HESI LPN
HESI PN Exit Exam 2023
1. A female Native American client who is receiving chemotherapy places a native artifact, an Indian medicine wheel, in her hospital room. The HCP removes the medicine wheel and tells the client, 'This type of thing does not belong in the hospital.' Which intervention should the PN implement?
- A. Teach the client about the importance of adhering to the chemotherapy regimen
- B. Act as the client's advocate when addressing the issue with the HCP
- C. Consult with a Native American healer about the appropriate use of a medicine wheel
- D. Inform the HCP about the client's feelings of culture shock
Correct answer: B
Rationale: Acting as the client's advocate is the most appropriate intervention in this situation. Removing a culturally significant artifact without considering the client's beliefs and emotional needs can be distressing. By advocating for the client, the PN can ensure that the client's cultural practices are respected, which is crucial for her emotional and spiritual well-being during treatment. Choice A is incorrect because while chemotherapy adherence is important, it is not the most immediate concern in this scenario. The client's cultural needs and well-being take precedence. Choice C is incorrect because consulting with a Native American healer might not be necessary at this point and could delay addressing the immediate issue of advocating for the client's rights. Choice D is incorrect because simply reporting the client's feelings of culture shock to the HCP does not actively address the situation or advocate for the client's rights and cultural needs.
2. What dietary considerations must the nurse keep in mind for a patient who is an Orthodox Jew?
- A. They can eat any food unless it is Yom Kippur
- B. They cannot mix meat and dairy
- C. They cannot eat meat on Ash Wednesday
- D. They are vegetarian
Correct answer: B
Rationale: Orthodox Jews follow dietary laws (Kashrut) that prohibit mixing meat and dairy products in the same meal. This restriction is known as 'not mixing milk and meat.' Therefore, choice B is the correct answer. Choices A, C, and D are incorrect because being an Orthodox Jew does not mean they can eat any food unless it is Yom Kippur, avoid meat on Ash Wednesday, or are necessarily vegetarian.
3. The PN determines that a client with cirrhosis is experiencing peripheral neuropathy. What action should the PN take?
- A. Protect the client's feet from injury
- B. Apply a heating pad to the affected area
- C. Keep the client's feet elevated
- D. Assess the feet and legs for jaundice
Correct answer: A
Rationale: Protecting the client's feet from injury is the most appropriate action for a client with cirrhosis experiencing peripheral neuropathy. Peripheral neuropathy can lead to a loss of sensation, making the client prone to unnoticed injuries. Applying a heating pad (Choice B) is contraindicated as it may cause burns or further damage to the affected area. Keeping the client's feet elevated (Choice C) is not directly related to managing peripheral neuropathy and may not provide significant benefit. Assessing the feet and legs for jaundice (Choice D) is important for monitoring liver function in clients with cirrhosis, but in this case, the priority is to prevent injury to the feet due to decreased sensation.
4. A post-operative client is prescribed sequential compression devices (SCDs) while on bed rest. What is the primary purpose of this device?
- A. To prevent deep vein thrombosis (DVT).
- B. To improve circulation in the legs.
- C. To prevent pressure ulcers.
- D. To alleviate post-operative pain.
Correct answer: A
Rationale: The correct answer is A: 'To prevent deep vein thrombosis (DVT).' Sequential compression devices (SCDs) are primarily used to prevent deep vein thrombosis (DVT) by promoting blood flow in the legs and reducing venous stasis, which is a common risk for post-operative clients who are on bed rest. While SCDs do improve circulation in the legs indirectly, their primary purpose is DVT prevention. Preventing pressure ulcers is typically achieved through repositioning and support surfaces, not with SCDs, making choice C incorrect. SCDs are not used to alleviate post-operative pain, so choice D is also incorrect.
5. Which neurotransmitter is most closely associated with mood regulation and is targeted by antidepressants?
- A. Serotonin
- B. Dopamine
- C. GABA
- D. Acetylcholine
Correct answer: A
Rationale: The correct answer is A: Serotonin. Serotonin plays a vital role in mood regulation, and its imbalance is often associated with depression. Many antidepressants function by boosting serotonin levels in the brain. Dopamine (Choice B) is more linked to reward and pleasure pathways in the brain, not primarily targeted for mood regulation. GABA (Choice C) is an inhibitory neurotransmitter that helps reduce neuronal excitability, not primarily associated with mood regulation. Acetylcholine (Choice D) is involved in muscle movement and cognitive functions, not the primary target of antidepressants for mood regulation.
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