which patient is most at risk for osgood schlatter disease

HESI LPN

Leadership and Management HESI Test Bank

1. Which individual is most at risk for Osgood-Schlatter disease?

A. An elderly female who is hospitalized with a hip fracture and on bed rest
B. A middle-aged male patient who has been exposed to asbestos in the shipping industry
C. An adolescent who is physically active and the captain of their soccer team
D. An infant of low birth weight and a gestational age of 28 weeks

Correct answer: C

Rationale: Osgood-Schlatter disease is a condition that commonly affects adolescents who are physically active, especially during growth spurts. It is caused by overuse of the knee, leading to inflammation of the patellar ligament at the tibial tuberosity. The repetitive stress on the growth plate during activities like running and jumping can trigger this condition. Therefore, an adolescent who is physically active and the captain of their soccer team is most at risk for Osgood-Schlatter disease. Choices A, B, and D are not at high risk for this condition as it is primarily seen in active adolescents.

2. Which anatomic malformations are associated with Tetralogy of Fallot?

A. A sub-aortic septal defect, an overriding aorta, left ventricular hypertrophy, and right ventricular outflow
B. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and left ventricular outflow
C. A sub-aortic septal defect, an overriding aorta, pulmonary atresia, and right ventricular outflow
D. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow

Correct answer: D

Rationale: Tetralogy of Fallot is characterized by a combination of four heart defects: a sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow obstruction. This leads to mixing of oxygen-poor and oxygen-rich blood, resulting in cyanosis. Therefore, the correct answer is D. Choices A, B, and C are incorrect because they do not accurately describe the specific combination of anatomic malformations seen in Tetralogy of Fallot.

3. A nurse is supervising an assistive personnel (AP) who is feeding a client who has dysphagia. Which of the following actions by the AP should the nurse identify as correct technique?

A. Elevating the head of the client's bed to 30 degrees during mealtime
B. Withholding fluids until the end of the meal
C. Providing a 10-minute rest period prior to meals
D. Instructing the client to place her chin toward her chest when swallowing

Correct answer: D

Rationale: The correct technique for a client with dysphagia is to instruct them to place their chin toward their chest when swallowing. This action helps to close off the airway during swallowing, reducing the risk of aspiration. Elevating the head of the client's bed to 30 degrees during mealtime helps prevent aspiration, but this is not the responsibility of the AP. Withholding fluids until the end of the meal can lead to dehydration and is not a recommended practice. Providing a 10-minute rest period prior to meals is not specifically related to improving swallowing safety for clients with dysphagia.

4. A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?

A. Withhold the benzodiazepine but continue the opioid
B. Contact the provider about replacing the opioid with an NSAID
C. Administer the benzodiazepine but withhold the opioid
D. Continue the medication dosages that relieve the client's pain

Correct answer: B

Rationale: The correct action for the nurse to take is to contact the provider about replacing the opioid with an NSAID. In this scenario, the client is experiencing excessive sedation after the administration of both opioid and benzodiazepine. Switching to a non-opioid analgesic like an NSAID can help manage pain effectively without causing additional sedation. Option A is incorrect because continuing the opioid may exacerbate sedation. Option C is incorrect as administering the benzodiazepine may further increase sedation. Option D is incorrect because maintaining the current medication dosages that are causing excessive sedation is not in the client's best interest.

5. When reinforcing teaching and instructing the patient, which basic principle of teaching should you follow?

A. Sequence the instruction from the least complex to the most complex.
B. Assume that the patient knows little or nothing about the topic.
C. Tell the patient to call their significant other so you can instruct them.
D. Use medically oriented terms so the patient will be able to speak with the doctor.

Correct answer: A

Rationale: The correct principle of teaching to follow when reinforcing teaching and instructing the patient is to sequence the instruction from the least complex to the most complex. This approach facilitates learning by building upon simpler concepts before moving to more advanced ones. Choice B is incorrect because assuming the patient knows little or nothing about the topic may not always be accurate and can be patronizing. Choice C is incorrect as it does not focus on the direct teaching approach to the patient. Choice D is incorrect as using medically oriented terms may confuse the patient rather than facilitate understanding.