Fundamentals HESI

Fundamentals HESI Related

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When ethical dilemmas arise, what should newly licensed nurses expect and identify as an ethical dilemma?

  • A. A nurse on a medical-surgical unit demonstrates signs of chemical impairment.
  • B. A nurse overhears another nurse telling an older adult client that if he doesn't stay in bed, she will have to apply restraints.
  • C. A family has conflicting feelings about the initiation of enteral tube feedings for their father, who is terminally ill.
  • D. A client who is terminally ill hesitates to name their partner on their durable power of attorney form.
Correct Answer: C

Rationale: An ethical dilemma involves a situation where there are conflicting values or principles that make it difficult to make a clear decision. In the given scenarios, option C best represents an ethical dilemma as the family has conflicting feelings about initiating enteral tube feedings for their terminally ill father. This situation presents a clash between different values and beliefs, making it challenging to reach a resolution. Options A, B, and D do not illustrate conflicting values or principles that characterize an ethical dilemma. Option A describes a nurse's impairment, which is a concern but not a direct ethical dilemma. Option B depicts a potential breach of client autonomy and restraint use, which is an ethical issue but not a true ethical dilemma. Option D involves a client's personal decision regarding a durable power of attorney form, which, although important, does not present conflicting values or principles that define an ethical dilemma.

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In a client with liver cirrhosis, which symptom would be most concerning during assessment?

  • A. Jaundice
  • B. Ascites
  • C. Hepatomegaly
  • D. Altered mental status
Correct Answer: D

Rationale: Altered mental status would be the most concerning symptom in a client with liver cirrhosis. It may indicate hepatic encephalopathy, a serious complication requiring immediate intervention. While jaundice, ascites, and hepatomegaly are common in liver cirrhosis, they do not directly correlate with the urgency and severity of hepatic encephalopathy as altered mental status does. Therefore, altered mental status takes priority for immediate attention and intervention.

During a blood transfusion, which observation indicates that the client is experiencing a transfusion reaction?

  • A. The client reports feeling warm and flushed.
  • B. The client develops a rash on the chest and back.
  • C. The client experiences chills and a fever.
  • D. The client complains of back pain and shortness of breath.
Correct Answer: D

Rationale: Complaints of back pain and shortness of breath are classic signs of a transfusion reaction, specifically indicating a hemolytic reaction. This reaction can lead to the release of hemoglobin into the bloodstream, causing back pain and shortness of breath due to clot formation in the blood vessels, leading to decreased oxygen delivery. Warmth, flushing, rash, chills, and fever are more commonly associated with allergic reactions or febrile non-hemolytic reactions during transfusions. Therefore, options A, B, and C are incorrect in this context.

A client has a sodium level of 125. What findings should the nurse expect?

  • A. Abdominal cramping
  • B. Elevated blood pressure
  • C. Decreased heart rate
  • D. Increased thirst
Correct Answer: A

Rationale: Low sodium levels (hyponatremia) often present with various symptoms, including abdominal cramping. Abdominal cramping is a common manifestation of hyponatremia due to the altered electrolyte balance. Option B ('Elevated blood pressure') is incorrect because low sodium levels typically lead to decreased blood pressure, not elevated. Option C ('Decreased heart rate') is incorrect as low sodium levels are more likely to cause an irregular heart rate rather than a decreased heart rate. Option D ('Increased thirst') is incorrect because excessive thirst is more commonly associated with high sodium levels (hypernatremia) rather than low sodium levels.

To ensure the safety of a client receiving a continuous intravenous normal saline infusion, how often should the LPN change the administration set?

  • A. Every 4 to 8 hours
  • B. Every 12 to 24 hours
  • C. Every 24 to 48 hours
  • D. Every 72 to 96 hours
Correct Answer: D

Rationale: The correct answer is to change the administration set every 72 to 96 hours. This practice helps reduce the risk of infection by preventing the build-up of bacteria in the tubing. Changing the set too frequently (choices A, B, and C) may increase the chances of contamination and infection without providing additional benefits. Therefore, the LPN should follow the guideline of changing the administration set every 72 to 96 hours to maintain the client's safety during the continuous intravenous normal saline infusion.

A nurse in a provider's office is obtaining the health and medication history of a client who has a respiratory infection. The client tells the nurse that she is not aware of any allergies, but that she did develop a rash the last time she was taking an antibiotic. Which of the following information should the nurse give to the client?

  • A. We need to document the exact medication you were taking because you might be allergic to it.
  • B. You should take a different type of antibiotic this time.
  • C. A rash is a common reaction and is not usually concerning.
  • D. You can take the same antibiotic again if needed.
Correct Answer: A

Rationale: The nurse should advise the client to document the exact medication taken to identify potential allergies and prevent adverse reactions. This is important as the client developed a rash previously while taking an antibiotic, indicating a possible allergic reaction. Choice B is not appropriate as switching antibiotics without proper evaluation can be risky. Choice C is incorrect as rashes should not be dismissed without further investigation, especially in the context of taking medication. Choice D is also not recommended as re-taking the same antibiotic without clarifying the allergic reaction can lead to a potentially severe outcome.

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