HESI LPN
Adult Health 1 Exam 1
1. A client is admitted with diabetic ketoacidosis. What is the most critical treatment to initiate?
- A. Administer sodium bicarbonate IV
- B. Start an insulin drip
- C. Monitor glucose and ketone levels
- D. Provide oral hydration
Correct answer: B
Rationale: In the case of diabetic ketoacidosis, the most critical treatment to initiate is starting an insulin drip. Insulin therapy is crucial for reducing blood glucose levels by promoting glucose uptake in cells and inhibiting the production of ketones. Administering sodium bicarbonate IV is generally not recommended as it may lower the pH further and potentially worsen the condition. While monitoring glucose and ketone levels is important for assessing the response to treatment, initiating insulin therapy takes precedence. Providing oral hydration alone is insufficient to manage the metabolic derangements seen in diabetic ketoacidosis.
2. A client with hypothyroidism is taking levothyroxine (Synthroid). Which symptom should prompt the nurse to notify the healthcare provider?
- A. Weight gain
- B. Bradycardia
- C. Nervousness and tremors
- D. Fatigue
Correct answer: C
Rationale: The correct answer is C: Nervousness and tremors. These symptoms may indicate hyperthyroidism resulting from excessive dosing of levothyroxine. Weight gain (Choice A) is a common symptom of hypothyroidism and may indicate undertreatment or inadequate dosing. Bradycardia (Choice B) is a symptom of hypothyroidism and may improve with levothyroxine therapy; it does not typically indicate an urgent need for healthcare provider notification. Fatigue (Choice D) is a symptom of hypothyroidism and can persist even with levothyroxine treatment, so it is not a symptom that would require immediate notification of the healthcare provider.
3. What should the nurse prioritize when providing discharge instructions to a client with a new colostomy?
- A. Skin care around the stoma site
- B. The schedule for colostomy bag replacement
- C. Techniques for odor control
- D. Dietary modifications
Correct answer: A
Rationale: Correct answer: Skin care around the stoma site. Proper skin care around the stoma site is crucial for preventing skin irritation and infection, which are common issues for patients with new colostomies. While the schedule for colostomy bag replacement (Option B) is important, it is not the priority during initial discharge instructions. Techniques for odor control (Option C) are relevant but secondary to skin care for a new colostomy. Dietary modifications (Option D) may be discussed later but are not the priority at this stage.
4. The healthcare provider is assessing a client who has just undergone abdominal surgery. Which finding should be reported to the healthcare provider immediately?
- A. Absence of bowel sounds
- B. Mild abdominal distention
- C. Drainage of serosanguineous fluid from the incision
- D. Sudden onset of severe abdominal pain
Correct answer: D
Rationale: Sudden onset of severe abdominal pain may indicate complications such as peritonitis, bowel perforation, or internal bleeding. These conditions are serious and require immediate medical attention to prevent further complications or deterioration. Absence of bowel sounds, mild abdominal distention, and drainage of serosanguineous fluid are common findings after abdominal surgery and may not necessarily indicate an emergency situation requiring immediate reporting to the healthcare provider. Severe abdominal pain post-surgery should always be reported promptly as it could signify a life-threatening situation that needs urgent evaluation and intervention.
5. After placing a client at 26-weeks gestation in the lithotomy position, the client complains of dizziness and becomes pale and diaphoretic. What action should the nurse implement?
- A. Instruct the client to take deep breaths.
- B. Place a wedge under the client's hip.
- C. Place the client in the Trendelenburg position.
- D. Remove the client's legs from the stirrups.
Correct answer: B
Rationale: Placing a wedge under the client's hip is the correct action in this scenario. This helps relieve the pressure on the vena cava, which can become compressed in the lithotomy position during pregnancy, improving circulation and reducing symptoms like dizziness and pallor. Instructing the client to take deep breaths (Choice A) may not address the underlying cause of the symptoms. Placing the client in the Trendelenburg position (Choice C) would worsen the situation by further compressing the vena cava. Removing the client's legs from the stirrups (Choice D) may provide temporary relief but does not address the root cause of the issue.
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