HESI LPN
CAT Exam Practice
1. A client prescribed warfarin is being taught about dietary modifications by a nurse. Which statement by the client indicates understanding of the teaching?
- A. ''I need to avoid foods high in vitamin C.''
- B. ''I should eat a consistent amount of vitamin K each day.''
- C. ''I can eat as many leafy greens as I want.''
- D. ''I should not worry about any changes in my diet.''
Correct answer: B
Rationale: The correct answer is B. Consistency in vitamin K intake is crucial for clients on warfarin to maintain stable anticoagulation levels. Option A is incorrect as vitamin C does not directly interact with warfarin. Option C is incorrect because although leafy greens are high in vitamin K, excessive consumption can affect warfarin's effectiveness. Option D is incorrect as any changes in diet, particularly in vitamin K intake, can impact the efficacy of warfarin.
2. A young adult client, admitted to the emergency department following a motor vehicle collision, is transfused with 4 units of PRBCs. The client’s pretransfusion hematocrit is 17%. Which hematocrit value should the nurse expect the client to have after all PRBCs have been transfused?
- A. 23%
- B. 25%
- C. 27%
- D. 29%
Correct answer: D
Rationale: One unit of PRBCs typically raises the hematocrit by 3%. Since the client received 4 units, the hematocrit is expected to increase by approximately 12% (4 units x 3% per unit). Therefore, the nurse should expect the client's hematocrit to be 29% after all PRBCs have been transfused. Choices A, B, and C are incorrect as they do not account for the cumulative effect of multiple PRBC units on the hematocrit level.
3. A 3-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the priority nursing intervention?
- A. Administering IV immunoglobulin
- B. Monitoring for coronary artery aneurysms
- C. Encouraging fluid intake
- D. Providing nutritional support
Correct answer: B
Rationale: The priority nursing intervention for a 3-year-old child with Kawasaki disease is monitoring for coronary artery aneurysms. Kawasaki disease can lead to coronary artery complications, making early detection crucial in preventing serious outcomes. Administering IV immunoglobulin is a standard treatment for Kawasaki disease but does not take precedence over monitoring for potential complications. Encouraging fluid intake and providing nutritional support are important aspects of care but are not the priority when compared to monitoring for coronary artery aneurysms to prevent long-term cardiac issues.
4. A male client with schizophrenia is jerking his neck and smacking his lips. Which finding indicates to the nurse that he is experiencing an irreversible side effect of antipsychotic agents?
- A. Cramping muscular pain
- B. Worming movements of the tongue
- C. Decreased tendon reflexes
- D. Dry oral mucous membranes
Correct answer: B
Rationale: The correct answer is B: Worming movements of the tongue. Worming movements of the tongue, known as tardive dyskinesia, are an irreversible side effect of antipsychotic medications. Tardive dyskinesia is characterized by involuntary, repetitive movements of the tongue, lips, face, trunk, and extremities. Cramping muscular pain (Choice A) is more indicative of dystonia, an extrapyramidal side effect that can be treated effectively with antiparkinsonian medications. Decreased tendon reflexes (Choice C) are not typically associated with irreversible side effects of antipsychotic agents. Dry oral mucous membranes (Choice D) are not specific to irreversible side effects of antipsychotic medications.
5. A client has a new prescription for parenteral nutrition (PN) in 20% dextrose and fat emulsions. Which of the following is an appropriate action to include in the plan of care?
- A. Monitor blood glucose levels daily.
- B. Change the PN infusion bag every 24 hours.
- C. Prepare the client for a central venous line.
- D. Administer the PN and fat emulsion together.
Correct answer: C
Rationale: When a client requires parenteral nutrition (PN) with a high dextrose concentration, such as 20%, it typically has a high osmolarity. High osmolarity solutions should be infused through a central venous line to prevent peripheral vein irritation and potential complications. Therefore, preparing the client for a central venous line is essential for the safe administration of PN with high dextrose. Monitoring blood glucose levels daily is important but not directly related to the need for a central venous line. Changing the PN infusion bag every 24 hours helps prevent bacterial contamination, but it is not the most critical action in this scenario. Administering the PN and fat emulsion together or separately is a matter of compatibility and administration guidelines, but it is not the key concern in this situation.