HESI LPN
Adult Health 1 Final Exam
1. After a 26-year-old gravida 4, para 0 experienced a spontaneous abortion at 9 weeks gestation, how should the nurse intervene after observing the client crying softly one hour post dilation and curettage (D&C)?
- A. Offer to call the social worker to discuss the possibility of adoption
- B. Reassure the client that the infertility specialist can help
- C. Express sorrow for the client's grief and offer to sit with her
- D. Chart the vital signs and amount of vaginal bleeding
Correct answer: C
Rationale: After a traumatic experience like a spontaneous abortion, it is crucial for the nurse to provide emotional support. Expressing sorrow for the client's grief and offering to sit with her demonstrates empathy and allows the client to process her emotions. Options A and B focus on future possibilities and medical interventions, which may not be immediately appropriate. Option D, while important for monitoring the client's physical status, does not address the client's emotional needs at that moment.
2. A client with a history of peptic ulcer disease (PUD) is prescribed omeprazole (Prilosec). What is the primary action of this medication?
- A. Neutralizes stomach acid
- B. Reduces gastric acid production
- C. Forms a protective barrier over ulcers
- D. Increases gastric mucus production
Correct answer: B
Rationale: The correct answer is B: Reduces gastric acid production. Omeprazole is a proton pump inhibitor that works by reducing gastric acid production, thereby helping to heal ulcers. While neutralizing stomach acid is associated with antacids, forming a protective barrier over ulcers is more characteristic of medications like sucralfate. The action described in choice D, increasing gastric mucus production, is not the primary mechanism of action of omeprazole in treating peptic ulcer disease.
3. The nurse observes that a post-operative client's surgical wound has reddened edges and is oozing. What is the appropriate nursing action?
- A. Apply an antibiotic ointment
- B. Clean the wound with sterile saline
- C. Cover the wound with a sterile dressing
- D. Notify the surgeon immediately
Correct answer: D
Rationale: The correct action when a post-operative client's surgical wound has reddened edges and is oozing is to notify the surgeon immediately. Reddened, oozing wound edges can indicate an infection that requires prompt evaluation and intervention by the surgical team. Applying an antibiotic ointment (Choice A) without proper assessment and guidance can be inappropriate. Cleaning the wound with sterile saline (Choice B) and covering it with a sterile dressing (Choice C) may not address the potential infection adequately, and the client may require more specialized care that the surgeon can provide.
4. A client with a diagnosis of bipolar disorder is prescribed lithium. Which electrolyte imbalance should the nurse monitor for?
- A. Hyponatremia
- B. Hypokalemia
- C. Hypercalcemia
- D. Hypernatremia
Correct answer: A
Rationale: The correct answer is A: Hyponatremia. Lithium can affect sodium levels in the body, potentially leading to hyponatremia, which is a condition characterized by low sodium levels. This imbalance requires close monitoring as it can lead to symptoms such as confusion, weakness, and even seizures. Choices B, C, and D are incorrect because lithium is not primarily associated with causing hypokalemia, hypercalcemia, or hypernatremia. While these imbalances can occur in certain conditions or with other medications, the main electrolyte imbalance to monitor when a client is prescribed lithium is hyponatremia.
5. What is the most important aspect of colostomy care to teach the client?
- A. Change the colostomy bag daily
- B. Irrigate the colostomy daily
- C. Avoid high-fiber foods
- D. Assess the stoma for color and swelling
Correct answer: D
Rationale: The most crucial aspect of colostomy care to teach the client is to assess the stoma for color and swelling. This is essential to detect early signs of complications such as ischemia or infection. Changing the colostomy bag daily is important but not as critical as assessing the stoma for complications. Irrigating the colostomy daily is not a standard recommendation and should be performed based on healthcare provider's instructions. While avoiding high-fiber foods may be beneficial for some individuals with a colostomy, it is not the most important aspect of care compared to monitoring the stoma for complications.
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