HESI LPN
Nutrition Final Exam
1. What dietary modification is important for a child with celiac disease?
- A. Increase dairy intake
- B. Avoid gluten-containing foods
- C. Decrease protein intake
- D. Increase fiber intake
Correct answer: B
Rationale: The correct answer is B: Avoid gluten-containing foods. For a child with celiac disease, it is crucial to eliminate gluten from their diet to manage the condition effectively. Gluten triggers an immune response in individuals with celiac disease, leading to symptoms and damage to the small intestine. Choices A, C, and D are incorrect because increasing dairy intake, decreasing protein intake, or increasing fiber intake are not specific dietary modifications for managing celiac disease.
2. After receiving report, which client should the nurse assess last?
- A. An older client with dark red drainage on a postoperative dressing, but no drainage in the Hemovac
- B. An adult client with no postoperative drainage in the Jackson-Pratt drain with the bulb compressed
- C. An older client with a distended abdomen and no drainage from the nasogastric tube
- D. An adult client with rectal tube draining clear pale red liquid drainage
Correct answer: D
Rationale: The correct answer is D because the client with rectal tube drainage of clear pale red liquid is likely to be the least urgent since this is a normal post-operative finding. Clear pale red liquid drainage from a rectal tube is typically not a cause for immediate concern. Choices A, B, and C present clients with concerning signs that may require more immediate assessment and intervention. A client with dark red drainage on a postoperative dressing may indicate active bleeding, a client with a compressed Jackson-Pratt drain bulb may have inadequate drainage resulting in complications, and a client with a distended abdomen and no drainage from the nasogastric tube may be experiencing gastrointestinal issues that need prompt evaluation.
3. A 72-year-old female client is admitted to the psychiatric unit with a diagnosis of major depression. Which statement by the client should be of greatest concern to the nurse and require further assessment?
- A. "I will die if my cat dies."
- B. "I don't feel like eating this morning."
- C. "I just went to my friend's funeral."
- D. "Don't you have more important things to do?"
Correct answer: A
Rationale: Sometimes a client will use an analogy to describe themselves, and (A) would be an indication for conducting a suicide assessment. (B) could have a variety of etiologies, and while further assessment is indicated, this statement does not indicate potential suicide. The normal grief process differs from depression, and at this client's age, peer/cohort deaths are more frequent, so (C) would be within normal limits. (D) is an expression of low self-esteem typical of depression. Choices (B), (C), and (D) are examples of decreased energy and mood levels which would negate suicide ideation at this time.
4. A client is complaining of a tingling sensation in the fingers, nose tip, and earlobes 24 hours after a total thyroidectomy. Which measure should the PN implement first?
- A. Apply sequential compression devices bilaterally
- B. Initiate prescribed L-thyroxine replacement therapy
- C. Obtain prescribed calcium gluconate for tetany
- D. Prepare for emergency tracheotomy at the bedside
Correct answer: C
Rationale: The correct answer is C: Obtain prescribed calcium gluconate for tetany. Tingling sensations post-thyroidectomy may indicate hypocalcemia, a potential complication that requires prompt treatment with calcium gluconate to prevent tetany. Initiating L-thyroxine replacement therapy (choice B) is important but not the first priority in this situation. Applying sequential compression devices (choice A) is not indicated for tingling sensations and does not address the potential complication of hypocalcemia. Preparing for an emergency tracheotomy (choice D) is not warranted based on the client's symptoms of tingling sensations.
5. A client with a diagnosis of generalized anxiety disorder is prescribed citalopram. The nurse should instruct the client that this medication may have which potential side effect?
- A. Nausea
- B. Drowsiness
- C. Insomnia
- D. Headache
Correct answer: A
Rationale: The correct potential side effect of citalopram is nausea. Citalopram can cause gastrointestinal disturbances such as nausea, so clients should be advised to take the medication with food if nausea occurs to help minimize this side effect. While other side effects like drowsiness, insomnia, and headache may also occur with citalopram, nausea is a common side effect that clients should be informed about. Drowsiness and insomnia are more commonly associated with other medications used to treat anxiety or depression, such as benzodiazepines or certain antidepressants. Headache is a less common side effect of citalopram compared to nausea.