HESI LPN
HESI Practice Test Pharmacology
1. A client with rheumatoid arthritis is prescribed methotrexate. What is the most important instruction the practical nurse (PN) should provide to the client?
- A. Take the medication on an empty stomach.
- B. Avoid taking folic acid supplements.
- C. Report any signs of infection immediately.
- D. Increase intake of vitamin C-rich foods.
Correct answer: C
Rationale: Correct Answer: The most important instruction for a client taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. Early detection and treatment of infections are crucial to prevent complications. Instructing the client to be vigilant for signs of infection empowers them to take prompt action, enhancing their overall safety and well-being.
2. What action should the nurse take to prevent the development of deep vein thrombosis (DVT) in a client who is postoperative day 2 following hip replacement surgery?
- A. Encourage the client to remain on bed rest as much as possible.
- B. Apply sequential compression devices (SCDs) to the client's legs.
- C. Massage the client's legs to improve circulation.
- D. Encourage the client to perform ankle and foot exercises.
Correct answer: B
Rationale: The correct action to prevent DVT in a postoperative client is to apply sequential compression devices (SCDs) to promote venous return. This helps prevent stasis of blood in the lower extremities, reducing the risk of clot formation. Encouraging bed rest (Choice A) may lead to decreased mobility and increase the risk of DVT. Massaging the client's legs (Choice C) is contraindicated in the presence of DVT as it can dislodge a clot. Encouraging ankle and foot exercises (Choice D) may be beneficial for circulation, but SCDs are more effective at preventing DVT in this scenario.
3. On admission to the psychiatric unit, the client is trembling and appears fearful. The nurse’s initial response should be to
- A. Give the client orientation materials and review the unit rules and regulations
- B. Introduce oneself and accompany the client to their room
- C. Take the client to the day room and introduce them to the other clients
- D. Ask the nursing assistant to get the client’s vital signs and complete the admission search
Correct answer: B
Rationale: In situations where a client is trembling and fearful upon admission to a psychiatric unit, it is essential to prioritize building trust and reducing anxiety. By introducing oneself and accompanying the client to their room, the nurse can establish a therapeutic relationship, provide a sense of security, and address the client's immediate emotional needs. Choices A, C, and D are not the most appropriate initial responses as they do not directly address the client's emotional state or focus on establishing a supportive relationship.
4. The nurse is assisting with the admission of a young adult female Korean exchange student with acute abdominal pain. Although the client has been able to easily answer questions, when asked about sexual activity, she looks away. What action should the nurse take?
- A. Omit the section of the assessment form
- B. Ask her if she would like an interpreter to help her understand the question
- C. Reword the question to make it more culturally sensitive
- D. Observe the client's response when asked a different question
Correct answer: D
Rationale: Observing the client's response to another question is the most appropriate action in this scenario. By doing so, the nurse can assess whether the client's discomfort is due to cultural sensitivity or a misunderstanding. This approach allows the nurse to proceed with sensitivity and respect, ensuring effective communication. Option A is incorrect because omitting the section of the assessment form may result in missing crucial information relevant to the client's condition. Option B jumps to assumptions about a language barrier without confirming it first. Option C focuses on rewording the question without addressing the underlying issue causing the client's discomfort, which may not necessarily be due to a lack of understanding.
5. A young adult female client is admitted to a psychiatric facility with a medical diagnosis of bulimia nervosa. Which nursing intervention has the highest priority?
- A. Schedule the client for group therapy with other clients with bulimia nervosa.
- B. Assign the client's care to a nurse with relevant experience in eating disorders.
- C. Monitor the client carefully for binging and purging activities.
- D. Assess and report the client's electrolyte status to the healthcare provider.
Correct answer: D
Rationale: The correct answer is D. Assessing and reporting the client's electrolyte status to the healthcare provider is the highest priority in a client with bulimia nervosa. Electrolyte imbalances, such as hypokalemia and metabolic alkalosis, are common due to purging behaviors associated with bulimia. Monitoring electrolyte levels is crucial to prevent life-threatening complications. Choices A, B, and C are incorrect because while therapy and monitoring for binging activities are important, addressing the electrolyte imbalances caused by purging behaviors takes precedence in the immediate care of a client with bulimia nervosa.