HESI LPN
HESI CAT Exam 2024
1. The healthcare provider changes a client’s medication prescription from IV to PO administration and doubles the dose. The nurse notes in the drug guide that the prescribed medication, when given orally, has a high first-pass effect and reduces bioavailability. What action should the nurse implement?
- A. Continue administering the medication via the IV route.
- B. Give half the prescribed oral dose until consulting the provider.
- C. Administer the medication orally as prescribed.
- D. Consult with the pharmacist regarding the prescription change.
Correct answer: D
Rationale: The correct action for the nurse to implement is to consult with the pharmacist regarding the change in prescription. With the high first-pass effect of the medication when given orally, it reduces its bioavailability, meaning a dosage adjustment may be necessary to achieve the desired therapeutic effect. Continuing to administer the medication via the IV route (choice A) is not appropriate as the prescription has been changed to oral administration. Giving half the prescribed oral dose until consulting the provider (choice B) is not recommended without proper guidance, which should come from consulting with the pharmacist. Simply administering the medication orally as prescribed (choice C) without addressing the potential issue of reduced bioavailability may lead to suboptimal treatment outcomes.
2. The nurse is preparing a client with chronic obstructive pulmonary disease, which medication should the nurse review with the client to manage this?
- A. Guaifenesin
- B. Prednisone
- C. Salmeterol
- D. Tiotropium
Correct answer: D
Rationale: Tiotropium is commonly used for COPD management.
3. Which of the following tools is used by community health nurses to identify the health needs of a population?
- A. Health survey
- B. Medical records
- C. Patient interviews
- D. Epidemiological studies
Correct answer: D
Rationale: Epidemiological studies are used by community health nurses to identify the health needs of a population. These studies involve investigating patterns, causes, and effects of health and disease conditions in defined populations. While health surveys, medical records, and patient interviews are valuable tools in healthcare, epidemiological studies provide a broader population-based perspective essential for understanding and addressing community health needs.
4. In the change of shift report, the nurse is told that a client has a stage 2 pressure ulcer. Which ulcer appearance is most likely to be observed?
- A. Shallow open ulcer with a red-pink wound bed.
- B. Intact skin with non-blanchable redness.
- C. Full-thickness tissue loss with visible fat.
- D. Full-thickness tissue loss with exposed bone, tendon, or muscle.
Correct answer: A
Rationale: The correct answer is A: 'Shallow open ulcer with a red-pink wound bed.' Stage 2 pressure ulcers involve partial-thickness skin loss and typically appear as shallow open ulcers with a red-pink wound bed. Choice B describes a stage 1 ulcer, where the skin is intact but shows non-blanchable redness. Choice C describes a stage 3 ulcer, with full-thickness tissue loss exposing fat. Choice D is characteristic of a stage 4 ulcer, where there is full-thickness tissue loss exposing bone, tendon, or muscle. Therefore, option A best fits the description of a stage 2 pressure ulcer.
5. A nurse is caring for a client who wanders through the halls yelling obscenities at staff, other clients, and visitors. Which of the following actions should the nurse take?
- A. Keep the client in their room with the door closed
- B. Contact a family member to come and sit with the client
- C. Place the client in a wheelchair with a lap tray
- D. Administer a sedative to the client
Correct answer: B
Rationale: When dealing with a client exhibiting disruptive behavior like yelling obscenities, involving a family member can provide emotional support and help in de-escalating the situation. Keeping the client isolated in their room (Choice A) may lead to further agitation. Placing the client in a wheelchair (Choice C) or administering a sedative (Choice D) should not be the first interventions for managing behavioral issues.