HESI LPN
Adult Health Exam 1 Chamberlain
1. The nurse is assessing a client with chronic liver disease. Which lab value is most concerning?
- A. Elevated AST and ALT levels
- B. Decreased albumin level
- C. Elevated bilirubin level
- D. Prolonged PT/INR
Correct answer: D
Rationale: In a client with chronic liver disease, a prolonged PT/INR is the most concerning lab value. This finding indicates impaired liver function affecting the synthesis of clotting factors, leading to an increased risk of bleeding. Elevated AST and ALT levels (Choice A) indicate liver cell damage but do not directly correlate with the risk of bleeding. A decreased albumin level (Choice B) is common in liver disease but is not the most concerning in terms of bleeding risk. Elevated bilirubin levels (Choice C) are seen in liver disease but do not directly reflect the risk of bleeding as PT/INR values do.
2. A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed oxygen therapy at 2 liters per minute via nasal cannula. What is the most important instruction the nurse should provide?
- A. Increase the oxygen flow rate if shortness of breath occurs
- B. Use oxygen only when experiencing shortness of breath
- C. Do not adjust the oxygen flow rate without consulting a healthcare provider
- D. Use a humidifier with the oxygen to prevent dry mucous membranes
Correct answer: C
Rationale: The most important instruction the nurse should provide to a client with COPD prescribed oxygen therapy is not to adjust the oxygen flow rate without consulting a healthcare provider. This is crucial because too much oxygen can suppress the client's respiratory drive, leading to further complications. Choice A is incorrect because increasing the oxygen flow rate without medical advice can be harmful. Choice B is incorrect as oxygen therapy should be used as prescribed, not just when symptoms occur. Choice D is incorrect as the priority is to ensure the correct oxygen flow rate rather than using a humidifier.
3. A new mother is at the clinic with her 4-week-old for a well-baby check-up. The nurse should tell the mother to anticipate that the infant will demonstrate which milestone by 2 months of age?
- A. Turns from side to back and returns
- B. Consistently returns smiles to mother
- C. Finds hands and plays with fingers
- D. Holds head up and supports weight with arms
Correct answer: B
Rationale: The correct answer is B because social smiling is a developmental milestone typically expected around 2 months of age. At this stage, infants start to engage more with their caregivers and show positive emotional responses. The other choices are incorrect. Choice A describes a motor skill that usually emerges later. Choice C involves more coordination and exploration, which is not typically seen by 2 months. Choice D relates to head control and arm strength, which also develop progressively but may not be fully achieved by 2 months.
4. The client with hypertension is being taught about lifestyle modifications. What topic is most important?
- A. Stress management
- B. Salt intake reduction
- C. Regular physical activity
- D. Weight loss
Correct answer: B
Rationale: Reducing salt intake is crucial for managing hypertension. Excessive salt consumption can lead to fluid retention, increasing blood pressure. While stress management, regular physical activity, and weight loss are beneficial for overall health, reducing salt intake is the most important lifestyle modification for controlling hypertension. Stress management may help reduce overall stress levels but does not directly impact blood pressure as salt intake does. Regular physical activity and weight loss can also benefit blood pressure control, but the immediate impact of reducing salt intake is more significant.
5. After morning dressing changes, a male client with paraplegia contaminates his ischial decubiti dressing with diarrheal stool. What is the best activity for the nurse to assign to the unlicensed assistive personnel (UAP)?
- A. Identify the need for additional supplies for an extra dressing change
- B. Provide perianal care and collect clean linens for the dressing change
- C. Document the diarrhea that necessitates an additional dressing change
- D. Position the client for access to the decubiti sites and remove dressings
Correct answer: B
Rationale: The best activity for the nurse to assign to the unlicensed assistive personnel (UAP) in this situation is to provide perianal care and collect clean linens for the dressing change. This task is crucial to maintain proper hygiene, prevent infection, and promote healing in the areas affected by decubiti. Choice A is not the priority as addressing the contamination and ensuring hygiene is more critical. Choice C is not the immediate concern and does not address the current situation. Choice D involves direct client care tasks that should be handled by licensed nursing staff.
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