HESI LPN
Community Health HESI Study Guide
1. A young child is admitted for treatment of lead poisoning. The nurse recognizes that the most serious effect of chronic lead poisoning is
- A. Central nervous system damage
- B. Moderate anemia
- C. Renal tubule damage
- D. Growth impairment
Correct answer: A
Rationale: Corrected Rationale: Chronic lead poisoning can lead to severe and irreversible damage to the central nervous system, including cognitive and developmental delays. Central nervous system damage is the most serious effect of chronic lead poisoning because it can have long-lasting consequences on a child's cognitive function and overall development. Moderate anemia (Choice B), renal tubule damage (Choice C), and growth impairment (Choice D) can also occur due to lead poisoning, but they are not as severe or potentially irreversible as the damage to the central nervous system.
2. A client is suspected of being poisoned and presents with symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth. The nurse should consider these findings consistent with which potential bioterrorism agent?
- A. ricin
- B. botulism toxin
- C. sulfur mustard
- D. yersinia pestis
Correct answer: B
Rationale: The correct answer is B: botulism toxin. Botulism toxin is associated with symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth, which are consistent with the client's presentation. Ricin (Choice A) typically presents with gastrointestinal symptoms. Sulfur mustard (Choice C) is a blistering agent causing skin, eye, and respiratory issues. Yersinia pestis (Choice D) is associated with the bubonic plague, presenting with fever, malaise, and buboes.
3. You are teaching a client about the patient-controlled analgesia (PCA) planned for post-operative care. Which statement indicates further teaching may be needed by the client?
- A. ''I will be receiving continuous doses of medication.''
- B. ''I should call the nurse before I take additional doses.''
- C. ''I will call for assistance if my pain is not relieved.''
- D. ''The machine will prevent an overdose.''
Correct answer: B
Rationale: PCA allows patients to self-administer pain medication within prescribed limits, without the need to call the nurse before taking an additional dose. Choice B suggests a misunderstanding of how PCA works, as the patient should be educated that they can self-administer doses within the safety parameters set by the healthcare provider. Choices A, C, and D demonstrate proper understanding of PCA, hence are not indicative of needing further teaching.
4. While explaining an illness to a 10-year-old, what should the nurse keep in mind about the cognitive development at this age?
- A. They are able to make simple associations of ideas
- B. They are able to think logically in organizing facts
- C. Interpretation of events originates from their own perspective
- D. Conclusions are based on previous experiences
Correct answer: B
Rationale: Correct answer: At the age of 10, children are in the stage of concrete operational thought, where they can think logically and organize facts. Choice A is incorrect as simple associations of ideas are more characteristic of earlier developmental stages. Choice C is incorrect as while children at this age are developing perspective-taking skills, their interpretations are not solely limited to their own perspective. Choice D is incorrect as while previous experiences influence their thinking, the ability to think logically and organize facts is more prominent in this stage of cognitive development.
5. A client with cirrhosis of the liver is experiencing ascites. The nurse should implement which of the following interventions?
- A. Restrict fluid intake
- B. Increase sodium intake
- C. Encourage high-protein diet
- D. Administer diuretics
Correct answer: D
Rationale: Corrected Rationale: Ascites, the accumulation of fluid in the abdominal cavity, is a common complication of cirrhosis. Diuretics are the primary intervention to manage ascites by promoting the excretion of excess fluid from the body, thus reducing abdominal swelling. Restricting fluid intake (Choice A) would not be appropriate as it may lead to dehydration. Increasing sodium intake (Choice B) is contraindicated as it can worsen fluid retention. Encouraging a high-protein diet (Choice C) is not directly related to managing ascites.
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