Hesi Rn Fundamental NSG
HESI RN Fundamentals – NSG Practice Questions With Answers
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Free Hesi Rn Fundamental NSG Questions
A male client reports the onset of a burning sensation in his hands and legs. How should the nurse document this finding in the electronic medical record (EMR)?
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Inflammation present
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Reports feeling "on fire"
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Circulation impaired
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Paresthesia reported
Explanation
Correct Answer:
D. Paresthesia reported
Explanation:
Paresthesia is a clinical term used to describe abnormal sensations such as burning, tingling, prickling, or numbness, often felt in the extremities. These sensations are typically caused by nerve irritation, compression, or damage. When a client describes a burning feeling in the hands and legs, this symptom aligns with paresthesia. Nurses should use accurate and standardized clinical terminology like "paresthesia" in documentation to ensure clarity and continuity of care among healthcare professionals. Using objective, medically recognized terms is essential for precise communication in the EMR.
Why the other options are incorrect:
A. Inflammation present
This is an assumption. Burning sensations can be due to many causes other than inflammation, such as neuropathy or spinal nerve compression. Without physical signs or a medical diagnosis, documenting inflammation would be inappropriate.
B. Reports feeling "on fire"
While it reflects the client's own words, this is a subjective expression and should not be used as a primary medical documentation phrase. Instead, the nurse can record this in quotation marks within the notes while using the appropriate clinical term—paresthesia—for official documentation.
C. Circulation impaired
This may be a cause of burning sensations, but it is also an assumption. Unless the nurse has assessed for and confirmed poor perfusion (e.g., by checking capillary refill, pulse strength, temperature), it should not be documented as such.
The nurse is performing a cranial nerve exam on an older adult client. The nurse notes that the client has a reduced upward gaze, a decreased corneal reflex, a high-frequency hearing loss, and a reduced gag reflex. Which action should the nurse take next?
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Continue the assessment of the next pairs of cranial nerves.
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Implement neurological (neuro) vital signs every 2 hours to detect Cushing's triad.
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Review past history for any episodes of a cerebral cortex lesion.
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Assess the spinal reflexes for demyelination symptoms.
Explanation
Correct Answer:
A. Continue the assessment of the next pairs of cranial nerves.
Explanation:
In this scenario, the nurse has observed several age-related changes that affect the cranial nerves. A reduced upward gaze, decreased corneal reflex, high-frequency hearing loss, and a reduced gag reflex are common findings in older adults due to natural aging processes, such as the slowing of neural conduction and changes in sensory functions. These findings do not necessarily suggest a serious neurological issue but should be noted. Therefore, the best action is to continue with the cranial nerve exam to complete the assessment of all 12 cranial nerves. The findings might be part of normal aging, but a comprehensive exam will help confirm that.
Why the Other Options Are Incorrect:
B. Implement neurological (neuro) vital signs every 2 hours to detect Cushing's triad:
Cushing's triad is a clinical syndrome that includes hypertension, bradycardia, and irregular respirations, and is often seen with increased intracranial pressure (ICP). The symptoms described here (reduced upward gaze, decreased corneal reflex, etc.) do not suggest ICP or Cushing's triad. Therefore, regular neuro vital signs every 2 hours are not warranted in this case.
C. Review past history for any episodes of a cerebral cortex lesion:
While it's always important to review the client's medical history, the symptoms described are more indicative of age-related changes than a cerebral cortex lesion. A lesion of the cerebral cortex would likely cause more pronounced neurological deficits, such as motor or sensory abnormalities, cognitive impairments, or severe deficits in cranial nerve function. Given that the client is older, it is more reasonable to consider these findings as part of the normal aging process.
D. Assess the spinal reflexes for demyelination symptoms:
Demyelination typically affects the spinal cord or peripheral nervous system and presents with more significant motor deficits, sensory loss, and other neurologic abnormalities. The symptoms presented here (reduced upward gaze, decreased corneal reflex, etc.) are more likely related to age-related changes rather than demyelination. This makes spinal reflex assessment unnecessary at this point.
Which method should the nurse use to assess response to painful stimuli for a client with a marked reduction in the level of consciousness (LOC)?
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Press firmly on the center of the sternum.
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Shake and call the client's name.
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Use aromatic spirits of peppermint.
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Run a pointed object up the sole of foot.
Explanation
Correct Answer:
A. Press firmly on the center of the sternum.
Explanation:
For clients with a significantly decreased level of consciousness, the nurse uses a graded approach to assess responsiveness. When verbal stimuli (such as calling the client's name or a gentle shake) fail to produce a response, the next step involves applying a painful stimulus. Pressing firmly on the center of the sternum (also called a sternal rub) is a standard method of providing a noxious stimulus that typically elicits a reaction if there is any neurological responsiveness. It is a quick, effective, and commonly used method in acute care settings to evaluate deeper levels of unconsciousness.
Why the Other Options are Incorrect:
B. Shaking and calling the client's name is appropriate for assessing response to verbal stimuli but is insufficient when there is a marked reduction in LOC and no verbal response is elicited.
C. Using aromatic spirits of peppermint is a method used to assess olfactory response or awaken someone who is merely faint or lightheaded; it is not suitable for evaluating deeper levels of unconsciousness.
D. Running a pointed object up the sole of the foot is part of the Babinski reflex test, which evaluates upper motor neuron function, not a general painful stimulus response.
The nurse begins a client's musculoskeletal assessment. While using the technique of inspection, the nurse assesses for which possible finding(s)? Select all that apply.
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Osteopenia.
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Kyphosis.
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Contracture.
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Atrophy.
- Crepitus.
Explanation
Correct Answers:
B. Kyphosis.
C. Contracture.
D. Atrophy.
Explanation:
When performing a musculoskeletal inspection, the nurse visually examines the body for abnormalities such as deformities, asymmetries, muscle wasting, or changes in posture. The following findings can be observed through inspection:
Kyphosis (Option B) is a visible abnormal curvature of the spine, often characterized by a forward rounding of the upper back. This can be observed by the nurse when inspecting the patient's posture.
Contracture (Option C) refers to the abnormal shortening of muscles or tendons, leading to limited range of motion in a joint. Contractures are typically visible through inspection when a joint appears deformed or when the client demonstrates a limited range of motion.
Atrophy (Option D) is the wasting or shrinkage of muscle tissue, and it can be observed through inspection if there is visible reduction in the size or bulk of muscles, particularly in the limbs.
Why the Other Options are Incorrect:
Osteopenia (Option A) is a condition of reduced bone density, but it cannot be observed through inspection. Osteopenia is typically diagnosed using imaging studies like a bone density scan.
Crepitus (Option E) is a sensation or sound heard when joints or bones move, often due to air, gas, or rough surfaces within the joint. It cannot be assessed through inspection; rather, it is detected through palpation or auscultation during joint movement.
During a health assessment for a young adult female client's gynecological annual screening, the client reports amenorrhea. The nurse calculates the client's body mass index (BMI) as 16 kg/m² (normal: 18 to 24.9 kg/m²). Which finding should the nurse document in the electronic medical record (EMR) that indicates an expected rationale for this condition?
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Increased calcium intake with 3 glasses of nonfat milk daily.
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Reports a history of chronic urinary tract infections (UTI).
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Trains for competition and runs 12 miles every day.
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Received an implanted intrauterine device (IUD) last month.
Explanation
Correct Answer:
C. Trains for competition and runs 12 miles every day.
Explanation:
Amenorrhea (absence of menstruation) in a young female with a low BMI can be caused by excessive physical activity, especially when paired with low body fat. This is commonly seen in athletes, particularly those involved in endurance sports such as distance running. The physical stress of intense training, combined with inadequate caloric intake to meet energy demands, can disrupt the hypothalamic-pituitary-ovarian axis, resulting in functional hypothalamic amenorrhea. This is a known and expected physiological response in female athletes with significantly low BMI.
Why the Other Options are Incorrect:
A. Increased calcium intake is generally beneficial for bone health but does not cause or explain amenorrhea.
B. A history of UTIs does not correlate with menstrual irregularities or amenorrhea.
D. While IUDs can sometimes alter menstrual patterns, amenorrhea shortly after insertion is more common with hormonal IUDs, not all types. Additionally, this would not explain the low BMI and intense training pattern, which is more clinically relevant.
After a young adult woman describes feeling palpitations when she lies on her left side, it is most important for the nurse to auscultate heart sounds at which anatomical location?
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Base of the heart at second intercostal space, right of the sternal border.
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Left third intercostal space, left lateral sternal border.
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Apex of the heart at left fifth intercostal space at the midclavicular line.
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Second intercostal space, left of the sternal border.
Explanation
Correct Answer:
C. Apex of the heart at left fifth intercostal space at the midclavicular line.
Explanation:
When a patient describes palpitations that are felt when lying on their left side, this could indicate that they are more aware of their heart's beat due to the position of the heart in the chest. The apex of the heart is located at the left fifth intercostal space along the midclavicular line, which is the point of maximal impulse (PMI). Palpitations are often most pronounced when the heart is closest to the chest wall, which happens when the person is lying on their left side. Auscultating at the apex allows the nurse to better assess the heart sounds, including murmurs or irregular rhythms that might be causing the palpitations.
Why the other options are incorrect:
A. Base of the heart at second intercostal space, right of the sternal border
The base of the heart is located at the top of the heart, where the great vessels are. It is best for auscultating sounds such as the aortic or pulmonic valves, but it is not the ideal location to assess for palpitations, especially if they are felt more strongly near the apex.
B. Left third intercostal space, left lateral sternal border
This location is associated with auscultation of the tricuspid valve area, but it is not the most effective place to listen for heart sounds related to palpitations, which are more often felt near the apex.
D. Second intercostal space, left of the sternal border
This is the location for auscultating the pulmonic valve. While it is an important point for listening to specific valve sounds, it is not the optimal area for assessing palpitations, which are better detected at the apex where the heart's impulse is most prominent.
During an assessment for jugular vein distension of a client with right sided heart failure (HF), the nurse observes distension bilaterally using tangential lighting with the client in a semi-Fowler's position. Which action should the nurse take next?
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Flex the client's neck with a pillow and repeat assessment.
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Repeat without using the lighting.
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Document the findings as observed.
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Position the client supine and repeat the assessment.
Explanation
Correct Answer:
C. Document the findings as observed.
Explanation:
If the nurse observes jugular vein distension (JVD) in the semi-Fowler's position using tangential lighting, and it is clear and consistent with the signs of right-sided heart failure (HF), the findings should be documented. JVD is a key indicator of increased central venous pressure, which is commonly seen in clients with right-sided heart failure. Since the assessment has already been performed correctly with the use of tangential lighting, and the client is in a semi-Fowler's position (which is typically sufficient for assessing JVD), the nurse can document the findings as observed.
Why the Other Options are Incorrect:
A. Flexing the client's neck with a pillow and repeating the assessment is unnecessary unless there is a need for a further change in the client’s position to provide better visualization. The semi-Fowler's position is generally sufficient for assessing JVD.
B. Repeating without using the lighting is unnecessary. Tangential lighting helps the nurse to clearly see the veins and is a valuable tool for assessing JVD. It should be used effectively to ensure an accurate evaluation.
D. Positioning the client supine may not be necessary if the JVD is already visible in the semi-Fowler’s position. While supine positioning can sometimes provide clearer visualization, the semi-Fowler’s position is often sufficient to assess for JVD.
The nurse is examining the abdomen of an older adult male client who expresses suprapubic tenderness on palpation. The client reports that it sometimes feels like there is still pressure in that area after urination. Which additional finding should the nurse expect with continued interview of the client?
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A weak urinary stream.
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A cloudy discharge.
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Black tarry stools.
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An overactive bladder
Explanation
Correct Answer:
A. A weak urinary stream.
Explanation:
Suprapubic tenderness combined with a sensation of incomplete bladder emptying after urination is commonly associated with urinary retention or bladder outlet obstruction. In older adult males, this is often due to benign prostatic hyperplasia (BPH). BPH causes the prostate gland to enlarge, which can compress the urethra and lead to symptoms such as a weak urinary stream, hesitancy, dribbling, and incomplete emptying. A weak stream is a classic symptom of this condition, and it supports the suspicion of an obstructive urological issue when combined with suprapubic discomfort.
Why the other options are incorrect:
B. A cloudy discharge
This may suggest a urinary tract infection or possibly a sexually transmitted infection, but it is not the most directly associated finding with suprapubic pressure and urinary retention.
C. Black tarry stools
These indicate gastrointestinal bleeding, typically from the upper GI tract. This symptom is unrelated to urinary complaints and would not be expected based on the information provided.
D. An overactive bladder
Overactive bladder involves frequent urination, urgency, and sometimes incontinence. While urgency can lead to a sensation of pressure, it does not typically involve suprapubic tenderness or a feeling of incomplete emptying after urination.
The nurse is assessing a client for a goiter and is unable to observe the thyroid gland. Which action should the nurse take?
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Palpate deeply and firmly over the location of the thyroid gland.
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Document that thyroid gland size is normal with no visible goiter.
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Defer the thyroid exam and observe the client for signs of myxedema.
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Ask the client to swallow while palpating along the sides of the trachea.
Explanation
Correct Answer:
D. Ask the client to swallow while palpating along the sides of the trachea.
Explanation:
The thyroid gland is not always visible, especially in healthy individuals without enlargement. If it cannot be observed, the correct next step is to palpate it. The best technique to facilitate palpation is to have the client swallow while the nurse palpates on either side of the trachea. Swallowing moves the thyroid gland upward, making it easier to feel any enlargement or nodules. This is the standard assessment method for identifying goiters or thyroid abnormalities.
Why the other options are incorrect:
A. Palpate deeply and firmly over the location of the thyroid gland
Deep and firm palpation is not appropriate and may cause discomfort. Gentle palpation during swallowing is the correct method to assess the thyroid gland.
B. Document that thyroid gland size is normal with no visible goiter
It is premature to document the gland as normal without completing palpation. Visual inspection alone is insufficient, especially when a goiter may not be externally visible.
C. Defer the thyroid exam and observe the client for signs of myxedema
Myxedema is a severe form of hypothyroidism and not a first-line consideration when a goiter is suspected. The thyroid exam should not be deferred; proper palpation should be completed.
Which is the best approach for the nurse to use when interviewing a client about alcohol and substance use?
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Begin with questions that are less sensitive in nature.
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Get the most difficult questions over with first.
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Share personal values to put the client at ease.
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Ask questions in a vague, nonspecific format.
Explanation
Correct Answer:
A. Begin with questions that are less sensitive in nature.
Explanation:
When discussing sensitive topics such as alcohol or substance use, it's most effective for the nurse to build rapport and establish trust with the client by starting the interview with less personal or emotionally charged questions. This approach helps reduce anxiety and defensiveness, encouraging the client to be more open and honest later in the conversation when more sensitive questions are introduced.
Why the Other Options are Incorrect:
B. Getting difficult questions out of the way early can feel intrusive or confrontational, which may shut down communication or lead to inaccurate answers.
C. Sharing personal values is inappropriate in a clinical setting and can bias the interaction or make the client feel judged.
D. Vague questions often lead to unclear or misleading answers. Specific, direct, and nonjudgmental questions are more effective in assessing substance use.
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1. Introduction
The HESI RN Fundamentals Online Practice Guide equips nursing students with the foundational knowledge and practice tools essential for success on the HESI RN exit exam and NCLEX-RN. This resource focuses on real-world application of nursing principles, patient-centered care, and safe clinical practice. All content is aligned with the HESI RN blueprint and national nursing standards, helping students build confidence in basic nursing skills and clinical judgment.
2. Safety and Infection Control
Safety is a central theme in nursing care. This section reviews protocols for preventing injury, maintaining a safe environment, and controlling infections.
Key topics include:
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Standard and transmission-based precautions
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Proper use of PPE (gloves, masks, gowns, goggles)
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Fall prevention strategies and patient identification
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Isolation techniques and hand hygiene best practices
Students will learn how to protect both patients and healthcare staff while reducing the risk of hospital-acquired infections.
3. Foundations of the Nursing Process
The nursing process—assessment, diagnosis, planning, implementation, and evaluation—is a core framework for nursing care.
This section helps students:
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Perform accurate assessments (head-to-toe, focused, and vital signs)
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Formulate nursing diagnoses based on client data
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Set realistic goals and prioritize interventions
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Evaluate outcomes and modify care as needed
Practice questions emphasize critical thinking and prioritization strategies, such as ABCs (Airway, Breathing, Circulation) and Maslow’s hierarchy of needs.
4. Basic Patient Care Skills and Communication
Providing holistic care involves a range of nursing interventions and therapeutic communication techniques.
Topics include:
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Hygiene, mobility, nutrition, and elimination
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Range of motion exercises and positioning for safety
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Active listening, open-ended questions, and cultural sensitivity
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Communication with non-verbal or cognitively impaired patients
Students are guided through realistic scenarios involving client interaction, delegation, and documentation.
5. Fluid, Electrolyte, and Basic Pharmacology Concepts
Fundamentals students must understand early signs of imbalance and safe medication practices.
Key areas include:
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Recognizing fluid volume deficit/excess
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Common electrolytes (sodium, potassium, calcium) and related nursing actions
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Introductory pharmacology concepts (e.g., medication routes, adverse effects, safe administration)
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Importance of the “Six Rights” of medication administration
Case Study Example:
Patient: Mrs. Jackson, 76 years old, admitted for dehydration and weakness. Reports dizziness and dry mouth. BP: 88/52 mmHg, HR: 110 bpm, Na+: 130 mEq/L.
Scenario:
Mrs. Jackson requires IV fluids and careful monitoring for fall risk. Nursing interventions include hourly vital signs, input/output tracking, and client education on fluid intake.
Analysis:
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Assessment: Monitor vital signs and lab values
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Diagnosis: Risk for electrolyte imbalance; risk for falls
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Planning: Maintain stable blood pressure and hydration
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Implementation: Administer fluids, educate on fall prevention
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Evaluation: Check improvement in vitals and patient comfort
Frequently Asked Question
Your subscription provides access to expertly written HESI-style questions, clinical scenarios, in-depth answer explanations, and comprehensive coverage of essential nursing concepts tested on the HESI Fundamentals exam.
Our questions are designed to bridge theory and practice. You’ll engage with patient care scenarios that challenge you to apply the nursing process, prioritize interventions, and make safe, effective decisions—just like you will in clinicals and on the real exam.
You’ll find multiple-choice, select-all-that-apply, prioritization, and delegation questions that mirror the HESI RN format. Each item is paired with detailed rationales to explain not just what’s right—but why it’s right.
Mastering the fundamentals is the first step toward NCLEX success. This resource reinforces safety, communication, and patient-centered care—key pillars of both the HESI and NCLEX blueprints. You’ll build confidence in test-taking strategies early on.
Absolutely. All questions are reviewed and updated regularly to align with current nursing best practices, HESI test plan updates, and national standards for patient safety and care.
It’s ideal for RN students preparing for their HESI Fundamentals exam and anyone who wants to reinforce clinical reasoning, safety protocols, and nursing process skills in a low-pressure, high-impact way.