an infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula the mother asks whe
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Nursing Elites

HESI LPN

Community Health HESI Study Guide

1. An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?

Correct answer: C

Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.

2. In reviewing the assessment data of a client suspected of having diabetes insipidus, the nurse expects which of the following after a water deprivation test?

Correct answer: B

Rationale: After a water deprivation test in a client suspected of having diabetes insipidus, the nurse would expect the urine specific gravity to remain unchanged. This occurs because in diabetes insipidus, the kidneys are unable to concentrate urine, leading to a low urine specific gravity even after water deprivation. Choices A, C, and D are incorrect. Increased edema and weight gain are not typical findings in diabetes insipidus. Rapid protein excretion is not directly related to the condition, and decreased blood potassium is not a common outcome of a water deprivation test for diabetes insipidus.

3. What is the primary function of a public health nurse?

Correct answer: C

Rationale: The primary function of a public health nurse is to promote and protect the health of populations. Public health nurses focus on preventing diseases, promoting healthy behaviors, and addressing health disparities within communities. Providing bedside care (choice A) is typically done by nurses in clinical settings, not public health nurses. Administering medications (choice B) is part of nursing practice but not the primary role of a public health nurse. Performing surgical procedures (choice D) is usually the responsibility of surgical nurses or healthcare providers specializing in surgery, not public health nurses.

4. The client with Parkinson's disease spends over 1 hour to dress for scheduled therapies. What is the most appropriate action for the nurse to take in this situation?

Correct answer: C

Rationale: The most appropriate action for the nurse is to allow the client the time needed to dress. Patients with Parkinson's disease may experience difficulties with activities of daily living due to their condition. Allowing the client sufficient time to dress promotes independence and dignity, which are essential aspects of patient-centered care. Asking family members to dress the client may undermine the client's autonomy and self-esteem. Encouraging the client to dress more quickly may lead to frustration and feelings of inadequacy. Demonstrating methods on how to dress more quickly may not address the underlying challenges the client faces and could be perceived as insensitive or dismissive of the client's needs.

5. A client with heart failure is receiving digoxin (Lanoxin). The nurse should monitor the client for which of the following signs of digoxin toxicity?

Correct answer: C

Rationale: The correct answer is C: Bradycardia. Digoxin toxicity often presents with bradycardia, which is a common sign of toxicity associated with this medication. Tachycardia (Choice A) is not typically seen with digoxin toxicity. Hypotension (Choice B) can occur but is less specific to digoxin toxicity. Hyperglycemia (Choice D) is not a typical sign of digoxin toxicity. Therefore, monitoring for bradycardia is crucial in clients receiving digoxin to detect toxicity early.

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