HESI LPN
Adult Health 2 Exam 1
1. A client with chronic kidney disease is being evaluated for dialysis. Which laboratory value would be most concerning to the nurse?
- A. Hemoglobin 9.5 g/dL
- B. Potassium 6.2 mEq/L
- C. Creatinine 3.5 mg/dL
- D. BUN 50 mg/dL
Correct answer: B
Rationale: The correct answer is B: Potassium 6.2 mEq/L. In chronic kidney disease, the kidneys struggle to regulate potassium levels, leading to hyperkalemia. A potassium level of 6.2 mEq/L is dangerously high and can cause life-threatening cardiac arrhythmias. Hemoglobin of 9.5 g/dL may indicate anemia, which is common in chronic kidney disease but is not immediately life-threatening. Creatinine and BUN levels are markers of kidney function; although elevated levels indicate kidney impairment, they are not acutely life-threatening like severe hyperkalemia.
2. An adult male was diagnosed with stage IV lung cancer three weeks ago. His wife approaches the nurse and asks how she will know that her husband's death is imminent because their two adult children want to be there when he dies. What is the best response by the nurse?
- A. Explain that the client will start to lose consciousness and his body systems will slow down
- B. Reassure the spouse that the healthcare provider will let her know when to call the children
- C. Offer to discuss the client’s health status with each of the adult children
- D. Gather information on how long it will take for the children to arrive
Correct answer: A
Rationale: The best response for the nurse is to explain that the client will start to lose consciousness and his body systems will slow down. Providing information on the signs of impending death helps the family prepare emotionally and allows them to be present at the appropriate time. Choice B is incorrect because it does not empower the family with the knowledge they seek. Choice C is incorrect as discussing the client’s health status individually with the adult children may not address the wife's immediate concern. Choice D is incorrect as the priority should be on preparing the family for the signs of imminent death rather than focusing on logistical details.
3. Which client requires careful nursing assessment for signs and symptoms of hypomagnesemia?
- A. A young adult client with intractable vomiting from food poisoning
- B. A client who developed hyperparathyroidism in late adolescence
- C. A middle-aged male client in renal failure following an unsuccessful kidney transplant
- D. A female client who is overzealous with her intake of simple carbohydrates
Correct answer: A
Rationale: The correct answer is A. Vomiting can lead to significant loss of magnesium, causing hypomagnesemia. In this scenario, the young adult client with intractable vomiting from food poisoning is at higher risk of developing hypomagnesemia due to the loss of magnesium through vomiting. Choices B, C, and D are less likely to present with hypomagnesemia. Hyperparathyroidism (B) is associated with hypercalcemia, renal failure (C) can lead to hypermagnesemia, and overconsumption of simple carbohydrates (D) is not directly linked to magnesium imbalances.
4. A healthcare professional is reviewing the laboratory values for a client who has a positive Chvostek's sign. Which of the following laboratory findings should the healthcare professional expect?
- A. Decreased calcium
- B. Elevated potassium
- C. Increased sodium
- D. Low hemoglobin
Correct answer: A
Rationale: A positive Chvostek's sign is a clinical indication of low calcium levels, known as hypocalcemia. This sign is elicited by tapping the facial nerve anterior to the ear, resulting in facial muscle twitching. The correct laboratory finding associated with a positive Chvostek's sign is decreased calcium. Elevated potassium (Choice B) is not typically associated with Chvostek's sign but can be seen in conditions like renal failure. Increased sodium (Choice C) is not directly related to Chvostek's sign and is more commonly associated with hypernatremia. Low hemoglobin (Choice D) is not the expected laboratory finding in a client with a positive Chvostek's sign; instead, it suggests anemia, which is unrelated to this clinical manifestation.
5. After spinal fusion surgery, a client reports numbness and tingling in the legs. What should the nurse do first?
- A. Assess the client’s neurovascular status in the lower extremities.
- B. Reposition the client to relieve pressure on the spine.
- C. Administer prescribed pain medication.
- D. Notify the healthcare provider immediately.
Correct answer: A
Rationale: After spinal fusion surgery, numbness and tingling in the legs may indicate nerve compression or damage. The priority action for the nurse is to assess the client’s neurovascular status in the lower extremities. This assessment will help determine the cause and severity of the symptoms, guiding further interventions. Repositioning the client may be necessary for comfort, but assessing neurovascular status is the initial step. Administering pain medication should only follow the assessment to address any discomfort. Notifying the healthcare provider immediately is not the first action unless there are emergent signs requiring urgent intervention.