HESI LPN
Fundamentals of Nursing HESI
1. A client is being taught about dietary management of hypercholesterolemia. Which of the following foods should be suggested to add to the diet?
- A. Avocados
- B. Fried chicken
- C. Whole milk
- D. Bacon
Correct answer: A
Rationale: Avocados are a good choice to suggest adding to the diet of a client with hypercholesterolemia because they are high in healthy fats, particularly monounsaturated fats, which can help manage cholesterol levels. On the other hand, fried chicken, whole milk, and bacon are high in saturated fats and cholesterol, which should be limited in a diet aimed at managing hypercholesterolemia. Therefore, choices B, C, and D are incorrect.
2. A client with amphetamine toxicity and sensory overload is being cared for by a nurse. Which intervention should the nurse implement?
- A. Immediately conduct a thorough assessment.
- B. Encourage visitors to distract the client.
- C. Provide a private room and limit stimulation.
- D. Speak softly to the client.
Correct answer: C
Rationale: The most appropriate intervention for a client with amphetamine toxicity and sensory overload is to provide a private room and limit stimulation. This approach helps reduce external stimuli, which can exacerbate sensory overload, and creates a calming environment for the client. Encouraging visitors to distract the client may worsen sensory overload by adding more stimulation. Speaking softly, rather than at a higher volume, is more suitable to help maintain a calm environment. Therefore, the correct choice is to provide a private room and limit stimulation (option C) in this scenario.
3. The healthcare provider is assessing a client diagnosed with rheumatoid arthritis. Which assessment finding would be most concerning?
- A. Morning stiffness
- B. Joint deformities
- C. Weight loss
- D. Fever
Correct answer: D
Rationale: Fever in a client with rheumatoid arthritis can indicate an underlying infection or a more serious systemic involvement, such as vasculitis or inflammation of internal organs. These conditions can lead to serious complications and require immediate medical attention. Joint deformities and morning stiffness are common manifestations of rheumatoid arthritis itself and may not be indicative of an acute issue. Weight loss can be seen in chronic inflammatory conditions like rheumatoid arthritis but is not as concerning as fever, which suggests an acute process requiring prompt evaluation and intervention.
4. While starting an intravenous infusion (IV) for a client, the nurse notices that her gloved hands get spotted with blood. The client has not been diagnosed with any infection transmitted via the bloodstream. Which of the following should the nurse do as soon as the task is completed?
- A. Remove the gloves carefully and follow with hand hygiene
- B. Change gloves and continue
- C. Wash hands immediately without removing gloves
- D. Report the incident to the supervisor
Correct answer: A
Rationale: After completing the task, the nurse should remove the gloves carefully and follow with hand hygiene. This practice is crucial to prevent the transmission of any potential pathogens, maintain cleanliness, and reduce the risk of infection. Changing gloves and continuing without proper hand hygiene may lead to contamination. Washing hands immediately without removing gloves is not recommended as it does not ensure thorough hand hygiene. Reporting the incident to the supervisor should be done if there are specific protocols in place for such incidents, but immediate hand hygiene is the priority in this scenario to ensure patient and nurse safety.
5. A nurse is planning care for a client who had a stroke. What task should be assigned to the assistive personnel?
- A. Assist the client with a partial bed bath
- B. Measure the client’s blood pressure after the nurse administers antihypertensive medications
- C. Use a communication board to ask what the client wants for lunch
- D. Feed the client
Correct answer: A
Rationale: The correct answer is to assign the assistive personnel to assist the client with a partial bed bath. This task falls within the scope of practice for assistive personnel and is a common activity in caring for clients who have had a stroke. Choice B involves measuring blood pressure, which should be done by a licensed nurse. Choice C requires the use of a communication board, which can be done by any healthcare team member, not just assistive personnel. Choice D involves feeding the client, which may require assessment and intervention by a licensed nurse to ensure proper nutrition and safety.
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