HSRT Patient Care 3

Question 1

A patient scheduled for surgery is found to have an unwitnessed advance directive stating 'no resuscitation.' The surgical team plans to temporarily suspend the DNR during the perioperative period. Which patient care principle is MOST relevant to this scenario?

Accepted Answer

Patient autonomy — the patient's advance directive should be honored; any modification requires explicit informed consent from the patient while competent

Answer

Routinely suspending DNR orders perioperatively without patient consent violates autonomy. The patient must be consulted while competent about their perioperative resuscitation wishes.

Question 2

A 35-year-old Jehovah's Witness patient is admitted with a ruptured ectopic pregnancy and significant hemorrhage. She is conscious and repeatedly refuses blood transfusion. The surgical team argues she will die without transfusion. The MOST appropriate care approach is:

Accepted Answer

Respect the competent patient's informed refusal, use bloodless surgery techniques and alternative volume expanders, and document thoroughly

Answer

A competent adult's informed refusal of treatment — even life-saving treatment — must be respected. Bloodless medicine techniques should be optimized.

Question 3

During bedside handover, the oncoming nurse notices the departing nurse did not assess a patient's pressure injury documented as Stage 2. The patient has been immobile for 8 hours. Which patient care action is MOST immediately required?

Accepted Answer

Immediately assess the pressure injury, reposition the patient, implement a pressure redistribution plan, and escalate the documentation gap to the charge nurse

Answer

An immobile patient with a Stage 2 pressure injury who has not been repositioned in 8 hours requires immediate assessment, repositioning, and escalation of the care gap.

Question 4

A registered nurse delegates urinalysis collection to a nursing assistant. Which principle governs the appropriateness of this delegation?

Accepted Answer

The Five Rights of Delegation: right task, right circumstances, right person, right direction, right supervision — all must be satisfied

Answer

Safe delegation requires assessing five criteria: the task is appropriate to delegate, the patient situation is stable, the delegate is competent, instructions are clear, and supervision is provided.

Question 5

A patient reports: 'The doctor said something about my heart, but I didn't understand.' The healthcare provider reviews the medical record and confirms the patient has a new diagnosis of atrial fibrillation. Which patient care response BEST supports health literacy?

Accepted Answer

Explain atrial fibrillation using plain language, check for understanding using teach-back, provide written materials at an appropriate reading level, and invite questions

Answer

Health literacy best practices: plain language, teach-back method, appropriate written materials, and an open invitation for questions.

HSRT - Health Sciences Reasoning Test Practice Test

HSRT - Health Sciences Reasoning Test Practice Test

HSRT Patient Care 3