HESI - Adaptive Quizzing

The nurse is caring for a client who is terminally ill with cancer. The health care team meets and agrees to provide the client with information to help the client make decisions regarding treatment. Which ethical principles are applied in this situation? Select all that apply.

1) justice 2) fidelity 3) veracity 4) autonomy

The nurse is assessing a client following abdominal surgery. Which assessment findings should the nurse use to form a data cluster? Select all that apply.

1) the patient reports pain with movement 2) the patient has pain over the surgical area 3) the client rates the pain as 8 on the scale

While performing a physical assessment of a female client, the nurse positions the client in Sims' position. Which body system will be assessed in this position? Select all that apply.

1) vagina 2) rectum

A nurse is planning to provide self-care health information to several clients. Which client should the nurse anticipate will be most motivated to learn?

A 56-year-old client who had a heart attack last week and is requesting information about exercise

A nursing instructor is teaching a group of nursing students about sentinel events. What is appropriate to include in the education?

A sentinel event is undesirable and largely avoidable.

A nurse is caring for an elderly client with dementia who has developed dehydration as a result of vomiting and diarrhea. Which assessment best reflects the fluid balance of this client?

Blood lab results

A nursing instructor provides teaching about the ethical principle of nonmaleficence to a group of nursing students. What is appropriate for the nurse to include in the education?

Act in ways to prevent harm to clients.

The nurse places a pulse oximetry probe on the finger and toe of a client with a respiratory disorder to determine the oxygen saturation of hemoglobin (SpO2). Which other parameter can be determined using this technique?

Arterial oxygen saturation

After abdominal surgery a client reports pain. What action should the nurse take first?

Determine the characteristics of the pain.

While entering data for a client in the electronic health record (EHR), the nurse uses North American Nursing Diagnosis Association (NANDA) International terminology to document which part of the nursing process?

Diagnosis

The nurse starts a new job and recognizes that the client population is very diverse. What action will help the nurse to provide culturally competent care?

Increase self-awareness of cultural identity, cultural knowledge, and potential biases.

The nurse finds that a client with a urinary disorder has very pale-yellow-colored urine. What is the significance of this abnormal finding?

It indicates dilute urine.

While obtaining the vital signs of a client, the nurse finds that the body temperature of the client is 98.6 °F. The nurse concludes that the client is experiencing what?

Normothermia

Which action performed by the nursing student during the chest examination of a client needs correction?

Placing the stethoscope over bony prominences

Which step of the nursing process is directly affected if the nurse does not make a nursing diagnosis?

Planning

While providing palliative care, the nurse finds symptoms of dyspnea. What will be the priority nursing intervention in this situation?

Providing prescribed oxygen by nasal cannula

During chest examination in a healthy client, the APN percusses and hears a low-pitched sound over the lungs. Which sound should the nurse document in the medical record?

Resonance

The student nurse is reviewing the electronic health record for clients in a health care facility. Which action by the student nurse may inhibit clients from disclosing personal information?

Sharing clients' data with family members

Which feature is characteristic of a risk nursing diagnosis?

The diagnosis does not have related factors.

What can be inferred when a professional is said to have ethical sensitivity?

The professional has the ability to recognize ethical dilemmas.

Which related factor is appropriate for a nursing diagnosis?

Trauma of incision

The nurse is entering a client's data in the electronic health record. What action should the nurse take to minimize ambiguity and confusion?

Use consistent, codified terminology.

Which ethical principle is violated when the nurse forgets to give a painkiller to a client as promised?

fidelity

The nurse is working with a female client who is from Southeast Asia that presents with general fatigue. The nurse asks the client if there is any reason for her fatigue. Which statements are most culturally consistent with a client from Southeast Asian culture? Select all that apply.

1) "I'm tired because I have less blood in my body." 2) "I'm tired because my blood vessels are weak." 3) "I'm tired because I haven't been eating right lately."

Which physical assessment findings of a client suspected of having a respiratory disorder would be considered normal? Select all that apply.

1) A midline trachea 2) pink nasal mucosa 3) non labored respirations of 12 breaths/min

What is the correct order of steps of the nursing diagnostic process?

1) Assess the client's health status. 2) validate 3) interpret 4) cluster 5) clients need 6) formulate diagnosis

Which features distinguish nursing diagnoses from medical diagnoses? Select all that apply.

1) Nursing diagnoses involve the client when possible. 2) Nursing diagnoses involve the sorting of health problems within the nursing domain. 3) Nursing diagnoses involve clinical judgment about the client's response to health problems.

The nurse is teaching the benefits of electronic health records (EHRs) to clients in a community health care center. What would be appropriate for the nurse to include in the education? Select all that apply.

1) The EHR helps obtain Medicare and Medicaid payments. 2) The EHR helps to share personal health information with selected family members. 3) The EHR helps provide more accurate diagnoses and treatment in emergency conditions.

What should the nurse do when the defining characteristics of assessment data for a client can apply to more than one diagnosis? Select all that apply.

1) gather more information 2) identify related factors 3) review all defining characteristics