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. The nurse plans to administer the rubella vaccine to a postpartum client whose titer is < 1:8 and who is breastfeeding. What information should the nurse provide this client?
- A. The client should bottle feed and pump her breast for 3 days following immunization
- B. The vaccine is given to produce maternal antibodies before lactation occurs
- C. The infant will receive immunization through the mother's breast milk
- D. The client should not get pregnant for 3 months after immunization
Correct answer: D
Rationale: Educating about the waiting period helps prevent possible rubella infection in a subsequent early pregnancy.
3. The nurse is teaching a client with diabetes about foot care. Which instruction is most important to prevent complications?
- A. Soak feet in warm water daily
- B. Apply moisturizer between the toes
- C. Wear cotton socks
- D. Inspect feet daily for cuts or sores
Correct answer: D
Rationale: The correct answer is D: Inspect feet daily for cuts or sores. Daily foot inspection is crucial for clients with diabetes to detect early signs of injury or infection. Soaking feet in warm water daily (choice A) can lead to skin maceration, making the skin more susceptible to breakdown. Applying moisturizer between the toes (choice B) can increase moisture and the risk of fungal infections. While wearing cotton socks (choice C) is beneficial for diabetic foot care, it is not as crucial as daily foot inspections to prevent complications.
4. A client with a urinary tract infection is prescribed antibiotics. What should the nurse inform the client about antibiotic therapy?
- A. It may interfere with oral contraceptive effectiveness
- B. It can cause drowsiness
- C. It should be taken with meals
- D. Completing the full course is crucial
Correct answer: D
Rationale: Completing the full course of antibiotics is crucial to fully eradicate the infection and prevent the development of antibiotic resistance. Informing the client about the importance of finishing the prescribed course helps in ensuring the effectiveness of the treatment and reduces the risk of recurrence. Choice A is incorrect because antibiotics do not generally interfere with oral contraceptive effectiveness. Choice B is incorrect because drowsiness is not a common side effect of antibiotics. Choice C is incorrect because while some antibiotics may need to be taken with meals, it is not a universal rule for all antibiotics.
5. The nurse is caring for a client who underwent a total knee replacement yesterday. What activity level should the nurse encourage today?
- A. Bed rest with bathroom privileges only
- B. Frequent, short walks with assistance
- C. Range of motion exercises to the knee every four hours
- D. Leg elevation to reduce swelling
Correct answer: B
Rationale: After a total knee replacement, early ambulation is crucial for promoting circulation and preventing complications like thrombosis. Bed rest should be avoided as it can increase the risk of complications. Range of motion exercises are important but should be performed gradually and not excessively. Leg elevation is beneficial for reducing swelling but should not be the primary activity level encouraged immediately after surgery.
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