a nurse is assessing an older adult client who was brought to the emergency department by his son who reports that the client fell at home the nurse s
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HESI Leadership and Management Quizlet

1. A nurse is assessing an older adult client who was brought to the emergency department by his son, who reports that the client fell at home. The nurse suspects elder abuse. Which of the following actions should the nurse take?

Correct answer: C

Rationale: The correct action for the nurse to take is to ask the client's son to go to the waiting area. This allows the nurse to interview the client independently to assess for signs of elder abuse without the son's potential influence. Filing an incident report may be necessary later but is not the immediate action required. Asking about injuries with the son present could lead to biased responses or intimidation. Treating and discharging the client without addressing the suspicion of elder abuse would neglect the nurse's responsibility to ensure the client's safety.

2. Serge, who has diabetes mellitus, is taking oral agents and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of action for the nurse regarding Serge's oral medications?

Correct answer: C

Rationale: The best plan of action for the nurse is to notify the physician and request orders regarding Serge's oral medications. By involving the physician, the nurse ensures that appropriate instructions are obtained, considering Serge's medical condition and the need for NPO status for the diagnostic test. Administering the medications without medical guidance (choice A) can be risky, as it may affect the test results. Notifying the diagnostic department (choice B) is not the most direct and appropriate action; the physician is the primary healthcare provider responsible for medication orders. Administering the medications with water before the test (choice D) is not advisable when the patient is supposed to be NPO, as it can interfere with the test requirements.

3. Which of the following is an example of a chronic disease?

Correct answer: C

Rationale: Diabetes is classified as a chronic disease because it is a long-term condition that requires ongoing management. Choices A, B, and D, which are the common cold, influenza, and food poisoning, are acute illnesses that typically resolve on their own without long-lasting implications.

4. Select the stage of shock that is accurately paired with its characteristic.

Correct answer: C

Rationale: The progressive stage of shock is accurately described as the stage where histamine is released, leading to fluid and proteins leaking into surrounding tissues and the blood thickening. In this stage, the body's compensatory mechanisms are overwhelmed, resulting in a cascade of events that worsen the shock state. Choice A is incorrect as hyperventilation and a rise in blood pH are more characteristic of the compensatory stage. Choice B is incorrect as hypoxia and a rise in lactic acid are more typical of the progressive stage. Choice D is incorrect as the described electrolyte imbalances and metabolic acidosis are more aligned with the refractory stage of shock.

5. Which of the following strategies can help improve patient adherence to treatment plans?

Correct answer: A

Rationale: Providing clear and understandable instructions can help improve patient adherence to treatment plans. Clear instructions help patients better understand their treatment plans, leading to increased compliance. Choices B, C, and D are incorrect. Using medical jargon can confuse patients and reduce adherence. Limiting patient education deprives patients of essential information needed for adherence. Ignoring patient feedback can lead to misunderstandings and hinder the patient's commitment to the treatment plan.

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