during an assessment the nurse notices that a patient is handling a small charm that is tied to a leather strip around his neck which action by the nu
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Nursing Elites

HESI A2

HESI A2 Practice Test Anatomy and Physiology

1. During an assessment, the nurse notices that a patient is handling a small charm that is tied to a leather strip around his neck. Which action by the nurse is appropriate?

Correct answer: A

Rationale: The appropriate action for the nurse in this situation is to ask the patient about the charm and its significance. This helps the nurse understand the patient's cultural beliefs, personal values, and any potential significance the charm holds for the patient. It also shows respect for the patient's personal belongings. Asking about the charm can help establish rapport and cultural competence in the nurse-patient relationship. Choices B and C do not address the patient's attachment to the charm or provide an opportunity for cultural understanding. Choice D is incorrect as it dismisses the importance of acknowledging and respecting the patient's personal belongings.

2. When communicating with a patient who has a hearing impairment, what technique would be most beneficial?

Correct answer: A

Rationale: When communicating with a patient who has a hearing impairment, it is crucial to determine the preferred communication method, whether it involves signing, lip reading, or writing. By directly asking the patient for their preferred method of communication, the healthcare provider can ensure effective and respectful interaction tailored to the individual's specific needs and preferences. Option B is incorrect because using facial and hand gestures can actually aid in communication for some individuals with hearing impairments. Option C is not always necessary and may not be the preferred method for all patients. Option D is incorrect because speaking loudly and with exaggerated facial movements is not necessary and may not be preferred by the patient.

3. During an interview, the nurse states, 'You mentioned shortness of breath. Tell me more about that.' Which verbal skill is used with this statement?

Correct answer: D

Rationale: The nurse's statement, 'Tell me more about that,' is an example of an open-ended question. Open-ended questions encourage the interviewee to provide detailed information and expand on their responses. This type of question is useful for gathering narrative information and allows the interviewee to express themselves freely. Reflection involves restating or paraphrasing the client's words, facilitation encourages the client to say more, and direct questions typically elicit specific, close-ended responses, unlike open-ended questions.

4. During an interview, the interviewer is using open-ended questions. Which of the following statements are true regarding open-ended questions? Select all that apply.

Correct answer: B

Rationale: Open-ended questions are designed to encourage the interviewee to express themselves freely, leading to more detailed and insightful responses. These questions help build rapport by showing interest in the interviewee's thoughts and feelings. By allowing for self-expression, open-ended questions facilitate a deeper and more meaningful conversation, making them a valuable tool in conducting interviews. Choice A is incorrect because open-ended questions aim to gather detailed and subjective information, not just cold facts. Choice D is incorrect as open-ended questions often lead to more engaging interactions rather than leaving them neutral.

5. When planning a cultural assessment, which component should be included?

Correct answer: D

Rationale: When planning a cultural assessment, the nurse should include the component of health-related beliefs. Understanding a person's cultural background and beliefs about health and wellness is crucial for providing culturally competent care. Health-related beliefs can impact a person's attitudes towards illness, treatment preferences, and adherence to medical recommendations. Therefore, assessing health-related beliefs is essential for delivering effective and respectful healthcare services. Choices A, B, and C are important components of a comprehensive patient assessment but are not specific to cultural considerations. While family history, chief complaint, and medical history are pertinent to understanding a patient's health status, health-related beliefs focus specifically on the cultural aspect that influences an individual's health perceptions and behaviors.

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