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NUR 206 HESI REVIEW EXAM WITH 280+ QUESTIONS & CORRECT ANSWERS
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NUR 206 HESI REVIEW EXAM WITH 280+ QUESTIONS & CORRECT ANSWERS NUR 206 HESI REVIEW EXAM WITH 280+ QUESTIONS & CORRECT ANSWERS
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NUR 206 HESI REVIEW EXAM WITH 280+ QUESTIONS& CORRECT ANSWERS
1. The nurse is caring for an unresponsive terminally ill patient who has 20-second
periods of apnea followed by periods of deep and rapid breathing. Which action by
the nurse would be appropriate?
a. Suction the patient's mouth.
b. Administer oxygen via face mask.
c. Document Cheyne-Stokes respirations.
d. Place the patient in high Fowler's position. - ANSWER-ANS: C
Cheyne-Stokes respirations are characterized by periods of apnea alternating with
deep and rapid breaths. Cheyne-Stokes respirations are expected in the last days of
life and are not position dependent. There is also no need for supplemental oxygen
by face mask or suctioning the patient.
2. The nurse is caring for an adolescent patient who is dying. The patient's parents
are interested in organ donation and ask the nurse how the health care providers
determine brain death. Which response by the nurse accurately describes brain
death determination?
a. "If CPR does not restore a heartbeat, the brain cannot function."
b. "Brain death has occurred if there is not any breathing or brainstem reflexes."
c. "Brain death has occurred if a person has flaccid muscles and does not awaken."
d. "If respiratory efforts cease and no apical pulse is audible, brain death is
present." - ANSWER-ANS: B
The diagnosis of brain death is based on irreversible loss of all brain functions,
including brainstem functions that control respirations and brainstem reflexes. The
other descriptions describe other clinical manifestations associated with death but
are insufficient to declare a patient brain dead.
,3. A patient in hospice is manifesting a decrease in all body system functions
except for a heart rate of 124 beats/min and a respiratory rate of 28 breaths/min.
Which statement, if made by the nurse to the patient's family member, is most
appropriate?
a. "These vital signs will continue to increase until death finally occurs."
b. "These vital signs are an expected response now but will slow down later."
c. "These vital signs may indicate an improvement in the patient's condition."
d. "These vital signs are a helpful response to the slowing of other body systems." -
ANSWER-ANS: B
An increase in heart and respiratory rate may occur before the slowing of these
functions in a dying patient. Heart and respiratory rate typically slow as the patient
progresses further toward death. In a dying patient, high respiratory and pulse rates
do not indicate improvement or compensation, and it would be inappropriate for
the nurse to indicate this to the family.
4. A patient who has been diagnosed with inoperable lung cancer and has a poor
prognosis plans a trip across the country "to settle some issues with family
members." The nurse recognizes that the patient is manifesting which psychosocial
response to death?
a. Protesting the unfairness of death
b. Anxiety about unfinished business
c. Fear of having lived a meaningless life
d. Restlessness about the uncertainty of prognosis - ANSWER-ANS: B
The patient's statement indicates that there is some unfinished family business that
the patient would like to address before dying. There is no indication that the
patient is protesting the prognosis, feels uncertain about the prognosis, or fears that
life has been meaningless.
,5. A patient with terminal cancer is being admitted to a family-centered inpatient
hospice. The patient's spouse visits daily and cheerfully talks with the patient about
wedding anniversary plans for the next year. When the nurse asks about any
concerns, the spouse says, "I'm busy at work, but otherwise things are fine." Which
provisional nursing diagnosis is appropriate for the patient's spouse?
a. Ineffective coping related to lack of grieving
b. Anxiety related to complicated grieving process
c. Hopelessness related to knowledge deficit about cancer
d. Caregiver role strain related to spouse's complex care needs - ANSWER-ANS:
A
The spouse's behavior and statements indicate the absence of anticipatory grieving,
which may lead to impaired adjustment as the patient progresses toward death. The
spouse does not appear to feel overwhelmed, hopeless, or anxious.
6. As the nurse admits a patient in end-stage renal disease to the hospital, the
patient tells the nurse, "If my heart or breathing stop, I do not want to be
resuscitated." Which action should the nurse take first?
a. Place a "Do Not Resuscitate" (DNR) notation in the patient's care plan.
b. Invite the patient to add a notarized advance directive in the health record.
c. Advise the patient to designate a person to make future health care decisions.
d. Ask if the decision has been discussed with the patient's health care provider. -
ANSWER-ANS: D
A health care provider's order should be written describing the actions that the
nurses should take if the patient requires CPR, but the primary right to decide
belongs to the patient or family. The nurse should document the patient's request
but does not have the authority to place the DNR order in the care plan. A
notarized advance directive is not needed to establish the patient's wishes. The
patient may need a durable power of attorney for health care (or the equivalent),
but this does not address the patient's current concern with possible resuscitation.
, 7. A young adult patient with metastatic cancer, who is very close to death, appears
restless. The patient keeps repeating, "I am not ready to die." Which action is best
for the nurse to take?
a. Remind the patient that no one feels ready for death.
b. Sit at the bedside and ask if there is anything the patient needs.
c. Insist that family members remain at the bedside with the patient.
d. Tell the patient that everything possible is being done to delay death. -
ANSWER-ANS: B
Staying at the bedside and listening allows the patient to discuss any unresolved
issues or physical discomforts that should be addressed. Stating that no one feels
ready for death fails to address the individual patient's concerns. Telling the patient
that everything is being done does not address the patient's fears about dying,
especially because the patient is likely to die soon. Family members may not feel
comfortable staying at the bedside of a dying patient, and the nurse should not
insist that they remain there.
8. The nurse is caring for a terminally ill patient who is experiencing continuous
and severe pain. How should the nurse schedule the administration of opioid pain
medications?
a. Plan around-the-clock routine administration of analgesics.
b. Provide PRN doses of medication whenever the patient requests them.
c. Suggest small analgesic doses to avoid decreasing the respiratory rate.
d. Offer enough pain medication to keep the patient sedated and unaware of
stimuli. - ANSWER-ANS: A
The principles of beneficence and nonmaleficence indicate that the goal of pain
management in a terminally ill patient is adequate pain relief even if the effect of
pain medications could hasten death. Administration of analgesics on a PRN basis
will not provide the consistent level of analgesia the patient needs. Patients usually
do not require so much pain medication that they are oversedated and unaware of
stimuli. Adequate pain relief may require a dosage that will result in a decrease in
respiratory rate.
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