HESI LPN
Medical Surgical HESI
1. Which dietary modification is most appropriate for a client with nephrotic syndrome?
- A. High protein, low sodium
- B. Low protein, high sodium
- C. High protein, high potassium
- D. Low protein, low sodium
Correct answer: D
Rationale: The most appropriate dietary modification for a client with nephrotic syndrome is a low protein, low sodium diet. This diet helps reduce the workload on the kidneys and manage edema, which are common issues in nephrotic syndrome. Choice A, high protein, low sodium, is not recommended because excessive protein intake can further strain the kidneys. Choice B, low protein, high sodium, is inappropriate as high sodium can worsen fluid retention and hypertension. Choice C, high protein, high potassium, is not ideal as high potassium levels can be problematic for individuals with kidney issues.
2. The mother of a child with acute laryngotracheobronchitis (LTB) asks why her child must be kept NPO. Which response would be the most correct?
- A. The epinephrine given causes nausea and vomiting.
- B. The child is being hydrated with IV fluids.
- C. The child is not hungry.
- D. The child's rapid respirations pose a risk for aspiration.
Correct answer: D
Rationale: The correct answer is D because rapid respirations predispose to aspiration in a child with acute laryngotracheobronchitis. Choice A is incorrect because epinephrine does not directly relate to the need for NPO status. Choice B is incorrect as hydration with IV fluids is not the primary reason for keeping the child NPO. Choice C is incorrect as the child being hungry is not the main concern when keeping a child NPO in this situation.
3. A client with hypertension is prescribed a low-sodium diet. Which food should the client avoid?
- A. Fresh fruits
- B. Processed cheese
- C. Whole grain bread
- D. Fresh vegetables
Correct answer: B
Rationale: The correct answer is B: Processed cheese. Processed cheese is high in sodium and should be avoided in a low-sodium diet for clients with hypertension. Fresh fruits, whole grain bread, and fresh vegetables are generally low in sodium and can be part of a healthy diet for clients with hypertension.
4. A client with deep vein thrombosis (DVT) is being treated with warfarin. Which dietary instruction should the nurse provide?
- A. Avoid foods high in vitamin C
- B. Increase intake of green leafy vegetables
- C. Limit intake of foods high in vitamin K
- D. Avoid dairy products
Correct answer: C
Rationale: The correct answer is C: 'Limit intake of foods high in vitamin K'. Vitamin K can interfere with the effectiveness of warfarin, an anticoagulant medication commonly used to treat conditions like deep vein thrombosis (DVT). Patients on warfarin should maintain a consistent intake of vitamin K-rich foods and be monitored closely. Choices A, B, and D are incorrect because avoiding foods high in vitamin C, increasing intake of green leafy vegetables, and avoiding dairy products are not essential dietary instructions for a client on warfarin therapy for DVT.
5. After a CT scan with intravenous contrast medium, a client returns to the room complaining of shortness of breath and itching. Which intervention should the nurse implement?
- A. Call respiratory therapy to administer a breathing treatment.
- B. Send for an emergency tracheostomy set.
- C. Prepare a dose of epinephrine.
- D. Review the client's complete list of allergies.
Correct answer: C
Rationale: Preparing a dose of epinephrine is the correct intervention in this situation as the client is displaying symptoms of an anaphylactic reaction to the contrast medium used during the CT scan. Epinephrine is the first-line treatment for anaphylaxis due to its ability to reverse the symptoms rapidly. Calling respiratory therapy for a breathing treatment (Choice A) may not address the underlying allergic reaction and delay appropriate treatment. Sending for an emergency tracheostomy set (Choice B) is not indicated as the client's symptoms suggest an allergic reaction rather than airway obstruction. Reviewing the client's complete list of allergies (Choice D) is important but would not provide immediate relief for the client's current symptoms; administering epinephrine takes precedence in this situation.
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