HESI - Medical Surgical Nursing test 2026/2027)
– Adult Health Nursing Assessment |175 Q&A
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Terms in this set (170)
When describing patient education C. Informal teaching is individualized one on one
approaches, the nurse educator teaching which represents the majority of patient
would explain that informal teaching education done by nurses that occurs when an
is an approach that intervention is explained or a question is answered.
Group needs are often the focus of formal patient
a. follows formalized plans education courses or classes. Informal teaching
b. has standardized content does not necessarily follow a specific formalized
c. often occurs one-to-one plan. It may be planned with specific content, but it
d. addresses group needs is individualized responses to patient needs.
Formal teaching involves the use of a
curriculum/course plan with standardized content.
,A patient expresses a strong interest C. Cognitive theorists believe that attention,
in returning to their work, family, and relevance, confidence, and satisfaction (ARCS) are
hobbies after having a stroke. Which the conditions that, when integrated, motivate
theory type would the nurse use to someone to learn. Field theorists place significance
develop a plan of care for the best on how achievement, power, the need for
results of this patient's motivation affiliation, and avoidance motives influence
style? individual behavior. Sociologic theories are not
involved in motivation.
a. field
b. biological
c. cognitive
d. sociologic
The nurse is assessing a group of C, D, E, F
clients. Which clients are at greater
risk for hypothermia or frostbite? clients with poor nutrition, fatigue, and multiple
(select all that apply) chronic illnesses are at greater risk for
hypothermia. Clients who smoke, consume alcohol,
a. an older woman with hypertension or have impaired peripheral circulation have a
b. a young man with a body mass higher incidence of frostbite.
index of 42
c. a young many who has just
consumed six martinis
d. an older man who smokes a pack
of cigarettes a day
e. a young woman who is anorexic
f. a young woman who is diabetic
,Which statement made by a nurse D
represents the need for further
education regarding pain There is no evidence to support the idea that older
management in older adult clients? adult clients perceive pain any differently than
younger clients. The other statements are accurate
a. older adults tend to report pain regarding older clients and pain.
less often than younger adults
b. older clients usually have more
experience with pain than younger
clients
c. older adults are at greatest risk for
under treated pain
d. older clients have a different pain
mechanism and do not feel it as
much
The nurse is working at a first aid C
booth for a spring training game on
a hot day. A spectator comes in, The spectator shows signs of heat stroke, which is a
reporting that he is not feeling well. medical emergency. The spectator should be
Vital signs are temp 104.1 F, pulse 132 transported to the ED ASAP. The nurs should take
BPM, respirs 26 breaths/min, and actions to lower his body temp in teh meantime by
blood pressure 106/66 mm Hg. He removing his shirt and sponging his body with cool
trips over his feet as the nurse leads water. Lowering body temp by drinking cool fluids
him to a cot. What is the priory action or taking acetaminophen is not as effective in an
of the nurse? emergency situation. The client needs to be cooled
quickly and is a priority for treatment
a. admin tylenol 650 mg orally
b. encourage rest, and reassess in 15
minutes
c. sponge the victim with cool water
and remove his shirt
d. encourage drinking of cool water
or sports drink
, The client is receiving an IV of 60 D
mEq of potassium chloride ina 1000
mL solution of dextrose 5% in 0.45% Potassium is a severe tissue irritant. The safest
saline. The client states that the area action is to discontinue the solution that contains
around the IV site burns. What the potassium and discontinue the IV altogether, in
intervention does the nurse perform which case the client would need another site
first? started. Assessing for a blood return may or may
not be successful. The solution could be diluted
a. assess for a blood return (less potassium) and the rate could be slowed
b. notify the physician once it is determined that the needle is in the vein.
c. document the finding
d. stop the IV infusion
A nurse is caring for an older adult D
client who lives alone. Which
economic situation presents the Older adults on fixed incomes are unable to adjust
most serious problem for this client? their income to meet rising costs associated with
meeting basic needs
a. costs of creating a living will
b. stock market fluctuations
c. increased provider benefits
d. social security as the basis of
income
– Adult Health Nursing Assessment |175 Q&A
Save
Terms in this set (170)
When describing patient education C. Informal teaching is individualized one on one
approaches, the nurse educator teaching which represents the majority of patient
would explain that informal teaching education done by nurses that occurs when an
is an approach that intervention is explained or a question is answered.
Group needs are often the focus of formal patient
a. follows formalized plans education courses or classes. Informal teaching
b. has standardized content does not necessarily follow a specific formalized
c. often occurs one-to-one plan. It may be planned with specific content, but it
d. addresses group needs is individualized responses to patient needs.
Formal teaching involves the use of a
curriculum/course plan with standardized content.
,A patient expresses a strong interest C. Cognitive theorists believe that attention,
in returning to their work, family, and relevance, confidence, and satisfaction (ARCS) are
hobbies after having a stroke. Which the conditions that, when integrated, motivate
theory type would the nurse use to someone to learn. Field theorists place significance
develop a plan of care for the best on how achievement, power, the need for
results of this patient's motivation affiliation, and avoidance motives influence
style? individual behavior. Sociologic theories are not
involved in motivation.
a. field
b. biological
c. cognitive
d. sociologic
The nurse is assessing a group of C, D, E, F
clients. Which clients are at greater
risk for hypothermia or frostbite? clients with poor nutrition, fatigue, and multiple
(select all that apply) chronic illnesses are at greater risk for
hypothermia. Clients who smoke, consume alcohol,
a. an older woman with hypertension or have impaired peripheral circulation have a
b. a young man with a body mass higher incidence of frostbite.
index of 42
c. a young many who has just
consumed six martinis
d. an older man who smokes a pack
of cigarettes a day
e. a young woman who is anorexic
f. a young woman who is diabetic
,Which statement made by a nurse D
represents the need for further
education regarding pain There is no evidence to support the idea that older
management in older adult clients? adult clients perceive pain any differently than
younger clients. The other statements are accurate
a. older adults tend to report pain regarding older clients and pain.
less often than younger adults
b. older clients usually have more
experience with pain than younger
clients
c. older adults are at greatest risk for
under treated pain
d. older clients have a different pain
mechanism and do not feel it as
much
The nurse is working at a first aid C
booth for a spring training game on
a hot day. A spectator comes in, The spectator shows signs of heat stroke, which is a
reporting that he is not feeling well. medical emergency. The spectator should be
Vital signs are temp 104.1 F, pulse 132 transported to the ED ASAP. The nurs should take
BPM, respirs 26 breaths/min, and actions to lower his body temp in teh meantime by
blood pressure 106/66 mm Hg. He removing his shirt and sponging his body with cool
trips over his feet as the nurse leads water. Lowering body temp by drinking cool fluids
him to a cot. What is the priory action or taking acetaminophen is not as effective in an
of the nurse? emergency situation. The client needs to be cooled
quickly and is a priority for treatment
a. admin tylenol 650 mg orally
b. encourage rest, and reassess in 15
minutes
c. sponge the victim with cool water
and remove his shirt
d. encourage drinking of cool water
or sports drink
, The client is receiving an IV of 60 D
mEq of potassium chloride ina 1000
mL solution of dextrose 5% in 0.45% Potassium is a severe tissue irritant. The safest
saline. The client states that the area action is to discontinue the solution that contains
around the IV site burns. What the potassium and discontinue the IV altogether, in
intervention does the nurse perform which case the client would need another site
first? started. Assessing for a blood return may or may
not be successful. The solution could be diluted
a. assess for a blood return (less potassium) and the rate could be slowed
b. notify the physician once it is determined that the needle is in the vein.
c. document the finding
d. stop the IV infusion
A nurse is caring for an older adult D
client who lives alone. Which
economic situation presents the Older adults on fixed incomes are unable to adjust
most serious problem for this client? their income to meet rising costs associated with
meeting basic needs
a. costs of creating a living will
b. stock market fluctuations
c. increased provider benefits
d. social security as the basis of
income
