HESI LPN
Adult Health 1 Exam 1
1. A client is admitted with diabetic ketoacidosis. What is the most critical treatment to initiate?
- A. Administer sodium bicarbonate IV
- B. Start an insulin drip
- C. Monitor glucose and ketone levels
- D. Provide oral hydration
Correct answer: B
Rationale: In the case of diabetic ketoacidosis, the most critical treatment to initiate is starting an insulin drip. Insulin therapy is crucial for reducing blood glucose levels by promoting glucose uptake in cells and inhibiting the production of ketones. Administering sodium bicarbonate IV is generally not recommended as it may lower the pH further and potentially worsen the condition. While monitoring glucose and ketone levels is important for assessing the response to treatment, initiating insulin therapy takes precedence. Providing oral hydration alone is insufficient to manage the metabolic derangements seen in diabetic ketoacidosis.
2. A nurse on a medical-surgical unit is washing her hands prior to assisting with a surgical procedure. Which of the following actions by the nurse demonstrates proper surgical hand-washing technique?
- A. The nurse washes with her hands held higher than her elbows.
- B. The nurse uses an alcohol-based hand rub for 30 seconds.
- C. The nurse scrubs hands and forearms for 2 minutes with soap and water.
- D. The nurse washes her hands with soap and water for only 15 seconds.
Correct answer: A
Rationale: Proper surgical hand-washing technique involves washing with the hands held higher than the elbows. This positioning is essential to ensure proper rinsing and to prevent the risk of contamination. Option B, using an alcohol-based hand rub for 30 seconds, is not specific to surgical hand-washing and is more commonly used for routine hand hygiene. Option C, scrubbing hands and forearms for 2 minutes with soap and water, is excessive and not typically required for routine hand-washing. Option D, washing hands with soap and water for only 15 seconds, is insufficient for thorough surgical hand-washing.
3. After surgical repair of a cleft palate, what should be used to prevent injury to the suture line?
- A. Straw
- B. Spoon
- C. Syringe
- D. Cup
Correct answer: C
Rationale: The correct answer is C: Syringe. Using a syringe helps in feeding without causing injury to the suture line after cleft palate repair because it avoids direct contact with the suture area. Straws and spoons can potentially put pressure on the suture line, leading to injury. Cups may not provide the necessary control to prevent contact with the suture line, unlike a syringe.
4. A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. Which finding indicates that preterm labor is occurring?
- A. Estriol is not found in maternal saliva.
- B. Irregular, mild uterine contractions occur every 12 to 15 minutes.
- C. Fetal fibronectin is present in vaginal secretions.
- D. The cervix is effacing and dilated to 2 cm.
Correct answer: D
Rationale: The correct answer is D. Cervical changes such as effacement and dilation to 2 cm are strong indicators of imminent preterm labor. These changes, combined with regular contractions, can signify labor at any gestation. Estriol can be detected in maternal plasma as early as 9 weeks of gestation. Levels of salivary estriol have been linked to preterm birth. Irregular, mild contractions occurring every 12 to 15 minutes without cervical change are generally not concerning. While the presence of fetal fibronectin in vaginal secretions between 24 and 36 weeks of gestation may predict preterm labor, its predictive value is limited (20%-40%). Therefore, cervical changes provide more reliable information regarding the risk of preterm labor.
5. This refers to trained community health workers or health auxiliary volunteers:
- A. Village health workers
- B. Barangay health workers
- C. All of the above
- D. None of the above
Correct answer: C
Rationale: The correct answer is C, 'All of the above.' Both village health workers and barangay health workers are trained community health workers or health auxiliary volunteers. Choice A, 'Village health workers,' is correct as they are trained community health workers. Choice B, 'Barangay health workers,' is also correct as they also refer to trained community health workers. Therefore, since both options A and B are accurate, the correct answer is C, 'All of the above.' Choice D, 'None of the above,' is incorrect as both village health workers and barangay health workers fit the description provided in the question.