HESI LPN
HESI CAT Exam Test Bank
1. A client with myasthenia gravis (MG) is receiving immunosuppressive therapy. Review of recent laboratory test results shows that the client’s serum magnesium level has decreased below the normal range. In addition to contacting the healthcare provider, what nursing action is most important?
- A. Check the visual difficulties
- B. Note the most recent hemoglobin level
- C. Assess for hand and joint pain
- D. Observe rhythm on telemetry monitor
Correct answer: D
Rationale: The correct answer is to observe the rhythm on the telemetry monitor. Decreased magnesium levels can lead to cardiac issues, such as arrhythmias. Monitoring the heart rhythm is crucial in this situation. Checking visual difficulties (choice A) is not directly related to the potential cardiac effects of low magnesium levels. Noting the hemoglobin level (choice B) and assessing for hand and joint pain (choice C) are not the priority when dealing with low magnesium levels and possible cardiac complications.
2. A patient is prescribed sucralfate (Carafate) and asks the nurse what the purpose of taking this medication is. Which is the nurse's best response?
- A. The medication helps reduce bacteria levels in the stomach
- B. The medication helps neutralize gastric acid in the stomach
- C. The medication is used to protect the gastrointestinal mucosa
- D. The medication can reduce the patient's constipation
Correct answer: C
Rationale: The correct answer is C. Sucralfate (Carafate) is used to protect the gastrointestinal mucosa by forming a protective barrier over ulcers. This barrier helps prevent stomach acid from further damaging the ulcers and promotes healing. It does not directly reduce bacteria levels, neutralize gastric acid, or have a direct effect on constipation.
3. A client receiving chemotherapy has severe neutropenia. Which snack is best for the nurse to recommend to the client?
- A. Plain yogurt sweetened with raw honey
- B. Peanuts in the shell, roasted or unroasted
- C. Aged farmer’s cheese with celery sticks
- D. Baked apples topped with dried raisins
Correct answer: A
Rationale: The correct answer is A: Plain yogurt sweetened with raw honey. This option is the best choice for a client with severe neutropenia undergoing chemotherapy because it is less likely to harbor harmful bacteria, which could cause infections due to the weakened immune system. Peanuts in the shell (choice B) may carry a risk of contamination, while aged farmer's cheese with celery sticks (choice C) and baked apples topped with dried raisins (choice D) may not be as safe as plain yogurt for a client with severe neutropenia.
4. A child with a diagnosis of celiac disease is admitted to the hospital. What dietary restriction should the nurse teach the parents?
- A. Avoid dairy products
- B. Avoid gluten
- C. Avoid high-fat foods
- D. Avoid foods high in sugar
Correct answer: B
Rationale: The correct answer is to 'Avoid gluten.' Celiac disease is an autoimmune disorder triggered by the consumption of gluten, a protein found in wheat, barley, and rye. When individuals with celiac disease ingest gluten, it causes an immune response that attacks the lining of the small intestine. Therefore, avoiding gluten is crucial in managing celiac disease to prevent symptoms and intestinal damage. Choices A, C, and D are incorrect because they do not address the specific dietary restriction necessary for individuals with celiac disease. While some individuals with celiac disease may also have lactose intolerance (not dairy allergy) or may need to manage fat or sugar intake for other health reasons, the primary dietary focus for celiac disease is the strict avoidance of gluten-containing foods.
5. What is an important consideration when administering medications to a child with a history of chronic renal failure?
- A. Increased frequency of medication administration
- B. Adjustments in dosage due to altered drug metabolism
- C. Avoidance of all medications
- D. Use of only intravenous medications
Correct answer: B
Rationale: When administering medications to a child with chronic renal failure, it is crucial to consider adjustments in dosage due to altered drug metabolism. Children with chronic renal failure may have impaired drug excretion, leading to potential drug accumulation and toxicity. Increasing the frequency of medication administration (choice A) may not address the altered drug metabolism issue and could increase the risk of adverse effects. Avoiding all medications (choice C) is not practical or safe as some medications may be necessary for the child's health. Using only intravenous medications (choice D) is not always required and may not be the best route of administration for all medications needed.