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    Hesi RN Exit Proctored ExamQuestion 117
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    Hesi RN Exit Proctored Exam
    Select All That Apply

    Exhibits Click to highlight the aspects of the assessment that require urgent attention. 0900 Pain assessment completed. The client's pain is 2 on a 0 to 10 pain scale. The client requests sleeping medication for the night. She explains that she keeps having horrible thoughts and memories about the house collapsing and that it is keeping her from falling asleep. She states, "I used to be so happy before all of this happened. Now I can't seem to get out of this funk I am in." The client would also prefer to be in a quieter area of the unit as she is currently by the nurses' station and hears talking and alarms constantly.

    Explanation & Rationale

    Horrible Thoughts and Memories: The client expresses having "horrible thoughts and memories" about the house collapsing, which indicates the possibility of acute stress reactions or post-traumatic stress disorder (PTSD). This mental health concern needs immediate attention to ensure the client's psychological well-being. Difficulty Falling Asleep: The client's difficulty falling asleep due to intrusive thoughts is concerning. Sleep is crucial for recovery, and ongoing sleep disturbances can exacerbate mental health issues and impede healing. Addressing her need for sleep medications or alternative interventions should be prioritized. Emotional State: The client states, "I used to be so happy before all of this happened. Now I can't seem to get out of this funk I am in," indicating possible depression or an adjustment disorder. This emotional state warrants evaluation and support from a mental health professional. Request for Quieter Area: The client requests a quieter area of the unit due to the noise from the nurses' station. While this may not be as urgent as the mental health concerns, accommodating her request can significantly improve her comfort and ability to rest

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