HESI LPN
Pharmacology HESI 2023
1. A client is prescribed phenytoin for the management of seizures. What instruction should the practical nurse provide to the client regarding this medication?
- A. Take the medication at the same time every day.
- B. Discontinue the medication if a rash develops.
- C. Avoid consuming dairy products.
- D. Monitor blood pressure regularly.
Correct answer: A
Rationale: The correct instruction the practical nurse should provide to the client regarding phenytoin is to take the medication at the same time every day. This consistency helps maintain a steady level of the medication in the bloodstream, which is crucial for effectively managing seizures. It is important for clients to adhere to their prescribed dosing schedule to optimize the therapeutic benefits of phenytoin. Choices B, C, and D are incorrect because discontinuing the medication without healthcare provider guidance can be dangerous, there is no specific interaction between phenytoin and dairy products, and monitoring blood pressure is not a primary concern with phenytoin therapy for seizures.
2. A child with a diagnosis of diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?
- A. Monitor blood glucose levels daily
- B. Administer insulin based on blood glucose levels
- C. Recognize signs of hypoglycemia
- D. Follow a specific meal plan
Correct answer: D
Rationale: For a child with diabetes mellitus, following a specific meal plan is crucial for managing blood glucose levels effectively. This helps in maintaining stable blood sugar levels and preventing complications associated with the condition. Monitoring blood glucose levels daily and recognizing signs of hypoglycemia are also important aspects of managing diabetes; however, adherence to a specific meal plan plays a fundamental role in overall diabetes care. Administering insulin based on blood glucose levels alone is not recommended without a specific plan provided by healthcare providers.
3. Which client is at the highest risk for developing pressure ulcers?
- A. A 50-year-old client with a fractured femur
- B. A 30-year-old client with diabetes mellitus
- C. A 65-year-old client with limited mobility
- D. A 70-year-old client with a history of stroke
Correct answer: C
Rationale: Clients with limited mobility are at the highest risk for developing pressure ulcers due to prolonged pressure on specific areas of the body. This constant pressure can lead to tissue damage and ultimately result in pressure ulcers. While age and medical conditions such as diabetes and a history of stroke can contribute to the risk of pressure ulcers, limited mobility is the most significant factor as it directly affects the ability to shift positions and relieve pressure on vulnerable areas of the body. Therefore, the 65-year-old client with limited mobility is at the highest risk compared to the other clients. The 50-year-old client with a fractured femur may have limited mobility due to the injury, but it is temporary and may not be as prolonged as chronic limited mobility. The 30-year-old client with diabetes mellitus and the 70-year-old client with a history of stroke are at risk for developing pressure ulcers, but their conditions do not directly impact their ability to shift positions and alleviate pressure like limited mobility does.
4. The healthcare provider is assessing a client diagnosed with rheumatoid arthritis. Which assessment finding would be most concerning?
- A. Morning stiffness
- B. Joint deformities
- C. Weight loss
- D. Fever
Correct answer: D
Rationale: Fever in a client with rheumatoid arthritis can indicate an underlying infection or a more serious systemic involvement, such as vasculitis or inflammation of internal organs. These conditions can lead to serious complications and require immediate medical attention. Joint deformities and morning stiffness are common manifestations of rheumatoid arthritis itself and may not be indicative of an acute issue. Weight loss can be seen in chronic inflammatory conditions like rheumatoid arthritis but is not as concerning as fever, which suggests an acute process requiring prompt evaluation and intervention.
5. What are general guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion?
- A. Examining the child in the parent's arms
- B. Palpating the painful area of the abdomen first
- C. Placing the child supine and palpating the abdomen
- D. Separating the child from the parent to ensure a reliable examination
Correct answer: A
Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is important to examine the child in the parent's arms. This approach helps reduce the child's anxiety, provides comfort, and can facilitate a more accurate assessment. Palpating the painful area of the abdomen first (choice B) may cause discomfort and increase anxiety in the child. Placing the child supine and palpating the abdomen (choice C) without considering the child's comfort and security may lead to resistance and inaccurate assessment. Separating the child from the parent to ensure a reliable examination (choice D) can further increase anxiety and hinder the assessment process. Therefore, examining the child in the parent's arms (choice A) is the most appropriate and effective approach in this scenario.