Fatigue Sherpath

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Sample questions from Fatigue Sherpath

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

1. 1.During an emergency department assessment for worsening fatigue, the RN reviews new findings. Refer to the client's chart. Which actions should the RN take immediately? Select all that apply.

   • A.Maintain bed rest and assist with toileting.
   • B.Prepare for prescribed intravenous fluids and blood products.
   • C.Begin discharge teaching about iron-rich foods.
   • D.Delegate evaluation of the blood pressure trend to assistive personnel.
   • E.Activate the facility's urgent clinical response process.

   Rationale: The blood pressure decrease to 86/50 mm Hg, rising heart rate, melena, and hemoglobin of 6.8 g/dL indicate probable hemorrhage with impaired perfusion, requiring urgent escalation. Bed rest with assisted toileting reduces injury risk, and preparation for prescribed fluid and blood replacement addresses circulatory compromise. Interpreting the blood pressure trend requires RN assessment and cannot be delegated to assistive personnel. Dietary teaching does not address this unstable client's immediate needs.

2. 2.On a rehabilitation unit, a 44-year-old client with multiple sclerosis reports predictable afternoon fatigue. The client's morning assessment is unchanged, and vital signs are stable. Which task is appropriate for the RN to delegate to trained assistive personnel?

   • A.Assist with a scheduled shower using the established rest-break plan.
   • B.Teach the client how to modify the activity schedule.
   • C.Determine whether the fatigue represents a new exacerbation.
   • D.Evaluate whether the current energy-conservation plan is effective.

   Rationale: Assisting a stable client with hygiene according to an established plan is within the role of trained assistive personnel. Determining whether symptoms indicate an exacerbation requires nursing assessment. Initial teaching and evaluation of the plan also remain RN responsibilities. Delegate predictable tasks, not clinical judgment.

3. 3.At change of shift on a medical unit, a 72-year-old client admitted for fatigue and poor intake now has potassium 6.2 mEq/L and new peaked T waves. Which action has priority?

   • A.Assess the client's usual sleep pattern.
   • B.Notify the provider urgently and initiate the unit's hyperkalemia response.
   • C.Plan assistance with morning activities.
   • D.Request a dietitian consultation about potassium restriction.

   Rationale: Hyperkalemia with electrocardiographic changes threatens life through lethal dysrhythmias and requires immediate escalation and treatment. Dietary restriction may help later but cannot rapidly stabilize the myocardium. Sleep assessment and activity assistance are reasonable fatigue interventions only after the immediate threat is addressed. Prioritization follows physiologic risk rather than the admission complaint.

4. 4.In an outpatient infusion center, a 35-year-old client receiving chemotherapy reports fatigue rated 8/10 but wants to continue caring for two children at home. Hemoglobin is 10.2 g/dL, temperature is 36.9 C, and SpO2 is 98% on room air. Which referral best addresses the client's stated functional concern?

   • A.Hospice enrollment because severe fatigue indicates terminal decline.
   • B.Emergency transport for immediate blood transfusion.
   • C.Occupational therapy for energy conservation during parenting tasks.
   • D.Speech therapy to assess swallowing.

   Answer and rationale are in the full material.

5. 5.During a home health visit for fatigue, the RN identifies a change in condition. Refer to the client's chart. Which action is the priority?

   • A.Encourage the client to increase fluids to treat fatigue.
   • B.Arrange a routine follow-up appointment in 2 weeks.
   • C.Ask assistive personnel to supervise a walking program.
   • D.Arrange immediate emergency evaluation.

   Answer and rationale are in the full material.