HESI LPN
CAT Exam Practice
1. Several months after a foot injury, an adult woman is diagnosed with neuropathic pain. The client describes the pain as severe and burning and is unable to put weight on her foot. She asks the nurse when the pain will 'finally go away.' How should the nurse respond?
- A. Explain that healing from the injury can take many months.
- B. Assist the client in developing a goal of managing the pain.
- C. Encourage the client to verbalize her fears about the pain.
- D. Complete an assessment of the client’s functional ability.
Correct answer: B
Rationale: The correct answer is B: 'Assist the client in developing a goal of managing the pain.' In cases of chronic neuropathic pain, complete resolution is often not achievable. Therefore, the most appropriate approach is to help the client develop strategies to manage the pain effectively. Choice A is incorrect because it may give false hope of immediate resolution, which is unlikely with neuropathic pain. Choice C is incorrect as it does not directly address the client's need for pain management. Choice D is incorrect as it focuses on functional ability assessment, which is not the priority when addressing the client's pain concerns.
2. The nurse instructs an unlicensed assistive personnel (UAP) to turn an immobilized elderly client with an indwelling urinary catheter every two hours. What additional action should the nurse instruct the UAP to take each time the client is turned?
- A. Empty the urinary drainage bag
- B. Feed the client a snack
- C. Offer the client oral fluids
- D. Assess the breath sounds
Correct answer: A
Rationale: The correct additional action the nurse should instruct the UAP to take each time the immobilized elderly client with an indwelling urinary catheter is turned is to empty the urinary drainage bag. This action helps to prevent backflow of urine, reduces the risk of infection, and prevents bladder distention, which are crucial for the client's comfort and health. Choices B, C, and D are incorrect as they are not directly related to the care of a client with an indwelling urinary catheter. Feeding a snack, offering oral fluids, or assessing breath sounds are important aspects of care but not the immediate action needed when turning a client with an indwelling urinary catheter to prevent complications.
3. A male client with diabetes mellitus takes NPH/regular 70/30 insulin before meals and azithromycin PO daily, using medication he brought from home. When the nurse delivers his breakfast tray, the client tells the nurse that he took his insulin but forgot to take his daily dose of azithromycin an hour before breakfast as instructed. What action should the nurse implement?
- A. Provide a PRN dose of an antacid to take with the azithromycin right after breakfast
- B. Offer to obtain a new breakfast tray in an hour so the client can take the azithromycin
- C. Instruct the client to eat his breakfast and take the azithromycin two hours after eating
- D. Tell the client to skip that day's dose and resume taking the azithromycin the next day
Correct answer: C
Rationale: Azithromycin should ideally be taken on an empty stomach; however, if taken after breakfast, it should not affect its efficacy. Instructing the client to eat his breakfast and take the azithromycin two hours after eating allows for proper absorption without compromising its effectiveness. Providing an antacid with azithromycin is not necessary in this case. Offering a new breakfast tray in an hour or skipping the dose is not the best course of action as it may lead to missed doses and potential effectiveness issues.
4. A client is admitted to the intensive care unit with diabetes insipidus due to a pituitary gland tumor. Which potential complication should the nurse monitor closely?
- A. Hypokalemia
- B. Ketonuria
- C. Peripheral edema
- D. Elevated blood pressure
Correct answer: A
Rationale: The correct answer is A: Hypokalemia. In diabetes insipidus, there is excessive urination leading to fluid loss, which can result in electrolyte imbalances such as hypokalemia. Monitoring potassium levels is crucial to prevent complications like cardiac arrhythmias. Choices B, C, and D are incorrect. Ketonuria is typically seen in diabetic ketoacidosis, peripheral edema is more commonly associated with conditions like heart failure or kidney disease, and elevated blood pressure is not a direct complication of diabetes insipidus related to a pituitary gland tumor.
5. Which action should the nurse include in the plan of care for a client receiving acyclovir (Zovirax) IV for treatment of herpes zoster (shingles)?
- A. Initiate cardiac telemetry monitoring
- B. Maintain continuous pulse oximetry
- C. Perform capillary glucose measurements
- D. Monitor serum creatinine levels
Correct answer: D
Rationale: The correct answer is D: Monitor serum creatinine levels. Acyclovir can lead to nephrotoxicity, making it essential to monitor kidney function through serum creatinine levels. While cardiac telemetry monitoring (choice A) and maintaining continuous pulse oximetry (choice B) are important in certain conditions, they are not directly related to acyclovir therapy for herpes zoster. Performing capillary glucose measurements (choice C) is not a priority when administering acyclovir for herpes zoster. Monitoring serum creatinine levels is crucial to detect any potential renal issues early, as the drug's nephrotoxic potential requires close monitoring of kidney function.
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