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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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.
The community health center has noticed a dramatic increase in influenza cases over prior years. The facility nurses have been charged with reviewing outcome data to determine if there is a trend in vaccination rates, and if a trend is noted, reasons for decline. An action plan will be developed to increase rates, if needed. The facility nursing team develops a plan to survey the community and facility records. Select all applicable action(s) that will facilitate gathering data for analysis.
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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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Ask for the support of one of the client's friends.
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Request a family member to remain with the client.
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Use drawings that are universal for all cultures.
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Obtain a staff member who is a bilingual interpreter.
Explanation
Correct Answer: (D) Obtain a staff member who is a bilingual interpreter.
The first priority when a client does not understand English is to establish effective communication through a qualified bilingual interpreter. A trained staff interpreter ensures accurate exchange of clinical information, supports informed consent, and addresses the client's fear by enabling direct, clear communication in their own language.
Why Other Options are Incorrect:
A. Ask for the support of one of the client's friends — Friends are not trained interpreters and may introduce inaccurate translations or breach confidentiality, making them inappropriate for clinical communication.
B. Request a family member to remain with the client — Family members, like friends, are not trained interpreters and may filter or alter information, which can compromise the accuracy of the assessment.
C. Use drawings that are universal for all cultures — While drawings can be a supplementary communication tool, they are insufficient for conducting a thorough clinical assessment and do not replace accurate verbal communication.
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Rotate assignment of this client among staff members so that one nurse is not overworked.
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Set up a meeting with the client, the client's family, and all staff members to discuss the client's demands.
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Ask the nursing supervisor to move the client to another unit where the nurse-client ratio is higher.
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Check on the client at designated time intervals and let the client know when the nurse will return.
Explanation
Correct Answer: (D) Check on the client at designated time intervals and let the client know when the nurse will return.
This approach directly addresses the root cause of the behavior — the client's anxiety and need for reassurance — by providing predictable, scheduled contact. When the client knows the nurse will return at specific intervals, the need to use the call button excessively decreases, promoting independence while maintaining a therapeutic relationship and reducing staff burden.
Why the other options are incorrect:
A. Rotate the client's assignment among staff — Rotating staff increases inconsistency in care, which may worsen the client's anxiety and need for attention rather than reducing call button use.
B. Set up a meeting with the client, family, and all staff — While communication is important, a large group meeting may feel confrontational or overwhelming for the client and does not address the immediate behavior in a practical way.
C. Move the client to a unit with a higher nurse-client ratio — Transferring the client does not address the underlying anxiety driving the behavior and may disrupt continuity of care unnecessarily.
Two days after surgery, a client experiences incisional pain while dangling at the bedside and refuses to ambulate as prescribed. The nurse establishes a problem of, "Activity intolerance related to pain." Based on this problem, which outcome statement is best for the nurse to include in this client's plan of care?
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Take analgesics as prescribed.
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Show evidence of incision healing.
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Ambulate without discomfort.
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Avoid pain-causing activity.
Explanation
A correctly written outcome statement must be client-focused, measurable, realistic, and directly address the nursing diagnosis. Since the problem is activity intolerance related to pain, the goal is for the client to achieve the ability to ambulate without experiencing discomfort. This outcome is specific, measurable, and directly resolves the identified problem of activity intolerance caused by pain.
Why the other options are incorrect:
A. Take analgesics as prescribed — This describes a nursing intervention, not a client outcome. Outcome statements describe what the client will achieve or demonstrate, not what the nurse or client will do as an action step.
B. Show evidence of incision healing — While wound healing is an important goal, it does not directly address the identified nursing diagnosis of activity intolerance related to pain. It targets a different problem.
D. Avoid pain-causing activity — This outcome contradicts the goal of restoring activity and ambulation. Avoiding activity does not resolve activity intolerance and would actually worsen the client's postoperative recovery.
Which activity by the nurse best describes the adoption of an evidence-based practice in the delivery of client care?
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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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A local place of worship.
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The school classroom.
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Home of one of the children.
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Community center.
Explanation
The school classroom is the most familiar and comfortable environment for 10-year-olds, making it the setting most likely to encourage participation. Preadolescents are accustomed to learning in a classroom setting, and the structured, peer-inclusive environment promotes engagement and reduces anxiety about participation in health education activities.
Why the other options are incorrect:
A. A local place of worship — While accessible to some, a place of worship may not be inclusive of all children due to varying religious affiliations, potentially limiting participation.
C. Home of one of the children — This setting may create social discomfort or favoritism among peers and is not a neutral or equally accessible environment for all participants.
D. Community center — While a community center is a neutral space, it is less familiar to children than their school environment and may not feel as safe or routine for active participation.
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Video presentation followed by a demonstration of BGM.
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Small group discussions with a packet of free BGM supplies.
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Lecture followed by a question and answer session.
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Distribution of pamphlets on BGM with a follow-up quiz.
Explanation
Correct Answer: (A) Video presentation followed by a demonstration of BGM.
For adults learning a new psychomotor skill like blood glucose monitoring, a combination of visual learning through video and hands-on demonstration is the most effective teaching strategy. The video provides a clear visual model of the procedure, while the demonstration reinforces learning through observation and allows for return demonstration, which is the gold standard for evaluating skill acquisition.
Why the other options are incorrect:
B. Small group discussions with free BGM supplies — While providing supplies is helpful, small group discussion alone does not adequately teach the procedural steps of blood glucose monitoring without a visual or hands-on component.
C. Lecture followed by Q&A — Lecture is effective for conveying information but is insufficient for teaching a hands-on skill that requires demonstration and practice to master.
D. Distribution of pamphlets with a follow-up quiz — Pamphlets can supplement learning but are passive teaching tools that do not effectively teach a skill-based procedure, and a quiz only evaluates knowledge, not the ability to perform the skill.
The nurse is caring for a client with extensive open wounds to the face. Which problem should the nurse prioritize?
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Disturbed body image.
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Impaired social interaction.
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Ineffective airway clearance.
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Risk for infection.
Explanation
Correct Answer: (C) Ineffective airway clearance.
Using the ABCs framework (Airway, Breathing, Circulation), airway is always the highest priority. Extensive open wounds to the face pose a significant risk of airway compromise due to swelling, bleeding, secretions, or debris obstructing the upper airway. Ensuring a patent airway is the most immediately life-threatening concern and must be addressed before all other problems.
Why the other options are incorrect:
A. Disturbed body image — While facial wounds can significantly affect self-perception and body image, this is a psychosocial concern that is addressed after physiological priorities, particularly airway safety, are secured.
B. Impaired social interaction — Social interaction concerns are important in holistic care but are not an immediate life-threatening priority compared to airway management.
D. Risk for infection — Infection prevention is an important nursing concern with open wounds, but it is not an immediate life-threatening priority. Airway compromise can cause death within minutes, making it the priority over infection risk.
The nurse implements a change in the approach to client care after gathering evidence in support of the new approach. Which action should the nurse take next?
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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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