HESI Case Studies–Medical/Surgical-Parkinson’s (Leo White)

1. Which statement explains the mechanisms of action of Sinemet in the treatment of Parkinson’s disease?
Sinemet is converted to dopamine and provides an exogenous form of dopamine replacement

2. How should the nurse respond?
Instruct Nancy to bring Leo to the healthcare provider’s office now

3. In planning care, which nursing diagnosis is the priority?
Impaired physical mobility related to muscle rigidity and motor weakness

4. How should the nurse respond?
Encourage Nancy to provide a soft diet with mainly thick liquids

5. In providing client teaching related to ambulation. which instruction should the nurse include?
Demonstrate how to walk with a wide-based stance

6. Which member of the interdisciplinary team can best assist Leo in his desire to maintain independence when performing his ADLs?
Occupational therapist

7. Which action should the nurse implement?
Provide Leo with information about a Durable Power of Attorney for Health Care

8. What should the home health nurse do?
Suggest that Nancy call a neighbor to witness the signature

9. Which independent nursing action should be implemented first?
Assess Leo’s bowel sounds and check his abdomen for distention

10. Which intervention should the nurse implement first to address Leo’s weight loss?
Discuss providing supplemental feedings between meals

11. How should the home health nurse respond first?
Allow Nancy to cry and discuss her feelings

12. Which intervention will the nurse recommend to Nancy to address this problem?
Stand directly in front of Leo when he is speaking

13. Which statement by the nurse leader best describes Parkinson’s disease?
A chemical imbalance in the brain leads to movement and coordination problems

14. What is the best response by the nurse leader?
There is really no known specific cause for Parkinson’s disease

15. How should the social worker respond?
If you and Leo are financially qualified, Medicaid will pay for the home.

16. What is the best response by the nurse?
“Ask the director of nursing for the names and phone numbers of persons willing to serve as references for the facility”

17. How should the home health nurse respond?
“You may want to visit at different times, rather than following a routine visiting schedule”

18. How should the nurse respond?
“Bring some pictures and personal items from home and decorate the room”

19. Which nursing task(s) can be delegated to the unlicensed assistive personnel (UAP)? (Select all)
-Empty foley catheter and report output for a client with a urinary tract infection
-Help leo ambulate down the hall to the shower area

20. What action should the primary nurse take?
Instruct the UAP to go to the nurse’s station

21. Which nursing intervention must be implemented prior to inserting the PEG tube?
Ensure that an informed consent for the PEG tube placement has been signed

22. Upon Leo’s return to his room, which intervention should the nurse implement?
Assess the insertion site for signs of bleeding

23. Which statement correctly explains the rationale for this positioning?
Placing Leo in a semi-Fowlers position helps prevent aspiration of tube feeding

24. Which intervention should the nurse implement first?
Check the residual volume

25. Which intervention(s) should the nurse implement regarding the administration of these medications? (Select all)
-Crush the tablets and dissolve in warm water prior to administering via PEG tube
-Flush tube with water before medication administration, in-between each medication, and after medication administration

26. Which action should the nurse take next?
Assess Leo’s serum potassium level

27. What is the best response by the nurse?
“To be eligible for hospice care, Leo must have fewer than 6 months to be alive”

28. Which statement by Nancy indicates to the nurse that Nancy understands the role of hospice care in the home?
“The hospice nurses and staff will help keep Leo comfortable at home until he dies”

29. Which statement provides correct information about payment for hospice care?
Medicare Hospice Benefit will cover the cost for Medicare beneficiaries

30. Which statement accurately describes the rationale for an Out-of Hospital Do-Not-Resuscitate Order?
It is an order that will prevent paramedics from starting cardiopulmonary resuscitation

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