HESI LPN
Medical Surgical Assignment Exam HESI Quizlet
1. 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.
2. A client with bipolar disorder is taking lithium. Which client assessment data would indicate a potential adverse effect of lithium therapy?
- A. Increased appetite
- B. Dry mouth and increased thirst
- C. Tremors and polyuria
- D. Constipation
Correct answer: B
Rationale: When assessing a client taking lithium, dry mouth and increased thirst are indicators of potential adverse effects. Lithium can lead to nephrogenic diabetes insipidus, causing polyuria and subsequent increased thirst due to impaired water reabsorption in the kidneys. Tremors can also be a sign of lithium toxicity. Monitoring and recognizing these symptoms are crucial in managing lithium therapy and preventing further complications.
3. What actions should the nurse take regarding an older adult male who had an abdominal cholecystectomy and has become increasingly confused and disoriented over the past 24 hours, found wandering into another client’s room and returned to his own room by the unlicensed assistive personnel (UAP)? (Select all that apply)
- A. Apply soft upper limb restraints and raise all four bed rails
- B. Report mental status change to the healthcare provider
- C. Assess the client’s breath sounds and oxygen saturation
- D. Assign the UAP to re-assess the client’s risk for falls
Correct answer: B
Rationale: In this situation, the appropriate action for the nurse to take is to report the mental status change to the healthcare provider. Confusion and disorientation post-surgery can be indicative of various factors, such as electrolyte imbalances or respiratory issues, necessitating comprehensive assessment by the healthcare team. Applying restraints and raising bed rails may not address the underlying cause of the confusion, and assigning the UAP to reassess the client's risk for falls does not directly address the cognitive changes observed.
4. What instructions should the practical nurse (PN) review with a client diagnosed with vaginal trichomoniasis who is prescribed oral metronidazole?
- A. Avoid direct sunlight exposure and use a sunscreen product with SPF100.
- B. The client's sexual partner(s) should also be treated.
- C. Avoid vinegar or commercial product douches.
- D. Eliminate dairy products from the diet during treatment.
Correct answer: B
Rationale: The correct answer is B. The practical nurse should instruct the client that their sexual partner(s) should also be treated when dealing with vaginal trichomoniasis. This is crucial to prevent reinfection as sexual intercourse is the route of spread for this infection. Choices A, C, and D are incorrect. While avoiding direct sunlight exposure and using sunscreen is important for some medications, it is not specifically related to metronidazole treatment for trichomoniasis. Avoiding vinegar or commercial douches is a general recommendation for vaginal health and not specific to this infection. Eliminating dairy products from the diet is not a typical instruction for clients prescribed metronidazole for vaginal trichomoniasis.
5. A nurse on a medical-surgical unit is dividing care for four clients. The nurse should identify which of the following situations as an ethical dilemma?
- A. A client who has a new colostomy refuses to take instructions from the ostomy therapist because she 'doesn't like him.'
- B. A surgeon who removed the wrong kidney during a surgical procedure refuses to take responsibility for her actions.
- C. The family of a client who has a terminal illness asks the provider not to tell the client the diagnosis.
- D. A client who has Crohn's disease reports that his prescription drug plan will not pay for his medications.
Correct answer: C
Rationale: The correct answer is C because an ethical dilemma involves conflicting moral principles. In this scenario, the family's request not to disclose the terminal diagnosis to the client raises the moral question of truth-telling and patient autonomy. Choice A does not present an ethical dilemma but rather a challenge in client compliance. Choice B involves professional responsibility and accountability, not an ethical dilemma. Choice D relates to financial concerns and insurance coverage, which do not constitute an ethical dilemma but rather a financial issue.