Extra Credit HESI Module 6
1. Questions
1. 1.ID: 0
Which event would require a nurse to complete and file an incident report?
A. A client has a seizure.
B. The nurse determines that a client would benefit from the use of a walker to ambulate.
C. The nurse, preparing an intravenous infusion,...
extra credit hesi module 6 1 questions 1 1id 9476950840 which event would require a nurse to complete and file an incident report a a client has a seizure b the nurse determines that a client
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Extra Credit HESI Module 6
1. Questions
1. 1.ID: 9476950840
Which event would require a nurse to complete and file an incident report?
A. A client has a seizure.
B. The nurse determines that a client would benefit from the use of a
walker to ambulate.
C. The nurse, preparing an intravenous infusion, notes that the
battery of an intravenous infusion pump is not working.
D. When a visitor suddenly becomes weak and dizzy, the nurse
checks the visitor’s blood pressure and takes the visitor to the
emergency department for treatment. Correct
Rationale: An incident is any event that is not consistent with the routine
operation of a healthcare unit or routine care of a client. Examples of incidents
include client falls, needlestick injuries, a visitor having symptoms of illness,
medication administration errors, accidental omission of prescribed therapies,
and circumstances leading to injury or a risk for injury. An incident report does
not need to be filed if a client has a seizure unless the client sustains injury as
a result of the seizure. If the nurse determines that a client would benefit from
the use of a walker to ambulate, he or she should take the appropriate action to
obtain one. If the nurse notes that the battery of an intravenous infusion pump
is not working, he or she should obtain a functioning pump and send the
nonfunctioning pump to the appropriate department for repair.
Test-Taking Strategy: Use the process of elimination and read each option
carefully. Recalling that an incident is any event that is not consistent with the
routine operation of a healthcare unit or routine care of a client will direct you to
the correct option. Review the reasons for filing an incident report if you had
difficulty with this question.
Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., pp.
336, 337, 403). St. Louis: Mosby.
Cognitive Ability: Applying
Client Needs: Safe and Effective Care Environment
Integrated Process: Nursing Process/Implementation
Content Area: Ethical/Legal
Giddens Concepts: Clinical Judgment, Health Policy
HESI Concepts: Clinical Decision-Making/Clinical Judgment, Health
Policy/Systems
Awarded 1.0 points out of 1.0 possible points.
2. 2.ID: 9476944425
A nurse, charting the administration of medications to an assigned client at 9
pm, notes that atenolol (Tenormin) was prescribed to be administered at 9
am
, instead of 9 pm. The nurse checks the client’s vital signs, completes an
incident report, and calls the physician to report the error. The physician tells
the nurse that an incident report is not needed but instructs her to monitor the
client during the night for hypotension. What action should the nurse take?
A. Notifying the nursing supervisor
B. Tearing up and discarding the incident report
C. Telling the physician that the error warrants the completion of an
incident report Correct
D. Telling the nursing supervisor that the physician did not want an
incident report completed and filed Incorrect
Rationale: Incident reports are an important part of a healthcare agency’s
quality improvement program. An incident is any event that is not consistent
with the routine operation of a healthcare unit or routine care of a client. An
example of an incident is administering a medication at a time at which it is not
prescribed to be given. Whenever an incident occurs, an incident report is
completed and filed in accordance with agency guidelines. The nursing
supervisor would be notified of the incident; however, on the basis of the data
in the question, the nurse should tell the physician that the error warrants
completion and follow-through with an incident report. Therefore, the other
options are incorrect.
Test-Taking Strategy: Focus on the subject of the question, the physician’s
telling the nurse that an incident report is not needed. Eliminate the options that
are comparable or alike in that they involve notifying the nursing supervisor. To
select from the remaining options, recall the purpose of an incident report to
select the correct option. Review the procedures involved in completing and
filing incident reports if you had difficulty with this question.
Reference: Huber, D. (2010). Leadership and nursing care management
(4th ed., pp. 557, 558). St. Louis: Saunders.
Cognitive Ability: Applying
Client Needs: Safe and Effective Care Environment
Integrated Process: Nursing Process/Implementation
Content Area: Ethical/Legal
Giddens Concepts: Clinical Judgment, Health Policy
HESI Concepts: Clinical Decision-Making/Clinical Judgment, Health
Policy/Systems
Awarded 0.0 points out of 1.0 possible points.
3. 3.ID: 9476948372
Contact precautions are initiated for a client with methicillin-
resistant Staphylococcus aureus (MRSA) infection. The nurse, providing
instructions to a nursing assistant about caring for the client, tells the assistant:
A. To transfer the client to a semiprivate room
, B. That gloves only are needed to care for the client
C. To wear gloves and a gown when changing the client's bed
linen. Correct
D. To wear a gown when caring for the client and remove the
gown immediately after leaving the client’s room
Rationale: Contact precautions require the use of gloves, gown, and goggles if
direct client contact is anticipated. Goggles are worn to protect the mucous
membranes of the eye during interventions that may produce splashes of blood
or body fluids, secretions, or excretions. The client should be placed in a
private room or, if a private room is not available, in a semiprivate room with
another client who has active infection with the same microorganism but no
other infection. The nursing assistant would remove the protective gear before
leaving the client’s room.
Test-Taking Strategy: Use the process of elimination. Eliminate the option that
includes the closed-ended word “only.” Next eliminate the option that involves
removal of the gown after leaving the client’s room. To select from the
remaining options, read each carefully and visualize the procedure instituted for
contact precautions, which will direct you to the correct option. If you had
difficulty with this question, review contact precautions.
Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., pp.
655, 663). St. Louis: Mosby.
Cognitive Ability: Applying
Client Needs: Safe and Effective Care
Environment Integrated Process: Teaching and
Learning Content Area: Leadership/Management
Giddens Concepts: Infection, Leadership
HESI Concepts: Collaboration/Managing Care—Leadership, Infection
Awarded 1.0 points out of 1.0 possible points.
4. 4.ID: 10466367548
A nurse hears someone calling, “Help! My bed is on fire!” On entering the
room, the nurse finds a client trying to beat out the flames with a pillow. Place
in order of priority the actions that the nurse should take:
Correct
A. Removing the client from the room
B. Pulling the nearest fire alarm
C. Closing the door to the room
D. Running to get the nearest fire extinguisher
Rationale: A nurse who encounters a fire emergency should think of the
mnemonic RACE. The first step is to remove the client from the room, after
which the nurse should activate the fire alarm, contain the fire,
and extinguish the fire. This is a universal standard that may be applied to any
type of fire emergency. Removing the client from the room is the first step.
, Pulling the nearest fire alarm is the second step (alarm). Closing the door to the
room to contain the fire is the third action. Obtaining the nearest fire
extinguisher to put out the fire is the fourth action.
Test-Taking Strategy: Focus on the subject, the steps to take in a
fire emergency. With this in mind, sequence the actions, using the
RACE mnemonic. Review fire safety if you had difficulty with this
question.
Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed.,
pp. 839, 840). St. Louis: Mosby.
Content
AwardedArea: Delegating/Prioritizing
1.0 points out of 1.0 possible points.
2. 5.ID: 9476945972
The mother of a 3-year-old calls a neighbor who is a nurse and reports that her
child just drank some window cleaner that had been stored in a cabinet. The
nurse should instruct the mother to immediately:
A. Call a poison control center Correct
B. Administer an excessive amount of fluids to induce vomiting
C. Call an ambulance to bring the child to the emergency
department
D. Leave a message at the physician answering service about the
incident
Rationale: When a poisoning occurs, a poison center should be called
immediately. Vomiting should not be induced if the victim is unconscious or if
the substance ingested was a strong corrosive or petroleum product. Also,
vomiting should not be induced unless a healthcare provider has given specific
instructions to induce vomiting. Neither calling an ambulance nor calling the
physician’s answering service is the immediate action, because either would
delay treatment. Additionally, the physician would immediately make a referral
to the poison control center. The poison control center may advise the mother
to bring the child to the emergency department; if this is the case, the mother
should then call an ambulance.
Test-Taking Strategy: Note the strategic word “immediately” in the query of the
question. First, recalling that vomiting should not be induced without
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