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. What explanation is best for the nurse to provide a client who asks the purpose of using the log-rolling technique for turning?
- A. Working together can decrease the risk of back injury.
- B. The technique is intended to maintain straight spinal alignment.
- C. Using two or three people increases client safety.
- D. Turning instead of pulling reduces the likelihood of skin damage.
Correct answer: B
Rationale: The correct answer is B: 'The technique is intended to maintain straight spinal alignment.' Log-rolling is a technique used to move a person as a single unit to maintain the alignment of the spinal column. This is crucial to prevent spinal cord injury, especially in clients with suspected spine fractures. Choice A is incorrect because log-rolling focuses on spinal alignment, not just decreasing back injury risks. Choice C is incorrect because the number of people involved is not the primary purpose of log-rolling, which is maintaining spinal alignment. Choice D is incorrect because while turning instead of pulling may help prevent skin damage, the primary goal of log-rolling is to protect the spine, not the skin.
3. A client has had several episodes of clear, watery diarrhea that started yesterday. What action should the nurse implement?
- A. Administer a prescribed PRN antiemetic
- B. Assess the client for the presence of hemorrhoids
- C. Check the client’s hemoglobin level
- D. Review the client’s current list of medications
Correct answer: D
Rationale: The correct action for the nurse to implement in a client experiencing clear, watery diarrhea is to review the client's current list of medications. Certain medications can cause diarrhea as a side effect, so identifying any potential culprits is essential. Administering an antiemetic (Choice A) is not appropriate for diarrhea, as antiemetics are used to control nausea and vomiting, not diarrhea. Assessing for hemorrhoids (Choice B) is not the priority when the client is experiencing watery diarrhea; addressing the root cause is crucial. Checking the client’s hemoglobin level (Choice C) is not the immediate action needed for this situation as it does not directly address the cause of diarrhea.
4. A nurse working on an endocrine unit should see which client first?
- A. An adolescent male with diabetes who is arguing about his insulin dose.
- B. An older client with Addison’s disease whose current blood sugar level is 62mg/dl (3.44 mmol/l).
- C. An adult with a blood sugar of 384mg/dl (21.31mmol/l) and urine output of 350 ml in the last hour.
- D. A client taking corticosteroids who has become disoriented in the last two hours.
Correct answer: B
Rationale: The correct answer is B. The client with Addison’s disease and a blood sugar level of 62mg/dl (3.44 mmol/l) is experiencing hypoglycemia, which can progress to adrenal crisis. This situation requires immediate attention to prevent further complications. Choices A, C, and D, although concerning, do not pose an immediate life-threatening risk compared to the client with Addison’s disease and hypoglycemia. The adolescent arguing about his insulin dose can be addressed after stabilizing the client with Addison’s disease. The adult with high blood sugar and increased urine output may have hyperglycemia but is not in immediate danger. The client taking corticosteroids who is disoriented needs evaluation but is not in an acute life-threatening condition as the client with hypoglycemia.
5. A young adult male who is being seen at the employee health care clinic for an annual assessment tells the nurse that his mother was diagnosed with schizophrenia when she was his age and that life with a schizophrenic mother was difficult indeed. Which response is best for the nurse to provide?
- A. Ask the client if he is worried about becoming schizophrenic at the age his mother was diagnosed.
- B. Encourage the client to seek genetic counseling to determine his risk for mental illness.
- C. Inform the client that his mother’s schizophrenia has affected his psychological development.
- D. Tell the client that mental illness has a familial predisposition so he should see a psychiatrist.
Correct answer: B
Rationale: Genetic counseling can help assess risk and provide guidance for the client’s concerns about potential hereditary conditions.
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