HESI LPN
HESI CAT Exam
1. The nurse is caring for a client who is receiving continuous ambulatory peritoneal dialysis (CAPD) and notes that the output flow is 100ml less than the input flow. Which actions should the nurse implement first?
- A. Continue to monitor intake and output with the next exchange
- B. Check the client's blood pressure and serum bicarbonate levels
- C. Irrigate the dialysis catheter
- D. Change the client's position
Correct answer: D
Rationale: In this situation, the priority action for the nurse is to change the client's position. Altering the client's position can help facilitate better fluid drainage in peritoneal dialysis, potentially resolving the issue without the need for more invasive interventions. Continuing to monitor intake and output (Choice A) is important but addressing the immediate drainage issue takes precedence. Checking blood pressure and serum bicarbonate levels (Choice B) is not directly related to the observed output flow discrepancy. Irrigating the dialysis catheter (Choice C) should not be the initial action as it is more invasive and should be considered only if repositioning does not resolve the issue.
2. A dispersion consists of a solute dispersed through a dispersing vehicle. Which of the following dispersions is a liquid for topical application that contains insoluble solids or liquids?
- A. Ointment
- B. Lotion
- C. Paste
- D. Gel
Correct answer: B
Rationale: The correct answer is B, 'Lotion.' A lotion is a liquid dispersion that contains insoluble solids or liquids for topical application. Ointments are more semi-solid and occlusive, pastes are thicker and contain higher concentrations of solids, and gels have a jelly-like consistency due to their three-dimensional network structure. Therefore, among the options, a lotion is the most suitable choice for containing insoluble solids or liquids for topical application.
3. Rotating injection sites when administering insulin prevents which of the following complications?
- A. Insulin edema
- B. Insulin lipodystrophy
- C. Insulin resistance
- D. Systemic allergic reactions
Correct answer: B
Rationale: Rotating injection sites when administering insulin helps prevent insulin lipodystrophy, which is the abnormal distribution of fat at injection sites. Insulin edema (choice A) is not prevented by rotating injection sites; it is characterized by swelling at the site of insulin injection due to increased capillary permeability. Insulin resistance (choice C) is a condition where the body's cells become less responsive to insulin, and rotating injection sites does not directly prevent this. Systemic allergic reactions (choice D) are not specifically prevented by rotating injection sites; they are related to an allergic response to insulin.
4. What is the structure of deoxyribonucleic acid (DNA)?
- A. single spiral
- B. double helix
- C. sphere
- D. cube
Correct answer: B
Rationale: The correct answer is B: double helix. DNA is structured as a double helix, resembling a twisted ladder made up of two strands of nucleotides. Choice A, single spiral, is incorrect as DNA is not a single spiral structure. Choice C, sphere, is incorrect as DNA does not form a spherical shape. Choice D, cube, is incorrect as DNA does not have a cubic structure. Understanding the double helix structure of DNA is essential as it allows for the storage and transmission of genetic information in living organisms.
5. Who should document care?
- A. The LPNs should document the care that they provided and the care that was given by unlicensed assistive staff.
- B. The registered nurse must document all of the care that is provided by the nursing assistants because they are accountable for all care.
- C. All staff members should document all of the care that they have provided.
- D. All staff should document all of the care that they have provided but the registered nurse, as the only independent practitioner, signs it.
Correct answer: C
Rationale: All staff members should document the care they provided as part of their accountability and to ensure accurate and comprehensive records. In healthcare settings, it is essential for all staff to document the care they deliver for continuity of care and legal purposes. The registered nurse may sign off on the documentation for oversight purposes, but the responsibility of documenting care extends to all staff involved in patient care. Choices A and B incorrectly limit the responsibility to specific roles, while choice D inaccurately suggests that only the registered nurse signs off on the documentation, overlooking the importance of comprehensive documentation by all staff members involved.