HESI A2 Critical Thinking 2021
The Patient: A 65-year- old male.
The Situation: The family brings the patient to the emergency room because he just took an entire bottle of pills.
The Question: What action should the nurse take first?
(ANS- Determine the patient's level of consciousness.
The Patient: An 80 year-old male who has used continuous oxygen for the past
three years.The Situation: While making a home visit, the wife tells the nurse that her husband was doing well on 2 litres of oxygen per minute until late last night when he developed severe shortness of breath on the way to the bathroom.
The Question: What action should the nurse take first?
(ANS- Assess the patient's oxygen saturation by pulse oximeter.
The Patient: A 41-year-old male.
The Situation: The patient is complaining of severe stomach pain and states that he has been "vomiting all the time."
The Question: What should the nurse do first?
(ANS- Administer a prescribed pain medication.
The Patient: The wife of a wealthy owner of the town's bank.
The Situation: The patient and her husband arrive on the unit. While orienting the patient to the hospital room, the nurse notices that the patient has placed a large amount of cash and some expensive earrings in the drawer of the bedside table.The Question: What is the best action for the nurse to take? 1 / 2
(ANS- Advise the patient to have her husband take the items home when he leaves.
The Patient: A 45-year-old female who is 5' 2" tall, weighs 200 pounds, and has smoked since age 21.The Situation: The patient comes to the clinic with a complaint of "leg pain." The Question: It is most important for the nurse to obtain information about which previous occurrence?(ANS- A previous blood clot in the leg.
The Patient: A 61-year-old female.
The Situation: The patient has a fever of unknown origin. The nurse administered a fever-reducing medication 30 minutes ago. At this time there has been no decrease in the patient's fever.
The Question: What action would be best for the nurse to take?
(ANS- Sponge the patient with cool water.
The Patient: A 70-year-old male who is relatively healthy.
The Situation: A liquid mediation is prescribed for this patient.
The Question: Prior to administering the prescribed medication, what intervention has the highest priority?(ANS- Determine if the patient is allergic to the medication.
The Patient: A fifty-eight-year-old female.
The Situation: While the nurse is offering the patient her morning medications, she tells the nurse that she does not recall ever taking a pill that was pink-colored.
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