HESI LPN
Nutrition Final Exam
1. What is a key intervention for a child with a new diagnosis of type 1 diabetes?
- A. Insulin administration
- B. Increased dietary fat intake
- C. Restricted fluid intake
- D. Routine physical examinations only
Correct answer: A
Rationale: The correct answer is A: Insulin administration. When a child is diagnosed with type 1 diabetes, insulin administration is a crucial intervention. Insulin helps regulate blood glucose levels by enabling cells to take in glucose from the bloodstream. Without sufficient insulin, blood glucose levels can become dangerously high, leading to various complications. Increased dietary fat intake (choice B) is not a recommended intervention for type 1 diabetes management, as it can contribute to weight gain and other health issues. Restricted fluid intake (choice C) is also not appropriate, as adequate hydration is essential for overall health. Routine physical examinations (choice D) are important but are not the primary intervention needed to manage type 1 diabetes.
2. A client with AIDS has impaired gas exchange from a respiratory infection. Which assessment finding warrants immediate intervention by the nurse?
- A. Elevated temperature
- B. Generalized weakness
- C. Diminished lung sounds
- D. Pain when swallowing
Correct answer: D
Rationale: In a client with AIDS and impaired gas exchange from a respiratory infection, pain when swallowing can indicate esophageal involvement, such as esophagitis or an esophageal infection like candidiasis. These conditions can significantly impact the client's ability to take in nutrition and medications, leading to complications like dehydration and malnutrition. Therefore, immediate intervention is required to address the underlying cause and prevent further complications. Elevated temperature (choice A) may indicate infection but does not directly address the impaired gas exchange. Generalized weakness (choice B) and diminished lung sounds (choice C) are concerning but do not directly relate to the immediate need for intervention in the context of esophageal involvement in a client with impaired gas exchange.
3. A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the teaching plan?
- A. Avoid taking folic acid supplements
- B. Report any signs of infection immediately
- C. Limit fluid intake to prevent edema
- D. Increase intake of high-calcium foods
Correct answer: B
Rationale: The correct instruction that the nurse should include in the teaching plan for a client prescribed methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the individual more susceptible to infections. Reporting signs of infection promptly allows for timely intervention. Choices A, C, and D are incorrect. Avoiding folic acid supplements is not recommended because methotrexate can lead to folate deficiency, so supplementation may be necessary. There is no direct correlation between fluid intake limitation and methotrexate use. Increasing high-calcium foods is not specifically related to methotrexate therapy for rheumatoid arthritis.
4. The practical nurse (PN) is assigned to work with three registered nurses (RN) who are caring for neurologically compromised clients. The client with which change in status is best to assign to the PN?
- A. Diabetic ketoacidosis whose Glasgow Coma Scale score changed from 10 to 7
- B. Subdural hematoma whose blood pressure changed from 150/80 mmHg to 170/60 mmHg
- C. Myxedema coma whose blood pressure changed from 80/50 mmHg to 70/40 mmHg
- D. Viral meningitis whose temperature changed from 101° F (38.3 C) to 102° F (38.9C)
Correct answer: D
Rationale: The correct answer is D because viral meningitis with a slight increase in temperature is less acute and complex compared to the other conditions. This change in temperature does not indicate a critical or urgent situation requiring immediate attention or intervention beyond the scope of a practical nurse. Choices A, B, and C present more significant changes in health status such as a decrease in Glasgow Coma Scale score, an increase in intracranial pressure indicated by blood pressure changes, and a significant drop in blood pressure, respectively. These changes require closer monitoring and intervention by registered nurses due to the higher acuity and complexity of care needed for these conditions.
5. A client is prescribed an antacid for the treatment of peptic ulcer disease. What is the action of this medication that is effective in treating the client's ulcer?
- A. Decrease in the production of gastric secretions
- B. Production of an adherent barrier over the ulcer
- C. Maintenance of a gastric pH of 3.5 or above
- D. Decrease in the gastric motor activity
Correct answer: C
Rationale: The correct answer is C. Antacids work by neutralizing gastric acids and maintaining a gastric pH of 3.5 or above. This pH level is crucial to prevent the activation of pepsinogen, a precursor to pepsin, which can further damage the ulcer. Choice A is incorrect because antacids do not directly decrease the production of gastric secretions; they neutralize existing acid. Choice B is incorrect as antacids do not form a physical barrier over the ulcer but rather neutralize the acid around it. Choice D is also incorrect as antacids do not affect gastric motor activity but focus on reducing acidity in the stomach.