HESI LPN
Nutrition Final Exam
1. What is the main purpose of the initial assessment of a child with a suspected fracture?
- A. To determine the type of fracture
- B. To check for potential complications
- C. To identify the cause of the injury
- D. To plan for long-term rehabilitation
Correct answer: B
Rationale: The main purpose of the initial assessment of a child with a suspected fracture is to check for potential complications, such as neurovascular impairment, and to ensure appropriate treatment. Choice A is incorrect because determining the type of fracture usually requires imaging studies like X-rays, which may not be part of the initial assessment. Choice C is incorrect because identifying the cause of the injury is important for the history-taking part but may not be the main purpose of the initial assessment. Choice D is incorrect because long-term rehabilitation planning typically occurs after the acute phase of fracture management.
2. Which of the following statements is true of sickle-cell anemia?
- A. It is typically managed with treatments such as pain relief medications.
- B. It is caused by a mutation in the beta-globin gene.
- C. It leads to the obstruction of small blood vessels and decreased oxygen delivery.
- D. It is more prevalent in individuals of African, Mediterranean, Middle Eastern, and Indian descent.
Correct answer: C
Rationale: The correct answer is C. Sickle-cell anemia results from a mutation in the beta-globin gene, causing red blood cells to become sickle-shaped. These misshapen cells can obstruct small blood vessels, leading to reduced oxygen delivery to tissues. Choices A, B, and D are incorrect because sickle-cell anemia is typically managed with treatments such as pain relief medications, hydration, and in severe cases, blood transfusions. It is caused by a specific mutation in the beta-globin gene, not by the inability to metabolize phenylalanine. Additionally, sickle-cell anemia is more prevalent in individuals of African, Mediterranean, Middle Eastern, and Indian descent, not exclusive to any specific gender.
3. A client is expressing anger about his diagnosis of colorectal cancer. Which of the following actions should the nurse take?
- A. Reassure the client that this is an expected response to grief.
- B. Ignore the client’s anger and continue with the plan of care.
- C. Tell the client that anger is not going to help his situation.
- D. Encourage the client to express his anger.
Correct answer: A
Rationale: When a client is expressing anger about a diagnosis, it is essential for the nurse to validate the client's feelings. Choice A is correct because reassuring the client that anger is an expected response to grief acknowledges the client's emotions and encourages expression, fostering a therapeutic relationship. This validation helps the client feel understood and supported during a challenging time. Choice B is incorrect as ignoring the client's anger can lead to feelings of neglect and hinder effective communication, which is crucial for providing holistic care. Choice C is inappropriate because telling the client that anger is not helpful dismisses the client's emotions and can further escalate the situation, potentially damaging the nurse-client relationship. Choice D is not the best option as it does not involve acknowledging the client's feelings or providing support and validation, which are vital in promoting emotional well-being and trust between the client and the nurse.
4. The healthcare provider changes a client’s medication prescription from IV to PO administration and doubles the dose. The nurse notes in the drug guide that the prescribed medication, when given orally, has a high first-pass effect and reduces bioavailability. What action should the nurse implement?
- A. Continue administering the medication via the IV route.
- B. Give half the prescribed oral dose until consulting the provider.
- C. Administer the medication orally as prescribed.
- D. Consult with the pharmacist regarding the prescription change.
Correct answer: D
Rationale: The correct action for the nurse to implement is to consult with the pharmacist regarding the change in prescription. With the high first-pass effect of the medication when given orally, it reduces its bioavailability, meaning a dosage adjustment may be necessary to achieve the desired therapeutic effect. Continuing to administer the medication via the IV route (choice A) is not appropriate as the prescription has been changed to oral administration. Giving half the prescribed oral dose until consulting the provider (choice B) is not recommended without proper guidance, which should come from consulting with the pharmacist. Simply administering the medication orally as prescribed (choice C) without addressing the potential issue of reduced bioavailability may lead to suboptimal treatment outcomes.
5. A client with a history of deep vein thrombosis is prescribed rivaroxaban. The nurse should monitor for which potential adverse effect?
- A. Increased risk of bleeding
- B. Decreased risk of bleeding
- C. Increased risk of infection
- D. Decreased risk of infection
Correct answer: A
Rationale: When a client with a history of deep vein thrombosis is prescribed rivaroxaban, the nurse should monitor for signs of bleeding as rivaroxaban increases the risk of bleeding. Common adverse effects of rivaroxaban include bleeding events, such as easy bruising, prolonged bleeding from cuts, or blood in the urine or stool. It is crucial for the nurse to assess for these signs to prevent complications and ensure the client's safety. Choices B, C, and D are incorrect because rivaroxaban does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. Monitoring for bleeding is essential due to the anticoagulant properties of rivaroxaban.