HESI Compass Module 5 Coordinated Care

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Sample questions from HESI Compass Module 5 Coordinated Care

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift in a pediatric clinic, a 6-year-old with asthma has audible wheezing, speaks in two-word phrases, and has an SpO2 of 89% on room air. Which action should the nurse take first?

   • A.Assign an experienced practical nurse to administer the prescribed rescue medication.
   • B.Arrange a follow-up appointment with the child's primary care provider.
   • C.Assess airway and breathing while initiating the clinic's emergency response.
   • D.Ask the parent to describe the child's usual asthma symptoms.

   Rationale: The child's low oxygen saturation, wheezing, and inability to speak in full sentences indicate acute respiratory distress requiring immediate assessment and emergency intervention. A practical nurse may administer medication within scope, but delegation does not replace the registered nurse's initial assessment of an unstable client. History gathering and routine follow-up are important only after immediate breathing concerns are addressed.

2. 2.During a home visit, a 74-year-old client with heart failure says, "I stopped taking the water pill because it makes me go to the bathroom too much." The client has new ankle edema and has gained 2.3 kg (5 lb) in 4 days. Which action is best?

   • A.Advise the client to restrict all fluids until the edema resolves.
   • B.Assess the client's breathing and notify the prescribing clinician of the symptoms and medication change.
   • C.Tell the client to restart the medication at twice the prescribed dose.
   • D.Ask a family member to administer the medication without discussing the client's concerns.

   Rationale: Rapid weight gain and edema may indicate worsening fluid retention, and the nurse should assess for respiratory compromise and promptly coordinate care with the prescriber. Doubling a prescribed dose or imposing a fluid restriction without an order could cause harm. Involving family without the client's consent does not address the client's concern or support informed participation in care.

3. 3.In a rehabilitation unit, a 10-year-old recovering from an appendectomy is stable and needs assistance with bathing and walking. Which task is appropriate for the registered nurse to delegate to experienced unlicensed assistive personnel?

   • A.Evaluate the child's response to the prescribed analgesic.
   • B.Assess the child's pain before ambulation.
   • C.Teach the child how to splint the incision when coughing.
   • D.Assist the child with bathing and report the amount of assistance needed.

   Rationale: Bathing assistance for a stable client is a routine task that can be delegated, with directions to report relevant observations. Pain assessment, teaching, and evaluation of a medication response require nursing judgment and remain the registered nurse's responsibility. The nurse should follow up on delegated care and reassess the child's condition as needed.

4. 4.A 68-year-old client is admitted to the medical unit with fever and suspected infection. The client is newly confused, has a temperature of 39.1 C, HR 124/min, RR 28/min, and BP 88/54 mm Hg. Which actions should the nurse take to coordinate prompt and safe care? Select all that apply.

   • A.Reassess vital signs and perfusion while another team member obtains supplies.
   • B.Obtain prescribed cultures promptly, without delaying urgent treatment.
   • C.Wait for the next scheduled provider round before reporting the blood pressure.
   • D.Delegate ongoing assessment of the client's mental status to unlicensed assistive personnel.
   • E.Notify the rapid response team or activate the facility's escalation process.

   Answer and rationale are in the full material.

5. 5.A provider prescribes a procedure for a 16-year-old client who is alert and has decision-making capacity. The client says, "I do not understand what could go wrong," while the parent urges the nurse to proceed. What should the nurse do?

   • A.Pause the preparation and contact the provider to answer the client's questions.
   • B.Ask the parent to sign the consent form on the client's behalf.
   • C.Witness the consent because the parent has agreed to the procedure.
   • D.Explain the procedure's risks and obtain the client's signature.

   Answer and rationale are in the full material.