HESI LPN
Medical Surgical Assignment Exam HESI Quizlet
1. A client with cirrhosis is receiving lactulose. What is the desired effect of this medication?
- A. Decrease blood glucose levels
- B. Reduce serum ammonia levels
- C. Increase platelet count
- D. Lower serum bilirubin levels
Correct answer: B
Rationale: The correct answer is B: Reduce serum ammonia levels. Lactulose is used to reduce serum ammonia levels in clients with cirrhosis, helping to prevent hepatic encephalopathy. Lactulose works by acidifying the colon, trapping ammonia for excretion. Decreasing blood glucose levels (choice A) is not the primary effect of lactulose. Increasing platelet count (choice C) and lowering serum bilirubin levels (choice D) are not direct effects of lactulose in the management of cirrhosis.
2. A client with a spinal cord injury at the level of T1 is at risk for autonomic dysreflexia. Which symptom is indicative of this condition?
- A. Hypotension
- B. Tachycardia
- C. Severe headache
- D. Flushed skin below the level of injury
Correct answer: C
Rationale: Corrected Rationale: Autonomic dysreflexia is a condition commonly seen in clients with spinal cord injuries at T6 or above. It is characterized by a sudden onset of severe hypertension, pounding headache, profuse sweating, nasal congestion, and flushing of the skin above the level of injury. The severe headache is a key symptom resulting from uncontrolled hypertension. Choices A, B, and D are incorrect as autonomic dysreflexia typically presents with hypertension, not hypotension, tachycardia, or flushed skin below the level of injury.
3. A client reports new onset hearing loss bilaterally after taking a medication with known ototoxic effects. Which type of hearing loss should the nurse suspect?
- A. Conductive
- B. Sensorineural
- C. Mixed
- D. Central
Correct answer: B
Rationale: The correct answer is B: Sensorineural. Ototoxic medications can lead to sensorineural hearing loss by affecting the inner ear or auditory nerve. Conductive hearing loss is related to issues in the middle or outer ear, not typically caused by ototoxic medications. Mixed hearing loss is a combination of conductive and sensorineural components. Central hearing loss is related to the central nervous system, not commonly caused by ototoxic medications. Therefore, in this case, the nurse should suspect sensorineural hearing loss.
4. A client is admitted to the emergency department with symptoms of arm numbness, chest pain, and nausea/vomiting. The examining healthcare provider believes that the client has experienced an acute myocardial infarction (AMI) within the past three hours and would like to initiate tissue plasminogen activator (tPA) therapy. Which client history findings contraindicate the use of tPA?
- A. Treats hypoglycemia with an oral hypoglycemic agent.
- B. Had a cerebrovascular hemorrhage 2 months ago.
- C. Current age 65, father died of MI at 55.
- D. Report of being intolerant of medication that contains aspirin.
Correct answer: B
Rationale: A history of cerebrovascular hemorrhage is a contraindication for tPA therapy due to the risk of bleeding. Choice A is incorrect because treating hypoglycemia with an oral hypoglycemic agent is not a contraindication for tPA therapy. Choice C is incorrect as age and family history of MI do not contraindicate the use of tPA. Choice D is incorrect as being intolerant of medication containing aspirin is not a contraindication for tPA therapy.
5. How often should the casts be changed for a newborn with talipes who is wearing casts?
- A. Daily
- B. Weekly
- C. Biweekly
- D. Monthly
Correct answer: B
Rationale: The correct answer is B: Weekly. Treatment of talipes involves manipulation and applying short leg casts. The casts need to be changed weekly to allow for further manipulation and to accommodate the rapid growth of the infant. Changing the casts daily (choice A) would be too frequent and may not provide enough time for the correction to take place. Changing the casts biweekly (choice C) or monthly (choice D) would not provide adequate support for the ongoing correction process required for talipes.
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