HESI Leadership | Nurselytic

Extract:

Question 1 of 5

Following a six-week refresher course, a female nurse who has been out of the workforce for 10 years is assigned to a medical unit for orientation. After the first week of orientation, the charge nurse notes that the orientee is overwhelmed by her daily assignments, which are less than one-half the assignments of the regular staff, and the assignments are incomplete at the end of each day. The following week, which action is best for the charge nurse to take?

Correct Answer: B

Rationale: Pairing with an experienced nurse provides mentorship, enhancing skills and confidence. Waiting, transferring, or suggesting a less stressful environment may delay support or undermine the orientee's potential.

Question 2 of 5

It is most important to assign which client to a registered nurse rather than a practical nurse (PN)?

A. One hour after receiving hydromorphone prescribed for every 4 hours PRN use, a client reports severe pain. B. Two hours after receiving morphine for acute pain, a client's vital signs are BP 112/60 mm Hg, pulse 88 beats/minute, and respirations 14 breaths/minute. C. After ambulating, a postoperative client grimaces and reports incisional pain at a '9 on a ten-point scale'. D. The fentanyl transdermal patch for a client with chronic cancer pain needs to be replaced.

Correct Answer: C

Rationale: The postoperative client with severe pain requires immediate RN assessment and intervention due to potential complications. The other clients' needs (PRN medication, stable vitals, routine patch replacement) can be managed by a PN under supervision.

Question 3 of 5

A fire is reported in the kitchen on the first floor of a three-floor community hospital, and the operator notifies the charge nurse on the third floor to start evacuation procedures. Which intervention should the charge nurse implement?

A. Instruct unlicensed assistive personnel (UAPs) to transfer all non-ambulatory clients via wheelchairs. B. Instruct the nursing staff to evacuate ambulatory clients to the nearest fire exits. C. Shut all doors to client rooms and tell everyone to stay in their rooms until the fire department arrives. D. Announce in a calm voice that all visitors should proceed immediately to the first floor via the service elevators.

Correct Answer: C

Rationale: Shutting doors and keeping everyone in rooms follows the RACE protocol (Rescue, Alarm, Contain, Extinguish), containing the fire and protecting from smoke. Evacuating clients or using elevators during a fire risks exposure to danger.

Question 4 of 5

When triaging emergency room clients, which client should the nurse assess first?

A. A male adolescent who has been vomiting for the past 12 hours and describes himself as very weak. B. A female client with severe right lower abdominal pain who is febrile and vomiting. C. An elderly client with peripheral vascular disease who is complaining of severe leg pain when ambulating. D. A child who has had a cold for two days and now is coughing up green sputum.

Correct Answer: B

Rationale: Severe right lower abdominal pain with fever and vomiting suggests appendicitis, a surgical emergency requiring immediate assessment. Vomiting, leg pain, and green sputum are less urgent conditions.

Question 5 of 5

The nurse manager decides to report a staff nurse to the Peer Review Committee (PRC). Which activity merits this action?

A. Administered two medications to the same client at the wrong time. B. Documented data in the clinical record before assessing client's condition. C. Served a diet tray to a client who was NPO for a scheduled procedure. D. Changed work assignments without prior approval from charge nurse.

Correct Answer: B

Rationale: Falsifying documentation by recording data before assessment is a serious ethical breach, warranting PRC review. Medication errors, serving a tray, or changing assignments are less severe and can be addressed through counseling.