HESI LPN
Medical Surgical HESI
1. The client with osteoporosis is being taught about dietary modifications by the nurse. Which food should the nurse recommend to increase calcium intake?
- A. Broccoli
- B. Chicken breast
- C. White bread
- D. Apple
Correct answer: A
Rationale: Broccoli is the correct answer as it is a good source of calcium, which is essential for clients with osteoporosis. Broccoli is a green leafy vegetable that provides a significant amount of calcium. Chicken breast, white bread, and apple do not contain as much calcium as broccoli and therefore are not the best choices to recommend for increasing calcium intake in clients with osteoporosis.
2. What should the nurse assess in an infant who has been diagnosed with hypertrophic pyloric stenosis?
- A. A history of diarrhea following each feeding
- B. Gastric pain evidenced by vigorous crying
- C. Poor appetite due to a poor sucking reflex
- D. An olive-shaped mass right of the midline
Correct answer: D
Rationale: The correct answer is D. In hypertrophic pyloric stenosis, a key assessment finding is an olive-shaped mass in the right upper quadrant of the abdomen, to the right of the midline. This mass is palpable and represents the hypertrophied pyloric muscle. Choices A, B, and C are incorrect because although they may be present in infants with feeding problems, the definitive assessment for hypertrophic pyloric stenosis is the presence of an olive-shaped mass on the right side of the abdomen, not a history of diarrhea, gastric pain, or poor appetite.
3. The nurse is reviewing blood pressure readings for a group of clients on a medical unit. Which client is at the highest risk for complications related to hypertension?
- A. Post-menopausal Caucasian female who overeats and is 20% above her ideal body weight.
- B. Young adult Hispanic female who has hemoglobin at 11 g/dl (110 g/L) and drinks beer daily.
- C. Older adult who consumes a diet of smoked, cured, and pickled foods.
- D. Middle-aged African-American male who has a serum creatinine level of 2.9 mg/dL (256.4 micromol/L).
Correct answer: D
Rationale: The correct answer is D. An elevated serum creatinine level indicates kidney damage, which significantly increases the risk of complications from hypertension. High blood pressure can damage the kidneys over time, leading to impaired kidney function. Choices A, B, and C do not directly correlate with increased risk of complications related to hypertension. Choice A focuses on obesity and overeating, Choice B on anemia and alcohol consumption, and Choice C on a diet high in sodium and nitrates, none of which are as directly related to hypertension complications as kidney damage.
4. A client who is newly diagnosed with emphysema is being prepared for discharge. Which instruction is best for the nurse to provide the client to assist them with dyspnea self-management?
- A. Allow additional time to complete physical activities to reduce oxygen demand.
- B. Practice inhaling through the nose and exhaling slowly through pursed lips.
- C. Use a humidifier to increase home air quality humidity between 30-50%.
- D. Strengthen abdominal muscles by alternating leg raises during exhalation.
Correct answer: B
Rationale: The correct answer is B. Instructing the client to practice inhaling through the nose and exhaling slowly through pursed lips can help improve oxygenation and reduce dyspnea. This technique, known as pursed lip breathing, can help regulate breathing patterns and decrease the work of breathing in clients with emphysema. Choice A is incorrect because allowing additional time for physical activities does not directly address dyspnea management. Choice C is incorrect as using a humidifier, although beneficial for respiratory conditions, does not specifically assist with dyspnea self-management. Choice D is also incorrect as strengthening abdominal muscles through leg raises does not directly target dyspnea relief.
5. The nurse is teaching a client with gastroesophageal reflux disease (GERD) about dietary modifications. Which food should the client avoid?
- A. Applesauce
- B. White rice
- C. Coffee
- D. Bananas
Correct answer: C
Rationale: The correct answer is C: Coffee. Coffee should be avoided by clients with GERD as it can relax the lower esophageal sphincter, leading to an increase in GERD symptoms. Choices A, B, and D are not directly associated with worsening GERD symptoms and can be included in moderation in the diet of a client with GERD.
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