HESI Basic Care of Dying Patient

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You are transporting a 20-year-old pregnant female from a local hospital to a medical facility that specializes in high-risk pregnancies when you note the patient is experiencing unexplained hypotension and bradycardia. The patient has a patent IV and is being administered magnesium that was initiated by hospital staff. On the cardiac monitor, the patient presents with a lengthening PR interval and signs of an impending high-degree nodal block. Which of the following interventions would be most appropriate in this case?

  • A. Increase the magnesium sulfate infusion rate, and administer a 1,000 mL normal saline bolus to support the patient's blood pressure
  • B. Stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity
  • C. Continue the infusion, but administer potassium chloride to counteract the adverse effects of the magnesium chloride administration
  • D. Reduce the infusion by half, and administer dextrose 50% to counteract the adverse cardiac effects caused by the magnesium chloride infusion
Correct Answer: B

Rationale: The correct answer is B: Stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity.

Rationale:
1. Magnesium toxicity can lead to hypotension, bradycardia, and cardiac conduction abnormalities.
2. Stopping the magnesium infusion is crucial to prevent further adverse effects.
3. Calcium chloride is the antidote for magnesium toxicity as it competes with magnesium for binding sites on cardiac cells, restoring normal cardiac function.
4. Administering a normal saline bolus (choice A) would not address the underlying cause of magnesium toxicity.
5. Administering potassium chloride (choice C) is not appropriate as it can exacerbate the cardiac effects of magnesium toxicity.
6. Reducing the magnesium infusion and administering dextrose 50% (choice D) would not address the magnesium toxicity and may not reverse the cardiac effects.

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The medical term for paralysis on one side of the body is

  • A. Hemoptysis
  • B. Hemiplegia
  • C. Hemophilia
  • D. Hematuria
Correct Answer: B

Rationale: The correct answer is B: Hemiplegia. "Hemi-" means half or one side, and "plegia" refers to paralysis. Therefore, hemiplegia specifically indicates paralysis on one side of the body.

Incorrect Choices:
A: Hemoptysis - This term refers to coughing up blood from the respiratory tract.
C: Hemophilia - This is a genetic disorder that impairs the body's ability to clot blood.
D: Hematuria - This refers to the presence of blood in the urine.

In summary, hemiplegia is the correct term for paralysis on one side of the body, while the other choices are unrelated terms referring to different medical conditions.

A specific aspect of the treatment of thermal injury is:

  • A. Chemical burn require the immediate removal of clothing
  • B. Patients who sustain thermal injury are at lower risk for hypothermia
  • C. Patients with circumferential truncal burns need prompt fasciotomies
  • D. Electrical burns are associated with extensive skin necrosis (from entry point to exit)
Correct Answer: A

Rationale: The correct answer is A because in the treatment of thermal injuries, immediate removal of clothing is crucial to stop the heat source and prevent further damage to the skin. Removing clothing also allows for a quick assessment of the extent of the burn and initiation of appropriate treatment. Choice B is incorrect as patients with thermal injuries are at risk for hypothermia due to heat loss from damaged skin. Choice C is incorrect as fasciotomies are not typically indicated for circumferential truncal burns unless there is evidence of compartment syndrome. Choice D is incorrect as electrical burns can lead to deep tissue injury but are not always associated with extensive skin necrosis from entry to exit points.

Which of the following is an example of a plant-based protein?

  • A. Salmon
  • B. Tofu
  • C. Steak
  • D. Bacon
Correct Answer: B

Rationale: The correct answer is B: Tofu. Tofu is made from soybeans, which are a plant-based source of protein. Soybeans are rich in essential amino acids, making tofu a complete protein. Salmon (A), steak (C), and bacon (D) are all animal-based proteins. They are not plant-based sources of protein and do not fit the criteria for the question. Therefore, the correct choice is B because it is the only plant-based protein option provided.

One way for a nursing assistant to help a resident with AD with eating is to

  • A. Put a few types of food on the plate at the same time.
  • B. Use dishes without patterns and simple place settings.
  • C. Withhold food until the resident is very hungry.
  • D. Serve steaming hot food.
Correct Answer: B

Rationale: The correct answer is B because using dishes without patterns and simple place settings can help residents with Alzheimer's disease focus on their meal. Complex patterns can be distracting and confusing for them. This approach promotes independence and reduces agitation during mealtime.

Choice A is incorrect because presenting multiple types of food on the plate can overwhelm and confuse the resident, leading to decreased appetite and difficulty eating.

Choice C is incorrect as withholding food until the resident is very hungry can lead to frustration, increased agitation, and may even result in malnutrition.

Choice D is incorrect because serving steaming hot food can pose a burn risk to the resident if they have sensory impairments or cognitive deficits that prevent them from recognizing the temperature.

The advantage of a dental bridge is

  • A. The nursing assistant does not have to wear gloves while handling it
  • B. It replaces missing teeth
  • C. It will never crack
  • D. It cannot be cleaned
Correct Answer: B

Rationale: The correct answer is B: It replaces missing teeth. A dental bridge is a prosthetic device used to fill the gap created by one or more missing teeth. By bridging the gap, it helps restore proper chewing and speaking functions, prevents shifting of surrounding teeth, and improves the overall appearance of the smile. The other choices are incorrect because: A is incorrect as gloves are still necessary for handling dental bridges due to hygiene reasons; C is incorrect as dental bridges can crack over time depending on the material used and maintenance; and D is incorrect as dental bridges can and should be cleaned regularly to maintain oral health.