HESI LPN
HESI Fundamentals Study Guide
1. A client with osteoporosis is prescribed alendronate (Fosamax). What instruction should the LPN/LVN provide to the client?
- A. Take the medication with a full glass of water.
- B. Take the medication at bedtime.
- C. Take the medication with food.
- D. Take the medication on an empty stomach.
Correct answer: A
Rationale: The correct instruction for a client prescribed alendronate (Fosamax) is to take the medication with a full glass of water. Alendronate can cause irritation to the esophagus, so it is important to take it with a full glass of water and remain upright for at least 30 minutes after taking the medication to help prevent this irritation. Taking the medication at bedtime (choice B) may increase the risk of esophageal irritation as lying down can allow the medication to remain in the esophagus longer. Taking the medication with food (choice C) or on an empty stomach (choice D) can also interfere with the absorption of alendronate, reducing its effectiveness in treating osteoporosis.
2. A client with moderate persistent asthma is admitted for a minor surgical procedure. On admission, the peak flow meter is measured at 480 liters/minute. Post-operatively, the client is complaining of chest tightness. The peak flow has dropped to 200 liters/minute. What should the nurse do first?
- A. Notify the healthcare provider
- B. Administer the PRN dose of Albuterol
- C. Apply oxygen at 2 liters per nasal cannula
- D. Repeat the peak flow reading in 30 minutes
Correct answer: B
Rationale: In a client with moderate persistent asthma experiencing a drop in peak flow and chest tightness post-operatively, the first action the nurse should take is to administer the PRN dose of Albuterol. Albuterol is a short-acting bronchodilator that helps relieve bronchospasm and improve breathing. Notifying the healthcare provider (choice A) can be done after initiating immediate treatment with Albuterol. Applying oxygen (choice C) may be necessary but addressing the bronchospasm with Albuterol is the priority. Repeating the peak flow reading (choice D) can be considered after administering Albuterol to assess the response to treatment.
3. A male client with angina pectoris is being discharged from the hospital. What instructions should the nurse plan to include in the discharge teaching?
- A. Engage in physical exercise before eating to help decrease cholesterol levels.
- B. Avoid walking briskly in cold weather to prevent a decrease in cardiac output.
- C. Keep nitroglycerin in a light-colored plastic bottle and readily available.
- D. Avoid all isometric exercises, but walk regularly.
Correct answer: C
Rationale: The correct answer is to keep nitroglycerin in a light-colored container and readily available. Nitroglycerin should be protected from light to maintain its effectiveness. Option A is incorrect because physical exercise immediately before eating can trigger angina. Option B is incorrect as cold weather can exacerbate angina symptoms. Option D is incorrect as isometric exercises can increase the workload on the heart, which is not recommended for individuals with angina.
4. How does a double-blind experiment work?
- A. Both subject groups take turns receiving each treatment.
- B. Neither subjects nor researchers know which subjects are in the control or experimental group.
- C. Neither group of subjects knows whether they are in the control or experimental group, but the researchers do not know.
- D. Both subject groups know whether they are in the control or experimental group, but the researchers do not know.
Correct answer: B
Rationale: The correct answer is B. In a double-blind experiment, neither the subjects nor the researchers know which subjects are in the control or experimental group. This helps to eliminate bias and ensure that the results are more objective. Choice A is incorrect as in a double-blind experiment, subjects do not take turns receiving each treatment; it is about masking the treatment allocation. Choice C is incorrect because it implies that the researchers are aware of the group allocation, which goes against the principle of blinding in a double-blind study. Choice D is incorrect as both subject groups should not know whether they are in the control or experimental group to maintain the blindness of the study.
5. An adult female client with type 1 diabetes mellitus is receiving NPH insulin 35 units in the morning. Which finding should the PN document as evidence that the amount of insulin is inadequate?
- A. States that her feet are constantly cold and feel numb
- B. A wound on the ankle that starts to drain and becomes painful
- C. Consecutive evening serum glucose greater than 260 mg/dL
- D. Reports nausea in the morning but can still eat breakfast
Correct answer: C
Rationale: The correct answer is C. High evening glucose levels indicate that the morning dose of NPH insulin may be insufficient to control blood sugar throughout the day. Choice A is incorrect as cold and numb feet are more indicative of a circulation issue rather than an insulin inadequacy. Choice B suggests a wound infection rather than inadequate insulin. Choice D, nausea in the morning, may be due to other causes and does not necessarily indicate inadequate insulin dosage.