HESI EXIT FAMILY NURSE PRACTITIONER AND ADVANCE
b b b b b bb
D PRACTICE REGISTERED NURSE (APRN) FINAL EXAM 2.
b b b b b b b
HESI EXIT FAMILY NURSE PRACTITIONER FINAL EXAM
b b b b b b
S(GRADED A,RATIONALE AND 100% VERIFIED). b b b b
1. Which of the following nursing actions demonstrates that the nurse
b b b b b b b b b b
understands the nursing process? b b b
a) Prioritizing patient goals, documenting all health records precisely,
b b b b b b b b
conducting the health history, and documenting the nursing diagnosis
b b b b b b b b
b) Reviewing health record, documenting patient goals, identifying etiology
b b b b b b b b
of the nursing problem, and evaluating treatment outcome.
b b b b b b b
c) Assessing for allergies, administering analgesic, obtaining baseline vital
b b b b b b b b
signs, and documenting nursing diagnosis as acute pain
b b b b b b b
d) Obtaining vital signs, documenting nursing diagnosis as acute pain,
b b b b b b b b b
administering analgesic, and evaluating comfort level b b b b b
d) Obtaining vital signs, documenting nursing diagnosis as acute pain, admin
b b b b b b b b b b
istering analgesic, and evaluating comfort level
b b b b b
Rationale: Steps of the nursing process in order are: Assessment, Diagnosis,
b b b b b b b b b b b
Planning, Implementation, and Evaluation. Assessment is the systematic coll
b b b b b b b b
ection of data to determine the patient's health status and any actual or pote
b b b b b b b b b b b b b
ntial health problems. Nursing diagnoses are actual or potential health probl
b b b b b b b b b b
ems that can be managed by independent nursing interventions.
b b b b b b b b
Planning is the development of goals and outcomes. Implementation is the
b b b b b b b b b b b
actualization of the plan of care through nursing interventions. Evaluation i
b b b b b b b b b b
s the determination of the patient’s responses to the nursing interventions
b b b b b b b b b b b
and the extent to which the outcomes have been achieved.
b b b b b b b b b
2. The nurse educator is planning a teaching session for nursing students r
b b b b b b b b b b b
elated to treatment and management of gestational diabetes. The nurse ed
b b b b b b b b b b
ucator arranges for a dietitian, pharmacist, and physician assistant to parti
b b b b b b b b b b
cipate in the lesson plan. Which professional nurse competency is the nurs
b b b b b b b b b b b
e educator demonstrating?
b b
,a) Evidence-based practice b
b) Patient-centered care b
c) Interdisciplinary teamwork b
d) Quality improvement measures b b
c) Interdisciplinary teamwork
b b
Rationale: By integrating interdisciplinary core competencies into their res
b b b b b b b b
pective curricula the nurse educator is demonstrating interdisciplinary tea
b b b b b b b b
mwork. A case- b b
study approach planning care around individual patient preferences is an e
b b b b b b b b b b
xample of patient-centered care. Conducting an evidence-
b b b b b b
based literature review related to gestational diabetes reflects evidence-
b b b b b b b b
based practice. Providing education related to measures/indicators or tool
b b b b b b b b
s used to assess the level of care provided within a system of care to popula
b b b b b b b b b b b b b b b
tions of patients with gestational diabetes exemplifies a quality improveme
b b b b b b b b b
nt measure.
b
3. A nursing student observes the home care nurse provide education to a
b b b b b b b b b b b b
patient with congestive heart failure (CHF). The nurse teaches the patient
b b b b b b b b b b b
how to read food labels and calculate sodium content. The nursing student
b b b b b b b b b b b b
recognizes that the home care nurse is aware of which of the following bas
b b b b b b b b b b b b b
ic principles of patient education?
b b b b
a) The home care nurse is providing hospital discharge instructions
b b b b b b b b
b) The home care nurse has a physician order to teach a 2-g sodium diet
b b b b b b b b b b b b b
c) Patients are required to learn about their therapeutic nutritional regimen
b b b b b b b b b
d) Patient instruction related to self- b b b b
care activities promotes patient independence
b b b b
d) Patient instruction related to self-
b b b b b
care activities promotes patient independence
b b b b
Rationale: Teaching is a function of nursing to assist patients to alter lifestyl
b b b b b b b b b b b b
e patterns that increase health risk. By teaching the client how to calculate s
b b b b b b b b b b b b b
odium content of foods the nurse is facilitating independence in nutrition di
b b b b b b b b b b b
sease management. Patients have the right to decide whether or not to learn.
b b b b b b b b b b b b b
Teaching is an independent function of nursing and does not require a physi
b b b b b b b b b b b b
cian’s order. Teaching related to food labels in the patient
b b b b b b b b b
,home is an appropriate environment for this client. The nurse can use actua
b b b b b b b b b b b b
l foods from the patient’s kitchen.
b b b b b
4. A nurse working in the intensive care unit (ICU) refers to the Institute for
b b b b b b b b b b b b b b
Healthcare Improvement (IHI) Ventilator Bundle prior to planning patient
b b b b b b b b b
care. The nurse realizes nursing interventions outlined in the bundle will i
b b b b b b b b b b b
mprove patients’ outcomes. Which of the following statement best describe
b b b b b b b b b
s how IHI-
b b
established nursing interventions should be included in each bundle?
b b b b b b b b
a) Nursing interventions found within the IHI bundles were selected based
b b b b b b b b b b
on the ability to provide optimal time management for the nurse
b b b b b b b b b b
b) Best practice derived from valid and reliable research studies guided
b b b b b b b b b b
nursing interventions being added to the IHI bundles
b b b b b b b
c) Nurse case managers serving as patient advocates recommended nursing
b b b b b b b b b
interventions to be included in the IHI bundles based on patient preference b b b b b b b b b b b
d) Hospitals, physicians, and nurses worked collaboratively to design b b b b b b b b
patient care activities included in IHI bundles
b b b b b b
b) Best practice derived from valid and reliable research studies guided nursi
b b b b b b b b b b b
ng interventions being added to the IHI bundles
b b b b b b b
Rationale: Bundles include evidence- b b b
based practices. Hospitals, physicians, and nurses work collaboratively to pr
b b b b b b b b b
ovide care directed by bundles.
b b b b
Nurses advocate on behalf of the patient. Effective time management is a
b b b b b b b b b b b b
key element in the provision of care, however; IHI-
b b b b b b b b
based bundles on evidence-based practice.
b b b b
5. A 54-year- b
old woman on a fixed income has had an electrocardiogram (ECG) as part
b b b b b b b b b b b b
bof her annual physical examination. Her physician notes an abnormal Q
b b b b b b b b b b b
wave on an otherwise unremarkable ECG. What legislation supports this
b b b b b b b b b b
focus on disease prevention, health promotion, and management of chro
b b b b b b b b b
nic conditions?
b
a) Building a Safer Health System Act b b b b b
b) The Patient Protection and Affordable Care Act
b b b b b b
c) Healthcare Research and Quality Improvement Bill b b b b b
d) A New Health System for the 21st Century Bill
b b b b b b b b
b) The Patient Protection and Affordable Care Act
b b b b b b
, Rationale: The Patient Protection and Affordable Care Act, also known as th
b b b b b b b b b b b
e ACA, supports access to quality, affordable health care, improved access to
b b b b b b b b b b b b
innovative and preventive health care programs and therapies, and expand
b b b b b b b b b
ed insurance coverage. “To Err Is Human: Building a Safer Health System” a
b b b b b b b b b b b b
nd “Crossing the Quality Chasm: A New Health System for the 21st Century”
b b b b b b b b b b b b b
are IOM reports. Centers for Medicare and Medicaid Services (CMS) partner
b b b b b b b b b b
ed with the Agency for Healthcare Research and Quality (AHRQ) to launch t
b b b b b b b b b b b b
he Hospital Consumer Assessment of Healthcare Providers and Systems (H
b b b b b b b b b
CAHPS) survey. b
6. According to Hood and Leddy (2007), which of the following are
b b b b b b b b b b b
components of wellness? b b
a) Inability to obtain personal goals b b b b
b) Expression of disharmony b b
c) Feelings of well-being b b
d) Inability to adapt to changing situations b b b b b
c) Appropriateness of services b b
Rationale: The goals of care management are quality, appropriateness, and
b b b b b b b b b b
timeliness of services as well as cost reduction. Case managers do not have
b b b b b b b b b b b b b
prescriptive authority. Fixed- b b
price reimbursement is a feature of managed care. Case managers do not u
b b b b b b b b b b b b
se the nursing process.
b b b
7. The school nurse informs the mother of a second-
b b b b b b b b
grade student that she found lice in her child’s hair. The mother explains to
b b b b b b b b b b b b b b
the nurse that she has another child to pick up and cannot stay to receive ed
b b b b b b b b b b b b b b b
ucation related to the treatment of lice at this time. The mother reassures th
b b b b b b b b b b b b b
e nurse that she will “look up treatment options on the Internet and take car
b b b b b b b b b b b b b b
e of the child.” What would be the best action of the school nurse in this situ
b b b b b b b b b b b b b b b b
ation?
a) Instruct the mother to treat the other child for lice in the same manner as t
b b b b b b b b b b b b b b b
he second grade child
b b b
b) Provide the mother with a list of credible Web sites related to the
b b b b b b b b b b b b b
treatment of lice b b
c) Notify the social worker of suspected child neglect and make a referral to
b b b b b b b b b b b b b
child protective services
b b
b b b b b bb
D PRACTICE REGISTERED NURSE (APRN) FINAL EXAM 2.
b b b b b b b
HESI EXIT FAMILY NURSE PRACTITIONER FINAL EXAM
b b b b b b
S(GRADED A,RATIONALE AND 100% VERIFIED). b b b b
1. Which of the following nursing actions demonstrates that the nurse
b b b b b b b b b b
understands the nursing process? b b b
a) Prioritizing patient goals, documenting all health records precisely,
b b b b b b b b
conducting the health history, and documenting the nursing diagnosis
b b b b b b b b
b) Reviewing health record, documenting patient goals, identifying etiology
b b b b b b b b
of the nursing problem, and evaluating treatment outcome.
b b b b b b b
c) Assessing for allergies, administering analgesic, obtaining baseline vital
b b b b b b b b
signs, and documenting nursing diagnosis as acute pain
b b b b b b b
d) Obtaining vital signs, documenting nursing diagnosis as acute pain,
b b b b b b b b b
administering analgesic, and evaluating comfort level b b b b b
d) Obtaining vital signs, documenting nursing diagnosis as acute pain, admin
b b b b b b b b b b
istering analgesic, and evaluating comfort level
b b b b b
Rationale: Steps of the nursing process in order are: Assessment, Diagnosis,
b b b b b b b b b b b
Planning, Implementation, and Evaluation. Assessment is the systematic coll
b b b b b b b b
ection of data to determine the patient's health status and any actual or pote
b b b b b b b b b b b b b
ntial health problems. Nursing diagnoses are actual or potential health probl
b b b b b b b b b b
ems that can be managed by independent nursing interventions.
b b b b b b b b
Planning is the development of goals and outcomes. Implementation is the
b b b b b b b b b b b
actualization of the plan of care through nursing interventions. Evaluation i
b b b b b b b b b b
s the determination of the patient’s responses to the nursing interventions
b b b b b b b b b b b
and the extent to which the outcomes have been achieved.
b b b b b b b b b
2. The nurse educator is planning a teaching session for nursing students r
b b b b b b b b b b b
elated to treatment and management of gestational diabetes. The nurse ed
b b b b b b b b b b
ucator arranges for a dietitian, pharmacist, and physician assistant to parti
b b b b b b b b b b
cipate in the lesson plan. Which professional nurse competency is the nurs
b b b b b b b b b b b
e educator demonstrating?
b b
,a) Evidence-based practice b
b) Patient-centered care b
c) Interdisciplinary teamwork b
d) Quality improvement measures b b
c) Interdisciplinary teamwork
b b
Rationale: By integrating interdisciplinary core competencies into their res
b b b b b b b b
pective curricula the nurse educator is demonstrating interdisciplinary tea
b b b b b b b b
mwork. A case- b b
study approach planning care around individual patient preferences is an e
b b b b b b b b b b
xample of patient-centered care. Conducting an evidence-
b b b b b b
based literature review related to gestational diabetes reflects evidence-
b b b b b b b b
based practice. Providing education related to measures/indicators or tool
b b b b b b b b
s used to assess the level of care provided within a system of care to popula
b b b b b b b b b b b b b b b
tions of patients with gestational diabetes exemplifies a quality improveme
b b b b b b b b b
nt measure.
b
3. A nursing student observes the home care nurse provide education to a
b b b b b b b b b b b b
patient with congestive heart failure (CHF). The nurse teaches the patient
b b b b b b b b b b b
how to read food labels and calculate sodium content. The nursing student
b b b b b b b b b b b b
recognizes that the home care nurse is aware of which of the following bas
b b b b b b b b b b b b b
ic principles of patient education?
b b b b
a) The home care nurse is providing hospital discharge instructions
b b b b b b b b
b) The home care nurse has a physician order to teach a 2-g sodium diet
b b b b b b b b b b b b b
c) Patients are required to learn about their therapeutic nutritional regimen
b b b b b b b b b
d) Patient instruction related to self- b b b b
care activities promotes patient independence
b b b b
d) Patient instruction related to self-
b b b b b
care activities promotes patient independence
b b b b
Rationale: Teaching is a function of nursing to assist patients to alter lifestyl
b b b b b b b b b b b b
e patterns that increase health risk. By teaching the client how to calculate s
b b b b b b b b b b b b b
odium content of foods the nurse is facilitating independence in nutrition di
b b b b b b b b b b b
sease management. Patients have the right to decide whether or not to learn.
b b b b b b b b b b b b b
Teaching is an independent function of nursing and does not require a physi
b b b b b b b b b b b b
cian’s order. Teaching related to food labels in the patient
b b b b b b b b b
,home is an appropriate environment for this client. The nurse can use actua
b b b b b b b b b b b b
l foods from the patient’s kitchen.
b b b b b
4. A nurse working in the intensive care unit (ICU) refers to the Institute for
b b b b b b b b b b b b b b
Healthcare Improvement (IHI) Ventilator Bundle prior to planning patient
b b b b b b b b b
care. The nurse realizes nursing interventions outlined in the bundle will i
b b b b b b b b b b b
mprove patients’ outcomes. Which of the following statement best describe
b b b b b b b b b
s how IHI-
b b
established nursing interventions should be included in each bundle?
b b b b b b b b
a) Nursing interventions found within the IHI bundles were selected based
b b b b b b b b b b
on the ability to provide optimal time management for the nurse
b b b b b b b b b b
b) Best practice derived from valid and reliable research studies guided
b b b b b b b b b b
nursing interventions being added to the IHI bundles
b b b b b b b
c) Nurse case managers serving as patient advocates recommended nursing
b b b b b b b b b
interventions to be included in the IHI bundles based on patient preference b b b b b b b b b b b
d) Hospitals, physicians, and nurses worked collaboratively to design b b b b b b b b
patient care activities included in IHI bundles
b b b b b b
b) Best practice derived from valid and reliable research studies guided nursi
b b b b b b b b b b b
ng interventions being added to the IHI bundles
b b b b b b b
Rationale: Bundles include evidence- b b b
based practices. Hospitals, physicians, and nurses work collaboratively to pr
b b b b b b b b b
ovide care directed by bundles.
b b b b
Nurses advocate on behalf of the patient. Effective time management is a
b b b b b b b b b b b b
key element in the provision of care, however; IHI-
b b b b b b b b
based bundles on evidence-based practice.
b b b b
5. A 54-year- b
old woman on a fixed income has had an electrocardiogram (ECG) as part
b b b b b b b b b b b b
bof her annual physical examination. Her physician notes an abnormal Q
b b b b b b b b b b b
wave on an otherwise unremarkable ECG. What legislation supports this
b b b b b b b b b b
focus on disease prevention, health promotion, and management of chro
b b b b b b b b b
nic conditions?
b
a) Building a Safer Health System Act b b b b b
b) The Patient Protection and Affordable Care Act
b b b b b b
c) Healthcare Research and Quality Improvement Bill b b b b b
d) A New Health System for the 21st Century Bill
b b b b b b b b
b) The Patient Protection and Affordable Care Act
b b b b b b
, Rationale: The Patient Protection and Affordable Care Act, also known as th
b b b b b b b b b b b
e ACA, supports access to quality, affordable health care, improved access to
b b b b b b b b b b b b
innovative and preventive health care programs and therapies, and expand
b b b b b b b b b
ed insurance coverage. “To Err Is Human: Building a Safer Health System” a
b b b b b b b b b b b b
nd “Crossing the Quality Chasm: A New Health System for the 21st Century”
b b b b b b b b b b b b b
are IOM reports. Centers for Medicare and Medicaid Services (CMS) partner
b b b b b b b b b b
ed with the Agency for Healthcare Research and Quality (AHRQ) to launch t
b b b b b b b b b b b b
he Hospital Consumer Assessment of Healthcare Providers and Systems (H
b b b b b b b b b
CAHPS) survey. b
6. According to Hood and Leddy (2007), which of the following are
b b b b b b b b b b b
components of wellness? b b
a) Inability to obtain personal goals b b b b
b) Expression of disharmony b b
c) Feelings of well-being b b
d) Inability to adapt to changing situations b b b b b
c) Appropriateness of services b b
Rationale: The goals of care management are quality, appropriateness, and
b b b b b b b b b b
timeliness of services as well as cost reduction. Case managers do not have
b b b b b b b b b b b b b
prescriptive authority. Fixed- b b
price reimbursement is a feature of managed care. Case managers do not u
b b b b b b b b b b b b
se the nursing process.
b b b
7. The school nurse informs the mother of a second-
b b b b b b b b
grade student that she found lice in her child’s hair. The mother explains to
b b b b b b b b b b b b b b
the nurse that she has another child to pick up and cannot stay to receive ed
b b b b b b b b b b b b b b b
ucation related to the treatment of lice at this time. The mother reassures th
b b b b b b b b b b b b b
e nurse that she will “look up treatment options on the Internet and take car
b b b b b b b b b b b b b b
e of the child.” What would be the best action of the school nurse in this situ
b b b b b b b b b b b b b b b b
ation?
a) Instruct the mother to treat the other child for lice in the same manner as t
b b b b b b b b b b b b b b b
he second grade child
b b b
b) Provide the mother with a list of credible Web sites related to the
b b b b b b b b b b b b b
treatment of lice b b
c) Notify the social worker of suspected child neglect and make a referral to
b b b b b b b b b b b b b
child protective services
b b
