HESI A2 CRITICAL THINKING QUESTIONS EXAM QUESTIONS

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HESI A2 CRITICAL THINKING QUESTIONS EXAM QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

This Exam contains:

-Guarantee passing score -59 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation Question 1: 41. Which child's behavior warrants notifying the child developmental specialist?

• The 1-year-old child who cries when the parent leaves the room.
• The 2-year-old child who can talk in two- or three-word sentences.
• The 3-year-old child who is toilet trained for bowel and bladder.
• The 4-year-old child who throws frequent temper tantrums.

Answer:

• A 1 yr old child who cries when the parent leaves the room is developmentally on target

• The 2-year-old who can speak in two- or

three-word sentences is developmentally on target.

• The 3-year-old should be toilet trained by

this age.**4. The toddler (age 1-3) is expected to throw temper tantrums, but a 4-year-old child should not be doing this; therefore, the child is not developmentally on target and the child developmental specialist should be notified.

Question 2: 44. When assessing the quality of a patient's pain, the nurse should ask which question?

• "When did the pain start?"
• "Is the pain a stabbing pain?"
• "Is it a sharp pain or dull pain?"
• "What does your pain feel like?"

Answer:

• "What does your pain feel like?"

Page: 164. To assess the quality of a person's pain, have the patient describe the pain in his or her own words.Question 3: 55. The nurse has discovered decreased skin turgor in a patient and knows that this is an expected finding in which of these conditions?

• Severe obesity
• Childhood growth spurts
• Severe dehydration
• Connective tissue disorders such as scleroderma

Answer:

• Severe dehydration

Page: 215. Decreased skin turgor is associated with severe dehydration or extreme weight loss.Question 4: 6. The nurse enters the client's room and realizes the 9-month-old infant is not breath- ing. Which interventions should the nurse implement? Prioritize the nurse's actions from first (1) to last (5).

1. Perform cardiac compression 30:2.

• Check the infant's brachial pulse.
• Administer two puffs to the infant.
• Determine unresponsiveness.
• Open the infant's airway.

Answer:

Rationale

Correct Answer: 4, 5, 3, 2, 1

• The nurse must first determine the

infant's responsiveness by thumping the baby's feet.

• The nurse should then open the child's

airway using the head-tilt chin-lift tech- nique, with care taken not to hyperextend the neck. Then the nurse should look, listen, and feel for respirations.

• The nurse then administers quick puffs of air while covering the child's mouth and nose, preferably

with a rescue mask.

• The nurse should determine whether the infant has a pulse by checking the brachial artery.

• If the infant has no pulse, the nurse should begin chest compressions using two fingers at a rate of

30:2.

Question 5: 40. The nurse is examining an infant and prepares to elicit the Moro reflex at which time during the examination?

• When the infant is sleeping
• At the end of the examination
• Before auscultation of the thorax
• Halfway through the examination

Answer:

• At the end of the examination

Page: 123. Elicit the Moro or "startle" reflex at the end of the examination because it may cause the infant to cry.Question 6: 9. The nurse is conducting an interview in an outpatient clinic and is using a computer to record data. Which is the best use of the computer in this situation? Select all that apply.

• Collect the patient's data in a direct, face-to-face manner.
• Enter all the data as the patient states it.
• Ask the patient to wait as the nurse enters data.

• Type the data into the computer after the narrative is fully explored.
• Allow the patient to see the monitor during typing.

Answer:

• Collect the patient's data in a direct, face-to-face manner.

• Type the data into the computer after the narrative is fully explored.

• Allow the patient to see the monitor during typing.

Page: 32 The use of a computer can become a barrier. The nurse should begin the interview as usual by greeting the patient, establishing rapport, and collecting the patient's narrative story in a direct face-to-face manner. Only after the narrative is fully explored should the nurse type data into the computer. When typing, the nurse should position the monitor so that the patient can see it.Question 7: 5. The nurse is interviewing a patient who has a hearing impairment. What techniques would be most beneficial in communicating with this patient?

• Determine the communication method he prefers.
• Avoid using facial and hand gestures because most hearing-impaired people find this

degrading.

• Request a sign language interpreter before meeting with him to help facilitate the

communication.

• Speak loudly and with exaggerated facial movement when talking with him because this

helps with lip reading.

Answer:

• Determine the communication method he prefers.

Pages: 40-41 The nurse should ask the deaf person the preferred way to communicate-by signing, lip reading, or writing. If the person prefers lip reading, then the nurse should be sure to face him or her squarely and have good lighting on the nurse's face. The nurse should not exaggerate lip movements because this distorts words. Similarly, shouting distorts the reception of a hearing aid the person may wear. The nurse should speak slowly and should supplement his or her voice with appropriate hand gestures or pantomime.Question 8: 3. The 6-year-old client who has undergone abdominal surgery is attempting to make a pinwheel spin by blowing on it with the nurse's assistance. The child starts crying because the pinwheel won't spin. Which action should the nurse implement first?

• Praise the child for the attempt to make the pinwheel spin.
• Notify the respiratory therapist to implement incentive spirometry.