HESI LPN
Adult Health 1 Exam 1
1. During a home visit, a nurse finds that an elderly client is having trouble remembering to take their medications. What is the best intervention?
- A. Set up a pill organizer
- B. Involve family members in care
- C. Arrange for a home health aide
- D. Implement all of the above
Correct answer: D
Rationale: The best intervention when an elderly client is having trouble remembering to take their medications is to implement all of the above options. Setting up a pill organizer helps in organizing and remembering medication schedules. Involving family members in care ensures additional support and reminders. Arranging for a home health aide can provide direct assistance and supervision. Implementing all these strategies together can significantly improve medication adherence, especially in clients with memory issues. Each option plays a crucial role in addressing different aspects of the problem, making 'Implement all of the above' the most comprehensive and effective choice.
2. The nurse explains the 2-week dosage prescription of prednisone (Deltasone) to a client who has poison ivy over multiple skin surfaces. What should the nurse emphasize about the dosing schedule?
- A. Decrease the dosage daily as prescribed
- B. Monitor oral temperature daily
- C. Take the prednisone with meals
- D. Return for blood glucose monitoring in one week
Correct answer: A
Rationale: The correct answer is A: 'Decrease the dosage daily as prescribed.' Tapering the dosage of prednisone is crucial to prevent withdrawal symptoms and minimize the side effects of corticosteroid therapy. Decreasing the dosage gradually over time allows the body to adjust and reduces the risk of adrenal insufficiency. Choices B, C, and D are incorrect. Monitoring oral temperature daily, taking prednisone with meals, or returning for blood glucose monitoring in one week are not specific to the dosing schedule of prednisone for poison ivy treatment.
3. What skin care measure should the nurse implement for a client who underwent external radiation treatment the previous day?
- A. Cleanse the radiated area with water and pat the skin dry
- B. Lightly massage the radiated skin with a lanolin-based lotion
- C. Rinse the site with normal saline and cover with a sterile towel
- D. Use a soft washcloth to gently remove the skin markings
Correct answer: A
Rationale: The correct measure for skin care after external radiation treatment is to cleanse the radiated area with water and pat the skin dry. This gentle cleansing without harsh chemicals or friction helps protect the integrity of radiated skin, preventing irritation or further damage. Choice B is incorrect because massaging radiated skin can cause further irritation, which should be avoided. Choice C is incorrect as rinsing with normal saline and covering with a sterile towel may not be necessary and could potentially introduce infection due to excessive moisture. Choice D is incorrect as using a soft washcloth to remove skin markings can be too abrasive for radiated skin, risking damage and irritation.
4. A client presents to the emergency department with symptoms of a myocardial infarction. What should the nurse administer immediately under doctor's orders?
- A. Aspirin to prevent further blood clotting
- B. High-flow oxygen
- C. Intravenous fluids
- D. Nitroglycerin
Correct answer: A
Rationale: The correct answer is A: Aspirin to prevent further blood clotting. Administering aspirin is crucial in the immediate management of a myocardial infarction as it helps prevent further blood clot formation, which is a key component in the treatment and prevention of myocardial infarction. Oxygen therapy (Choice B) is often provided, but aspirin takes precedence due to its role in reducing clot formation. Intravenous fluids (Choice C) may be needed but are not the immediate priority in this situation. Nitroglycerin (Choice D) is commonly used for chest pain relief in myocardial infarction but is not the first medication to be administered in this scenario.
5. A client is admitted to the hospital with a diagnosis of Pneumonia. Which intervention should the nurse implement to prevent complications associated with Pneumonia?
- A. Encourage mobilization and ambulation
- B. Encourage energy conservation with complete bed rest
- C. Provide humidified oxygen via nasal cannula
- D. Restrict oral (PO) and intravenous fluids
Correct answer: A
Rationale: The correct intervention to prevent complications associated with pneumonia is to encourage mobilization and ambulation. These activities help prevent complications such as atelectasis by promoting lung expansion. Encouraging energy conservation with complete bed rest (Choice B) is not ideal as it can lead to complications like muscle weakness and decreased lung expansion. Providing humidified oxygen via nasal cannula (Choice C) is important in pneumonia treatment but does not directly prevent complications associated with pneumonia itself. Restricting oral (PO) and intravenous fluids (Choice D) is not recommended as adequate hydration is crucial for pneumonia patients to maintain respiratory function and overall health.
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