HESI LPN
Adult Health 2 Exam 1
1. What is the primary function of neutrophils?
- A. Heparin secretion
- B. Transport oxygen
- C. Phagocytotic action
- D. Antibody formation
Correct answer: C
Rationale: The correct answer is C: Phagocytotic action. Neutrophils are key components of the immune system, primarily involved in the phagocytosis of bacteria and other pathogens. Choice A, Heparin secretion, is incorrect as heparin is primarily secreted by mast cells and basophils. Choice B, Transport oxygen, is incorrect as this is mainly the function of red blood cells. Choice D, Antibody formation, is incorrect as antibody production is primarily carried out by B lymphocytes.
2. The nurse is preparing a client for discharge after a major surgical procedure. What is the priority instruction to include in the discharge teaching?
- A. Signs of infection to monitor for
- B. Pain management techniques
- C. Activity restrictions and safety measures
- D. All of the above
Correct answer: D
Rationale: The correct answer is D: All of the above. Providing comprehensive discharge instructions covering signs of infection to monitor for, pain management techniques, activity restrictions, and safety measures is crucial after a major surgical procedure. Each of these components plays a vital role in the client's recovery and well-being. It is important for the client to understand how to identify signs of infection, manage pain effectively, and adhere to activity restrictions to prevent complications and ensure a smooth recovery process. While each instruction is important on its own, combining all aspects into the discharge teaching ensures that the client has a holistic understanding of their post-operative care, empowering them to take charge of their health and know when to seek further assistance if needed. Choices A, B, and C are essential components of discharge teaching and should all be included to provide the client with comprehensive care instructions.
3. A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which dietary instruction should the nurse provide?
- A. Increase intake of green leafy vegetables
- B. Avoid foods high in vitamin K
- C. Increase intake of foods rich in vitamin C
- D. Limit intake of dairy products
Correct answer: B
Rationale: The correct answer is B: 'Avoid foods high in vitamin K.' Vitamin K can decrease the effectiveness of warfarin, so it is essential for clients on warfarin therapy to avoid foods high in vitamin K. Green leafy vegetables are high in vitamin K, so choice A is incorrect. Choices C and D are unrelated to the dietary restrictions needed for clients taking warfarin and are therefore incorrect.
4. The nurse is with a client when the healthcare provider explains that the biopsy classifies the results as a T1N0M0 tumor. What response should the nurse provide first?
- A. The letters represent tumor size, node involvement, and metastasis in cancer staging.
- B. The letters stand for tumor size, node involvement, and metastasis.
- C. Let me explain the cancer staging to you.
- D. Would you like further clarification on the tumor staging?
Correct answer: B
Rationale: Choice B is the correct answer as it accurately explains that the letters T, N, and M in cancer staging represent tumor size, node involvement, and metastasis, respectively. Understanding this staging system helps the client comprehend the extent and severity of the disease. Choices A, C, and D are incorrect. Choice A has the correct information but is not the most precise response. Choice C is vague and does not directly address the client's need for clarification. Choice D offers further clarification without directly addressing the initial explanation provided by the healthcare provider.
5. A client begins taking an antidepressant drug during the second day of hospitalization. Which assessment is most important for the nurse to include in this client's plan of care while the client is taking the antidepressant?
- A. Appetite
- B. Mood
- C. Withdrawal
- D. Energy level
Correct answer: B
Rationale: Corrected Rationale: Monitoring the client's mood is essential when starting an antidepressant to assess for any changes or adverse effects related to the medication. Changes in mood can indicate the effectiveness of the antidepressant or potential side effects. Assessing appetite (Choice A) is important but not as crucial as monitoring mood in this context. Withdrawal symptoms (Choice C) are more relevant when discontinuing antidepressants rather than starting them. Energy level (Choice D) can be influenced by various factors and may not directly reflect the client's response to the antidepressant.
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