HESI LPN
HESI CAT Exam
1. The healthcare provider prescribed furosemide for a 4-year-old child with a ventricular septal defect. Which outcome indicates to the nurse that this pharmacological intervention was effective?
- A. Urine specific gravity changing from 1.021 to 1.031
- B. Daily weight decrease of 2 pounds (0.9 kg)
- C. Blood urea nitrogen (BUN) increasing from 8 to 12 mg/dl (2.9 to 4.3)
- D. Urinary output decreasing by 5 ml/hour
Correct answer: B
Rationale: The correct answer is B. A daily weight decrease of 2 pounds (0.9 kg) is the most appropriate outcome to indicate the effectiveness of furosemide in a child with a ventricular septal defect. Furosemide is a diuretic medication that helps reduce fluid retention. Therefore, a decrease in weight reflects a reduction in fluid volume, which is the desired effect of furosemide. Choices A, C, and D are incorrect because changes in urine specific gravity, blood urea nitrogen (BUN) levels, and urinary output do not directly reflect the effectiveness of furosemide in this context.
2. While interviewing a client, the nurse records the assessment in the electronic health record. Which statement is most accurate regarding electronic documentation during an interview?
- A. The client's comfort level is increased when the nurse maintains eye contact while typing notes into the record
- B. The interview process is hindered by electronic documentation and may disrupt the flow of conversation
- C. The nurse has limited ability to observe nonverbal communication while entering the assessment electronically
- D. Completing the electronic record during an interview is optional and not a legal obligation of the examining nurse
Correct answer: C
Rationale: The most accurate statement is that the nurse has a limited ability to observe nonverbal communication while entering the assessment electronically. This is because the nurse's focus is on typing or inputting data, which may lead to missing important nonverbal cues from the client. Choices A and B are incorrect as they do not address the limitation of observing nonverbal cues. Choice A is incorrect because breaking eye contact to type notes may hinder the client's comfort level. Choice B is incorrect because it states that electronic documentation enhances the interview process, which may not always be the case. Choice D is incorrect as completing the electronic record during an interview is typically a standard practice but not a legal obligation.
3. The healthcare provider prescribes the nonsteroidal anti-inflammatory drug (NSAID) naproxen (Naprosyn) 500 mg PO twice a day for a client with osteoarthritis. During a follow-up visit one month later, the client tells the nurse, 'The pills don't seem to be working. They are not helping the pain at all.' Which factor should influence the nurse’s response?
- A. Noncompliance is probably impacting the optimum medication effectiveness.
- B. Drug dosage is inadequate and needs to be increased to four times a day.
- C. The drug needs 4 to 6 weeks to reach therapeutic levels in the bloodstream.
- D. NSAID response is variable, and another NSAID may be more effective.
Correct answer: D
Rationale: The correct answer is D. NSAID response can vary among individuals, and sometimes a different NSAID may be more effective for a specific client. In this case, since the current NSAID (naproxen) is not providing pain relief, it is reasonable to consider switching to another NSAID. Choice A is incorrect because there is no information provided to suggest noncompliance. Choice B is incorrect as increasing the dosage without assessing the response may lead to unnecessary side effects. Choice C is incorrect because although it may take time for NSAIDs to reach therapeutic levels, lack of pain relief after a month is a valid reason to consider changing the medication rather than waiting longer.
4. What should be assessed first in a child with suspected head trauma?
- A. Response to verbal stimuli
- B. Pupillary reaction
- C. Skin color
- D. Heart rate
Correct answer: A
Rationale: The correct answer is to assess the response to verbal stimuli first in a child with suspected head trauma. This assessment helps in determining the child's level of consciousness and neurological status. Assessing the response to verbal stimuli allows healthcare providers to quickly evaluate if the child is alert, oriented, and able to communicate effectively. This initial assessment is crucial in identifying any immediate concerns related to the child's neurological function. Choices B, C, and D are not the primary assessments in cases of suspected head trauma. While pupillary reaction, skin color, and heart rate are important assessments in trauma situations, assessing the response to verbal stimuli takes precedence in evaluating the neurological status of a child with head trauma.
5. BCG vaccine is supplied in:
- A. freeze-dried form in a sealed glass ampule
- B. liquid form in a sealed glass ampule
- C. liquid form in a vial
- D. both 2 and 3
Correct answer: A
Rationale: The correct answer is A. BCG vaccine is commonly supplied in freeze-dried form, not in liquid form. Therefore, choices B and C are incorrect. Option D is also incorrect as the vaccine is not supplied in liquid form in a glass ampule.