HESI LPN
Medical Surgical Assignment Exam HESI Quizlet
1. What is a priority action for the nurse when caring for a client with suspected meningitis?
- A. Isolate the client in a private room
- B. Administer intravenous antibiotics
- C. Obtain a throat culture
- D. Perform a chest x-ray
Correct answer: B
Rationale: Administering intravenous antibiotics is the priority when caring for a client with suspected meningitis. The prompt administration of antibiotics is crucial to treat bacterial meningitis and prevent potential complications. Isolating the client in a private room may be necessary to prevent the spread of infection, but antibiotic administration takes precedence. Obtaining a throat culture and performing a chest x-ray are important diagnostic measures, but they do not address the immediate need for antibiotic therapy in suspected bacterial meningitis.
2. Parents of a 6-month-old child, who has just been diagnosed with iron deficiency anemia, ask why it was not diagnosed earlier. What would be the best response by the nurse?
- A. Are you sure your child has iron deficiency anemia?
- B. This happens when the maternal stores of iron are depleted at about 6 months.
- C. This anemia is caused by blood loss.
- D. The child may not have had it for a long time.
Correct answer: B
Rationale: The best response by the nurse would be choice B: 'This happens when the maternal stores of iron are depleted at about 6 months.' Iron deficiency anemia becomes apparent at about 6 months of age in a full-term infant when the maternal stores of iron are depleted. Choice A is incorrect because it questions the diagnosis provided by the healthcare provider. Choice C is incorrect because iron deficiency anemia in infants is primarily due to insufficient iron intake rather than blood loss. Choice D is incorrect as iron deficiency anemia typically develops gradually due to inadequate iron intake.
3. How is gastroesophageal reflux (GER) typically treated in infants?
- A. By placing the infant NPO
- B. By thickening the formula or breast milk with cereal
- C. By placing the infant to sleep on the side
- D. By switching the infant to cow's milk
Correct answer: B
Rationale: Gastroesophageal reflux (GER) in infants is typically treated by thickening the formula or breast milk with cereal. This helps reduce reflux episodes by making the feedings heavier and less likely to come back up. Placing the infant NPO (nothing by mouth) is not the typical treatment for GER as infants need proper nutrition for growth. Placing the infant to sleep on the side is not recommended due to the risk of SIDS; infants should be placed on their back to sleep. Switching the infant to cow's milk is also not a treatment for GER, as cow's milk can be harder to digest and may exacerbate symptoms.
4. A client with chronic heart failure is being discharged with a new prescription for furosemide. Which instruction should the nurse include in the discharge teaching?
- A. Increase your intake of potassium-rich foods.
- B. Restrict your fluid intake to 1 liter per day.
- C. Avoid salt substitutes containing potassium.
- D. Weigh yourself once a week.
Correct answer: A
Rationale: The correct answer is to instruct the client to increase their intake of potassium-rich foods. Furosemide is a loop diuretic that can lead to potassium loss due to increased urinary excretion. Potassium-rich foods can help prevent hypokalemia, a potential side effect of furosemide. Restricting fluid intake (choice B) may not be suitable for all patients with heart failure, and a general restriction of 1 liter per day is not typically recommended. Avoiding salt substitutes containing potassium (choice C) is not a priority teaching point in this scenario. Weighing oneself once a week (choice D) is important for monitoring fluid status, but increasing potassium-rich foods is more directly related to the potential side effects of furosemide.
5. A client is admitted to the medical unit during an exacerbation of systemic lupus erythematosus (SLE). It is most important to report which assessment finding to the healthcare provider?
- A. Low-grade fever.
- B. Muscle atrophy.
- C. Hematuria.
- D. Joint pain.
Correct answer: C
Rationale: Hematuria is the most important assessment finding to report to the healthcare provider in a client with SLE during an exacerbation. Hematuria indicates kidney involvement, a serious complication of SLE that requires prompt medical attention. While low-grade fever, muscle atrophy, and joint pain are symptoms that can occur in SLE, hematuria signifies potential renal damage, which is a critical concern in SLE exacerbations.
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