HESI LPN
Adult Health 1 Final Exam
1. After a 26-year-old gravida 4, para 0 experienced a spontaneous abortion at 9 weeks gestation, how should the nurse intervene after observing the client crying softly one hour post dilation and curettage (D&C)?
- A. Offer to call the social worker to discuss the possibility of adoption
- B. Reassure the client that the infertility specialist can help
- C. Express sorrow for the client's grief and offer to sit with her
- D. Chart the vital signs and amount of vaginal bleeding
Correct answer: C
Rationale: After a traumatic experience like a spontaneous abortion, it is crucial for the nurse to provide emotional support. Expressing sorrow for the client's grief and offering to sit with her demonstrates empathy and allows the client to process her emotions. Options A and B focus on future possibilities and medical interventions, which may not be immediately appropriate. Option D, while important for monitoring the client's physical status, does not address the client's emotional needs at that moment.
2. A client with hypothyroidism is taking levothyroxine (Synthroid). Which symptom should prompt the nurse to notify the healthcare provider?
- A. Weight gain
- B. Bradycardia
- C. Nervousness and tremors
- D. Fatigue
Correct answer: C
Rationale: The correct answer is C: Nervousness and tremors. These symptoms may indicate hyperthyroidism resulting from excessive dosing of levothyroxine. Weight gain (Choice A) is a common symptom of hypothyroidism and may indicate undertreatment or inadequate dosing. Bradycardia (Choice B) is a symptom of hypothyroidism and may improve with levothyroxine therapy; it does not typically indicate an urgent need for healthcare provider notification. Fatigue (Choice D) is a symptom of hypothyroidism and can persist even with levothyroxine treatment, so it is not a symptom that would require immediate notification of the healthcare provider.
3. A client with a diagnosis of deep vein thrombosis (DVT) is receiving anticoagulant therapy. Which instruction should the nurse provide to the client?
- A. Avoid walking as much as possible
- B. Report any signs of bleeding to the healthcare provider
- C. Take aspirin for additional pain relief
- D. Wear compression stockings at night
Correct answer: B
Rationale: Reporting signs of bleeding is essential while on anticoagulant therapy to prevent complications.
4. During a home visit, a nurse finds that an elderly client is having trouble remembering to take their medications. What is the best intervention?
- A. Set up a pill organizer
- B. Involve family members in care
- C. Arrange for a home health aide
- D. Implement all of the above
Correct answer: D
Rationale: The best intervention when an elderly client is having trouble remembering to take their medications is to implement all of the above options. Setting up a pill organizer helps in organizing and remembering medication schedules. Involving family members in care ensures additional support and reminders. Arranging for a home health aide can provide direct assistance and supervision. Implementing all these strategies together can significantly improve medication adherence, especially in clients with memory issues. Each option plays a crucial role in addressing different aspects of the problem, making 'Implement all of the above' the most comprehensive and effective choice.
5. The nurse explains the 2-week dosage prescription of prednisone (Deltasone) to a client who has poison ivy over multiple skin surfaces. What should the nurse emphasize about the dosing schedule?
- A. Decrease the dosage daily as prescribed
- B. Monitor oral temperature daily
- C. Take the prednisone with meals
- D. Return for blood glucose monitoring in one week
Correct answer: A
Rationale: The correct answer is A: 'Decrease the dosage daily as prescribed.' Tapering the dosage of prednisone is crucial to prevent withdrawal symptoms and minimize the side effects of corticosteroid therapy. Decreasing the dosage gradually over time allows the body to adjust and reduces the risk of adrenal insufficiency. Choices B, C, and D are incorrect. Monitoring oral temperature daily, taking prednisone with meals, or returning for blood glucose monitoring in one week are not specific to the dosing schedule of prednisone for poison ivy treatment.
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