HESI LPN
HESI Leadership and Management Test Bank
1. Serge, who has diabetes mellitus, is taking oral agents and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of action for the nurse regarding Serge's oral medications?
- A. Administer the oral agents immediately after the test.
- B. Notify the diagnostic department and request orders.
- C. Notify the physician and request orders.
- D. Administer the oral agents with a sip of water before the test.
Correct answer: C
Rationale: The best plan of action for the nurse is to notify the physician and request orders regarding Serge's oral medications. By involving the physician, the nurse ensures that appropriate instructions are obtained, considering Serge's medical condition and the need for NPO status for the diagnostic test. Administering the medications without medical guidance (choice A) can be risky, as it may affect the test results. Notifying the diagnostic department (choice B) is not the most direct and appropriate action; the physician is the primary healthcare provider responsible for medication orders. Administering the medications with water before the test (choice D) is not advisable when the patient is supposed to be NPO, as it can interfere with the test requirements.
2. A client is preparing for an elective mastectomy. The client is wearing a plain gold wedding band. Which of the following is an appropriate procedure for taking care of this client's ring?
- A. Agree to keep the ring for the client until after surgery
- B. Place the ring in the bag with the client's clothing
- C. Tape the ring securely to the client's finger
- D. Place the client's ring in the facility safe
Correct answer: D
Rationale: In this scenario, placing the client's ring in the facility safe is the most appropriate procedure. This ensures the ring is kept secure and prevents any risk of loss or damage during the surgery. Agreeing to keep the ring for the client could raise concerns about accountability, while placing it in the bag with the client's clothing might lead to misplacement. Taping the ring securely to the client's finger is not recommended as it may hinder blood circulation or cause discomfort.
3. During which stage of anesthesia is a patient most likely to experience involuntary motor activity?
- A. Stage I
- B. Stage II
- C. Stage III
- D. Stage VI
Correct answer: B
Rationale: The correct answer is Stage II. During Stage II of anesthesia, a patient is most likely to experience involuntary motor activity. This stage is known as the excitement stage, where the patient may exhibit purposeful or involuntary movements. Choice A (Stage I) is incorrect because Stage I is the induction phase where the patient is transitioning from consciousness to unconsciousness, and involuntary motor activity is less likely to occur. Choice C (Stage III) is incorrect as it is the stage of surgical anesthesia characterized by muscle relaxation, and involuntary motor activity is less common during this stage. Choice D (Stage VI) is incorrect as there is no Stage VI in the standard stages of anesthesia. Therefore, the most appropriate stage where involuntary motor activity is likely to occur is Stage II.
4. Steven John has type 1 diabetes mellitus and receives insulin. Which laboratory test will the nurse assess?
- A. Potassium
- B. AST (aspartate aminotransferase)
- C. Serum amylase
- D. Sodium
Correct answer: A
Rationale: The correct answer is A: Potassium. Patients with type 1 diabetes receiving insulin are at risk of developing hypokalemia due to insulin's effects on potassium levels. Monitoring potassium levels is crucial to prevent complications such as cardiac arrhythmias. Choices B, C, and D are incorrect because AST, serum amylase, and sodium levels are not directly impacted by insulin therapy in type 1 diabetes and are not the primary concern that needs monitoring in this scenario.
5. A patient is admitted to the emergency department with hypovolemia. Which IV solution should the nurse anticipate administering?
- A. 3% sodium chloride
- B. 10% dextrose in water
- C. 0.45% sodium chloride
- D. Lactated Ringer's solution
Correct answer: D
Rationale: Lactated Ringer's solution is the most suitable IV solution for a patient with hypovolemia. It is a balanced crystalloid solution containing electrolytes such as sodium, chloride, potassium, calcium, and lactate, which closely resemble the body's natural fluids. This solution helps to restore intravascular volume and electrolyte balance in hypovolemic patients. Choice A, 3% sodium chloride, is a hypertonic solution used for specific situations like severe hyponatremia or cerebral edema, not typically for hypovolemia. Choice B, 10% dextrose in water, is a hypertonic solution primarily used for providing calories and free water, not for volume expansion. Choice C, 0.45% sodium chloride, is a hypotonic solution used for conditions like hypernatremia or as maintenance fluid, not for hypovolemia.
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