HESI LPN
Adult Health 1 Exam 1
1. 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.
2. When assisting a client to obtain a sputum specimen, the nurse observes the client cough and spit a large amount of frothy saliva in the specimen collection cup. What action should the nurse implement next?
- A. Advise the client that suctioning will be used to obtain another specimen
- B. Re-instruct the client in coughing techniques to obtain another specimen
- C. Provide the client a glass of water and mouthwash to rinse the mouth
- D. Label the container and place the container in a biohazard transport bag
Correct answer: C
Rationale: After observing the client cough and produce frothy saliva in the collection cup, the nurse should provide the client with a glass of water and mouthwash to rinse the mouth. This action helps clear the mouth of contaminants, ensuring a more accurate sputum specimen for diagnostic testing. Option A is incorrect because suctioning is not the appropriate next step in this situation. Option B is unnecessary as re-instructing the client in coughing techniques may not address the immediate issue of contaminated saliva in the specimen. Option D is premature since labeling and transporting the container should only be done after obtaining a valid specimen.
3. A client with a diagnosis of hypothyroidism is prescribed 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.' In a client with hypothyroidism prescribed levothyroxine, the development of nervousness and tremors may indicate hyperthyroidism, which can result from excessive dosing of levothyroxine. Therefore, the nurse should promptly notify the healthcare provider to adjust the medication dosage. Choices A, B, and D are incorrect because weight gain, bradycardia, and fatigue are more commonly associated with hypothyroidism itself, indicating that the levothyroxine therapy may not be effective enough, rather than being signs of excessive dosing.
4. A client with a history of seizures is being discharged home. Which instruction is most important for the nurse to provide?
- A. Take your medication as prescribed.
- B. Avoid driving until your condition is stable.
- C. Keep a seizure diary.
- D. Avoid alcohol consumption.
Correct answer: A
Rationale: The most important instruction for a client with a history of seizures being discharged home is to take their medication as prescribed. Consistent and timely intake of anti-seizure medication is vital in managing seizures and preventing episodes. While instructions like avoiding driving until the condition is stable, keeping a seizure diary, and avoiding alcohol consumption are important, none are as critical as ensuring proper medication adherence to control seizures effectively. Failure to take prescribed medications can lead to breakthrough seizures, compromising the patient's safety and seizure control.
5. A client requires application of an eye shield to the right eye. What should the nurse do in order to apply tape to anchor the shield most effectively?
- A. Place tape from the cheek to the forehead
- B. Secure tape from the nose to the ear
- C. Attach tape from the lower eyelid to the upper forehead
- D. Use circular bandaging around the head
Correct answer: C
Rationale: The correct way to apply tape to anchor an eye shield effectively is to attach the tape from the lower eyelid to the upper forehead. This method provides stability for the shield without putting pressure on the eye itself, thus helping to protect the eye. Choices A, B, and D are incorrect because taping from the cheek to the forehead, securing tape from the nose to the ear, or using circular bandaging around the head may not provide the necessary stability and protection required for the eye shield.
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