Start with realistic patient cases
Each case follows one patient through five decisions. Choose all correct answers on SATA questions. You get the rationale after locking in your choice.
All case studies
Session complete
Fundamentals review notes
Quick-reference review alongside your assigned Cooper & Gosnell textbook. Chapter 15 and 23 match topics we discussed; other chapter numbers vary by edition and should be verified against your table of contents.
The NGN clinical-judgment pathway
Recognize cues → Analyze cues → Prioritize hypotheses → Generate solutions → Take action → Evaluate outcomes. Ask: Which finding is NEW, abnormal, and dangerous? Which answer handles that threat FIRST?
ABCs and safety
Airway and breathing threats usually outrank comfort and routine tasks. A sudden change in consciousness or perfusion needs prompt assessment and escalation. Never delay emergency care to complete charting.
Oxygenation and suctioning
Compare oxygen saturation to prescribed targets and clinical signs. Assess work of breathing, respiratory rate and breath sounds. Suction based on assessment and monitor for hypoxemia and bradycardia.
Auscultation
Wheeze = musical narrowed-airway sound; crackles = discontinuous popping; stridor = upper-airway emergency sign when distressed. Assess abdomen: inspect → auscultate → percuss → palpate.
Fluid status and electrolytes
Dehydration may show tachycardia, dizziness, hypotension and scant dark urine. Fluid overload may show weight gain, crackles, edema and dyspnea. Hypokalemia can cause weakness and dysrhythmias.
Urinary and bowel elimination — Ch 15
Retention: assess bladder distention, voiding and bladder-scan volume if available. Prevent CAUTI: closed drainage and bag below bladder. Ileostomy output can cause significant water/electrolyte loss; stoma should be moist pink-red.
Specimen collection — Ch 23
Use two patient identifiers. Obtain correct specimen in proper container, avoid contamination, label at bedside and transport promptly. For catheter urine, use designated sampling port per protocol.
Nutrition and swallowing
Cough, wet voice, food pocketing and choking suggest possible dysphagia. Pause oral intake pending evaluation and follow ordered diet consistency. Position upright when eating.
Skin and hygiene
Stage 1 pressure injury = intact skin with nonblanchable erythema. Protect from pressure, shear and moisture. Record wound location, dimensions, drainage, tissue and surrounding skin objectively.
Medication administration
Use medication rights, two identifiers, allergy checks, safe pediatric weight-based dosing, hold parameters and reassessment. Avoid IV push potassium. Never crush extended-release or enteric-coated tablets without drug-specific guidance.
Mobility, sleep and pain
Orthostatic dizziness increases fall risk; use assistive devices and gradual position changes. New fluctuating confusion can be delirium. Pain report is subjective; assess, intervene, then reassess pain and adverse effects.
Teaching, culture and professional practice
Teach-back tests comprehension. Ask individuals about cultural/spiritual preferences; never assume. Delegate routine tasks only within training/scope and patient stability. Chart objective facts and actual care.
Test-taking elimination
Read the LAST sentence first. Look for FIRST/BEST/PRIORITY and SELECT ALL. Eliminate choices that delay urgent assessment, exceed scope, assume facts, or disregard a dangerous change.
Review schedule
Day 1: oxygenation, fluids, renal. Day 2: nutrition, elimination, ostomy. Day 3: asepsis, skin, wounds. Day 4: vital signs, meds, mobility. Day 5: communication, teaching, pain and sleep. Day 6: 50-question mixed test. Day 7: missed questions plus a fresh mixed test.
Educational practice built from established PN nursing fundamentals and the topic breakdown of your HESI report. These are original study questions, not leaked or official HESI items. Your answers are stored locally in this browser; clearing browser storage may erase progress. Follow instructor guidance, facility protocols and jurisdiction-specific scope of practice for clinical care.