HESI-HU NSG122 Nursing Fundamental Concepts Exam 1
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Free HESI-HU NSG122 Nursing Fundamental Concepts Exam 1 Questions
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Postanesthesia, the client's first dose of a narcotic is halved to maintain respiratory effort.
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Vital signs are recorded every shift on stable clients per current hospital-wide policy.
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Certain antimicrobials were discarded after being linked to increased nosocomial infection rates.
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Dependent clients on a medical unit are bathed every other day instead of daily by the staff.
Explanation
This option best describes evidence-based practice because it demonstrates a change in clinical practice that was directly driven by research evidence. When data showed that specific antimicrobials were associated with increased hospital-acquired infection rates, the clinical decision to discontinue their use was made based on that evidence, which is the core principle of evidence-based practice — integrating the best available research evidence into clinical decision-making to improve client outcomes.
Why the other options are incorrect:
A. Postanesthesia, the client's first dose of a narcotic is halved to maintain respiratory effort — While this may reflect a safety consideration, it describes a prescribing adjustment rather than a practice change based on systematically gathered and applied research evidence.
B. Vital signs are recorded every shift on stable clients per current hospital-wide policy — Following an existing institutional policy is a standard of care practice, not an example of adopting a new evidence-based change. It does not demonstrate the application of new research evidence to modify practice.
D. Dependent clients on a medical unit are bathed every other day instead of daily by the staff — While bathing frequency may be informed by some evidence, this example appears to reflect a staffing convenience decision rather than a change driven by research evidence to improve client outcomes.
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Modify the nursing interventions to achieve the client's goals.
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Determine if the expected outcomes were realistic.
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Obtain current client data to compare with expected outcomes.
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Review related professional standards of care.
Explanation
Correct Answer: (C) Obtain current client data to compare with expected outcomes.
After reviewing the expected outcomes in the plan of care, the nurse's next logical step is to gather current client data to compare against those outcomes. This is the foundation of the evaluation phase of the nursing process — you cannot determine whether goals have been met without first collecting current assessment data.
Why the other options are incorrect:
A. Modify the nursing interventions to achieve the client's goals — Modifying interventions comes after the nurse has compared actual outcomes with expected outcomes, not before. This step would be premature at this point.
B. Determine if the expected outcomes were realistic — Evaluating whether outcomes were realistic also comes after comparing current data with expected outcomes. You need the data first before making that judgment.
D. Review related professional standards of care — While professional standards are important, reviewing them is not the immediate next step after identifying expected outcomes. The priority is gathering current client data for comparison.
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Chaplain.
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Family attorney.
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Nurse manager.
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Hospice nurse.
Explanation
Correct Answer: (B) Family attorney.
Advance directives are legal documents that outline a client's wishes regarding medical treatment in the event they are unable to make decisions. A family attorney is the most appropriate professional to consult, as they can provide legal guidance on drafting, reviewing, and ensuring the validity of these documents according to state laws.
Why the other options are incorrect:
A. Chaplain — A chaplain provides spiritual and emotional support but is not qualified to offer legal guidance on advance directives.
C. Nurse manager — While a nurse manager can provide general information about hospital policies regarding advance directives, they are not the appropriate professional for legal advice on drafting them.
D. Hospice nurse — A hospice nurse is knowledgeable about end-of-life care but is not the appropriate professional to give legal counsel on advance directive documentation.
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Generate influenza immunization and case reports from the electronic record for prior year and current year
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Delineate geographic distribution of area to survey and review for patterns
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Determine change in immunization rates from prior year to current year
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Client survey both in clinic and in the home
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Ask a set number of clients if they have had the flu
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Develop an action plan to increase immunization rates
Explanation
Correct Answers: (A) Generate influenza immunization and case reports from the electronic record for prior year and current year, (B) Delineate geographic distribution of area to survey and review for patterns, (C) Determine change in immunization rates from prior year to current year, and (D) Client survey both in clinic and in the home.
These four actions directly support the data-gathering phase of the quality improvement process. Generating electronic records provides historical and current immunization data, delineating geographic distribution helps identify patterns, determining rate changes measures trends over time, and client surveys gather direct community input — all essential for building a comprehensive analysis.
Why the other options are incorrect:
E. Ask a set number of clients if they have had the flu — This is too informal and lacks the systematic structure needed for valid data collection in a quality improvement project.
F. Develop an action plan to increase immunization rates — This is an intervention step that comes after data has been gathered and analyzed, not during the data collection phase.
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A cross-sectional study that found a strong relationship between Vitamin D intake and bone density.
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A meta-analysis that concluded that bone density improved among individuals who took Vitamin D.
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A cohort study that concluded low levels of Vitamin D were linked to decreased bone mineral density.
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A time series design study that reported that those who took Vitamin D had improved bone density.
Explanation
Correct Answer: (B) A meta-analysis that concluded that bone density improved among individuals who took Vitamin D.
A meta-analysis sits at the top of the evidence hierarchy in research. It systematically combines and analyzes data from multiple independent studies, producing a statistically powerful and comprehensive conclusion that is far more reliable than any single study. For evaluating the effectiveness of an intervention such as Vitamin D supplementation, a meta-analysis provides the strongest and most trustworthy level of evidence.
Why the other options are incorrect:
A. A cross-sectional study that found a strong relationship between Vitamin D intake and bone density — Cross-sectional studies examine data at a single point in time and can identify associations but cannot establish cause and effect. They are lower on the evidence hierarchy than meta-analyses.
C. A cohort study that concluded low levels of Vitamin D were linked to decreased bone mineral density — Cohort studies follow groups over time and can suggest associations, but they rank below meta-analyses in terms of evidence strength and do not directly measure the effectiveness of supplementation.
D. A time series design study that reported that those who took Vitamin D had improved bone density — Time series studies track outcomes over multiple time points but are observational in nature and rank lower in the evidence hierarchy compared to a meta-analysis.
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Encourage peer support among the nursing staff to report issues.
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Repeat the study at the nurse manager's hospital.
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Review the hospital's definition of workplace violence.
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Develop a system for reporting workplace violence anonymously.
Explanation
The study identified that fear of reprisal was the primary barrier to reporting workplace violence. The most effective and direct action a nurse manager can take is to create an anonymous reporting system, which directly addresses that barrier and encourages staff to report incidents without fear of consequences.
Why the other options are incorrect:
A. Encourage peer support among nursing staff — While peer support is beneficial, it alone does not eliminate the fear of reprisal, which was identified as the core barrier to reporting in the study.
B. Repeat the study at the nurse manager's hospital — Replicating the study gathers more data but does not take immediate action to address the identified problem of underreporting due to fear of reprisal.
C. Review the hospital's definition of workplace violence — Clarifying definitions may be useful but does not directly address the fear of reprisal that discourages nurses from reporting incidents.
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Engage staff in evidence based practice.
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Consult with a clinical nursing expert.
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Evaluate effectiveness of the change.
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Revise clinical practice guidelines.
Explanation
After implementing a change in clinical practice, the next step in the evidence-based practice process is to evaluate whether the change achieved the desired outcome. Evaluation is essential to determine if the new approach is effective, safe, and beneficial for client care. This step follows implementation and precedes any decision to adopt, modify, or abandon the change.
Why the other options are incorrect:
A. Engage staff in evidence based practice — Staff engagement in evidence-based practice is an important step that occurs before implementation, during the education and preparation phase. It has already been addressed prior to implementing the change.
B. Consult with a clinical nursing expert — Expert consultation is a step that occurs earlier in the process, during evidence gathering and planning, not after implementation has already taken place.
D. Revise clinical practice guidelines — Revising guidelines is a step that follows successful evaluation of the change. Guidelines are updated only after the effectiveness of the new approach has been confirmed through evaluation.
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Ensure that all treatments prescribed by the healthcare provider (HCP) have been initiated.
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List the nursing actions that need to be implemented most immediately.
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Review the priority nursing problems included in the POC.
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Compare the client's manifestations with the defining criteria of related problems.
Explanation
Goals in a plan of care are directly derived from and linked to the identified nursing problems. Before establishing goals, the nurse must review the priority nursing problems in the plan of care to ensure that each goal is specifically written to address and resolve a corresponding nursing diagnosis. This ensures that the plan of care is organized, targeted, and outcome-driven.
Why the other options are incorrect:
A. Ensure that all treatments prescribed by the HCP have been initiated — This action relates to implementing medical orders, not to the process of identifying and writing client-centered goals for the nursing plan of care.
B. List the nursing actions that need to be implemented most immediately — Listing nursing actions describes the intervention step of the nursing process, not the goal-setting step. Goals must be established before interventions are planned.
D. Compare the client's manifestations with the defining criteria of related problems — This action describes the diagnostic reasoning process used during nursing diagnosis formulation, which occurs before goal identification. It is part of assessment and diagnosis, not goal-setting.
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Call American Medical Association members to determine the most frequently treated diagnoses.
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Conduct a random telephone survey to determine the public's perception about health problems.
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Survey major hospitals in the area to determine the most common reasons for admissions.
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Review morbidity data for the city's population compiled by the Bureau of Vital Statistics.
Explanation
Correct Answer: (D) Review morbidity data for the city's population compiled by the Bureau of Vital Statistics.
The Bureau of Vital Statistics compiles official, population-based morbidity and mortality data that provides the most comprehensive, objective, and statistically valid picture of the city's greatest health concerns. This is the most appropriate starting point for a data-driven community health presentation, as it reflects actual disease burden across the entire population.
Why the other options are incorrect:
A. Call AMA members for frequently treated diagnoses — This reflects individual clinical experiences rather than population-level data and introduces significant selection bias.
B. Conduct a random telephone survey — Public perception surveys capture how people feel about health problems but do not objectively measure actual disease prevalence or burden in the community.
C. Survey major hospitals for common admission reasons — Hospital admission data is limited to those who sought inpatient care and does not capture the full scope of health concerns affecting the broader city population.
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Use computers only in private secure areas.
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Refrain from sharing one's access with other staff.
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Utilize computer blocking screens.
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Log out before leaving the computer.
Explanation
Logging out before leaving the computer is the single most important action to protect EMR security. Failing to log out leaves patient data accessible to anyone who approaches the terminal, creating a significant breach of confidentiality and HIPAA compliance. This is a direct and immediate safeguard against unauthorized access.
Why the other options are incorrect:
A. Use computers only in private secure areas — While this reduces visibility, it is not always practical and does not prevent unauthorized access if the user remains logged in.
B. Refrain from sharing access with other staff — This is also important for security, but it addresses credential management rather than the immediate risk of an unattended open session.
C. Utilize computer blocking screens — Privacy screens limit shoulder surfing but do not prevent someone from directly accessing an open, logged-in session at the terminal.
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