HESI LPN
Adult Health Exam 1
1. A client with a diagnosis of rheumatoid arthritis is prescribed methotrexate. What is the primary action of this medication?
- A. Increases joint lubrication
- B. Reduces inflammation by suppressing the immune system
- C. Enhances bone density
- D. Stimulates cartilage regeneration
Correct answer: B
Rationale: The correct answer is B: Methotrexate is an immunosuppressant that works by suppressing the immune system, thereby reducing inflammation in rheumatoid arthritis. Methotrexate does not directly increase joint lubrication (Choice A) as its primary action is on the immune system. Choices C and D are incorrect since methotrexate does not enhance bone density or stimulate cartilage regeneration. It is crucial for healthcare providers to understand the mechanism of action of medications to provide safe and effective care to patients.
2. The client with hypertension is being taught about lifestyle changes. Which recommendation is most important to include?
- A. Increase sodium intake
- B. Engage in regular physical activity
- C. Consume a diet high in saturated fats
- D. Limit fluid intake
Correct answer: B
Rationale: Engaging in regular physical activity is crucial for managing hypertension as it helps lower blood pressure. Regular exercise can improve heart health, increase circulation, and contribute to overall well-being, all of which are beneficial for individuals with hypertension. Choice A, increasing sodium intake, is incorrect as reducing sodium is recommended for hypertension to help lower blood pressure. Choice C, consuming a diet high in saturated fats, is incorrect as a diet high in saturated fats can negatively impact blood pressure and cardiovascular health. Choice D, limiting fluid intake, is incorrect as maintaining adequate hydration is important for overall health and not directly related to hypertension management.
3. To assess pedal pulses, which arterial sites should the nurse palpate? (Select all that apply)
- A. Posterior tibial artery
- B. Radial artery
- C. External iliac artery
- D. Dorsalis pedis artery
Correct answer: D
Rationale: The correct answer is D: Dorsalis pedis artery. When assessing pedal pulses, the nurse should palpate the dorsalis pedis artery and the posterior tibial artery. The radial artery is located in the wrist and is not a site for assessing pedal pulses. The external iliac artery is not a correct site for assessing pedal pulses in the lower extremities, making it the correct answer.
4. A client is admitted with a diagnosis of myocardial infarction (MI). Which intervention is a priority during the acute phase?
- A. Administer morphine for pain relief
- B. Encourage the client to perform isometric exercises
- C. Position the client flat in bed
- D. Restrict fluid intake
Correct answer: A
Rationale: During the acute phase of a myocardial infarction (MI), the priority intervention is to administer morphine for pain relief. Morphine not only alleviates pain but also reduces myocardial oxygen demand, which is crucial in the management of MI. Encouraging the client to perform isometric exercises (choice B) can increase myocardial oxygen demand and should be avoided during the acute phase. Positioning the client flat in bed (choice C) may worsen symptoms by increasing venous return and workload on the heart. Restricting fluid intake (choice D) is not a priority intervention during the acute phase of MI; maintaining adequate hydration is important for organ perfusion.
5. An adult female client is admitted to the psychiatric unit with a diagnosis of major depression. After 2 weeks of antidepressant medication therapy, the nurse notices the client has more energy, is giving her belongings away to her visitors, and is in an overall better mood. Which intervention is best for the nurse to implement?
- A. Tell the client to keep her belongings because she will need them at discharge
- B. Ask the client if she has had any recent thoughts of harming herself
- C. Reassure the client that the antidepressant drugs are apparently effective
- D. Support the client by telling her what wonderful progress she is making
Correct answer: B
Rationale: In this scenario, the nurse should ask the client if she has had any recent thoughts of harming herself. Sudden mood improvements and behavioral changes, like giving away belongings, can be concerning signs of possible suicidal ideation. Assessing for suicidal thoughts is crucial to ensure the client's safety. Choice A is incorrect as it does not address the potential risk of harm or assess for suicidal ideation. Choice C is incorrect because simply reassuring the client about the effectiveness of antidepressants does not address the immediate concern of suicidal ideation. Choice D is incorrect as it focuses on praising progress without addressing the potential risk of harm the client may pose to herself.
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