HESI Fundamentals 2023 Quizlet

Correct Answer: B

Rationale: The correct answer is B. HIPAA guidelines specify that only healthcare professionals directly involved in a patient's care should access their medical information. Asking a nurse from another unit to assist with documentation involves sharing patient information with someone not directly caring for the patient, which violates HIPAA guidelines. Choices A, C, and D involve individuals directly involved in the client's care, making them appropriate actions in line with HIPAA regulations. Choice A involves educating a nursing student under the supervision of the nurse, which is permissible. Choice C involves communicating with the client's designated healthcare decision-maker, which is also allowed under HIPAA. Choice D involves discussing the client's status with another healthcare professional directly involved in the client's care, which is within HIPAA guidelines.

Correct Answer: C

Rationale: The correct answer is C: Pain with passive movement. Pain with passive movement in a client with a new cast can indicate compartment syndrome, a serious condition where pressure builds up within the muscles, nerves, and blood vessels of the affected limb, potentially leading to tissue damage. Immediate reporting is crucial to prevent further complications. Increased warmth in the affected arm could be a normal inflammatory response to the injury and casting process. Itching under the cast is common and can be managed without immediate concern. Drainage on the cast may be expected initially after casting due to residual moisture from the setting process, but ongoing or excessive drainage should be monitored and reported if persistent.

Correct Answer: C

Rationale: The correct answer is a partial bed bath (Choice C). A partial bed bath involves washing body parts that the patient cannot reach on their own, such as the back. It also includes providing assistance with a backrub to promote circulation and skin integrity. In this scenario, where the patient is bedridden and unable to reach all body parts, a partial bed bath is the most appropriate as it focuses on areas the patient cannot clean themselves. Choices A, B, and D are incorrect because a bag bath involves using premoistened disposable cloths for bathing, a sponge bath involves using a basin of water and a sponge for cleansing, and a complete bed bath involves washing the entire body, including areas the patient can reach, which are not necessary in this case.

Correct Answer: B

Rationale: When administering opioid medications, it is crucial to monitor the client for respiratory depression, which is a potential side effect of opioids. Monitoring for respiratory depression is a critical safety measure to ensure the client's well-being during opioid therapy. Option A is incorrect because additional monitoring, especially for respiratory depression, is necessary when giving opioids to prevent adverse effects. Option C is incorrect as administering the medication only upon client request may compromise effective pain management and adherence to the prescribed regimen. Option D is incorrect as medication verification by another healthcare professional is essential for safety but not directly related to monitoring the client for respiratory depression after opioid administration.

Correct Answer: C

Rationale: The correct answer is C. Clients with hypertension should ideally avoid or limit alcohol intake rather than just restricting it to weekends. Excessive alcohol consumption can raise blood pressure and interfere with the effectiveness of hypertension management. Choices A, B, and D are all positive statements that align with managing hypertension: reducing salt intake, regular exercise, and monitoring blood pressure are all beneficial lifestyle changes for individuals with hypertension. Therefore, the statement about drinking alcohol only on weekends requires further teaching to emphasize the importance of reducing alcohol consumption for better blood pressure control.