HESI LPN
Adult Health Exam 1 Chamberlain
1. A client with chronic obstructive pulmonary disease (COPD) is using a metered-dose inhaler (MDI). What technique should the nurse emphasize?
- A. The importance of using a spacer
- B. How to synchronize breaths with inhaler activation
- C. Regular cleaning of the inhaler
- D. All of the above
Correct answer: D
Rationale: In managing COPD with a metered-dose inhaler (MDI), the nurse should emphasize all of the techniques mentioned. Using a spacer can help improve drug delivery and reduce the risk of oral thrush. Synchronizing breaths with inhaler activation ensures proper medication delivery to the lungs. Regular cleaning of the inhaler prevents blockages and ensures optimal functioning. Therefore, all these techniques are important for effective COPD management, making 'All of the above' the correct answer. Choices A, B, and C are all crucial components of proper MDI technique in COPD, so they are not individually sufficient without the others.
2. What is the most important aspect of colostomy care to teach the client?
- A. Change the colostomy bag only when necessary
- B. Eat a low-residue diet
- C. Assess the stoma for color and swelling
- D. Irrigate the colostomy only if advised by a healthcare provider
Correct answer: C
Rationale: The most important aspect of colostomy care to teach the client is to assess the stoma for color and swelling. This is crucial as it ensures early detection of complications such as ischemia or infection. Changing the colostomy bag only when necessary is more appropriate than doing it daily, as it prevents unnecessary changes that may irritate the skin. While eating a low-residue diet is beneficial, it is not the most crucial aspect to teach. Irrigating the colostomy should only be done if advised by a healthcare provider, as it is not a routine procedure for all clients with a colostomy.
3. The nurse is caring for a client who is scheduled for surgery in the morning. The client reports drinking a glass of water at midnight. What should the nurse do?
- A. Notify the anesthesiologist
- B. Document the intake in the medical record
- C. Cancel the surgery
- D. Instruct the client to fast until the surgery
Correct answer: A
Rationale: The correct answer is to notify the anesthesiologist. When a client reports drinking water close to the time of surgery, it is important to inform the anesthesiologist as it can impact the administration of anesthesia. The anesthesiologist needs this information to make decisions regarding anesthesia administration. Documenting the intake in the medical record is important for documentation purposes, but the immediate action needed is to inform the anesthesiologist. Canceling the surgery is not necessary based solely on the intake of water; the anesthesiologist will determine the appropriate course of action. Instructing the client to fast until the surgery may not be appropriate without consulting the anesthesiologist first, as the situation needs to be assessed by the anesthesia team.
4. 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.
5. A client is scheduled for a sigmoidoscopy and expresses anxiety about the procedure. What should the nurse do first?
- A. Offer information about the procedure steps
- B. Administer an anxiolytic before the procedure
- C. Encourage the client to discuss their fears
- D. Reassure the client that the procedure is common and safe
Correct answer: C
Rationale: The correct first action for the nurse when a client expresses anxiety about a procedure is to encourage the client to discuss their fears. By allowing the client to express their concerns, the nurse can provide personalized support, address specific worries, and offer tailored information. This approach helps to establish trust, reduce anxiety, and promote a therapeutic nurse-client relationship. Offering information about the procedure steps (Choice A) may be helpful but should come after addressing the client's fears. Administering an anxiolytic (Choice B) should not be the first action as it focuses on symptom management rather than addressing the underlying cause of anxiety. Reassuring the client that the procedure is common and safe (Choice D) is important but should follow active listening and addressing the client's fears.
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