HESI LPN
Adult Health Exam 1 Chamberlain
1. An elderly client is concerned about constipation during a flight. What should the nurse recommend?
- A. Use an over-the-counter stool softener when needed
- B. Eat a high protein diet
- C. Increase the fluid intake in the diet
- D. Decrease the fat content in the diet
Correct answer: C
Rationale: The correct answer is to recommend increasing fluid intake in the diet. Adequate hydration is essential for preventing constipation, especially during travel when mobility may be reduced. Stool softeners are not the first-line recommendation and should only be used when necessary. Eating a high protein diet or decreasing fat content in the diet may not directly address the issue of constipation related to dehydration during a flight.
2. The client with high blood pressure is being taught by the nurse to avoid adding salt during cooking. What effect does sodium have on blood pressure?
- A. It decreases the viscosity of blood
- B. It leads to increased fluid retention
- C. It causes vasoconstriction of the blood vessels
- D. It enhances the excretion of potassium
Correct answer: C
Rationale: The correct answer is C: 'It causes vasoconstriction of the blood vessels.' Sodium can lead to vasoconstriction, which narrows the blood vessels, increasing resistance to blood flow and subsequently raising blood pressure. Choices A, B, and D are incorrect. Sodium does not decrease blood viscosity, but it can lead to fluid retention, which increases blood volume and pressure. It does not enhance the excretion of potassium; instead, high sodium intake can lead to potassium excretion by the kidneys.
3. A client with a diagnosis of chronic heart failure is receiving digoxin. What is the most important instruction the nurse should provide?
- A. Take the medication with a high-fiber meal
- B. Monitor pulse rate daily before taking the medication
- C. Avoid dairy products while on this medication
- D. Discontinue the medication if blurred vision is experienced
Correct answer: B
Rationale: The most important instruction the nurse should provide is to monitor pulse rate daily before taking the medication. Digoxin can lead to bradycardia, so it is crucial to assess the pulse rate before administering the medication. This practice helps ensure that the heart rate is not too low for the safe use of digoxin. Choice A is incorrect as there is no specific requirement to take digoxin with a high-fiber meal. Choice C is also incorrect because there is no need to avoid dairy products while on digoxin. Choice D is incorrect since blurred vision is not a common side effect of digoxin; hence, it is not the most critical instruction to provide.
4. A client with a diagnosis of bipolar disorder is taking lithium. What is the most important information the nurse should provide?
- A. Take the medication on an empty stomach
- B. Monitor sodium intake
- C. Report any signs of weight gain
- D. Avoid excessive caffeine intake
Correct answer: B
Rationale: The correct answer is B. Sodium levels can affect lithium levels in the body, so it is crucial to monitor sodium intake to prevent toxicity or subtherapeutic levels. Lithium is typically taken on an empty stomach to enhance absorption, making choice A more accurate than the original 'Take the medication with food.' Reporting weight gain, as mentioned in choice C, is important for monitoring side effects but is not as critical as ensuring proper lithium levels through sodium intake monitoring. Choice D, avoiding excessive caffeine intake, is not a priority concern directly related to lithium therapy.
5. The nurse is caring for a client postoperatively following a thyroidectomy. Which assessment finding should be reported to the healthcare provider immediately?
- A. Hoarseness of the voice.
- B. Slight swelling at the incision site.
- C. Tingling around the mouth.
- D. Mild fever.
Correct answer: C
Rationale: Tingling around the mouth should be reported to the healthcare provider immediately as it may indicate hypocalcemia, a potential complication after thyroidectomy. Hoarseness of the voice is common postoperatively due to surgical manipulation, slight swelling at the incision site is a normal response, and a mild fever can be expected after surgery. However, tingling around the mouth suggests a potential calcium imbalance, which requires prompt attention to prevent serious complications.
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