HESI LPN
Leadership and Management HESI Test Bank
1. A patient is admitted to the emergency department with hypovolemia. Which IV solution should the nurse anticipate administering?
- A. 3% sodium chloride
- B. 10% dextrose in water
- C. 0.45% sodium chloride
- D. Lactated Ringer's solution
Correct answer: D
Rationale: Lactated Ringer's solution is the most suitable IV solution for a patient with hypovolemia. It is a balanced crystalloid solution containing electrolytes such as sodium, chloride, potassium, calcium, and lactate, which closely resemble the body's natural fluids. This solution helps to restore intravascular volume and electrolyte balance in hypovolemic patients. Choice A, 3% sodium chloride, is a hypertonic solution used for specific situations like severe hyponatremia or cerebral edema, not typically for hypovolemia. Choice B, 10% dextrose in water, is a hypertonic solution primarily used for providing calories and free water, not for volume expansion. Choice C, 0.45% sodium chloride, is a hypotonic solution used for conditions like hypernatremia or as maintenance fluid, not for hypovolemia.
2. Your client has a doctor's order that reads 'advance diet as tolerated'. This client has returned from the recovery room after an appendectomy and he states, 'I am hungry'. What would you offer this client to consume?
- A. Cheese and crackers
- B. Apple sauce
- C. Chicken broth
- D. A peanut butter sandwich
Correct answer: C
Rationale: Chicken broth is a suitable option for a post-appendectomy patient beginning to tolerate oral intake. It is clear liquid and easily digestible, making it a gentle choice for someone who has just returned from surgery. Cheese and crackers, apple sauce, and a peanut butter sandwich are not ideal options for an individual who needs to start with a light and easily digestible diet.
3. Diabetes insipidus is the result of:
- A. A diet high in sugar and carbohydrates.
- B. A complicated pregnancy.
- C. A disorder of the pancreas.
- D. A disorder of the pituitary gland.
Correct answer: D
Rationale: Diabetes insipidus is caused by a disorder of the pituitary gland affecting ADH regulation. This disorder results in the decreased production or release of antidiuretic hormone (ADH), leading to the inability of the kidneys to concentrate urine properly. Choices A, B, and C are incorrect as they do not relate to the underlying cause of diabetes insipidus.
4. What does the mnemonic device ABCDE stand for?
- A. Allergy, bleeding, chemicals, dietary, environment
- B. Allergy, bleeding, cardio, diabetes, endocrine
- C. Allergy, bleeding, cardio, digestive, endocrine
- D. Allergy, bleeding, cortisone, diabetes, emboli
Correct answer: D
Rationale: The correct answer is D: 'Allergy, bleeding, cortisone, diabetes, emboli.' The ABCDE mnemonic is used in healthcare to help remember key assessment points. Choice A is incorrect as 'chemicals' and 'dietary' are not part of the ABCDE assessment. Choice B is incorrect as 'cardio' is not part of the ABCDE mnemonic. Choice C is incorrect as 'cardio' and 'digestive' are not part of the ABCDE mnemonic.
5. The nurse is planning care for a patient with acute hypernatremia. What should the nurse include in this patient's plan of care? (select one that does not apply)
- A. Reduce IV access
- B. Limit length of visits
- C. Restrict fluids to 1500 mL per day
- D. Conduct frequent neurologic checks
Correct answer: D
Rationale: For a patient with acute hypernatremia, the nurse should include interventions like reducing free water losses, correcting sodium levels slowly, monitoring neurologic status, and ensuring adequate fluid intake. Conducting frequent neurologic checks is essential in assessing the patient's neurological status and detecting any changes promptly. Therefore, this action should not be excluded from the plan of care. Choices A, B, and C are not directly related to managing acute hypernatremia and can be safely excluded from the plan of care. Reducing IV access, limiting length of visits, and restricting fluids to 1500 mL per day are not appropriate actions for managing acute hypernatremia.
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