2024-2025 HESI A2 Critical Thinking with Answers (124 Solved Questions)
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HESI A2 - Critical Thinking
100% VERIFIED ANSWERS
2024/2025 ALREADY
PASSED
1. The nurse is working in the emergency department (ED) of a children's medical
center. Which client should the nurse assess first?
1. The 1-month-old infant who has developed colic and is crying.
2. The 2-year-old toddler who was bitten by another child at the day-care center.
3. The 6-year-old school-age child who was hit by a car while riding a bicycle.
4. The 14-year-old adolescent whose mother suspects her child is sexually active.
Rationale
Correct - 3-The child hit by a car should be assessed first because he or she may have
life- threatening injuries that must be assessed and treated promptly.
1. In an interview, the nurse may find it necessary to take notes to aid his or her
memory later. Which statement is true regarding note-taking?
A) Note-taking may impede the nurse's observation of the patient's nonverbal
behaviors.
B) Note-taking allows the patient to continue at his or her own pace as the nurse
records what is said.
C) Note-taking allows the nurse to shift attention away from the patient, resulting
in an increased comfort level.
D) Note-taking allows the nurse to break eye contact with the patient, which may
increase his or her level of comfort.
100% VERIFIED ANSWERS
2024/2025 ALREADY
PASSED
1. The nurse is working in the emergency department (ED) of a children's medical
center. Which client should the nurse assess first?
1. The 1-month-old infant who has developed colic and is crying.
2. The 2-year-old toddler who was bitten by another child at the day-care center.
3. The 6-year-old school-age child who was hit by a car while riding a bicycle.
4. The 14-year-old adolescent whose mother suspects her child is sexually active.
Rationale
Correct - 3-The child hit by a car should be assessed first because he or she may have
life- threatening injuries that must be assessed and treated promptly.
1. In an interview, the nurse may find it necessary to take notes to aid his or her
memory later. Which statement is true regarding note-taking?
A) Note-taking may impede the nurse's observation of the patient's nonverbal
behaviors.
B) Note-taking allows the patient to continue at his or her own pace as the nurse
records what is said.
C) Note-taking allows the nurse to shift attention away from the patient, resulting
in an increased comfort level.
D) Note-taking allows the nurse to break eye contact with the patient, which may
increase his or her level of comfort.
HESI A2 - Critical Thinking
100% VERIFIED ANSWERS
2024/2025 ALREADY
PASSED
1. The nurse is working in the emergency department (ED) of a children's medical
center. Which client should the nurse assess first?
1. The 1-month-old infant who has developed colic and is crying.
2. The 2-year-old toddler who was bitten by another child at the day-care center.
3. The 6-year-old school-age child who was hit by a car while riding a bicycle.
4. The 14-year-old adolescent whose mother suspects her child is sexually active.
Rationale
Correct - 3-The child hit by a car should be assessed first because he or she may have
life- threatening injuries that must be assessed and treated promptly.
1. In an interview, the nurse may find it necessary to take notes to aid his or her
memory later. Which statement is true regarding note-taking?
A) Note-taking may impede the nurse's observation of the patient's nonverbal
behaviors.
B) Note-taking allows the patient to continue at his or her own pace as the nurse
records what is said.
C) Note-taking allows the nurse to shift attention away from the patient, resulting
in an increased comfort level.
D) Note-taking allows the nurse to break eye contact with the patient, which may
increase his or her level of comfort.
100% VERIFIED ANSWERS
2024/2025 ALREADY
PASSED
1. The nurse is working in the emergency department (ED) of a children's medical
center. Which client should the nurse assess first?
1. The 1-month-old infant who has developed colic and is crying.
2. The 2-year-old toddler who was bitten by another child at the day-care center.
3. The 6-year-old school-age child who was hit by a car while riding a bicycle.
4. The 14-year-old adolescent whose mother suspects her child is sexually active.
Rationale
Correct - 3-The child hit by a car should be assessed first because he or she may have
life- threatening injuries that must be assessed and treated promptly.
1. In an interview, the nurse may find it necessary to take notes to aid his or her
memory later. Which statement is true regarding note-taking?
A) Note-taking may impede the nurse's observation of the patient's nonverbal
behaviors.
B) Note-taking allows the patient to continue at his or her own pace as the nurse
records what is said.
C) Note-taking allows the nurse to shift attention away from the patient, resulting
in an increased comfort level.
D) Note-taking allows the nurse to break eye contact with the patient, which may
increase his or her level of comfort.
A) Note-taking may impede the nurse's observation of the patient's nonverbal
behaviors.
Page: 31 Some use of history forms and note-taking may be unavoidable. But be aware
that note-taking during the interview has disadvantages. It breaks eye contact too often,
and it shifts attention away from the patient, which diminishes his or her sense of
importance. It also may interrupt the patient's narrative flow, and it impedes the
observation of the patient's nonverbal behavior.
2. The 8-year-old client diagnosed with a vaso-occlusive sickle cell crisis is
complaining of a severe headache. Which intervention should the nurse
implement first?
1. Administer 6 L of oxygen via nasal cannula.
2. Assess the client's neurological status.
3. Administer a narcotic analgesic by intravenous push (IVP). 4. Increase the
client's intravenous (IV) rate.
Rationale
Correct - 2-Because the client is complaining of a headache, the nurse should first rule
out cerebrovascular accident (CVA) by assess- ing the client's neurological status and
then determine whether it is a headache that can be treated with medication.
2. During an interview, the nurse states, "You mentioned shortness of breath. Tell
me more about that." Which verbal skill is used with this statement?
A) Reflection
B) Facilitation
C) Direct question
D) Open-ended question
D) Open-ended question
Page: 32 The open-ended question asks for narrative information. It states the topic to
behaviors.
Page: 31 Some use of history forms and note-taking may be unavoidable. But be aware
that note-taking during the interview has disadvantages. It breaks eye contact too often,
and it shifts attention away from the patient, which diminishes his or her sense of
importance. It also may interrupt the patient's narrative flow, and it impedes the
observation of the patient's nonverbal behavior.
2. The 8-year-old client diagnosed with a vaso-occlusive sickle cell crisis is
complaining of a severe headache. Which intervention should the nurse
implement first?
1. Administer 6 L of oxygen via nasal cannula.
2. Assess the client's neurological status.
3. Administer a narcotic analgesic by intravenous push (IVP). 4. Increase the
client's intravenous (IV) rate.
Rationale
Correct - 2-Because the client is complaining of a headache, the nurse should first rule
out cerebrovascular accident (CVA) by assess- ing the client's neurological status and
then determine whether it is a headache that can be treated with medication.
2. During an interview, the nurse states, "You mentioned shortness of breath. Tell
me more about that." Which verbal skill is used with this statement?
A) Reflection
B) Facilitation
C) Direct question
D) Open-ended question
D) Open-ended question
Page: 32 The open-ended question asks for narrative information. It states the topic to
be discussed but only in general terms. The nurse should use it to begin the interview,
to introduce a new section of questions, and whenever the person introduces a new
topic.
3. The 6-year-old client who has undergone abdominal surgery is attempting to
make a pinwheel spin by blowing on it with the nurse's assistance. The child
starts crying because the pinwheel won't spin. Which action should the nurse
implement first?
1. Praise the child for the attempt to make the pinwheel spin.
2. Notify the respiratory therapist to implement incentive spirometry. 3.
Encourage the child to turn from side to side and cough.
4. Demonstrate how to make the pinwheel spin by blowing on it.
Rationale
Correct -1. The nurse should always praise the child for attempts at cooperation even if
the child did not accomplish what the nurse asked.
3. A nurse is taking complete health histories on all of the patients attending a
wellness workshop. On the history form, one of the written questions asks, "You
don't smoke, drink, or take drugs, do you?" This question is an example of:
A) talking too much.
B) using confrontation.
C) using biased or leading questions.
D) using blunt language to deal with distasteful topics.
C) using biased or leading questions.
Page: 36 This is an example of using leading or biased questions. Asking, "You don't
smoke, do you?" implies that one answer is "better" than another. If the person wants to
please someone, he or she is either forced to answer in a way corresponding to their
implied values or is made to feel guilty when admitting the other answer.
to introduce a new section of questions, and whenever the person introduces a new
topic.
3. The 6-year-old client who has undergone abdominal surgery is attempting to
make a pinwheel spin by blowing on it with the nurse's assistance. The child
starts crying because the pinwheel won't spin. Which action should the nurse
implement first?
1. Praise the child for the attempt to make the pinwheel spin.
2. Notify the respiratory therapist to implement incentive spirometry. 3.
Encourage the child to turn from side to side and cough.
4. Demonstrate how to make the pinwheel spin by blowing on it.
Rationale
Correct -1. The nurse should always praise the child for attempts at cooperation even if
the child did not accomplish what the nurse asked.
3. A nurse is taking complete health histories on all of the patients attending a
wellness workshop. On the history form, one of the written questions asks, "You
don't smoke, drink, or take drugs, do you?" This question is an example of:
A) talking too much.
B) using confrontation.
C) using biased or leading questions.
D) using blunt language to deal with distasteful topics.
C) using biased or leading questions.
Page: 36 This is an example of using leading or biased questions. Asking, "You don't
smoke, do you?" implies that one answer is "better" than another. If the person wants to
please someone, he or she is either forced to answer in a way corresponding to their
implied values or is made to feel guilty when admitting the other answer.
4. The nurse is caring for clients on the pediatric medical unit. Which client
should the nurse assess first?
1. The child diagnosed with type 1 diabetes who has a blood glucose level
of 180 mg/dL.
2. The child diagnosed with pneumonia who is coughing and has a temperature
of
100°F.
3. The child diagnosed with gastroenteritis who has a potassium (K+) level
of 3.9 mEq/L.
4. The child diagnosed with cystic fibrosis who has a pulse oximeter reading of
90%.
Rationale
Correct - 4. A pulse oximeter reading of less than 93% is significant and indicates
hypoxia, which is life threatening; therefore, this child should be assessed first.
4. During an interview, a parent of a hospitalized child is sitting in an open
position. As the interviewer begins to discuss his son's treatment, however, he
suddenly crosses his arms against his chest and crosses his legs. This would
suggest that the parent is:
A) just changing positions.
B) more comfortable in this position.
C) tired and needs a break from the interview.
D) uncomfortable talking about his son's treatment.
D) uncomfortable talking about his son's treatment.
Page: 37 Note the person's position. An open position with the extension of large
muscle groups shows relaxation, physical comfort, and a willingness to share
information. A closed position with the arms and legs crossed tends to look defensive
should the nurse assess first?
1. The child diagnosed with type 1 diabetes who has a blood glucose level
of 180 mg/dL.
2. The child diagnosed with pneumonia who is coughing and has a temperature
of
100°F.
3. The child diagnosed with gastroenteritis who has a potassium (K+) level
of 3.9 mEq/L.
4. The child diagnosed with cystic fibrosis who has a pulse oximeter reading of
90%.
Rationale
Correct - 4. A pulse oximeter reading of less than 93% is significant and indicates
hypoxia, which is life threatening; therefore, this child should be assessed first.
4. During an interview, a parent of a hospitalized child is sitting in an open
position. As the interviewer begins to discuss his son's treatment, however, he
suddenly crosses his arms against his chest and crosses his legs. This would
suggest that the parent is:
A) just changing positions.
B) more comfortable in this position.
C) tired and needs a break from the interview.
D) uncomfortable talking about his son's treatment.
D) uncomfortable talking about his son's treatment.
Page: 37 Note the person's position. An open position with the extension of large
muscle groups shows relaxation, physical comfort, and a willingness to share
information. A closed position with the arms and legs crossed tends to look defensive
and anxious. Note any change in posture. If a person in a relaxed position suddenly
tenses, it suggests possible discomfort with the new topic.
5. The nurse has received the a.m. shift report for clients on a pediatric unit.
Which medication should the nurse administer first?
1. The third dose of the aminoglycoside antibiotic to the child diagnosed with
methicillin-resistant Staphylococcus aureus (MRSA).
2. The IVP steroid methylprednisolone (Solu-Medrol) to the child diagnosed with
asthma.
3. The sliding scale insulin to the child diagnosed with type 1 diabetes mellitus.
4. The stimulant methylphenidate (Ritalin) to a child diagnosed with attention
deficit-hyperactivity disorder (ADHD).
Rationale
Correct - 3-Sliding scale insulin is ordered ac, which is before meals; therefore, this
medication must be administered first after receiving the a.m. shift report.
4-Routine medications have a 1-hour leeway before and after the scheduled time;
therefore, this medication does not have to be adminis- tered first.
5. The nurse is interviewing a patient who has a hearing impairment. What
techniques would be most beneficial in communicating with this patient?
A) Determine the communication method he prefers.
B) Avoid using facial and hand gestures because most hearing-impaired people
find this degrading.
C) Request a sign language interpreter before meeting with him to help facilitate
the communication.
D) Speak loudly and with exaggerated facial movement when talking with him
because this helps with lip reading.
A) Determine the communication method he prefers.
tenses, it suggests possible discomfort with the new topic.
5. The nurse has received the a.m. shift report for clients on a pediatric unit.
Which medication should the nurse administer first?
1. The third dose of the aminoglycoside antibiotic to the child diagnosed with
methicillin-resistant Staphylococcus aureus (MRSA).
2. The IVP steroid methylprednisolone (Solu-Medrol) to the child diagnosed with
asthma.
3. The sliding scale insulin to the child diagnosed with type 1 diabetes mellitus.
4. The stimulant methylphenidate (Ritalin) to a child diagnosed with attention
deficit-hyperactivity disorder (ADHD).
Rationale
Correct - 3-Sliding scale insulin is ordered ac, which is before meals; therefore, this
medication must be administered first after receiving the a.m. shift report.
4-Routine medications have a 1-hour leeway before and after the scheduled time;
therefore, this medication does not have to be adminis- tered first.
5. The nurse is interviewing a patient who has a hearing impairment. What
techniques would be most beneficial in communicating with this patient?
A) Determine the communication method he prefers.
B) Avoid using facial and hand gestures because most hearing-impaired people
find this degrading.
C) Request a sign language interpreter before meeting with him to help facilitate
the communication.
D) Speak loudly and with exaggerated facial movement when talking with him
because this helps with lip reading.
A) Determine the communication method he prefers.
Loading page 6...
Pages: 40-41 The nurse should ask the deaf person the preferred way to
communicate—by signing, lip reading, or writing. If the person prefers lip reading, then
the nurse should be sure to face him or her squarely and have good lighting on the
nurse's face. The nurse should not exaggerate lip movements because this distorts
words. Similarly, shouting distorts the reception of a hearing aid the person may wear.
The nurse should speak slowly and should supplement his or her voice with appropriate
hand gestures or pantomime.
6. The nurse enters the client's room and realizes the 9-month-old infant is not
breath- ing. Which interventions should the nurse implement? Prioritize the
nurse's actions from first (1) to last (5).
1. Perform cardiac compression 30:2.
2. Check the infant's brachial pulse. 3. Administer two puffs to the infant. 4.
Determine unresponsiveness.
5. Open the infant's airway.
Rationale
Correct Answer: 4, 5, 3, 2, 1
4. The nurse must first determine the
infant's responsiveness by thumping the
baby's feet.
5. The nurse should then open the child's
airway using the head-tilt chin-lift tech- nique, with care taken not to hyperextend the
neck. Then the nurse should look, listen, and feel for respirations.
3. The nurse then administers quick puffs of air while covering the child's mouth and
nose, preferably with a rescue mask.
2. The nurse should determine whether the infant has a pulse by checking the brachial
artery.
1. If the infant has no pulse, the nurse should begin chest compressions using two
fingers at a rate of 30:2.
communicate—by signing, lip reading, or writing. If the person prefers lip reading, then
the nurse should be sure to face him or her squarely and have good lighting on the
nurse's face. The nurse should not exaggerate lip movements because this distorts
words. Similarly, shouting distorts the reception of a hearing aid the person may wear.
The nurse should speak slowly and should supplement his or her voice with appropriate
hand gestures or pantomime.
6. The nurse enters the client's room and realizes the 9-month-old infant is not
breath- ing. Which interventions should the nurse implement? Prioritize the
nurse's actions from first (1) to last (5).
1. Perform cardiac compression 30:2.
2. Check the infant's brachial pulse. 3. Administer two puffs to the infant. 4.
Determine unresponsiveness.
5. Open the infant's airway.
Rationale
Correct Answer: 4, 5, 3, 2, 1
4. The nurse must first determine the
infant's responsiveness by thumping the
baby's feet.
5. The nurse should then open the child's
airway using the head-tilt chin-lift tech- nique, with care taken not to hyperextend the
neck. Then the nurse should look, listen, and feel for respirations.
3. The nurse then administers quick puffs of air while covering the child's mouth and
nose, preferably with a rescue mask.
2. The nurse should determine whether the infant has a pulse by checking the brachial
artery.
1. If the infant has no pulse, the nurse should begin chest compressions using two
fingers at a rate of 30:2.
Loading page 7...
6. The nurse is performing a health interview on a patient who has a language
barrier, and no interpreter is available. Which is the best example of an
appropriate question for the nurse to ask in this situation?
A) "Do you take medicine?"
B) "Do you sterilize the bottles?"
C) "Do you have nausea and vomiting?"
D) "You have been taking your medicine, haven't you?"
A) "Do you take medicine?"
Page: 46 In a situation where there is a language barrier and no interpreter available,
use simple words avoiding medical jargon. Avoid using contractions and pronouns. Use
nouns repeatedly and discuss one topic at a time.
7. A female patient does not speak English well, and the nurse needs to choose
an interpreter. Which of the following would be the most appropriate choice?
A) A trained interpreter
B) A male family member
C) A female family member
D) A volunteer college student from the foreign language studies department
A) A trained interpreter
Page: 46 whenever possible, the nurse should use a trained interpreter, preferably one
who knows medical terminology. In general, an older, more mature interpreter is
preferred to a younger, less experienced one, and the same gender is preferred when
possible.
7. The 3-year-old client has been admitted to the pediatric unit. Which task should
the nurse instruct the unlicensed assistive personnel (UAP) to perform first?
1. Orient the parents and child to the room.
barrier, and no interpreter is available. Which is the best example of an
appropriate question for the nurse to ask in this situation?
A) "Do you take medicine?"
B) "Do you sterilize the bottles?"
C) "Do you have nausea and vomiting?"
D) "You have been taking your medicine, haven't you?"
A) "Do you take medicine?"
Page: 46 In a situation where there is a language barrier and no interpreter available,
use simple words avoiding medical jargon. Avoid using contractions and pronouns. Use
nouns repeatedly and discuss one topic at a time.
7. A female patient does not speak English well, and the nurse needs to choose
an interpreter. Which of the following would be the most appropriate choice?
A) A trained interpreter
B) A male family member
C) A female family member
D) A volunteer college student from the foreign language studies department
A) A trained interpreter
Page: 46 whenever possible, the nurse should use a trained interpreter, preferably one
who knows medical terminology. In general, an older, more mature interpreter is
preferred to a younger, less experienced one, and the same gender is preferred when
possible.
7. The 3-year-old client has been admitted to the pediatric unit. Which task should
the nurse instruct the unlicensed assistive personnel (UAP) to perform first?
1. Orient the parents and child to the room.
Loading page 8...
2. Obtain an admission kit for the child.
3. Post the child's height and weight at the HOB. 4. Provide the child with a meal
tray.
Rationale
Correct - 1.The first intervention after the child is ad- mitted to the unit is to orient the
parents and child to the room, the call system, and the hospital rules, such as not
leaving the child alone in the room.
8. The clinic nurse is preparing to administer an intramuscular (IM) injection to
the 2-year-old toddler. Which intervention should the nurse implement first?
1. Immobilize the child's leg.
2. Explain the procedure to the child.
3. Cleanse the area with an alcohol swab. 4. Administer the medication in the
thigh.
Rationale
Correct - 2-The nurse must explain any procedure in words the child can understand. It
does not matter how old the child is.
8. The nurse is conducting an interview. Which of these statements is true
regarding open-ended questions? Select all that apply.
A) They elicit cold facts.
B) They allow for self-expression.
C) They build and enhance rapport.
D) They leave interactions neutral.
E) They call for short one- to two-word answers.
F) They are used when narrative information is needed.
B) They allow for self-expression.
C) They build and enhance rapport.
3. Post the child's height and weight at the HOB. 4. Provide the child with a meal
tray.
Rationale
Correct - 1.The first intervention after the child is ad- mitted to the unit is to orient the
parents and child to the room, the call system, and the hospital rules, such as not
leaving the child alone in the room.
8. The clinic nurse is preparing to administer an intramuscular (IM) injection to
the 2-year-old toddler. Which intervention should the nurse implement first?
1. Immobilize the child's leg.
2. Explain the procedure to the child.
3. Cleanse the area with an alcohol swab. 4. Administer the medication in the
thigh.
Rationale
Correct - 2-The nurse must explain any procedure in words the child can understand. It
does not matter how old the child is.
8. The nurse is conducting an interview. Which of these statements is true
regarding open-ended questions? Select all that apply.
A) They elicit cold facts.
B) They allow for self-expression.
C) They build and enhance rapport.
D) They leave interactions neutral.
E) They call for short one- to two-word answers.
F) They are used when narrative information is needed.
B) They allow for self-expression.
C) They build and enhance rapport.
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F) They are used when narrative information
Page: 32 Open-ended questions allow for self-expression, build rapport, and obtain
narrative information. These features enhance communication during an interview. The
other statements are appropriate for closed or direct questions.
9. The nurse is writing a care plan for the 5-year-old child diagnosed with
gastroenteritis. Which client problem is priority?
1. Imbalanced nutrition.
2. Fluid volume deficit.
3. Knowledge deficit. 4. Risk for infection.
Rationale
Correct - 2-The child diagnosed with gastroenteritis is at high risk for hypovolemic shock
resulting from vomiting and diarrhea; therefore, maintaining fluid and elec- trolyte
homeostasis is priority.
9. The nurse is conducting an interview in an outpatient clinic and is using a
computer to record data. Which is the best use of the computer in this situation?
Select all that apply.
A) Collect the patient's data in a direct, face-to-face manner.
B) Enter all the data as the patient states it.
C) Ask the patient to wait as the nurse enters data.
D) Type the data into the computer after the narrative is fully explored.
E) Allow the patient to see the monitor during typing.
A) Collect the patient's data in a direct, face-to-face manner.
D) Type the data into the computer after the narrative is fully explored.
E) Allow the patient to see the monitor during typing.
Page: 32 The use of a computer can become a barrier. The nurse should begin the
interview as usual by greeting the patient, establishing rapport, and collecting the
Page: 32 Open-ended questions allow for self-expression, build rapport, and obtain
narrative information. These features enhance communication during an interview. The
other statements are appropriate for closed or direct questions.
9. The nurse is writing a care plan for the 5-year-old child diagnosed with
gastroenteritis. Which client problem is priority?
1. Imbalanced nutrition.
2. Fluid volume deficit.
3. Knowledge deficit. 4. Risk for infection.
Rationale
Correct - 2-The child diagnosed with gastroenteritis is at high risk for hypovolemic shock
resulting from vomiting and diarrhea; therefore, maintaining fluid and elec- trolyte
homeostasis is priority.
9. The nurse is conducting an interview in an outpatient clinic and is using a
computer to record data. Which is the best use of the computer in this situation?
Select all that apply.
A) Collect the patient's data in a direct, face-to-face manner.
B) Enter all the data as the patient states it.
C) Ask the patient to wait as the nurse enters data.
D) Type the data into the computer after the narrative is fully explored.
E) Allow the patient to see the monitor during typing.
A) Collect the patient's data in a direct, face-to-face manner.
D) Type the data into the computer after the narrative is fully explored.
E) Allow the patient to see the monitor during typing.
Page: 32 The use of a computer can become a barrier. The nurse should begin the
interview as usual by greeting the patient, establishing rapport, and collecting the
Loading page 10...
patient's narrative story in a direct face-to-face manner. Only after the narrative is fully
explored should the nurse type data into the computer. When typing, the nurse should
position the monitor so that the patient can see it.
10. Which data would warrant immediate intervention from the pediatric nurse? 1.
Proteinuria for the child diagnosed with nephrotic syndrome.
2. Petechiae for the child diagnosed with leukemia.
3. Drooling for a child diagnosed with acute epiglottitis.
4. Elevated temperature in a child diagnosed with otitis media.
Rationale
Correct - 3-Drooling indicates the child is having trouble swallowing, and the epiglottis is
at risk of completely occluding the air- way. This warrants immediate interven- tion. The
nurse should notify the HCP and obtain an emergency tracheostomy tray for the
bedside.
10. 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?
A) Ask the patient about the item and its significance.
B) Ask the patient to lock the item with other valuables in the hospital's safe.
C) Tell the patient that a family member should take valuables home.
D) No action is necessary.
A) Ask the patient about the item and its significance.
Page: 21 The nurse should inquire about the amulet's meaning. Amulets, such as
charms, are often seen as an important means of protection from "evil spirits" by some
cultures.
11. Which client should the pediatric nurse assess first after receiving the a.m.
shift report? 1. The 6-month old child diagnosed with bacterial meningitis who is
explored should the nurse type data into the computer. When typing, the nurse should
position the monitor so that the patient can see it.
10. Which data would warrant immediate intervention from the pediatric nurse? 1.
Proteinuria for the child diagnosed with nephrotic syndrome.
2. Petechiae for the child diagnosed with leukemia.
3. Drooling for a child diagnosed with acute epiglottitis.
4. Elevated temperature in a child diagnosed with otitis media.
Rationale
Correct - 3-Drooling indicates the child is having trouble swallowing, and the epiglottis is
at risk of completely occluding the air- way. This warrants immediate interven- tion. The
nurse should notify the HCP and obtain an emergency tracheostomy tray for the
bedside.
10. 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?
A) Ask the patient about the item and its significance.
B) Ask the patient to lock the item with other valuables in the hospital's safe.
C) Tell the patient that a family member should take valuables home.
D) No action is necessary.
A) Ask the patient about the item and its significance.
Page: 21 The nurse should inquire about the amulet's meaning. Amulets, such as
charms, are often seen as an important means of protection from "evil spirits" by some
cultures.
11. Which client should the pediatric nurse assess first after receiving the a.m.
shift report? 1. The 6-month old child diagnosed with bacterial meningitis who is
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irritable and
crying.
2. The 9-month old child diagnosed with tetralogy of Fallot (TOF) who has edema
of
the face.
3. The 11-month old child diagnosed with Reye syndrome who is lethargic and
vomiting.
4. The 13-month-old child diagnosed with diarrhea who has sunken eyeballs and
decreased urine output.
Rationale
Correct - 4. Sunken eyeballs and decreased urine out- put are signs of dehydration,
which is a life-threatening complication of diarrhea; therefore, this child should be
assessed first.
11. In the majority culture of America, coughing, sweating, and diarrhea are
symptoms of an illness. For some individuals of Mexican-American origin,
however, these symptoms are a normal part of living. The nurse recognizes that
this is true, probably because Mexican-Americans:
A) have less efficient immune systems and are often ill.
B) consider these symptoms a part of normal living, not symptoms of ill health.
C) come from Mexico and coughing is normal and healthy there.
D) are usually in a lower socioeconomic group and are more likely to be sick.
B) consider these symptoms a part of normal living, not symptoms of ill health.
Page: 27 The nurse needs to identify the meaning of health to the patient, remembering
that concepts are derived, in part, from the way in which members of the cultural group
define health.
12. The pediatric clinic nurse is triaging telephone calls. Which client's parent
should the nurse call first?
crying.
2. The 9-month old child diagnosed with tetralogy of Fallot (TOF) who has edema
of
the face.
3. The 11-month old child diagnosed with Reye syndrome who is lethargic and
vomiting.
4. The 13-month-old child diagnosed with diarrhea who has sunken eyeballs and
decreased urine output.
Rationale
Correct - 4. Sunken eyeballs and decreased urine out- put are signs of dehydration,
which is a life-threatening complication of diarrhea; therefore, this child should be
assessed first.
11. In the majority culture of America, coughing, sweating, and diarrhea are
symptoms of an illness. For some individuals of Mexican-American origin,
however, these symptoms are a normal part of living. The nurse recognizes that
this is true, probably because Mexican-Americans:
A) have less efficient immune systems and are often ill.
B) consider these symptoms a part of normal living, not symptoms of ill health.
C) come from Mexico and coughing is normal and healthy there.
D) are usually in a lower socioeconomic group and are more likely to be sick.
B) consider these symptoms a part of normal living, not symptoms of ill health.
Page: 27 The nurse needs to identify the meaning of health to the patient, remembering
that concepts are derived, in part, from the way in which members of the cultural group
define health.
12. The pediatric clinic nurse is triaging telephone calls. Which client's parent
should the nurse call first?
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1. The 4-month-old child who had immunizations yesterday and the parent is
report- ing a high-pitched cry and a 103°F fever.
2. The 8-month-old whose parent is reporting the child is pulling on the right ear
and has a fever.
3. The 2-year-old child who has patent ductus arteriosis whose parent reports
running out of digoxin.
4. The 3-year-old child whose mother called and reported her daughter may have
chickenpox.
Rationale
Correct 1-A high fever and high-pitched crying may indicate a reaction to the
immunizations; therefore, this parent needs to be called first to bring the child to the
clinic.
12. Among many Asians there is a belief in the yin/yang theory, rooted in the
ancient Chinese philosophy of Tao. The nurse recognizes which statement that
most accurately reflects "health" in an Asian with this belief?
A) A person is able to work and produce.
B) A person is happy, stable, and feels good.
C) All aspects of the person are in perfect balance.
D) A person is able to care for others and function socially.
C) All aspects of the person are in perfect balance.
Page: 21 Many Asians believe in the yin/yang theory, in which health is believed to exist
when all aspects of the person are in perfect balance. The other statements do not
describe this theory.
13. The parent of a 12-year-old male child with a left below-the-knee cast calls the
pedi- atric clinic nurse and tells the nurse, "My son's foot is cold and he told me it
feels like his foot is asleep." Which action should the nurse implement first?
1. Prepare to bifurcate the left below-the-knee cast.
report- ing a high-pitched cry and a 103°F fever.
2. The 8-month-old whose parent is reporting the child is pulling on the right ear
and has a fever.
3. The 2-year-old child who has patent ductus arteriosis whose parent reports
running out of digoxin.
4. The 3-year-old child whose mother called and reported her daughter may have
chickenpox.
Rationale
Correct 1-A high fever and high-pitched crying may indicate a reaction to the
immunizations; therefore, this parent needs to be called first to bring the child to the
clinic.
12. Among many Asians there is a belief in the yin/yang theory, rooted in the
ancient Chinese philosophy of Tao. The nurse recognizes which statement that
most accurately reflects "health" in an Asian with this belief?
A) A person is able to work and produce.
B) A person is happy, stable, and feels good.
C) All aspects of the person are in perfect balance.
D) A person is able to care for others and function socially.
C) All aspects of the person are in perfect balance.
Page: 21 Many Asians believe in the yin/yang theory, in which health is believed to exist
when all aspects of the person are in perfect balance. The other statements do not
describe this theory.
13. The parent of a 12-year-old male child with a left below-the-knee cast calls the
pedi- atric clinic nurse and tells the nurse, "My son's foot is cold and he told me it
feels like his foot is asleep." Which action should the nurse implement first?
1. Prepare to bifurcate the left below-the-knee cast.
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2. Tell the parent to bring the child to the office.
3. Instruct the parent to elevate the left leg on two pillows.
4. Notify the child's orthopedist of the situation.
Rationale
Correct - 3. The nurse should first take care of the client's body by having the parent
elevate the left leg.
13. An individual who takes the magicoreligious perspective of illness and
disease is likely to believe that his or her illness was caused by:
A) germs and viruses.
B) supernatural forces.
C) eating imbalanced foods.
D) an imbalance within his or her spiritual nature.
B) supernatural forces.
Page: 21 The basic premise of the magicoreligious perspective is that the world is seen
as an arena in which supernatural forces dominate. The fate of the world and those in it
depends on the actions of supernatural forces for good or evil. The other answers do
not reflect the magicoreligious perspective.
14. If an American Indian has come to the clinic to seek help with regulating her
diabetes, the nurse can expect that she:
A) will comply with the treatment prescribed.
B) has obviously given up her beliefs in naturalistic causes of disease.
C) may also be seeking the assistance of a shaman or medicine man.
D) will need extra help in dealing with her illness and may be experiencing a crisis
of faith.
3. Instruct the parent to elevate the left leg on two pillows.
4. Notify the child's orthopedist of the situation.
Rationale
Correct - 3. The nurse should first take care of the client's body by having the parent
elevate the left leg.
13. An individual who takes the magicoreligious perspective of illness and
disease is likely to believe that his or her illness was caused by:
A) germs and viruses.
B) supernatural forces.
C) eating imbalanced foods.
D) an imbalance within his or her spiritual nature.
B) supernatural forces.
Page: 21 The basic premise of the magicoreligious perspective is that the world is seen
as an arena in which supernatural forces dominate. The fate of the world and those in it
depends on the actions of supernatural forces for good or evil. The other answers do
not reflect the magicoreligious perspective.
14. If an American Indian has come to the clinic to seek help with regulating her
diabetes, the nurse can expect that she:
A) will comply with the treatment prescribed.
B) has obviously given up her beliefs in naturalistic causes of disease.
C) may also be seeking the assistance of a shaman or medicine man.
D) will need extra help in dealing with her illness and may be experiencing a crisis
of faith.
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C) may also be seeking the assistance of a shaman or medicine man.
Page: 23 When self-treatment is unsuccessful, the individual may turn to the lay or folk
healing systems, to spiritual or religious healing, or to scientific biomedicine. In addition
to seeking help from a biomedical or scientific health care provider, patients may also
seek help from folk or religious healers.
14. Which child requires the nurse to notify the healthcare provider?
1. The 1-year-old child with iron deficiency anemia who has dark-colored stool.
2. The 3-year-old child with phenylketonuria (PKU) whose parent does not feed
the
child any meat or milk products.
3. The 5-year-old child with rheumatic heart fever who is having difficulty
breathing.
4. The 7-year-old child diagnosed with acute glomerulonephritis who has dark
"tea"-colored urine.
Rationale
Correct - 3-A complication of rheumatic heart disease is valvular disorders that may be
mani- fested by respiratory problems; therefore, the nurse should notify the child's
health- care provider.
15. The pediatric nurse on the surgical unit has just received a.m. shift report.
Which client should the nurse assess first?
1. The 3-week-old child 1 day postoperative with surgical repair of a
myelomeningo-
cele who has bulging fontanels.
2. The 3-month-old child 2 days postoperative temporary colostomy secondary to
Hirschsprung's disease who has a moist, pink stoma.
3. The 9-month-old child with a cleft palate repair who is spitting up formula and
Page: 23 When self-treatment is unsuccessful, the individual may turn to the lay or folk
healing systems, to spiritual or religious healing, or to scientific biomedicine. In addition
to seeking help from a biomedical or scientific health care provider, patients may also
seek help from folk or religious healers.
14. Which child requires the nurse to notify the healthcare provider?
1. The 1-year-old child with iron deficiency anemia who has dark-colored stool.
2. The 3-year-old child with phenylketonuria (PKU) whose parent does not feed
the
child any meat or milk products.
3. The 5-year-old child with rheumatic heart fever who is having difficulty
breathing.
4. The 7-year-old child diagnosed with acute glomerulonephritis who has dark
"tea"-colored urine.
Rationale
Correct - 3-A complication of rheumatic heart disease is valvular disorders that may be
mani- fested by respiratory problems; therefore, the nurse should notify the child's
health- care provider.
15. The pediatric nurse on the surgical unit has just received a.m. shift report.
Which client should the nurse assess first?
1. The 3-week-old child 1 day postoperative with surgical repair of a
myelomeningo-
cele who has bulging fontanels.
2. The 3-month-old child 2 days postoperative temporary colostomy secondary to
Hirschsprung's disease who has a moist, pink stoma.
3. The 9-month-old child with a cleft palate repair who is spitting up formula and
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clear
amber urine draining from indwelling catheter.
Rationale
Correct - 1-Bulging fontanels is a sign of increased intracranial pressure, which is a
compli- cation of neurological surgery; therefore, this child should be assessed first.
15. An elderly Mexican-American woman with traditional beliefs has been
admitted to an inpatient care unit. A culturally-sensitive nurse would:
A) contact the hospital administrator about the best course of action.
B) automatically get a curandero for her because it is not culturally appropriate
for her to request one.
C) further assess the patient's cultural beliefs and offer the patient assistance in
contacting a curandero or priest if she desires.
D) ask the family what they would like to do because Mexican-Americans
traditionally give control of decisions to their families.
C) further assess the patient's cultural beliefs and offer the patient assistance in
contacting a curandero or priest if she desires.
Pages: 22-23 In addition to seeking help from the biomedical/scientific health care
provider, patients may also seek help from folk or religious healers. Some people, such
as those of Mexican-American or American Indian origins, may believe that the cure is
incomplete unless the body, mind, and spirit are also healed (although the division of
the person into parts is a Western concept).
16. The charge nurse has assigned a staff nurse to care for an 8-year-old client
diagnosed with cerebral palsy. Which nursing action by the staff nurse would
warrant immediate intervention by the charge nurse?
1. The staff nurse performs gentle range-of-motion (ROM) exercises to
extremities. 2. The staff nurse puts the client's bed in the lowest position
possible.
amber urine draining from indwelling catheter.
Rationale
Correct - 1-Bulging fontanels is a sign of increased intracranial pressure, which is a
compli- cation of neurological surgery; therefore, this child should be assessed first.
15. An elderly Mexican-American woman with traditional beliefs has been
admitted to an inpatient care unit. A culturally-sensitive nurse would:
A) contact the hospital administrator about the best course of action.
B) automatically get a curandero for her because it is not culturally appropriate
for her to request one.
C) further assess the patient's cultural beliefs and offer the patient assistance in
contacting a curandero or priest if she desires.
D) ask the family what they would like to do because Mexican-Americans
traditionally give control of decisions to their families.
C) further assess the patient's cultural beliefs and offer the patient assistance in
contacting a curandero or priest if she desires.
Pages: 22-23 In addition to seeking help from the biomedical/scientific health care
provider, patients may also seek help from folk or religious healers. Some people, such
as those of Mexican-American or American Indian origins, may believe that the cure is
incomplete unless the body, mind, and spirit are also healed (although the division of
the person into parts is a Western concept).
16. The charge nurse has assigned a staff nurse to care for an 8-year-old client
diagnosed with cerebral palsy. Which nursing action by the staff nurse would
warrant immediate intervention by the charge nurse?
1. The staff nurse performs gentle range-of-motion (ROM) exercises to
extremities. 2. The staff nurse puts the client's bed in the lowest position
possible.
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3. The staff nurse takes the client in a wheelchair to the activity room.
4. The staff nurse places the child in semi-Fowler's position to eat lunch.
Rationale
Correct - 4-The child should be positioned upright to prevent aspiration during meals;
there- fore, this action would require the charge nurse to intervene.
16. The nurse is reviewing concepts of cultural aspects of pain. Which statement
is true regarding pain?
A) All patients will behave the same way when in pain.
B) Just as patients vary in their perceptions of pain, so will they vary in their
expressions of pain.
C) Cultural norms have very little to do with pain tolerance, because pain
tolerance is always biologically determined.
D) A patient's expression of pain is largely dependent on the amount of tissue
injury associated with the pain.
B) Just as patients vary in their perceptions of pain, so will they vary in their expressions
of pain.
Page: 25 In addition to expecting variations in pain perception and tolerance, the nurse
should expect variations in the expression of pain. It is well known that individuals turn
to their social environment for validation and comparison. The other statements are
incorrect.
17. The nurse and the unlicensed assistive personnel (UAP) are caring for clients
on the pediatric unit. Which action by the nurse indicates appropriate delegation?
1. The nurse requests the UAP to check the circulation on the child with a cast.
2. The nurse asks the UAP to feed an infant who has just had a cleft palate repair.
3. The nurse has the UAP demonstrate a catheterization for a child with a
neurogenic
bladder.
4. The staff nurse places the child in semi-Fowler's position to eat lunch.
Rationale
Correct - 4-The child should be positioned upright to prevent aspiration during meals;
there- fore, this action would require the charge nurse to intervene.
16. The nurse is reviewing concepts of cultural aspects of pain. Which statement
is true regarding pain?
A) All patients will behave the same way when in pain.
B) Just as patients vary in their perceptions of pain, so will they vary in their
expressions of pain.
C) Cultural norms have very little to do with pain tolerance, because pain
tolerance is always biologically determined.
D) A patient's expression of pain is largely dependent on the amount of tissue
injury associated with the pain.
B) Just as patients vary in their perceptions of pain, so will they vary in their expressions
of pain.
Page: 25 In addition to expecting variations in pain perception and tolerance, the nurse
should expect variations in the expression of pain. It is well known that individuals turn
to their social environment for validation and comparison. The other statements are
incorrect.
17. The nurse and the unlicensed assistive personnel (UAP) are caring for clients
on the pediatric unit. Which action by the nurse indicates appropriate delegation?
1. The nurse requests the UAP to check the circulation on the child with a cast.
2. The nurse asks the UAP to feed an infant who has just had a cleft palate repair.
3. The nurse has the UAP demonstrate a catheterization for a child with a
neurogenic
bladder.
Loading page 17...
4. The nurse checks to make sure the UAP's delegated tasks have been
completed.
Rationale
Correct - 4. The last step of delegating to a UAP is for the nurse to evaluate and
determine whether the delegated tasks have been completed and performed correctly.
This indicates the nurse has delegated appropriately.
17. The nurse recognizes that working with children with a different cultural
perspective may be especially difficult because:
A) children have spiritual needs that are influenced by their stages of
development.
B) children have spiritual needs that are direct reflections of what is occurring in
their homes.
C) religious beliefs rarely affect the parents' perceptions of the illness.
D) parents are often the decision makers, and they have no knowledge of their
children's spiritual needs.
A) children have spiritual needs that are influenced by their stages of development.
Page: 20. Illness during childhood may be an especially difficult clinical situation.
Children, as well as adults, have spiritual needs that vary according to the child's
developmental level and the religious climate that exists in the family. The other
statements are not correct.
18. The nurse on a pediatric unit has received the a.m. shift report and tells the
unli- censed assistive personnel (UAP) to keep the 2-year-old child NPO for a
procedure. At 0830, the nurse observes the mother feeding the child. Which
action should the nurse implement first?
1. Determine what the UAP did not understand about the instruction.
2. Tell the HCP the UAP did not follow the nurse's direction.
completed.
Rationale
Correct - 4. The last step of delegating to a UAP is for the nurse to evaluate and
determine whether the delegated tasks have been completed and performed correctly.
This indicates the nurse has delegated appropriately.
17. The nurse recognizes that working with children with a different cultural
perspective may be especially difficult because:
A) children have spiritual needs that are influenced by their stages of
development.
B) children have spiritual needs that are direct reflections of what is occurring in
their homes.
C) religious beliefs rarely affect the parents' perceptions of the illness.
D) parents are often the decision makers, and they have no knowledge of their
children's spiritual needs.
A) children have spiritual needs that are influenced by their stages of development.
Page: 20. Illness during childhood may be an especially difficult clinical situation.
Children, as well as adults, have spiritual needs that vary according to the child's
developmental level and the religious climate that exists in the family. The other
statements are not correct.
18. The nurse on a pediatric unit has received the a.m. shift report and tells the
unli- censed assistive personnel (UAP) to keep the 2-year-old child NPO for a
procedure. At 0830, the nurse observes the mother feeding the child. Which
action should the nurse implement first?
1. Determine what the UAP did not understand about the instruction.
2. Tell the HCP the UAP did not follow the nurse's direction.
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3. Ask the mother why she was feeding her child if the child was NPO.
4. Notify the dietary department to hold the child's meal trays.
Rationale
Correct - 1.Communication to the UAP must be clear, concise, correct, and complete.
The nurse must determine why there was a lack of communication, which resulted in
the child receiving food; therefore, this action should be implemented first.
18. When providing culturally competent care, nurses must incorporate cultural
assessments into their health assessments. Which statement is most appropriate
to use when initiating an assessment of cultural beliefs with an elderly American
Indian patient?
A) "Are you of the Christian faith?"
B) "Do you want to see a medicine man?"
C) "How often do you seek help from medical providers?"
D) "What cultural or spiritual beliefs are important to you?"
D) "What cultural or spiritual beliefs are important to you?"
Page: 17. The nurse needs to assess the cultural beliefs and practices of the patient.
American Indians may seek assistance from a medicine man or shaman, but the nurse
should not assume this. An open-ended question regarding cultural and spiritual beliefs
is best used initially when performing a cultural assessment.
19. The charge nurse on the six-bed pediatric burn unit is making shift
assignments and has one registered nurse (RN), one scrub technician, one
unlicensed assistive personnel (UAP), and a unit secretary. Which client care
assignment indicates the best use of the hospital personnel?
1. The RN performs daily whirlpool dressing changes.
2. The unit secretary transcribes the HCP's orders.
3. The scrub technician medicates the client prior to dressing changes. 4. The
UAP places the current laboratory results on the chart.
4. Notify the dietary department to hold the child's meal trays.
Rationale
Correct - 1.Communication to the UAP must be clear, concise, correct, and complete.
The nurse must determine why there was a lack of communication, which resulted in
the child receiving food; therefore, this action should be implemented first.
18. When providing culturally competent care, nurses must incorporate cultural
assessments into their health assessments. Which statement is most appropriate
to use when initiating an assessment of cultural beliefs with an elderly American
Indian patient?
A) "Are you of the Christian faith?"
B) "Do you want to see a medicine man?"
C) "How often do you seek help from medical providers?"
D) "What cultural or spiritual beliefs are important to you?"
D) "What cultural or spiritual beliefs are important to you?"
Page: 17. The nurse needs to assess the cultural beliefs and practices of the patient.
American Indians may seek assistance from a medicine man or shaman, but the nurse
should not assume this. An open-ended question regarding cultural and spiritual beliefs
is best used initially when performing a cultural assessment.
19. The charge nurse on the six-bed pediatric burn unit is making shift
assignments and has one registered nurse (RN), one scrub technician, one
unlicensed assistive personnel (UAP), and a unit secretary. Which client care
assignment indicates the best use of the hospital personnel?
1. The RN performs daily whirlpool dressing changes.
2. The unit secretary transcribes the HCP's orders.
3. The scrub technician medicates the client prior to dressing changes. 4. The
UAP places the current laboratory results on the chart.
Loading page 19...
1-The scrub technician is assigned to perform daily whirlpool dressing changes, which
is a lengthy procedure. Therefore, assigning the one RN to this task would be
inappropriate because he or she cannot be unavailable for an extended period of time.
**2-One of the responsibilities of the unit secretary is to transcribe the HCP's orders, but
the licensed nurse retains total responsibility for the correctness and accuracy of the
transcribed orders.
3-The scrub technician cannot administer medications.
4-The unit secretary and laboratory personnel are responsible for posting laboratory
data into the client's charts. The UAP should be on the unit taking care of the clients.
19. When planning a cultural assessment, the nurse should include which
component?
A) Family history
B) Chief complaint
C) Medical history
D) Health-related beliefs
D) Health-related beliefs
Pages: 19-20. Health-related beliefs and practices are one component of a cultural
assessment. The other items reflect other aspects of the patient's history.
20. The RN and the UAP are caring for clients on a pediatric surgical unit. Which
tasks would be most appropriate to delegate to the UAP? Select all that apply.
1. Pass dietary trays to the clients.
2. Obtain routine vital signs on the clients.
3. Complete the preoperative checklist.
4. Change linens on the clients' beds.
5. Document the clients' intake and output.
1, 2, 4, and 5 are correct.
1. The UAP can pass the dietary trays to
is a lengthy procedure. Therefore, assigning the one RN to this task would be
inappropriate because he or she cannot be unavailable for an extended period of time.
**2-One of the responsibilities of the unit secretary is to transcribe the HCP's orders, but
the licensed nurse retains total responsibility for the correctness and accuracy of the
transcribed orders.
3-The scrub technician cannot administer medications.
4-The unit secretary and laboratory personnel are responsible for posting laboratory
data into the client's charts. The UAP should be on the unit taking care of the clients.
19. When planning a cultural assessment, the nurse should include which
component?
A) Family history
B) Chief complaint
C) Medical history
D) Health-related beliefs
D) Health-related beliefs
Pages: 19-20. Health-related beliefs and practices are one component of a cultural
assessment. The other items reflect other aspects of the patient's history.
20. The RN and the UAP are caring for clients on a pediatric surgical unit. Which
tasks would be most appropriate to delegate to the UAP? Select all that apply.
1. Pass dietary trays to the clients.
2. Obtain routine vital signs on the clients.
3. Complete the preoperative checklist.
4. Change linens on the clients' beds.
5. Document the clients' intake and output.
1, 2, 4, and 5 are correct.
1. The UAP can pass the dietary trays to
Loading page 20...
the clients because it does not require
judgment.
2. One of the responsibilities of the UAP is
taking routine vital signs on clients.
3. The nurse must complete the preoperative checklist because it requires nursing judg-
ment to determine whether the client is ready for surgery.
4. One of the responsibilities of the UAP is changing bed linens.
5. The UAP can document the client's in- take and output, but the UAP cannot evaluate
the numbers.
20. When the nurse is evaluating the reliability of a patient's responses, which of
these statements would be correct? The patient:
A. has a history of drug abuse and therefore is not reliable.
B. provided consistent information and therefore is reliable.
C. smiled throughout interview and therefore is assumed reliable.
D. would not answer questions concerning stress and therefore is not reliable.
B. provided consistent information and therefore is reliable.
Page: 50. A reliable person always gives the same answers, even when questions are
rephrased or are repeated later in the interview. The other statements are not correct.
21. Which client should the charge nurse on the pediatric unit assign to the most
experienced nurse?
1. The 4-year-old child diagnosed with hemophilia receiving factor VIII.
2. The 8-year-old child with headaches who is scheduled for a CT scan.
3. The 6-year-old child recovering from a sickle cell crisis.
4. The 11-year-old child newly diagnosed with rheumatoid arthritis.
1-The administration of blood products does not require the most experienced nurse.
2-Preparing a child for a routine procedure does not require the most experienced
nurse.
judgment.
2. One of the responsibilities of the UAP is
taking routine vital signs on clients.
3. The nurse must complete the preoperative checklist because it requires nursing judg-
ment to determine whether the client is ready for surgery.
4. One of the responsibilities of the UAP is changing bed linens.
5. The UAP can document the client's in- take and output, but the UAP cannot evaluate
the numbers.
20. When the nurse is evaluating the reliability of a patient's responses, which of
these statements would be correct? The patient:
A. has a history of drug abuse and therefore is not reliable.
B. provided consistent information and therefore is reliable.
C. smiled throughout interview and therefore is assumed reliable.
D. would not answer questions concerning stress and therefore is not reliable.
B. provided consistent information and therefore is reliable.
Page: 50. A reliable person always gives the same answers, even when questions are
rephrased or are repeated later in the interview. The other statements are not correct.
21. Which client should the charge nurse on the pediatric unit assign to the most
experienced nurse?
1. The 4-year-old child diagnosed with hemophilia receiving factor VIII.
2. The 8-year-old child with headaches who is scheduled for a CT scan.
3. The 6-year-old child recovering from a sickle cell crisis.
4. The 11-year-old child newly diagnosed with rheumatoid arthritis.
1-The administration of blood products does not require the most experienced nurse.
2-Preparing a child for a routine procedure does not require the most experienced
nurse.
Loading page 21...
3-The child recovering from a sickle cell crisis would not require the most experienced
nurse.
**4-The child newly diagnosed with a chronic disease, which will have acute exacerba-
tions, requires extensive teaching; there- fore, the most experienced nurse should be
assigned to this child and family.
21. In recording the childhood illnesses of a patient who denies having had any,
which note by the nurse would be most accurate?
A. Patient denies usual childhood illnesses.
B. Patient states he was a "very healthy" child.
C. Patient states sister had measles, but he didn't.
D. Patient denies measles, mumps, rubella, chickenpox, pertussis, and strep
throat.
D. Patient denies measles, mumps, rubella, chickenpox, pertussis, and strep throat.
Page: 51. Childhood illnesses include measles, mumps, rubella, chickenpox, pertussis,
and strep throat. Avoid recording "usual childhood illnesses" because an illness
common in the person's childhood may be unusual today (e.g., measles).
22. The charge nurse is making shift assignments on a pediatric oncology unit.
Which delegation/assignment would be most appropriate?
1. Delegate the unlicensed assistive personnel (UAP) to obtain routine blood work
from the central line.
2. Instruct the licensed practical nurse (LPN) to contact the leukemia support
group.
3. Assign the chemotherapy-certified RN to administer chemotherapeutic
medication.
4. Have the dietitian check the meal trays for the amount eaten.
1-Only an RN can withdraw blood from a
central line.
nurse.
**4-The child newly diagnosed with a chronic disease, which will have acute exacerba-
tions, requires extensive teaching; there- fore, the most experienced nurse should be
assigned to this child and family.
21. In recording the childhood illnesses of a patient who denies having had any,
which note by the nurse would be most accurate?
A. Patient denies usual childhood illnesses.
B. Patient states he was a "very healthy" child.
C. Patient states sister had measles, but he didn't.
D. Patient denies measles, mumps, rubella, chickenpox, pertussis, and strep
throat.
D. Patient denies measles, mumps, rubella, chickenpox, pertussis, and strep throat.
Page: 51. Childhood illnesses include measles, mumps, rubella, chickenpox, pertussis,
and strep throat. Avoid recording "usual childhood illnesses" because an illness
common in the person's childhood may be unusual today (e.g., measles).
22. The charge nurse is making shift assignments on a pediatric oncology unit.
Which delegation/assignment would be most appropriate?
1. Delegate the unlicensed assistive personnel (UAP) to obtain routine blood work
from the central line.
2. Instruct the licensed practical nurse (LPN) to contact the leukemia support
group.
3. Assign the chemotherapy-certified RN to administer chemotherapeutic
medication.
4. Have the dietitian check the meal trays for the amount eaten.
1-Only an RN can withdraw blood from a
central line.
Loading page 22...
2. The social worker or case manager is respon-
sible for referring clients to support groups. This is not an expected responsibility of a
floor nurse/LPN.
**3. Only chemotherapy-certified RNs can administer antineoplastic, chemothera- peutic
medications. This is a national minimal standard of care according to the Oncology
Nursing Society.
4. The dietician is responsible for ensuring that the proper food is provided along with
evalu- ating the child's nutritional intake, not checking the amount of food eaten—this is
the responsibility of the nursing staff.
22. The mother of a 16-month-old toddler tells the nurse that her daughter has an
earache. What would be an appropriate response?
A. "Maybe she is just teething."
B. "I will check her ear for an ear infection."
C. "Are you sure she is really having pain?"
D. "Please describe what she is doing to indicate she is having pain."
D. "Please describe what she is doing to indicate she is having pain."
Page: 60. With a very young child, ask the parent, "How do you know the child is in
pain?" Pulling at ears alerts parent to ear pain. The statements about teething and
questioning whether the child is really having pain do not explore the symptoms, which
should be done before a physical examination.
23. The nurse observes the unlicensed assistive personnel (UAP) bringing a
cartoon video to a 6-year-old female child on bed rest so that she can watch it on
the television. Which action should the nurse take?
1. Tell the UAP that the child should not be watching videos.
2. Explain that this is the responsibility of the child life therapist.
3. Praise the UAP for providing the child with an appropriate activity. 4. Notify the
charge nurse that the UAP gave the child videos to watch.
sible for referring clients to support groups. This is not an expected responsibility of a
floor nurse/LPN.
**3. Only chemotherapy-certified RNs can administer antineoplastic, chemothera- peutic
medications. This is a national minimal standard of care according to the Oncology
Nursing Society.
4. The dietician is responsible for ensuring that the proper food is provided along with
evalu- ating the child's nutritional intake, not checking the amount of food eaten—this is
the responsibility of the nursing staff.
22. The mother of a 16-month-old toddler tells the nurse that her daughter has an
earache. What would be an appropriate response?
A. "Maybe she is just teething."
B. "I will check her ear for an ear infection."
C. "Are you sure she is really having pain?"
D. "Please describe what she is doing to indicate she is having pain."
D. "Please describe what she is doing to indicate she is having pain."
Page: 60. With a very young child, ask the parent, "How do you know the child is in
pain?" Pulling at ears alerts parent to ear pain. The statements about teething and
questioning whether the child is really having pain do not explore the symptoms, which
should be done before a physical examination.
23. The nurse observes the unlicensed assistive personnel (UAP) bringing a
cartoon video to a 6-year-old female child on bed rest so that she can watch it on
the television. Which action should the nurse take?
1. Tell the UAP that the child should not be watching videos.
2. Explain that this is the responsibility of the child life therapist.
3. Praise the UAP for providing the child with an appropriate activity. 4. Notify the
charge nurse that the UAP gave the child videos to watch.
Loading page 23...
1. A 6 year old child on best rest needs an appropriate activity to help with distraction; a
cartoon video would be an age appropriate activity.
2. The child life therapist is responsible for
recreational and developmental activity for the hospitalized child, but any staff member
should address the child's psychosocial needs.
**3. Part of the delegation process is to evaluate the UAP's performance of duties, and
the nurse should praise any initiative on the part of the UAP in being a client advocate.
4. Videos are one of the few age-appropriate activities to occupy a 6-year-old on bed
rest; therefore, there is no reason to notify the charge nurse.
23. A 5-year-old boy is being admitted to the hospital to have his tonsils removed.
Which information should the nurse collect before this procedure?
A. The child's birth weight
B. The age at which he crawled
C. Whether he has had the measles
D. Reactions to previous hospitalizations
D. Reactions to previous hospitalizations
Assess how the child reacted to hospitalization and any complications. If the child
reacted poorly, he or she may be afraid now and will need special preparation for the
examination that is to follow. The other items are not significant for the procedure.
24. Which newborn should the nurse in the neonatal intensive care unit (NICU)
assign to a new graduate who has just completed an NICU internship?
1. The 1-day-old infant diagnosed with a myelomeningocele.
2. The 2-week-old infant who was born 6 weeks premature.
3. The 3-hour-old infant who is being evaluated for esophageal atresia. 4. The 1-
week-old infant diagnosed with tetralogy of Fallot.
1-The newborn with the myelomeningocele has a portion of the spinal cord and mem-
branes protruding through the back and is at risk for hydrocephalus and meningitis; this
cartoon video would be an age appropriate activity.
2. The child life therapist is responsible for
recreational and developmental activity for the hospitalized child, but any staff member
should address the child's psychosocial needs.
**3. Part of the delegation process is to evaluate the UAP's performance of duties, and
the nurse should praise any initiative on the part of the UAP in being a client advocate.
4. Videos are one of the few age-appropriate activities to occupy a 6-year-old on bed
rest; therefore, there is no reason to notify the charge nurse.
23. A 5-year-old boy is being admitted to the hospital to have his tonsils removed.
Which information should the nurse collect before this procedure?
A. The child's birth weight
B. The age at which he crawled
C. Whether he has had the measles
D. Reactions to previous hospitalizations
D. Reactions to previous hospitalizations
Assess how the child reacted to hospitalization and any complications. If the child
reacted poorly, he or she may be afraid now and will need special preparation for the
examination that is to follow. The other items are not significant for the procedure.
24. Which newborn should the nurse in the neonatal intensive care unit (NICU)
assign to a new graduate who has just completed an NICU internship?
1. The 1-day-old infant diagnosed with a myelomeningocele.
2. The 2-week-old infant who was born 6 weeks premature.
3. The 3-hour-old infant who is being evaluated for esophageal atresia. 4. The 1-
week-old infant diagnosed with tetralogy of Fallot.
1-The newborn with the myelomeningocele has a portion of the spinal cord and mem-
branes protruding through the back and is at risk for hydrocephalus and meningitis; this
Loading page 24...
client should be assigned to a more experi- enced nurse.
**2-The new graduate who has completed the NICU internship should be able to care
for a premature infant because care is primarily supportive.
3-Esophageal atresia, a congenital anomaly in which the esophagus does not
completely develop, is a clinical and surgical emergency. It puts the newborn at risk for
aspiration be- cause the upper esophagus ends in a blind pouch with the lower part of
the esophagus connected to the trachea. This newborn should be assigned to a more
experienced nurse.
4-Tetralogy of Fallot is a cyanotic, congenital anomaly. It includes a combination of four
defects of the heart, all of which result in unoxygenated blood being pumped into the
systemic circulation. This newborn must be assigned to an experienced nurse.
24. The nurse is preparing to do a functional assessment. Which statement best
describes the purpose of a functional assessment?
A. It assesses how the individual is coping with life at home.
B. It determines how children are meeting developmental milestones.
C. It can identify any problems with memory the individual may be experiencing.
D. It helps to determine how a person is managing day-to-day activities.
D. It helps to determine how a person is managing day-to-day activities.
Page: 67. The functional assessment measures how a person manages day-to-day
activities. The other answers do not reflect the purpose of a functional assessment.
25. The newly hired nurse is working on a pediatric unit and needs the unlicensed
assistive personnel (UAP) to obtain a urine specimen on an 11-month-old infant.
Which statement made to the UAP indicates the nurse understands the
delegation process?
1. "Be sure to weigh the diaper when obtaining the urine specimen."
2. "Do you know how to apply the urine collection bag?"
**2-The new graduate who has completed the NICU internship should be able to care
for a premature infant because care is primarily supportive.
3-Esophageal atresia, a congenital anomaly in which the esophagus does not
completely develop, is a clinical and surgical emergency. It puts the newborn at risk for
aspiration be- cause the upper esophagus ends in a blind pouch with the lower part of
the esophagus connected to the trachea. This newborn should be assigned to a more
experienced nurse.
4-Tetralogy of Fallot is a cyanotic, congenital anomaly. It includes a combination of four
defects of the heart, all of which result in unoxygenated blood being pumped into the
systemic circulation. This newborn must be assigned to an experienced nurse.
24. The nurse is preparing to do a functional assessment. Which statement best
describes the purpose of a functional assessment?
A. It assesses how the individual is coping with life at home.
B. It determines how children are meeting developmental milestones.
C. It can identify any problems with memory the individual may be experiencing.
D. It helps to determine how a person is managing day-to-day activities.
D. It helps to determine how a person is managing day-to-day activities.
Page: 67. The functional assessment measures how a person manages day-to-day
activities. The other answers do not reflect the purpose of a functional assessment.
25. The newly hired nurse is working on a pediatric unit and needs the unlicensed
assistive personnel (UAP) to obtain a urine specimen on an 11-month-old infant.
Which statement made to the UAP indicates the nurse understands the
delegation process?
1. "Be sure to weigh the diaper when obtaining the urine specimen."
2. "Do you know how to apply the urine collection bag?"
Loading page 25...
3. "Use a small indwelling catheter when obtaining the urine specimen." 4. "I need
for you to get a urine specimen on the infant."
1-Weighing the diaper is the procedure for de- termining the infant's urinary output and
is not part of the procedure for obtaining a urine specimen.
**2-The NCSBN position paper in 1995 defined delegation as transferring to a
competent individual the authority to perform a selected nursing task in a se- lected
situation. The nurse retains the accountability for the delegation. The nurse must
determine whether the UAP has the ability and knowledge to perform a task. This
question clarifies whether the UAP has the ability to obtain a urine specimen.
3-Obtaining a urine specimen with an in- dwelling catheter on an 11-month-old infant
would require more expertise than a UAP would have on the pediatric unit.
Furthermore, it does not determine whether the UAP understands how to do the
procedure.
4. This statement does not determine whether the UAP understands how to perform the
procedure of obtaining a urine specimen from an 11-month-old infant.
25. The nurse is performing a functional assessment on an 82-year-old patient
who recently had a stroke. Which of these questions would be most important to
ask?
A. "Do you wear glasses?"
B. "Are you able to dress yourself?"
C. "Do you have any thyroid problems?"
D. "How many times a day do you have a bowel movement?"
B. "Are you able to dress yourself?"
Page: 67. Functional assessment measures how a person manages day-to-day
activities. For the older person, the meaning of health becomes those activities that they
can or cannot do. The other responses do not relate to functional assessment.
for you to get a urine specimen on the infant."
1-Weighing the diaper is the procedure for de- termining the infant's urinary output and
is not part of the procedure for obtaining a urine specimen.
**2-The NCSBN position paper in 1995 defined delegation as transferring to a
competent individual the authority to perform a selected nursing task in a se- lected
situation. The nurse retains the accountability for the delegation. The nurse must
determine whether the UAP has the ability and knowledge to perform a task. This
question clarifies whether the UAP has the ability to obtain a urine specimen.
3-Obtaining a urine specimen with an in- dwelling catheter on an 11-month-old infant
would require more expertise than a UAP would have on the pediatric unit.
Furthermore, it does not determine whether the UAP understands how to do the
procedure.
4. This statement does not determine whether the UAP understands how to perform the
procedure of obtaining a urine specimen from an 11-month-old infant.
25. The nurse is performing a functional assessment on an 82-year-old patient
who recently had a stroke. Which of these questions would be most important to
ask?
A. "Do you wear glasses?"
B. "Are you able to dress yourself?"
C. "Do you have any thyroid problems?"
D. "How many times a day do you have a bowel movement?"
B. "Are you able to dress yourself?"
Page: 67. Functional assessment measures how a person manages day-to-day
activities. For the older person, the meaning of health becomes those activities that they
can or cannot do. The other responses do not relate to functional assessment.
Loading page 26...
26. Which task is most appropriate for the pediatric nurse to delegate to the
unlicensed assistive personnel (UAP)?
1. Ask the UAP to orient the parents and child to the room.
2. Tell the UAP to prepare the child for an endoscopy.
3. Request the UAP to log roll the client who had a spinal surgery. 4. Instruct the
UAP to assess the child's developmental level.
**1-The UAP can orient the parents and child to the room, and demonstrate how to use
the call light, how the bed works, or how the television works.
2-The UAP cannot prepare a child for en- doscopy; this requires assessment and
evaluation to determine if the child is ready for the procedure.
3-There must be at least two people to log roll a child, and the UAP cannot do this
procedure alone.
4-The nurse cannot delegate assessment to the UAP.
26. The nurse is conducting a developmental history on a 5-year-old child. Which
questions are appropriate to ask the parents for this part of the assessment?
Select all that apply.
A. "How much junk food does your child eat?"
B. "How many teeth has he lost, and when did he lose them?"
C. "Is he able to tie his shoelaces?"
D. "Does he take a children's vitamin?"
E. "Can he tell time?"
F. "Does he have any food allergies?"
B. "How many teeth has he lost, and when did he lose them?"
C. "Is he able to tie his shoelaces?"
E. "Can he tell time?"
Page: 61. Questions about tooth loss, ability to tell time, and ability to tie shoelaces are
appropriate questions for a developmental assessment. Questions about junk food
unlicensed assistive personnel (UAP)?
1. Ask the UAP to orient the parents and child to the room.
2. Tell the UAP to prepare the child for an endoscopy.
3. Request the UAP to log roll the client who had a spinal surgery. 4. Instruct the
UAP to assess the child's developmental level.
**1-The UAP can orient the parents and child to the room, and demonstrate how to use
the call light, how the bed works, or how the television works.
2-The UAP cannot prepare a child for en- doscopy; this requires assessment and
evaluation to determine if the child is ready for the procedure.
3-There must be at least two people to log roll a child, and the UAP cannot do this
procedure alone.
4-The nurse cannot delegate assessment to the UAP.
26. The nurse is conducting a developmental history on a 5-year-old child. Which
questions are appropriate to ask the parents for this part of the assessment?
Select all that apply.
A. "How much junk food does your child eat?"
B. "How many teeth has he lost, and when did he lose them?"
C. "Is he able to tie his shoelaces?"
D. "Does he take a children's vitamin?"
E. "Can he tell time?"
F. "Does he have any food allergies?"
B. "How many teeth has he lost, and when did he lose them?"
C. "Is he able to tie his shoelaces?"
E. "Can he tell time?"
Page: 61. Questions about tooth loss, ability to tell time, and ability to tie shoelaces are
appropriate questions for a developmental assessment. Questions about junk food
Loading page 27...
intake and vitamins are part of a nutritional history. Questions about food allergies are
not part of a developmental history.
27. Which behavior by the unlicensed assistive personnel (UAP) warrants
intervention by the nurse?
1. The UAP weighs the child's diaper on a scale and records the urine output on
the intake & output (I&O) sheet.
2. The UAP sits with the child while the parent goes down to the cafeteria to get
something to eat.
3. The UAP bathes the child with congenital dislocated hip with the Pavlik
harness on the child.
4. The UAP applies wrist restraints on the 7-month-old who is 1 day postoperative
cleft palate repair.
1-The UAP can weigh the diapers and obtain urine output. The nurse must evaluate the
output.
2-A child under 12 years of age cannot be left alone in the room, and the UAP could
stay with the child while the parent gets some- thing to eat.
3-The Pavlik harness should not be removed, so bathing the child in the harness is
appro- priate and does not warrant intervention.
**4- The 7-month-old should have elbow restraints, not wrist restraints. Elbow restraints
prevent the child from putting fingers into the mouth, but allow the child to move the
arms.
27. During an examination, the nurse can assess mental status by which activity?
A) Examining the patient's electroencephalogram
B) Observing the patient as he or she performs an IQ test
C) Observing the patient and inferring health or dysfunction
D) Examining the patient's response to a specific set of questions
C) Observing the patient and inferring health or dysfunction
not part of a developmental history.
27. Which behavior by the unlicensed assistive personnel (UAP) warrants
intervention by the nurse?
1. The UAP weighs the child's diaper on a scale and records the urine output on
the intake & output (I&O) sheet.
2. The UAP sits with the child while the parent goes down to the cafeteria to get
something to eat.
3. The UAP bathes the child with congenital dislocated hip with the Pavlik
harness on the child.
4. The UAP applies wrist restraints on the 7-month-old who is 1 day postoperative
cleft palate repair.
1-The UAP can weigh the diapers and obtain urine output. The nurse must evaluate the
output.
2-A child under 12 years of age cannot be left alone in the room, and the UAP could
stay with the child while the parent gets some- thing to eat.
3-The Pavlik harness should not be removed, so bathing the child in the harness is
appro- priate and does not warrant intervention.
**4- The 7-month-old should have elbow restraints, not wrist restraints. Elbow restraints
prevent the child from putting fingers into the mouth, but allow the child to move the
arms.
27. During an examination, the nurse can assess mental status by which activity?
A) Examining the patient's electroencephalogram
B) Observing the patient as he or she performs an IQ test
C) Observing the patient and inferring health or dysfunction
D) Examining the patient's response to a specific set of questions
C) Observing the patient and inferring health or dysfunction
Loading page 28...
Page: 71. Mental status cannot be scrutinized directly like the characteristics of skin or
heart sounds. Its functioning is inferred through assessment of an individual's behaviors,
such as consciousness, language, mood and affect, and other aspects.
28. The nurse is assessing a 75-year-old man. As the nurse begins the mental
status portion of the assessment, the nurse expects that this patient:
A) will have no decrease in any of his abilities, including response time.
B) will have difficulty on tests of remote memory because this typically decreases
with age.
C) may take a little longer to respond, but his general knowledge and abilities
should not have declined.
D) will have had a decrease in his response time because of language loss and a
decrease in general knowledge.
C) may take a little longer to respond, but his general knowledge and abilities should not
have declined.
Page: 72. The aging process leaves the parameters of mental status mostly intact.
There is no decrease in general knowledge and little or no loss in vocabulary. Response
time is slower than in youth. It takes a bit longer for the brain to process information and
to react to it. Recent memory, which requires some processing is somewhat decreased
with aging, but remote memory is not affected.
28. The nurse is caring for pediatric clients. Which tasks are most appropriate to
assign to an unlicensed assistive personnel (UAP) and/or a licensed vocational
nurse (LPN)? Select all that apply.
1. Instruct the LPN to teach the parent of a child new diagnosed with type
1 diabetes.
2. Tell the UAP to apply an ice collar to the child who is 1 day postoperative
tonsillectomy.
3. Ask the UAP to place ointment on a child's diaper rash around the anal area.
heart sounds. Its functioning is inferred through assessment of an individual's behaviors,
such as consciousness, language, mood and affect, and other aspects.
28. The nurse is assessing a 75-year-old man. As the nurse begins the mental
status portion of the assessment, the nurse expects that this patient:
A) will have no decrease in any of his abilities, including response time.
B) will have difficulty on tests of remote memory because this typically decreases
with age.
C) may take a little longer to respond, but his general knowledge and abilities
should not have declined.
D) will have had a decrease in his response time because of language loss and a
decrease in general knowledge.
C) may take a little longer to respond, but his general knowledge and abilities should not
have declined.
Page: 72. The aging process leaves the parameters of mental status mostly intact.
There is no decrease in general knowledge and little or no loss in vocabulary. Response
time is slower than in youth. It takes a bit longer for the brain to process information and
to react to it. Recent memory, which requires some processing is somewhat decreased
with aging, but remote memory is not affected.
28. The nurse is caring for pediatric clients. Which tasks are most appropriate to
assign to an unlicensed assistive personnel (UAP) and/or a licensed vocational
nurse (LPN)? Select all that apply.
1. Instruct the LPN to teach the parent of a child new diagnosed with type
1 diabetes.
2. Tell the UAP to apply an ice collar to the child who is 1 day postoperative
tonsillectomy.
3. Ask the UAP to place ointment on a child's diaper rash around the anal area.
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Health Education Systems, Inc.