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The nurse is teaching an adolescent newly diagnosed with type 1
diabetes about self-care. Which is the primary long-term goal?
• Maintaining normoglycemia
• Complying with the diabetic diet
• Adhering to an exercise program
• Developing a non-stressful lifestyle
Rationale
Maintaining normoglycemia is a realistic goal because it decreases
the risk of complications such as neuropathy, retinopathy, and
atherosclerosis. A regimen of insulin, exercise, and diet will help
the adolescent achieve this goal. Compliance with a diabetic diet
is an objective because it will help the adolescent achieve the
long-term goal; diet alone is insufficient to achieve
normoglycemia. Adherence to an exercise program is an objective
because it will help the adolescent achieve the long-term goal;
exercise alone is insufficient to achieve normoglycemia.
Development of a lower stress lifestyle is a worthwhile goal but
developing a nonstressful lifestyle is not realistic.
A 16-year-old single mother of a 1-year-old infant and the infant’s
grandmother bring the baby to the emergency department and
NUR122: ME NUR 122 RESUME ESTUDIOS HESI Exam
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,NUR122: ME NUR 122 RESUME ESTUDIOS HESI Exam
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report that the infant accidentally fell down the stairs. The nurse
knows that a consent form for treatment would be signed. Who
has the responsibility for signing the consent?
• The mother, despite her age
• No one, because this is an emergency
• The grandmother, because she is a relative
• Family court, because the mother is a minor
Rationale
The client’s mother is an emancipated minor, meaning that she
has adult status. In most states the age of majority is 18 years;
however, parents younger than 18 years are considered
emancipated minors and may sign consents for themselves and
their children. Consent always is needed when a parent is present
and capable of providing it. The grandmother does not have the
legal right to give consent. Family court is unnecessary.
Which is the most important action the nurse would take in
preparation for a lumbar puncture for a child with a tentative
diagnosis of bacterial meningitis?
• Asking the parents what they were told about the test
• Using a doll to demonstrate the procedure to the child
NUR122: ME NUR 122 RESUME ESTUDIOS HESI Exam
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,NUR122: ME NUR 122 RESUME ESTUDIOS HESI Exam
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• Obtaining a pacifier for the child to suck on during the procedure
• Telling the parents that they may stay with their child during the
test
NUR122: ME NUR 122 RESUME ESTUDIOS HESI Exam
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, NUR122: ME NUR 122 RESUME ESTUDIOS HESI Exam
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Rationale
Informed consent is required. The procedure should be explained
to the parents by the health care practitioner, and the nurse
would confirm the parents’ comprehension and have them sign
the consent form. The child is too young to comprehend a
demonstration of the procedure. Although staying with the child
may be important to the parents, it is not the priority. Although a
pacifier may keep the child calm, this is not the priority either.
Which description by the nurse is a correct explanation of delegation?
• The transfer of responsibility for the performance of an activity
• The person’s responsibility and accountability for individual
actions or omissions
• The active process of directing, guiding, and influencing the
outcome of an individual
• The transfer of both the accountability and responsibility from one
person to another
A nurse is evaluating goal achievement for a client in skeletal
traction. Which finding would indicate to the nurse that the goals
NUR122: ME NUR 122 RESUME ESTUDIOS HESI Exam
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