Hesi Management Exam question and answers graded A+.

In application of the principles of pain treatment, what is the first consideration? - Correct Answer- The client's perception of pain must be accepted. The client must be believed, and his or her experience of pain must be acknowledged as valid. The data gathered via client reports can then be applied to the other options in developing the treatment plan. When an analgesic is titrated to manage pain, what is the priority goal? - Correct Answer- Titrate to the smallest dose that provides relief with the fewest side effects. The goal is to control pain while minimizing side effects. For severe pain, the medication can be titrated upward until the pain is controlled. Downward titration occurs when the pain begins to subside. Adequate dosing is important; however, the concept of controlled dosing applies more to potent vasoactive drugs. Which client is at greatest risk for respiratory depression while receiving opioids for analgesia? - Correct Answer- Child with an arm fracture and cystic fibrosis At greatest risk are elderly clients, opiate-naive clients, and those with underlying pulmonary disease. The child has two of the three risk factors. A client is crying and grimacing but denies pain and refuses pain medication, because "my sibling is a drug addict and has ruined our lives." What is the priority intervention for this client? - Correct Answer- Encourage expression of fears and past experiences. This client has strong beliefs and emotions related to the issue of the sibling's addiction. First, encourage expression. This indicates to the client that the feelings are real and valid. It is also an opportunity to assess beliefs and fears. Giving facts and information is appropriate at the right time. Family involvement is important, but it should be kept in mind that their beliefs about drug addiction may be similar to those of the client. The physician has ordered a placebo for a client with chronic pain. You are a newly hired nurse and you feel very uncomfortable administering the medication. What is the first action that you should take? - Correct Answer- Contact the charge nurse for advice. Administering placebos is generally considered unethical. Consult the charge nurse as a resource person who can help you clarify the situation and locate and review the hospital policy. If the physician is insistent, suggest that he or she could give the placebo. (Note: Use "could," not "should" when talking to the physician. This provides a small opportunity to rethink the decision. "Should" is more commanding and elicits a more defensive response.) While following your own ethical code is correct, you must ensure that the client is not abandoned and that care continues. For a cognitively impaired client who cannot accurately report pain, what is the first action that you should take? - Correct Answer- Obtain baseline behavioral indicators from family members.