Inability to attend church regularly.
cough, hoarseness, and a hard time breathing. d) Becoming widowed within the past year. -
He attributes these symptoms to his age. He ANSWER -d) Becoming widowed within the
describes waking up three to four times at night past year.
with coughing and difficulty breathing. He states -
that he has lost weight, but thinks it is because The combinations of sadness, loneliness from
he isn't really hungry anymore. He talks about losing a loved one in widowhood, and
being unusually tired lately and mentions that hopelessness leads to social withdrawal. Those
sometimes doesn't have enough energy to get feelings place an older adult at greater risk of
from the bedroom to the kitchen. The client also suffering from major depression because older
says he drinks nutrition shakes for meals adults are reluctant to adapt to changes.
because they are easy to prepare and they taste
good. The client's medical history includes
insulin-dependent type II diabetes mellitus. He
says that what bothers him the most is that he Physical Assessment - ANSWER -The
has difficulty concentrating. He compares it to client is alert and oriented to time and place. He
"suffering from some sort of brain fog." is a pale, thin male, with shallow respirations. He
exhibits some nasal flaring, mild intercostal
retractions, and a productive cough. He leans
forward as he sits in a tripod position. Upon
As the nurse documents the client's assessment, auscultation, the nurse notices wheezing to the
the nurse is correct to question which activity of a right side and diminished breath sounds to the
client with type II diabetes mellitus? (Select all left side, and his heart rate is slightly elevated.
that apply. One, some, or all options may be Visual inspection of the client reveals a barrel
correct.) chest, mild clubbing of the fingers, and cyanosis
a) Client's frequency for checking blood glucose. to the nail beds. His skin is very warm and dry to
b) Quantity of Ensure taken per day. the touch, and an examination reveals decreased
c) Reason for lack of appetite. skin turgor, and a stage II decubitus ulcer in the
d) Amount of water and other fluids taken daily. sacral area that scored a 14 on the Braden scale.
e) Last blood glucose result obtained by client. - The client has mild swelling of the feet and he
ANSWER -a) Client's frequency for reports limited mobility related to feeling weak.
checking blood glucose. He denies allergies to medication or food and
b) Quantity of Ensure taken per day. denies any pain. He does not have advance
c) Reason for lack of appetite. directives.
d) Amount of water and other fluids taken daily.
VITAL SIGNS - ANSWER -T 101.5° F
The client mentions that he feels "blue" lately (38.6° C), HR 110 beats/min, R 20 breaths/min,
because his wife died one year ago, and his BP 150/90 mmHg, blood glucose 200, O2
children live out of state and seldom visit. The saturation 88% on room air
nurse knows that the greatest risk for major
depression includes which event?
, NU371 HESI Case Study: Suicide, A Sentinel Event
Questions and Answers
surgery. As a result of the many treatment and
approaches to diabetes, it is important for the
MEDICATIONS - ANSWER -albuterol and nurse to clarify the drug and intravenous fluid
ipratropium bromide, meter dose inhalers prescriptions with the HCP.
diltiazem
furosemide
aspirin 81 mg
metformin The HCP prescribes 1000 mL normal saline
regular insulin (sliding scale) 0.45% with 20 mEq/L potassium chloride (KCl) to
enoxaparin sodium infuse at 125 mL/hr. The nurse calculates that it
will take how many hours for the infusion to be
complete? (Enter numeric value only. If rounding
is required, round to the whole number.) -
PRESCRIPTIONS - ANSWER -The nurse ANSWER -1 hr/125 mL X 1,000 =
follows the healthcare provider's (HCP) 1,000/125 = 8 hours
prescriptions for treatment of exacerbation of
chronic obstructive pulmonary disease (COPD)
Obtain ABG, CBC with diff, chemistry 7, blood
cultures (BC), urinanalysis (UA) The client is febrile with temperature of 101.5°F
PA and lateral chest x-ray (38.6°C). Based on this information, which
Consult PT/OT for wound care intervention should the nurse implement first?
Start sequential compression device (SCD) a) Contact the lab and request blood cultures be
Establish intravenous access (saline lock) drawn.
b) Administer acetaminophen per hospital
protocol.
c) Contact the HCP for a prescription for an
The HCP prescribes 1000 mL dextrose 5% with antibiotic.
normal saline 0.9% and 20 mEq/L potassium d) Retake temperature with a tympanic
chloride (KCl) to infuse at 100 mL/hr. The nurse thermometer. - ANSWER -a) Contact the
is correct to question which additive to this lab and request blood cultures be drawn.
infusion prescription? -
a) Normal saline (NS) and Potassium chloride Blood culture specimens are always drawn
(KCl). before giving acetaminophen or starting antibiotic
b) Normal saline (NS). therapy because the antibiotic usually interferes
c) Dextrose (D5). with the organism's growth in the laboratory.
d) Potassium chloride (KCl). - ANSWER -c)
Dextrose (D5).
-
Solutions that contain dextrose are not The HCP prescribes clindamycin 900 mg in 100
recommended for client with diabetes because mL over 30 minutes. The IV tubing drop factor is
they can result in the rise of insulin, which will 15 gtt/mL. The nurse should regulate the IV to
cause a decreased level of potassium in the deliver how many drops per minute? (Enter
blood. Dextrose may be prescribed for a client numeric value only. If rounding is required, round
with diabetes to prevent low blood sugar during to the nearest whole number.) - ANSWER -
