HESI LPN
Medical Surgical HESI 2023
1. An 82-year-old female client with type 2 diabetes and degenerative arthritis complains to the nurse that she has a hard time cutting her toenails. What should the nurse recommend?
- A. Seek routine nail care with a podiatrist.
- B. Encourage monthly pedicures at a nail salon.
- C. Soak feet for 10 minutes before cutting nails.
- D. Ask a family member to cut toenails.
Correct answer: A
Rationale: For an 82-year-old female client with type 2 diabetes and degenerative arthritis, the nurse should recommend seeking routine nail care with a podiatrist. This is crucial to ensure proper and safe toenail care, reducing the risk of injury and infection, which is especially important for diabetic clients. Encouraging monthly pedicures at a nail salon (choice B) may not address the underlying issues related to diabetes and arthritis. Soaking feet for 10 minutes before cutting nails (choice C) may help soften the nails but does not address the difficulty the client faces in cutting them. Asking a family member to cut toenails (choice D) may not guarantee the expertise needed for proper diabetic foot care, which a podiatrist can provide.
2. A client with a history of chronic pain requests a nonopioid analgesic. The client is alert but has difficulty describing the exact nature and location of the pain to the nurse. What action should the nurse implement next?
- A. Administer the analgesic as requested.
- B. Request a pain assessment from another nurse.
- C. Ask the client to describe the pain more precisely.
- D. Delay administration until the pain is better described.
Correct answer: D
Rationale: The correct action for the nurse to implement next is to delay administration until the pain is better described. It is essential to have a clear understanding of the nature and location of the pain before administering any analgesic to ensure appropriate and effective pain management. Requesting a pain assessment from another nurse or asking the client to describe the pain more precisely would also be appropriate actions to obtain more information before administering the analgesic. Administering the analgesic as requested without a clear description of the pain may not address the client's needs effectively and could potentially lead to ineffective pain management.
3. What is the priority patient problem for the parents of a newborn born with cleft lip and palate?
- A. Parental role conflict
- B. Risk for delayed growth and development
- C. Risk for impaired attachment
- D. Anticipatory grieving
Correct answer: C
Rationale: The correct answer is C: Risk for impaired attachment. Parents of a newborn with cleft lip and palate may face challenges in bonding with their child due to the physical appearance, impacting attachment. Promoting bonding between parents and the infant is crucial in this situation. Choice A (Parental role conflict) is incorrect as it focuses on conflicting roles rather than the attachment issue. Choice B (Risk for delayed growth and development) is not the priority issue in this scenario as the immediate concern is establishing a healthy attachment. Choice D (Anticipatory grieving) is not the priority patient problem as it pertains more to the emotional response to an anticipated loss, which is not the primary concern at this stage.
4. Based on this strip, what is the correct interpretation of this rhythm?
- A. Atrial fibrillation.
- B. Premature atrial fibrillation.
- C. AV block.
- D. Ventricular tachycardia.
Correct answer: A
Rationale: The correct interpretation of the rhythm strip is atrial fibrillation. This arrhythmia is characterized by an irregular heartbeat and the absence of distinct P waves. Choice B, premature atrial fibrillation, is incorrect as there is no indication of premature beats in the strip. Choice C, AV block, is also incorrect as there is no evidence of conduction delays between the atria and ventricles. Choice D, ventricular tachycardia, is not supported by the absence of wide QRS complexes typically seen in this arrhythmia.
5. Based on this strip, what is the interpretation of this rhythm?
- A. Atrial fibrillation.
- B. Ventricular tachycardia.
- C. Normal sinus rhythm.
- D. Second-degree heart block.
Correct answer: C
Rationale: The correct answer is C, Normal sinus rhythm. Normal sinus rhythm is characterized by a regular rhythm, normal P waves, and a consistent PR interval. In this context, the strip likely shows a normal ECG pattern with these characteristics, indicating a healthy heart rhythm. Choices A, B, and D are incorrect. Atrial fibrillation would show an irregularly irregular rhythm with no discernible P waves. Ventricular tachycardia would display wide QRS complexes and a fast heart rate. Second-degree heart block would exhibit intermittent dropped QRS complexes.
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