a hospice nurse is caring for a client who has a terminal illness and reports severe pain after the nurse administers the prescribed opioid and benzod

HESI LPN

HESI Leadership and Management Test Bank

1. A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?

A. Withhold the benzodiazepine but continue the opioid
B. Contact the provider about replacing the opioid with an NSAID
C. Administer the benzodiazepine but withhold the opioid
D. Continue the medication dosages that relieve the client's pain

Correct answer: B

Rationale: The correct action for the nurse to take is to contact the provider about replacing the opioid with an NSAID. In this scenario, the client is experiencing excessive sedation after the administration of both opioid and benzodiazepine. Switching to a non-opioid analgesic like an NSAID can help manage pain effectively without causing additional sedation. Option A is incorrect because continuing the opioid may exacerbate sedation. Option C is incorrect as administering the benzodiazepine may further increase sedation. Option D is incorrect because maintaining the current medication dosages that are causing excessive sedation is not in the client's best interest.

2. Which of the following is the best way for a nurse to improve quality of care?

A. Recognize that physicians are among the health-care professionals interested in improving quality of care.
B. Work with patients and families to improve healthcare.
C. Collaborate with other health-care professionals, patients, and their families.
D. Recognize that physicians are among the numerous professionals in health care.

Correct answer: C

Rationale: The best way for a nurse to improve the quality of care is by collaborating with other health-care professionals, patients, and their families. By working together with the healthcare team, patients, and families, nurses can ensure a holistic approach to care delivery, leading to better outcomes. Choices A and D are incorrect as they focus solely on physicians, while choice B, though important, does not fully encompass the collaborative aspect necessary for comprehensive care.

3. Select the stage of viral hepatitis that is accurately paired with its characteristic(s).

A. The prodromal stage: Jaundice begins
B. The icteric stage: Flu-like symptoms occur
C. The pre-icteric stage: Elevated urine bilirubin levels
D. The post-icteric stage: Jaundice and dark urine occur

Correct answer: D

Rationale: The post-icteric stage of viral hepatitis is accurately described as the stage where jaundice and dark urine occur due to the accumulation of bilirubin. The resolution of jaundice and normalization of urine color are seen in this stage. Choices A, B, and C are incorrect. In the prodromal stage, symptoms like fatigue and malaise appear before jaundice. The icteric stage is characterized by jaundice, not flu-like symptoms. The pre-icteric stage does not typically involve elevated urine bilirubin levels, as this occurs after the icteric stage.

4. Select the stage of shock that is accurately paired with its characteristic.

A. The initial stage of shock: Hyperventilation occurs and the blood pH rises.
B. The compensatory stage of shock: Hypoxia occurs and lactic acid rises.
C. The progressive stage of shock: Histamine is released; fluid and proteins leak into surrounding tissues and the blood thickens.
D. The refractory stage of shock: Potassium ions leak out; sodium ions build up, and metabolic acidosis increases.

Correct answer: C

Rationale: The progressive stage of shock is accurately described as the stage where histamine is released, leading to fluid and proteins leaking into surrounding tissues and the blood thickening. In this stage, the body's compensatory mechanisms are overwhelmed, resulting in a cascade of events that worsen the shock state. Choice A is incorrect as hyperventilation and a rise in blood pH are more characteristic of the compensatory stage. Choice B is incorrect as hypoxia and a rise in lactic acid are more typical of the progressive stage. Choice D is incorrect as the described electrolyte imbalances and metabolic acidosis are more aligned with the refractory stage of shock.

5. What is the normal sodium level in the body?

A. 135 to 145 milliequivalents per liter.
B. 3 to 5 milliequivalents per liter.
C. 135 to 145 microequivalents per liter.
D. 3 to 5 microequivalents per liter.

Correct answer: A

Rationale: The correct answer is A: 135 to 145 milliequivalents per liter. The normal range for sodium levels in the body is expressed in milliequivalents per liter, not microequivalents. Choice B and D provide a significantly lower range which is not within the normal values for sodium. Choice C incorrectly states 'microequivalents' instead of the correct unit 'milliequivalents'. Therefore, A is the correct answer.