HESI LPN
Adult Health 2 Final Exam
1. The healthcare professional is developing a care plan for a client with depression. What should be included in the plan?
- A. Regular physical activity
- B. Scheduled sleep patterns
- C. Social interaction with family and friends
- D. All of the above
Correct answer: D
Rationale: A comprehensive care plan for a client with depression should include multiple components to address various aspects of health. Regular physical activity can help improve mood and overall well-being. Scheduled sleep patterns are essential as sleep disturbances are common in depression and can worsen symptoms. Social interaction with family and friends provides emotional support and reduces feelings of isolation. Therefore, including all these aspects in the care plan can help support the client's recovery. Choice D, 'All of the above,' is the correct answer because all the options are important components of a holistic care plan for depression. Choices A, B, and C are incorrect because each of these elements plays a crucial role in managing depression.
2. A client is admitted with a diagnosis of pneumonia. Which intervention should the nurse implement to promote airway clearance?
- A. Administer bronchodilators as prescribed.
- B. Encourage increased fluid intake.
- C. Perform chest physiotherapy.
- D. Provide humidified oxygen.
Correct answer: B
Rationale: Encouraging increased fluid intake is the most appropriate intervention to promote airway clearance in a client with pneumonia. Adequate hydration helps to thin respiratory secretions, making it easier for the client to cough up and clear the airways. Administering bronchodilators (Choice A) may help with bronchospasm but does not directly promote airway clearance. Chest physiotherapy (Choice C) can be beneficial in certain cases but may not be the initial intervention for promoting airway clearance. Providing humidified oxygen (Choice D) can help improve oxygenation but does not specifically target airway clearance in pneumonia.
3. A client is diagnosed with type 1 diabetes mellitus. Which instruction about insulin administration should the nurse emphasize?
- A. Rotate injection sites to prevent tissue damage
- B. Inject insulin into the same site to increase absorption
- C. Only use insulin pens
- D. Mix different types of insulin in the same syringe
Correct answer: C
Rationale: The correct answer is to only use insulin pens. This is because insulin pens provide a convenient and accurate way to administer insulin. Rotating injection sites is important to prevent tissue damage and promote consistent insulin absorption, making choice A incorrect. Injecting insulin into the same site can lead to lipodystrophy and is not recommended, making choice B incorrect. Mixing different types of insulin in the same syringe can alter their action profiles and is generally not recommended, making choice D incorrect.
4. A client with a diagnosis of hypertension is prescribed a thiazide diuretic. Which potential side effect should the nurse monitor for?
- A. Hyperkalemia
- B. Hypernatremia
- C. Hypokalemia
- D. Hypoglycemia
Correct answer: C
Rationale: The correct answer is C: 'Hypokalemia.' Thiazide diuretics commonly cause potassium loss, which can lead to hypokalemia. Monitoring potassium levels is essential when a client is taking thiazide diuretics to prevent complications such as cardiac dysrhythmias. Choices A, B, and D are incorrect. Hyperkalemia (choice A) is an elevated level of potassium, which is not typically associated with thiazide diuretics. Hypernatremia (choice B) is an elevated level of sodium, and hypoglycemia (choice D) is low blood sugar, neither of which are directly linked to thiazide diuretic use.
5. The nurse is changing the colostomy bag for a client who is complaining of leakage of diarrheal stool under the disposable ostomy bag. What action should the nurse implement to prevent leakage?
- A. Place a 4x4 wick in the stoma opening
- B. Apply a layer of zinc oxide ointment to the perimeter of the stoma
- C. Cut the bag opening to the measurement of the stoma size
- D. Administer a PRN antidiarrheal agent
Correct answer: C
Rationale: To prevent leakage of stool under the disposable ostomy bag, the nurse should cut the bag opening to the measurement of the stoma size. This action ensures a proper fit, which is crucial in preventing leaks that can lead to skin irritation and compromise stoma care. Placing a 4x4 wick in the stoma opening or applying zinc oxide ointment may not address the issue of leakage effectively. Administering a PRN antidiarrheal agent is not directly related to preventing leakage caused by an ill-fitting ostomy bag.
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