HESI LPN
Medical Surgical HESI 2023
1. The parents of a child suffering from depression ask the nurse what causes depression in children. Which answer is an appropriate response by the nurse?
- A. The causes of major depression are unknown.
- B. Major affective disorders in parents increase depression in children.
- C. Boys are more likely than girls to be depressed.
- D. The prevalence rate is higher in prepubescent children.
Correct answer: B
Rationale: The correct answer is B because while the exact causes of depression in children are not fully understood, research indicates that children are more likely to experience depression if their parents have a major affective disorder. Choice A is incorrect because it suggests that the causes of major depression are entirely unknown, which is not accurate. Choice C is incorrect as there is no conclusive evidence that boys are more likely than girls to be depressed. Choice D is incorrect as the prevalence rate of depression is not necessarily higher in prepubescent children specifically.
2. After a CT scan with intravenous contrast medium, a client returns to the room complaining of shortness of breath and itching. Which intervention should the nurse implement?
- A. Call respiratory therapy to administer a breathing treatment.
- B. Send for an emergency tracheostomy set.
- C. Prepare a dose of epinephrine.
- D. Review the client's complete list of allergies.
Correct answer: C
Rationale: Preparing a dose of epinephrine is the correct intervention in this situation as the client is displaying symptoms of an anaphylactic reaction to the contrast medium used during the CT scan. Epinephrine is the first-line treatment for anaphylaxis due to its ability to reverse the symptoms rapidly. Calling respiratory therapy for a breathing treatment (Choice A) may not address the underlying allergic reaction and delay appropriate treatment. Sending for an emergency tracheostomy set (Choice B) is not indicated as the client's symptoms suggest an allergic reaction rather than airway obstruction. Reviewing the client's complete list of allergies (Choice D) is important but would not provide immediate relief for the client's current symptoms; administering epinephrine takes precedence in this situation.
3. Methotrexate is prescribed for a client with rheumatoid arthritis (RA) who is also taking aspirin. What is the best explanation for the nurse to provide as to why a second medication has been added?
- A. Methotrexate slows the disease progression while aspirin controls the symptoms.
- B. Methotrexate helps to reduce the side effects of aspirin.
- C. Methotrexate has fewer harmful side effects than aspirin.
- D. Methotrexate enhances the effect of aspirin.
Correct answer: A
Rationale: The correct answer is A. Methotrexate is a disease-modifying antirheumatic drug (DMARD) that slows the progression of rheumatoid arthritis (RA), while aspirin helps control symptoms such as pain and inflammation. Therefore, the combination of methotrexate and aspirin is beneficial in managing RA by addressing both disease progression and symptom control. Choices B, C, and D are incorrect because methotrexate is not added to reduce the side effects of aspirin, has different side effects compared to aspirin, and does not enhance the effect of aspirin.
4. A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?
- A. Osmolarity
- B. Glucose
- C. Albumin
- D. Platelets
Correct answer: B
Rationale: The correct answer is B: Glucose. Hydrocortisone can lead to increased blood glucose levels, so monitoring glucose is crucial to assess for hyperglycemia, a common side effect of corticosteroid therapy. Monitoring osmolarity (choice A) is not typically indicated in this scenario. Albumin (choice C) and platelets (choice D) are not directly affected by hydrocortisone therapy and are not the primary focus of monitoring in this case.
5. Which intervention should the nurse include in the plan of care for a client who has a chest tube due to hemothorax?
- A. Keep the arm and shoulder of the affected side immobile at all times.
- B. Encourage the client to breathe deeply and cough at frequent intervals.
- C. Maintain the pleura vac slightly above the chest level.
- D. Ensure there is no fluctuation in the water seal.
Correct answer: B
Rationale: Encouraging deep breathing and coughing is vital for a client with a chest tube due to hemothorax as it helps prevent atelectasis and promotes lung expansion. Keeping the arm and shoulder immobile (Choice A) is not necessary for chest tube management. Maintaining the pleura vac slightly above the chest level (Choice C) is incorrect as the pleura vac should be kept below the chest level to facilitate drainage. Ensuring no fluctuation in the water seal (Choice D) is important, but it is not the priority intervention when compared to promoting lung expansion through deep breathing and coughing.
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