HESI MODULE 5 - MANAGEMENT OF CARE
QUESTIONS
A client with leukemia is being considered for a bone marrow transplant. The
healthcare team is discussing the risks and benefits of this treatment and other possible
treatments with the goal of inflicting the least possible harm on the client. Which
principle of healthcare ethics is the team practicing?
Nonmaleficence
Autonomy
Justice
Fidelity - Answer -Nonmaleficence
Which action by the nurse represents the ethical principle of beneficence?
The nurse upholds a client's decision to refuse chemotherapy for lung cancer.
The nurse follows a plan of care designed to relieve pain in a client with cancer.
The nurse administers an immunization to a child even though it may cause discomfort.
The nurse provides equal amounts of care to all assigned clients on the basis of illness
acuity. - Answer -The nurse administers an immunization to a child even though it may
cause discomfort.
The nursing instructor asks a student to name an example of false imprisonment. Which
of the following situations reflects a violation of this client right?
Observing the provision of care to the client without the client's permission
Telling the client that he or she may not leave the hospital
Performing a procedure without consent
Threatening to give a client a medication against his or her will - Answer -Telling the
client that he or she may not leave the hospital
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:
Ask the nursing assistant to assist in getting the client back to bed
Ask the nursing assistant to complete an incident report
Contact the unit secretary on the intercom and ask that the client's primary health care
provider be called
Check the client's level of consciousness and vital signs - Answer -Check the client's
level of consciousness and vital signs
Which of the following actions exemplifies the use of evidence-based practice in the
delivery of client care?
Donning sterile gloves to change an abdominal wound dressing
,Advising a client to agree to the treatment recommended by her primary health care
provider
Taking a rectal temperature from a client for whom bleeding precautions have been
instituted
Encouraging a client to take an herbal substance to treat his insomnia - Answer -
Donning sterile gloves to change an abdominal wound dressing
The registered nurse has accepted a new position as case manager in a hospital.
Which of the following responsibilities are part of the nurse's new role? Select all that
apply.
Assessing the client's needs for home supplies and equipment
Prescribing treatments specific to the client's needs
Evaluating and updating the plan of care as needed
Coordinating consultations and referrals to facilitate discharge
Establishing a safe and cost-effective plan of care with the client - Answer -Evaluating
and updating the plan of care as needed
Assessing the client's needs for home supplies and equipment
Coordinating consultations and referrals to facilitate discharge
Establishing a safe and cost-effective plan of care with the client
The nurse manager of a quality improvement program asks a nurse in the neurological
unit to conduct a retrospective audit. Which of the following actions should the auditing
nurse plan to perform in this type of audit?
Obtaining the assigned medical record from the hospital's medical record room to
review documentation made during a client's hospital stay
Checking the crash cart to ensure that all needed supplies are readily available should
an emergency arise
Checking the documentation written - Answer -Obtaining the assigned medical record
from the hospital's medical record room to review documentation made during a client's
hospital stay
A nurse preparing a client for a bronchoscopy notes that the client is wearing a gold
necklace. What should the nurse do to safeguard the client's necklace?
Ask the client whether the necklace is gold
Ask the client to remove the necklace and place it in the top drawer of the bedside table
Ask the client for permission to lock the necklace in the hospital safe
Ask the client to sign a release to free the hospital of responsibility if the necklace is
damaged or lost during the procedure - Answer -Ask the client for permission to lock
the necklace in the hospital safe
, A nurse providing preoperative care to a client who is scheduled for a left mastectomy
and axillary lymph node dissection notes that the client is wearing a wedding band on
her left ring finger. The nurse should:
Tape the wedding band in place
Explain to the client why the wedding band must be removed
Ask the client to sign a release to free the hospital of responsibility if the wedding band
is lost during surgery
Ask the client whether she would like to remove the wedding band or wear it to su -
Answer -Explain to the client why the wedding band must be removed
** A nurse preparing a client to go to the radiology department for a chest x-ray notes
that the client is wearing a religious medal on a chain around the neck. The client, a
Catholic, expresses a concern about removing the medal. What is the most appropriate
action for the nurse to take?
Asking the client to remove the medal until the x-ray has been completed
Asking the client to place the medal in the top drawer of the bedside stand just before
leaving for the radiology department
Assisting t - Answer -Assisting the client in pinning the medal and chain to the
waistband of the client's pajama bottoms
** A physician writes a medication prescription in a client's record. While transcribing the
prescription, the nurse notes that the prescribed dose is three times higher than the
recommended dose. The nurse calls the physician, who states that this is the dose that
the client takes at home and that it is acceptable for this client's condition. What is the
appropriate action for the nurse to take?
Contact the nursing supervisor
Ask the nurse assigned to care for the client to administer the medi - Answer -
Contacting the nursing supervisor
** A nurse monitoring a client with a chest tube notes that there is no tidaling of fluid in
the water seal chamber. After further assessment, the nurse suspects that the client's
lung has reexpanded and notifies the physician. The physician verifies with the use of a
chest x-ray that the lung has reexpanded, then calls the nurse to asks that the chest
tube be removed. The nurse should first:
Explain the procedure to the client, then remove the chest tube
Obtain petrolatum-impregnated gauze and - Answer -Inform the physician that removal
of a chest tube is not a nursing procedure
A nurse calls a physician to report that a client with congestive heart failure (CHF) is
exhibiting dyspnea and worsening of wheezing. The physician, who is in a hurry
because of a situation in the emergency department, gives the nurse a telephone
QUESTIONS
A client with leukemia is being considered for a bone marrow transplant. The
healthcare team is discussing the risks and benefits of this treatment and other possible
treatments with the goal of inflicting the least possible harm on the client. Which
principle of healthcare ethics is the team practicing?
Nonmaleficence
Autonomy
Justice
Fidelity - Answer -Nonmaleficence
Which action by the nurse represents the ethical principle of beneficence?
The nurse upholds a client's decision to refuse chemotherapy for lung cancer.
The nurse follows a plan of care designed to relieve pain in a client with cancer.
The nurse administers an immunization to a child even though it may cause discomfort.
The nurse provides equal amounts of care to all assigned clients on the basis of illness
acuity. - Answer -The nurse administers an immunization to a child even though it may
cause discomfort.
The nursing instructor asks a student to name an example of false imprisonment. Which
of the following situations reflects a violation of this client right?
Observing the provision of care to the client without the client's permission
Telling the client that he or she may not leave the hospital
Performing a procedure without consent
Threatening to give a client a medication against his or her will - Answer -Telling the
client that he or she may not leave the hospital
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:
Ask the nursing assistant to assist in getting the client back to bed
Ask the nursing assistant to complete an incident report
Contact the unit secretary on the intercom and ask that the client's primary health care
provider be called
Check the client's level of consciousness and vital signs - Answer -Check the client's
level of consciousness and vital signs
Which of the following actions exemplifies the use of evidence-based practice in the
delivery of client care?
Donning sterile gloves to change an abdominal wound dressing
,Advising a client to agree to the treatment recommended by her primary health care
provider
Taking a rectal temperature from a client for whom bleeding precautions have been
instituted
Encouraging a client to take an herbal substance to treat his insomnia - Answer -
Donning sterile gloves to change an abdominal wound dressing
The registered nurse has accepted a new position as case manager in a hospital.
Which of the following responsibilities are part of the nurse's new role? Select all that
apply.
Assessing the client's needs for home supplies and equipment
Prescribing treatments specific to the client's needs
Evaluating and updating the plan of care as needed
Coordinating consultations and referrals to facilitate discharge
Establishing a safe and cost-effective plan of care with the client - Answer -Evaluating
and updating the plan of care as needed
Assessing the client's needs for home supplies and equipment
Coordinating consultations and referrals to facilitate discharge
Establishing a safe and cost-effective plan of care with the client
The nurse manager of a quality improvement program asks a nurse in the neurological
unit to conduct a retrospective audit. Which of the following actions should the auditing
nurse plan to perform in this type of audit?
Obtaining the assigned medical record from the hospital's medical record room to
review documentation made during a client's hospital stay
Checking the crash cart to ensure that all needed supplies are readily available should
an emergency arise
Checking the documentation written - Answer -Obtaining the assigned medical record
from the hospital's medical record room to review documentation made during a client's
hospital stay
A nurse preparing a client for a bronchoscopy notes that the client is wearing a gold
necklace. What should the nurse do to safeguard the client's necklace?
Ask the client whether the necklace is gold
Ask the client to remove the necklace and place it in the top drawer of the bedside table
Ask the client for permission to lock the necklace in the hospital safe
Ask the client to sign a release to free the hospital of responsibility if the necklace is
damaged or lost during the procedure - Answer -Ask the client for permission to lock
the necklace in the hospital safe
, A nurse providing preoperative care to a client who is scheduled for a left mastectomy
and axillary lymph node dissection notes that the client is wearing a wedding band on
her left ring finger. The nurse should:
Tape the wedding band in place
Explain to the client why the wedding band must be removed
Ask the client to sign a release to free the hospital of responsibility if the wedding band
is lost during surgery
Ask the client whether she would like to remove the wedding band or wear it to su -
Answer -Explain to the client why the wedding band must be removed
** A nurse preparing a client to go to the radiology department for a chest x-ray notes
that the client is wearing a religious medal on a chain around the neck. The client, a
Catholic, expresses a concern about removing the medal. What is the most appropriate
action for the nurse to take?
Asking the client to remove the medal until the x-ray has been completed
Asking the client to place the medal in the top drawer of the bedside stand just before
leaving for the radiology department
Assisting t - Answer -Assisting the client in pinning the medal and chain to the
waistband of the client's pajama bottoms
** A physician writes a medication prescription in a client's record. While transcribing the
prescription, the nurse notes that the prescribed dose is three times higher than the
recommended dose. The nurse calls the physician, who states that this is the dose that
the client takes at home and that it is acceptable for this client's condition. What is the
appropriate action for the nurse to take?
Contact the nursing supervisor
Ask the nurse assigned to care for the client to administer the medi - Answer -
Contacting the nursing supervisor
** A nurse monitoring a client with a chest tube notes that there is no tidaling of fluid in
the water seal chamber. After further assessment, the nurse suspects that the client's
lung has reexpanded and notifies the physician. The physician verifies with the use of a
chest x-ray that the lung has reexpanded, then calls the nurse to asks that the chest
tube be removed. The nurse should first:
Explain the procedure to the client, then remove the chest tube
Obtain petrolatum-impregnated gauze and - Answer -Inform the physician that removal
of a chest tube is not a nursing procedure
A nurse calls a physician to report that a client with congestive heart failure (CHF) is
exhibiting dyspnea and worsening of wheezing. The physician, who is in a hurry
because of a situation in the emergency department, gives the nurse a telephone
