HESI LPN
Adult Health 1 Final Exam
1. The healthcare provider is providing discharge instructions to a client with chronic heart failure. Which dietary recommendation is most appropriate?
- A. Increase fluid intake.
- B. Follow a low-sodium diet.
- C. Follow a high-protein diet.
- D. Increase sodium intake.
Correct answer: B
Rationale: The most appropriate dietary recommendation for a client with chronic heart failure is to follow a low-sodium diet. This helps manage the condition by reducing fluid retention and the workload on the heart. High fluid intake can lead to fluid overload and exacerbate heart failure symptoms. While protein is important for overall health, a high-protein diet is not specifically indicated for chronic heart failure. Increasing sodium intake is contraindicated in heart failure as it can worsen fluid retention and increase the workload on the heart.
2. A 3-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the priority nursing intervention?
- A. Administering IV immunoglobulin
- B. Monitoring for coronary artery aneurysms
- C. Encouraging fluid intake
- D. Providing nutritional support
Correct answer: B
Rationale: The priority nursing intervention for a 3-year-old child with Kawasaki disease is monitoring for coronary artery aneurysms. Kawasaki disease can lead to the development of coronary artery aneurysms, which are one of the most serious complications of the disease. Early detection and monitoring of coronary artery changes are essential for prompt intervention and prevention of adverse outcomes. Administering IV immunoglobulin is an important treatment for Kawasaki disease, but monitoring for coronary artery aneurysms takes precedence as it directly impacts the child's long-term prognosis. Encouraging fluid intake and providing nutritional support are important aspects of care but are not the priority when compared to monitoring for potential life-threatening complications.
3. The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. What should the nurse explain about exercise in type 1 diabetes?
- A. Exercise will increase blood glucose levels
- B. Exercise should be restricted
- C. Extra snacks are needed before exercise
- D. Extra insulin is required during exercise
Correct answer: C
Rationale: In type 1 diabetes, extra snacks are needed before exercise to prevent hypoglycemia. It is important to provide additional carbohydrates to maintain blood glucose levels during physical activity. Choices A, B, and D are incorrect. Exercise typically lowers blood glucose levels in individuals with diabetes; however, proper management and adjustments in insulin and food intake are necessary to prevent hypoglycemia. Exercise should not be restricted in individuals with type 1 diabetes but should be planned in coordination with healthcare providers to ensure safety and optimal glucose control. While some individuals may need adjustments in insulin dosages during exercise, the general statement that extra insulin is required during exercise in type 1 diabetes is not accurate.
4. A client who has a history of unstable angina is admitted to the emergency department with chest pain.
- A. Chest pain relieved by rest.
- B. Chest pain unrelieved after taking 3 sequential nitroglycerin tablets.
- C. Chest pain occurring only with exertion.
- D. Chest pain lasting less than 5 minutes.
Correct answer: B
Rationale: Chest pain unrelieved after taking 3 sequential nitroglycerin tablets indicates a possible myocardial infarction and requires immediate medical attention.
5. According to a study in 2014 by Skakkebaek et al., who among the following is most likely to have gynecomastia?
- A. Jennifer, a dancer, who has Down syndrome
- B. Frank, a teacher, who is diagnosed with XYY syndrome
- C. Peter, a fashion designer, who has Klinefelter syndrome
- D. Ria, a gym instructor, who is diagnosed with Turner syndrome
Correct answer: C
Rationale: Individuals with Klinefelter syndrome have an extra X chromosome (XXY) and typically have reduced testosterone levels, which can lead to gynecomastia (enlarged breasts). This condition is not usually associated with Down syndrome (choice A), XYY syndrome (choice B), or Turner syndrome (choice D), making them less likely to have gynecomastia.