HESI LPN
Leadership and Management HESI Quizlet
1. A nurse in the emergency department is assessing a client who is unconscious following a motor-vehicle crash. The client requires immediate surgery. Which of the following actions should the nurse take?
- A. Transport the client to the operating room without verifying informed consent
- B. Ask the anesthesiologist to sign the consent
- C. Obtain telephone consent from the facility administrator before the surgery
- D. Delay the surgery until the nurse can obtain informed consent
Correct answer: A
Rationale: In emergency situations where a client is unconscious and requires immediate surgery, implied consent applies. Implied consent allows healthcare providers, including nurses, to proceed with necessary treatment or surgery without formally verifying informed consent. Choice A is correct because the priority in this scenario is to ensure the client receives timely medical intervention to address life-threatening conditions. Choices B, C, and D are incorrect because in emergencies, waiting to obtain formal consent can delay critical treatment, risking the client's health and well-being.
2. A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority?
- A. A client who reports right-sided flank pain and is diaphoretic
- B. A client who has active bleeding from a puncture wound of the left groin area
- C. A client who has a raised red skin rash on his arms, neck, and face
- D. A client who reports shortness of breath and left neck and shoulder pain
Correct answer: D
Rationale: The correct answer is D because shortness of breath with referred pain may indicate a serious condition, such as a cardiac event or pulmonary embolism, making this the highest priority. Option A, flank pain with diaphoresis, could suggest kidney-related issues but is not as immediately life-threatening as compromised breathing. Option B, active bleeding, though serious, can usually be controlled with proper interventions. Option C, a raised red skin rash, may indicate an allergic reaction but is not as urgent as respiratory distress with neck and shoulder pain.
3. Based on the signs and symptoms of erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems, and skin nodules in your 32-year-old female patient, what disorder would you most likely suspect?
- A. Leukemia
- B. Histoplasmosis
- C. Pneumocystis jiroveci
- D. Rheumatoid arthritis
Correct answer: D
Rationale: The signs and symptoms described point towards rheumatoid arthritis. Erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac issues, and skin nodules are classic manifestations of rheumatic fever, which is a complication of untreated streptococcal infection. This condition can lead to rheumatoid arthritis over time. Choices A, B, and C are incorrect as they do not align with the provided signs and symptoms, and they are not associated with the clinical presentation described.
4. A client is in DKA, secondary to infection. As the condition progresses, which of the following symptoms might the nurse see?
- A. Kussmaul's respirations and a fruity odor on the breath
- B. Shallow respirations and severe abdominal pain
- C. Decreased respirations and increased urine output
- D. Cheyne-Stokes respirations and foul-smelling urine
Correct answer: A
Rationale: In diabetic ketoacidosis (DKA), as the condition progresses, the body tries to compensate for the acidic environment by increasing the respiratory rate, leading to Kussmaul's respirations. The accumulation of ketones in the body causes a fruity odor on the breath. Option A is correct because Kussmaul's respirations and a fruity odor on the breath are classic signs of DKA. Option B is incorrect because shallow respirations are not typically seen in DKA, and severe abdominal pain is more commonly associated with conditions like pancreatitis. Option C is incorrect as decreased respirations are not a typical finding in DKA, and increased urine output is more commonly seen in conditions like diabetes insipidus. Option D is incorrect because Cheyne-Stokes respirations are not characteristic of DKA, and foul-smelling urine is not a prominent symptom in this condition.
5. What is a major concern about the health-care system in the United States?
- A. Emphasis on disease prevention
- B. Quality of care
- C. Collaborative care
- D. Reduction in hospital-acquired drug-resistant infections
Correct answer: B
Rationale: The major concern about the health-care system in the United States is the quality of care provided. While disease prevention and collaborative care are important aspects, the primary focus of concern is ensuring that the care delivered meets high standards in terms of effectiveness, safety, and patient outcomes. Reduction in hospital-acquired drug-resistant infections, although relevant, is not the primary concern when evaluating the overall quality of healthcare services.
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