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NURSING MISC HESI A2 CRITICAL THINKING Q & A
ALL 100% CORRECT ANSWERS BEST EXAM
SOLUTION LATEST UPDATE 2021/2022 RATED A+
Hesi Critical Thinking
The nurse is working in the emergency department (ED) of
a children's medical center. Which client should the nurse
assess first?
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.
The nurse is caring for clients on the pediatric medical unit.
Which client should the nurse assess first?
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.
The nurse has received the a.m. shift report for clients on a
pediatric unit. Which medication should the nurse administer
first?
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.
A 6-month-old infant has been brought to the well-child clinic
for a check-up. She is currently sleeping. What should the nurse
NURSING MISC HESI A2 CRITICAL THINKING Q & A
ALL 100% CORRECT ANSWERS BEST EXAM
SOLUTION LATEST UPDATE 2021/2022 RATED A+
,NURSING MISC HESI A2 CRITICAL THINKING Q & A
ALL 100% CORRECT ANSWERS BEST EXAM
SOLUTION LATEST UPDATE 2021/2022 RATED A+
do first when beginning the examination?
) Auscultate the lungs and heart while the infant is
still sleeping. Rationale
When the infant is quiet or sleeping is an ideal time to assess the
cardiac, respiratory, and abdominal systems. Assessment of the
eye, ear, nose, and throat are invasive procedures and should be
performed at the end of the examination.
. 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).
Rationale
Correct Answer: 4, 5, 3, 2, 1
4. The nurse must first
determine the infant's
responsiveness by thumping
the
NURSING MISC HESI A2 CRITICAL THINKING Q & A
ALL 100% CORRECT ANSWERS BEST EXAM
SOLUTION LATEST UPDATE 2021/2022 RATED A+
,NURSING MISC HESI A2 CRITICAL THINKING Q & A
ALL 100% CORRECT ANSWERS BEST EXAM
SOLUTION LATEST UPDATE 2021/2022 RATED A+
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.
. 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.
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-
NURSING MISC HESI A2 CRITICAL THINKING Q & A
ALL 100% CORRECT ANSWERS BEST EXAM
SOLUTION LATEST UPDATE 2021/2022 RATED A+
, NURSING MISC HESI A2 CRITICAL THINKING Q & A
ALL 100% CORRECT ANSWERS BEST EXAM
SOLUTION LATEST UPDATE 2021/2022 RATED A+
care provider
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?
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.
The clinic nurse is preparing to administer an intramuscular
(IM) injection to the 2- year-old toddler. Which intervention
should the nurse implement first?
Correct - 2-The nurse must explain any procedure in words the
child can understand. It does not matter how old the child is.
. The nurse is writing a care plan for the 5-year-old child diagnosed
with gastroenteritis. Which client problem is priority?
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.
Which data would warrant immediate intervention from
the pediatric nurse? 1. Proteinuria for the child diagnosed
with nephrotic syndrome.
Correct - 3-Drooling indicates the child is having trouble
swallowing, and the epiglottis is at risk of completely occluding
NURSING MISC HESI A2 CRITICAL THINKING Q & A
ALL 100% CORRECT ANSWERS BEST EXAM
SOLUTION LATEST UPDATE 2021/2022 RATED A+
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