HESI LPN
HESI PN Exit Exam 2023
1. Which of the following dietary modifications should be recommended for a patient with chronic kidney disease (CKD)?
- A. High protein, low sodium
- B. Low protein, high potassium
- C. Low sodium, low potassium
- D. High calcium, low phosphorus
Correct answer: C
Rationale: A low sodium, low potassium diet is often recommended for patients with CKD to manage fluid balance and prevent electrolyte imbalances that the kidneys can no longer regulate effectively. High protein diets, as mentioned in choice A, can put extra strain on the kidneys, making it an incorrect choice. Choice B, which suggests a low protein, high potassium diet, is also incorrect because high potassium levels can be harmful to individuals with CKD. Choice D, advocating for a high calcium, low phosphorus diet, is not the typical dietary recommendation for CKD patients, even though managing calcium and phosphorus levels is important in their diet.
2. In planning care for a 7-year-old boy with diabetes insipidus, what is the priority nursing diagnosis?
- A. Deficient fluid volume related to dehydration
- B. Excess fluid volume related to edema
- C. Deficient knowledge related to fluid intake regimen
- D. Imbalanced nutrition, more than body requirements related to excess weight
Correct answer: A
Rationale: The priority nursing diagnosis for a 7-year-old boy with diabetes insipidus is deficient fluid volume related to dehydration. Diabetes insipidus leads to excessive urination and fluid loss, which can result in dehydration. This diagnosis should take precedence as restoring fluid balance is crucial in managing this condition. Choices B, C, and D are less of a priority in this case. Excess fluid volume related to edema is not typically associated with diabetes insipidus. Deficient knowledge about fluid intake and imbalanced nutrition related to excess weight may be important but addressing the dehydration and fluid volume deficit is the most critical aspect in the immediate care of a child with diabetes insipidus.
3. What is the recommended treatment for a child with a first-degree burn?
- A. Immediate application of ice
- B. Administration of oral antibiotics
- C. Application of cool, moist compresses
- D. Application of hot packs
Correct answer: C
Rationale: The recommended treatment for a child with a first-degree burn is the application of cool, moist compresses. This helps in reducing pain and swelling without causing further damage to the skin. Applying ice directly to a burn can lead to frostbite and worsen the injury (Choice A). Oral antibiotics are not necessary for first-degree burns as they do not typically involve infection (Choice B). Hot packs should be avoided as they can further damage the skin and increase inflammation (Choice D).
4. When describing urticaria, what would an instructor include?
- A. It is a type IV hypersensitivity reaction.
- B. Histamine release leads to vasodilation.
- C. Wheals appear first followed by erythema.
- D. The nonpruritic rash blanches with pressure.
Correct answer: B
Rationale: The correct answer is B. Urticaria is a type I hypersensitivity reaction where histamine release leads to vasodilation and the formation of characteristic wheals. Choice A is incorrect as urticaria is associated with type I hypersensitivity, not type IV. Choice C is incorrect because in urticaria, erythema typically appears before the development of wheals. Choice D is incorrect as urticaria is typically pruritic and does not blanch with pressure.
5. The nurse notes that a depressed female client has been more withdrawn and non-communicative during the past two weeks. Which intervention is most important to include in the updated plan of care for this client?
- A. Encourage the client's family to visit more often
- B. Schedule a daily conference with the social worker
- C. Encourage the client to participate in group activities
- D. Engage the client in a non-threatening conversation
Correct answer: D
Rationale: Engaging the client in a non-threatening conversation is crucial as it can help build trust and provide support, addressing the client's withdrawal. This intervention focuses on establishing a therapeutic relationship and giving the client an opportunity to express their feelings. Choices A, B, and C do not directly target the client's need for communication and may not address the underlying issues contributing to her withdrawal. Encouraging the client's family to visit more often (Choice A) may add pressure or discomfort to the client. Scheduling a daily conference with the social worker (Choice B) may not address the client's immediate need for communication. Encouraging the client to participate in group activities (Choice C) may be overwhelming for the client and not address her withdrawal directly.