HESI LPN
Adult Health 2 Final Exam
1. A client with asthma is prescribed a corticosteroid inhaler. What instruction should the nurse give about the inhaler?
- A. Use it only during asthma attacks
- B. Rinse the mouth after each use to prevent oral thrush
- C. It will provide immediate relief during an asthma attack
- D. Increase the dose if breathing does not improve
Correct answer: B
Rationale: The correct instruction for a client using a corticosteroid inhaler is to rinse the mouth after each use to prevent the development of oral thrush, a common side effect of these inhalers. Choice A is incorrect as corticosteroid inhalers are often used regularly as a maintenance treatment, not just during asthma attacks. Choice C is incorrect because corticosteroid inhalers provide long-term control of asthma symptoms, not immediate relief during an attack. Choice D is incorrect and potentially dangerous advice as increasing the dose without medical guidance can lead to adverse effects.
2. A client with a diagnosis of heart failure is receiving furosemide (Lasix). Which electrolyte imbalance should the nurse monitor for?
- A. Hyperkalemia.
- B. Hyponatremia.
- C. Hypocalcemia.
- D. Hypokalemia.
Correct answer: D
Rationale: The correct answer is D: Hypokalemia. Furosemide is a loop diuretic that can cause potassium loss, leading to hypokalemia. Therefore, the nurse should monitor the client for low potassium levels. Choice A, Hyperkalemia, is incorrect as furosemide does not typically cause high potassium levels. Choice B, Hyponatremia, is incorrect as furosemide primarily affects potassium levels, not sodium. Choice C, Hypocalcemia, is incorrect as furosemide does not directly impact calcium levels.
3. A client who has just been diagnosed with tuberculosis (TB) is being discharged home. Which instruction is most important for the nurse to provide?
- A. Avoid close contact with others until treatment is complete
- B. Take all prescribed medications as directed
- C. Schedule a follow-up appointment with the healthcare provider
- D. Wear a mask when in public places
Correct answer: B
Rationale: The correct answer is B: 'Take all prescribed medications as directed.' This instruction is the most important because adherence to the prescribed medication regimen is crucial in treating tuberculosis effectively and preventing the development of drug-resistant TB. While choice A is important for infection control, ensuring treatment adherence through proper medication intake takes precedence. Choice C is also essential for monitoring progress but is not as critical as ensuring medication compliance. Choice D is relevant for preventing transmission but is not as crucial as ensuring proper treatment by taking medications as directed.
4. Which client will benefit most from the application of pneumatic compression devices to the lower extremities? The client who
- A. is immobile on prescribed bedrest.
- B. has pressure ulcers on several toes.
- C. has diminished pedal pulse volume.
- D. is confused and trying to climb out of bed.
Correct answer: A
Rationale: The correct answer is A. Pneumatic compression devices are most beneficial for immobile clients on prescribed bedrest to prevent deep vein thrombosis. Applying these devices helps in promoting circulation and preventing blood clots. Choices B, C, and D do not specifically relate to the primary indication for pneumatic compression devices, making them incorrect. Pressure ulcers, diminished pedal pulse volume, and confusion with climbing out of bed may require different interventions or treatments.
5. A client who fell 20 feet from the roof of his home has multiple injuries, including a right pneumothorax. Chest tubes were inserted in the emergency department prior to his transfer to the intensive care unit (ICU). The nurse observes that the suction control chamber is bubbling at the -10 cm H20 mark, with fluctuation in the water seal, and over the past hour, 75 mL of bright red blood is measured in the collection chamber. Which intervention should the nurse implement?
- A. Increase wall suction to eliminate fluctuation in the water seal.
- B. Give blood from the collection chamber as autotransfusion.
- C. Add sterile water to the suction control chamber.
- D. Manipulate blood in tubing to drain into chamber.
Correct answer: C
Rationale: The correct intervention for the nurse to implement is to add sterile water to the suction control chamber. This action helps maintain the proper functioning of the chest tube system by regulating the negative pressure. Increasing wall suction is not recommended as it could lead to excessive negative pressure. Giving blood from the collection chamber as autotransfusion is inappropriate and poses a risk of complications such as air embolism. Manipulating blood in the tubing is also unsafe as it could introduce air into the system, increasing the risk of complications for the client.
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