HESI LPN
Medical Surgical HESI
1. While planning care for a client with carpal tunnel syndrome, the nurse identifies a collaborative problem of pain. What is the etiology of this problem?
- A. Irritation of nerve endings
- B. Diminished blood flow
- C. Ischemic tissue changes
- D. Compression of a nerve
Correct answer: D
Rationale: The correct answer is D: Compression of a nerve. In carpal tunnel syndrome, pain arises from the compression of the median nerve within the carpal tunnel. This compression leads to symptoms such as pain, numbness, and tingling in the hand and arm. Choices A, B, and C are incorrect because carpal tunnel syndrome pain is primarily caused by the physical compression of the nerve, rather than irritation of nerve endings, diminished blood flow, or ischemic tissue changes.
2. During the admission interview, an older client answers some questions inappropriately. The nurse notes that a hearing aid is in one ear. Which intervention is most helpful in assisting the client to hear the nurse’s question?
- A. Move to the client's other side.
- B. Speak louder into the client's ear with the hearing aid.
- C. Ask the client to adjust the hearing aid volume.
- D. Restate questions articulating consonants carefully.
Correct answer: D
Rationale: Restating questions with clear articulation is the most helpful intervention in assisting the client to hear the nurse's question. This approach ensures that the client can better understand the question, especially if there are issues with the hearing aid. Moving to the client's other side or speaking louder into the ear with the hearing aid may not effectively address the problem of clarity in communication. Asking the client to adjust the hearing aid volume assumes that the issue lies solely with the volume, while restating questions with clear articulation can help overcome various hearing difficulties.
3. Parents of a 6-month-old child, who has just been diagnosed with iron deficiency anemia, ask why it was not diagnosed earlier. What would be the best response by the nurse?
- A. Are you sure your child has iron deficiency anemia?
- B. This happens when the maternal stores of iron are depleted at about 6 months.
- C. This anemia is caused by blood loss.
- D. The child may not have had it for a long time.
Correct answer: B
Rationale: The best response by the nurse would be choice B: 'This happens when the maternal stores of iron are depleted at about 6 months.' Iron deficiency anemia becomes apparent at about 6 months of age in a full-term infant when the maternal stores of iron are depleted. Choice A is incorrect because it questions the diagnosis provided by the healthcare provider. Choice C is incorrect because iron deficiency anemia in infants is primarily due to insufficient iron intake rather than blood loss. Choice D is incorrect as iron deficiency anemia typically develops gradually due to inadequate iron intake.
4. Which individual has the highest risk for developing skin cancer?
- A. A 16-year-old dark-skinned female who tans in tanning beds once a week.
- B. A 65-year-old fair-skinned male who is a construction worker
- C. A 25-year-old dark-skinned male whose mother had skin cancer.
- D. A 70-year-old fair-skinned female who works as a secretary.
Correct answer: B
Rationale: The correct answer is B, a 65-year-old fair-skinned male who is a construction worker. Fair-skinned individuals are at higher risk of developing skin cancer due to prolonged sun exposure. Construction workers are often exposed to the sun for long periods, further increasing the risk. Choices A, C, and D are less likely to develop skin cancer compared to choice B due to factors such as age, frequency of tanning bed use, and occupation.
5. A client is currently receiving an infusion labeled as 5% dextrose injection 500 ml with heparin sodium 25,000 units at 14 mL/hour per pump. A prescription is received to change the rate of the infusion to heparin 1,000 units/hour. How many ml/hour should the nurse program the infusion pump?
- A. 16 ml/hour.
- B. 18 ml/hour.
- C. 20 ml/hour.
- D. 22 ml/hour.
Correct answer: C
Rationale: To deliver 1,000 units/hour from a solution with 25,000 units in 500 ml, the rate should be set to 20 ml/hour. This is calculated by determining that the solution has 50 units/ml (25,000 units / 500 ml = 50 units/ml) and then dividing the required 1,000 units/hour by 50 units/ml, resulting in 20 ml/hour. Therefore, the nurse should program the infusion pump to deliver heparin at 20 ml/hour. Choices A, B, and D are incorrect as they do not align with the calculated rate of 20 ml/hour.
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