HESI LPN
Medical Surgical Assignment Exam HESI
1. A woman with chronic osteoarthritis is complaining of knee pain. Which pathophysiological process is contributing to her pain?
- A. Inflammation of the synovial membrane.
- B. Degeneration of the cartilage in the joint.
- C. Joint inflammation occurs when chondrocyte injury destroys joint cartilage, producing osteophytes.
- D. Formation of uric acid crystals in the joint space.
Correct answer: C
Rationale: The correct answer is C. In osteoarthritis, the breakdown of cartilage in the joints leads to chondrocyte injury, which results in the destruction of joint cartilage and the production of osteophytes. This process causes joint inflammation and pain. Choice A is incorrect because osteoarthritis primarily involves the articular cartilage rather than the synovial membrane. Choice B is incorrect as it describes the degeneration of cartilage but does not explain the specific pathophysiological process contributing to pain in osteoarthritis. Choice D is incorrect as the formation of uric acid crystals is characteristic of gout, not osteoarthritis.
2. A male client with diabetes mellitus is transferred from the hospital to a rehabilitation facility following treatment for a stroke resulting in right hemiplegia. He tells the nurse that his feet are always uncomfortably cool at night, preventing him from falling asleep. Which action should the nurse implement?
- A. Provide a warming pad for his feet
- B. Medicate the client with a prescribed sedative.
- C. Use a bed cradle to keep the covers off his feet.
- D. Place warm blankets next to the client's feet.
Correct answer: D
Rationale: Placing warm blankets next to the client's feet is the most appropriate action to provide warmth and comfort. This method is safe and effective in addressing the client's complaint of uncomfortably cool feet at night. Providing a warming pad (Choice A) may pose a risk of burns or injury, especially for a client with decreased sensation due to diabetes. Mediating the client with a sedative (Choice B) does not address the underlying issue of cool feet and may not be necessary. Using a bed cradle (Choice C) to hold the covers off the feet does not directly address the client's need for warmth and comfort.
3. The parents of a child who has had a myringotomy are instructed by the nurse to place the child in which position?
- A. Supine
- B. On the affected side
- C. On the unaffected side
- D. In Trendelenburg's position
Correct answer: B
Rationale: Placing the child on the affected side after a myringotomy facilitates ear drainage. This position helps prevent accumulation of fluids in the ear canal, aiding in the healing process. Placing the child in the supine position (Choice A) or on the unaffected side (Choice C) may not be as effective in promoting drainage. The Trendelenburg's position (Choice D) with the head lower than the body is used for conditions requiring increased venous return, not for post-myringotomy care.
4. A young adult male is admitted to the intensive care unit with multiple rib fractures and severe pulmonary contusions after falling 20 feet from a rooftop. The Chest X-ray suggests acute Respiratory distress Syndrome. Which assessment finding warrants immediate intervention by the Nurse?
- A. Apical pulse 58 bpm.
- B. Core body temperature 100.8°F.
- C. Tachypnea with dyspnea.
- D. Multiple bruises over the chest area.
Correct answer: C
Rationale: In a patient with multiple rib fractures, severe pulmonary contusions, and possible acute Respiratory Distress Syndrome (ARDS), tachypnea (rapid breathing) with dyspnea (shortness of breath) is a critical sign of respiratory distress that warrants immediate intervention by the nurse. Tachypnea and dyspnea indicate inadequate oxygenation and ventilation, which can lead to respiratory failure if not addressed promptly. The other options, such as apical pulse rate, core body temperature, and bruises over the chest area, are important assessments but do not directly indicate the immediate need for intervention in a patient with respiratory distress.
5. The nurse is evaluating teaching about drug therapy to treat gout. Which statement by the client demonstrates an understanding of the use of allopurinol to treat Gout?
- A. I need to take the prescribed amount of the drug to get rid of my gout.
- B. I need to take this drug every day to keep from having any flare-ups.
- C. I should take this drug when I have gout attacks to reduce symptoms.
- D. The pain and swelling can be controlled by taking this drug every day.
Correct answer: B
Rationale: Taking allopurinol every day helps to prevent gout flare-ups by reducing uric acid levels.
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