HESI LPN
Adult Health 1 Exam 1
1. The client is diagnosed with pneumonia. Which intervention is most effective in promoting airway clearance?
- A. Administer bronchodilators as prescribed
- B. Encourage increased fluid intake
- C. Perform chest physiotherapy
- D. Provide humidified oxygen
Correct answer: B
Rationale: Encouraging increased fluid intake is the most effective intervention in promoting airway clearance for a client with pneumonia. Increasing fluid intake helps to thin respiratory secretions, making it easier for the client to clear the airways. Administering bronchodilators may help with bronchospasm but does not directly promote airway clearance. Chest physiotherapy may be beneficial but is not the first-line intervention for promoting airway clearance in pneumonia. Providing humidified oxygen can improve oxygenation but does not directly address airway clearance.
2. A healthcare provider is reviewing a client's medication list during a routine visit. Which action is most important to ensure medication safety?
- A. Ask the client about any allergies to medications
- B. Review the purposes of each medication
- C. Check for potential drug interactions
- D. All of the above
Correct answer: D
Rationale: A comprehensive review of allergies, medication purposes, and potential interactions is crucial for ensuring medication safety. Asking about allergies helps prevent adverse reactions, reviewing medication purposes ensures the correct use of each drug, and checking for potential drug interactions reduces the risk of harmful effects when medications interact. Choosing 'All of the above' is the correct answer because all three actions are essential steps to enhance medication safety. Options A, B, and C individually play vital roles in promoting medication safety, making option D the most appropriate choice.
3. A client who fell 20 feet from the roof of his home has multiple injuries, including a right pneumothorax. Chest tubes were inserted in the emergency department prior to his transfer to the intensive care unit (ICU). The nurse observes that the suction control chamber is bubbling at the -10 cm H20 mark, with fluctuation in the water seal, and over the past hour, 75 mL of bright red blood is measured in the collection chamber. Which intervention should the nurse implement?
- A. Increase wall suction to eliminate fluctuation in the water seal.
- B. Give blood from the collection chamber as autotransfusion.
- C. Add sterile water to the suction control chamber.
- D. Manipulate blood in tubing to drain into chamber.
Correct answer: C
Rationale: The correct intervention for the nurse to implement is to add sterile water to the suction control chamber. This action helps maintain the proper functioning of the chest tube system by regulating the negative pressure. Increasing wall suction is not recommended as it could lead to excessive negative pressure. Giving blood from the collection chamber as autotransfusion is inappropriate and poses a risk of complications such as air embolism. Manipulating blood in the tubing is also unsafe as it could introduce air into the system, increasing the risk of complications for the client.
4. The nurse is teaching a client about the administration of a subcutaneous injection. Which site is most appropriate for this type of injection?
- A. Deltoid muscle
- B. Dorsogluteal muscle
- C. Ventrogluteal muscle
- D. Abdomen
Correct answer: D
Rationale: The abdomen is a common site for subcutaneous injections due to its accessibility and ample subcutaneous tissue. Subcutaneous injections are typically given in areas with a layer of fat between the skin and muscle, such as the abdomen, to allow for slow and consistent absorption of the medication. The deltoid muscle is more appropriate for intramuscular injections, not subcutaneous. The dorsogluteal muscle and ventrogluteal muscle are also more suited for intramuscular injections, not subcutaneous.
5. The nurse explains the 2-week dosage prescription of prednisone (Deltasone) to a client who has poison ivy over multiple skin surfaces. What should the nurse emphasize about the dosing schedule?
- A. Decrease the dosage daily as prescribed
- B. Monitor oral temperature daily
- C. Take the prednisone with meals
- D. Return for blood glucose monitoring in one week
Correct answer: A
Rationale: The correct answer is A: 'Decrease the dosage daily as prescribed.' Tapering the dosage of prednisone is crucial to prevent withdrawal symptoms and minimize the side effects of corticosteroid therapy. Decreasing the dosage gradually over time allows the body to adjust and reduces the risk of adrenal insufficiency. Choices B, C, and D are incorrect. Monitoring oral temperature daily, taking prednisone with meals, or returning for blood glucose monitoring in one week are not specific to the dosing schedule of prednisone for poison ivy treatment.
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