HESI LPN
HESI Fundamentals Exam
1. A client who has a new prescription for warfarin (Coumadin) is receiving discharge teaching from a nurse. Which of the following statements indicates that the client understands the teaching?
- A. I will take my warfarin at the same time every day.
- B. I should use a soft-bristled toothbrush while taking this medication.
- C. I should take my warfarin at bedtime.
- D. I should avoid eating foods high in vitamin K while taking this medication.
Correct answer: A
Rationale: The correct answer is A. Taking warfarin at the same time every day is essential to maintain a consistent blood level of the medication. This statement indicates that the client understands the teaching about the importance of consistency in medication timing. Choice B, regarding using a soft-bristled toothbrush, is not directly related to warfarin therapy and does not assess the client's understanding of warfarin administration. Choice C suggesting taking warfarin at bedtime is incorrect; it is generally recommended to take warfarin at the same time each day to avoid variations in drug levels. Choice D about avoiding foods high in vitamin K is relevant as vitamin K can interfere with warfarin's anticoagulant effects. However, it is not the best indicator of understanding the teaching on medication timing, which is crucial for warfarin efficacy.
2. Which of the following is the best way for a nurse to improve quality of care?
- A. Recognize that physicians are among the health-care professionals interested in improving quality of care.
- B. Work with patients and families to improve healthcare.
- C. Collaborate with other health-care professionals, patients, and their families.
- D. Recognize that physicians are among the numerous professionals in health care.
Correct answer: C
Rationale: The best way for a nurse to improve the quality of care is by collaborating with other health-care professionals, patients, and their families. By working together with the healthcare team, patients, and families, nurses can ensure a holistic approach to care delivery, leading to better outcomes. Choices A and D are incorrect as they focus solely on physicians, while choice B, though important, does not fully encompass the collaborative aspect necessary for comprehensive care.
3. Which of the following statements about CHN is wrong?
- A. CHN synthesizes public health with nursing
- B. CHN emphasizes health
- C. Promoting clients' autonomy is a responsibility of public nursing
- D. CHN makes a unique contribution to health care not by the nature of its practice but where it is practiced
Correct answer: D
Rationale: The statement in option D is incorrect. The unique contribution of Community Health Nursing (CHN) is not only where it is practiced but also by the nature of its practice. CHN's distinct value lies in its approach to care delivery, focusing on preventive care, health promotion, and addressing the needs of specific communities. Options A and B are correct as CHN involves synthesizing public health principles with nursing practice and emphasizes holistic health. Option C is incorrect as promoting clients' autonomy is a fundamental aspect of community health nursing, respecting individuals' rights to make decisions about their health.
4. A client who is experiencing respiratory distress is admitted with respiratory acidosis. Which pathophysiological process supports the client’s respiratory acidosis?
- A. Low oxygen levels are present in the blood.
- B. High levels of carbon dioxide have accumulated in the blood.
- C. Increased bicarbonate levels are causing alkalosis.
- D. Respiratory rate is increased, causing hyperventilation.
Correct answer: B
Rationale: High levels of carbon dioxide in the blood lead to respiratory acidosis due to inadequate ventilation. The correct answer is B. In respiratory acidosis, the accumulation of carbon dioxide in the blood occurs due to inadequate exhalation, leading to acidosis. Choice A is incorrect as low oxygen levels are related to hypoxemia, not respiratory acidosis. Choice C is incorrect as increased bicarbonate levels would lead to alkalosis, not acidosis. Choice D is incorrect as an increased respiratory rate causing hyperventilation would actually help decrease carbon dioxide levels, not lead to respiratory acidosis.
5. A nurse in a provider's office is assessing a client who has heart failure. The client has gained weight since her last visit, and her ankles are edematous. Which of the following findings by the nurse is another clinical manifestation of fluid volume excess?
- A. Bounding pulse
- B. Decreased blood pressure
- C. Dry mucous membranes
- D. Weak pulse
Correct answer: A
Rationale: A bounding pulse is indicative of fluid volume excess. In this case, the client's weight gain and edematous ankles already suggest fluid volume overload. A bounding pulse occurs due to increased blood volume and pressure. Choices B, C, and D are not indicative of fluid volume excess. Decreased blood pressure, dry mucous membranes, and weak pulse are more commonly associated with conditions such as dehydration or hypovolemia, where there is a decrease in fluid volume rather than an excess.