HESI Management Practice Exam 2021/2022 with complete solution

The nurse is preparing assignments for the day shift. It is most important that the client with which diagnosis and description is assigned to a registered nurse? Answer- Depression: Admitted during the night, following a suicide attempt with an overdose of Tylenol During report, the charge nurse informs a nurse that she must work on another unit. The nurse begins to sign deeply and tosses about her belongings as she is preparing to leave, making it known that she is very unhappy about having to "float." What is the best immediate action for the charge nurse to take? Answer- Continue with report, and talk to the nurse about the incident at a later time. A 15-year-old sexually active girl diagnosed with pelvic inflammatory disease (PID) is admitted to the hospital with a temperature of 101.6° F and a purulent vaginal discharge. She has no insurance and tells the nurse she enjoys small children. Which room should the nurse assign this client? Answer- A private room The registered nurse (RN) and unlicensed assisted personnel (UAP) are working together to provide care for a bedfast client needing total care, medication, and Foley catheter irrigation. How should the RN assign the client's care? Answer- UAP: Personal care, I&O. RN: Catheter irrigation, medications The charge nurse assigns the care of a client with diabetes who has hyperglycemia to a practical nurse (PN). In supervising the PN, what is the charge nurse's most important action? Answer- Confer with the PN about any manifestations the client is exhibiting. A registered nurse (RN) is caring for several clients on a progressive care "step-down" unit. After assessing the clients, which clerical task should the nurse assign to a unlicensed assistive personnel (UAP)? Answer- Transcribe the vital signs from a unit worksheet to the individual graphic page in the client charts Which situation requires intervention by the nurse who is caring for a terminally ill client in a hospital? Answer- The case manager notifies the family that the critical pathway requires transfer to a hospice facility. The unlicensed assistive personnel (UAP) reports morning vital signs to the primary nurse. Which client should the nurse assess first? The client who is Answer- diagnosed with pneumonia and has a respiratory rate of 26 breaths/min. A female client is receiving an enteral feeding via nasogastric feeding tube. The daughter reports to the charge nurse that her mother is coughing vigorously and sounds congested. Which staff member should the charge nurse ask to check on the client? Answer- Registered Nurse (RN) who is entering nursing notes at the computer The charge nurse, along with two registered nurses (RN), one practical nurse (PN), and one unlicensed assistive personnel (UAP), is working in an emergency department. What activity should be assigned to the UAP? Answer- Transport a client diagnosed with septicemia to the medical unit. The charge nurse working in a long-term care facility is informed by the LPN that a client's son is unhappy with the care his mother is receiving. What action should the nurse take first? Answer- Discuss with the LPN the son's concerns about his mother's care When the charge nurse is making assignments, which tasks can be assigned to an unlicensed assistive personnel (UAP)? Answer- Take vital signs, give a cleansing enema, and apply soft restraints to an older client. The charge nurse is assigning a room for a newly-admitted client, diagnosed with acute Pneumocystis carinii pneumonia, secondary to acquired immunodeficiency syndrome (AIDS). Which room would be best to assign to this client? Answer- A semi-private room that does not have a client in the other bed at this time A nurse who works in an acute minor illness clinic returns from lunch and finds several clients who need attention. Which client should the nurse attend to first? Answer- A 4- year-old receiving intravenous fluid for dehydration whose IV fluid bag is empty The nurse is designing a program to control nosocomial infections on a geriatric unit of an acute care hospital. What strategy should be included in this plan? Answer- Ensure that sterile technique is followed when changing surgical dressings. The charge nurse working the 3 to 11 shift of a 24-bed medical unit in a large acute care hospital is making assignments. Currently, there are 20 clients on the unit and 4 admissions are scheduled to arrive during the shift. Besides the charge nurse, the staff consists of two experienced practical nurses (PN) and one unlicensed assistive personnel (UAP) who has worked on the unit for 10 years. Taking into consideration the acuity of each client, which distribution of clients is the best assignment for the nurse to make? Answer- 10 clients to each of the PNs. Have the UAP take vital signs. The charge nurse takes the 4 new admissions. An emergency room anticipates an influx of injured clients from a large motor vehicle collision on a major freeway. Which client should the triage nurse send to the trauma staff for immediate intervention? Answer- An adult with a suspected intraabdominal bleed who was not breathing on arrival, but is currently responding since repositioning the airway Which pediatric client requires immediate intervention by the nurse? Answer- A 4-year- old with an easily palpable bladder and frequency. The nurse is caring for 4 clients on an orthopedic floor: 2 pts with total hips, 1 pt with total knee, and 1 pt with a fractured femur who is in skeletal traction. Which nursing task should the nurse delegate to the unlicensed assistive personnel (UAP)? Answer- Change the linens for the client with skeletal traction. The nurse is giving change-of-shift report for four clients in the emergency center and reports the client with the terminal disease has a living will and a "Do not resuscitate" (DNR) order on file. Which client fits the criteria for a terminal illness? Answer- 43-year- old male with amyotrophic lateral sclerosis who is refusing artificial nutrition or hydration. The nurse-manager is talking to a new nurse who is thinking about resigning before orientation to the unit is over. The nurse-manager explains that reality shock after graduation is common. Which explanation should the nurse-manager use to best describe reality shock to the new nurse? Answer- A period of role adjustment from school into the work force. Which task should the nurse delegate to an unlicensed assistive personnel (UAP)? Answer- Feed a client with minimal dysphagia The nurse receives report in the emergency center for four clients. Which client should the nurse assess first? Answer- A client experiencing shortness of breath and dyspnea. During coronary artery bypass graft (CABG) surgery, a male client with a history of chronic tobacco abuse experiences a dramatic decrease in his oxygen saturation. Subsequently, the client remains on a ventilator two days longer than anticipated. Which factor should the nurse consider when evaluating the client's progress? Answer- Variance The charge nurse working on a surgical unit must discharge as many clients as possible to prepare for emergency admissions. Which client is stable enough to be discharged from the unit? Answer- A client scheduled for a femoro-popliteal bypass surgery tomorrow. The nurse notes a client's postoperative leg is cool with a capillary refill greater than 4 seconds and calls the healthcare provider. After 30 minutes of not receiving a return call from the healthcare provider, which action should the nurse take first? Answer- Attempt to recall the same healthcare provider The nurse witnesses a male client's signature for surgical consent for a Billroth II procedure after the surgeon discusses the procedure and its implication with the client. After signing the consent, the client questions the importance of a change in his diet postoperatively. What action should the nurse implement? Answer- Review information about dumping syndrome. The nurse educator is teaching the nursing staff about a new computerized documentation system that is recently implemented. What information is the best indication that the education is effective? Answer- Less time for nursing staff to complete the daily charting. When planning care for a client with polycystic kidney disease, which collaborative problem has the highest priority? Answer- Hypertension