HESI LPN
Adult Health 1 Final Exam Questions
Question 1 of 5
What intervention should the nurse implement for a client experiencing an anxiety attack?
Correct Answer: C
Rationale: Administering prescribed anxiolytic medication is the most appropriate intervention for a client experiencing an anxiety attack. Anxiolytic medications can provide rapid relief from severe anxiety symptoms. Teaching deep breathing exercises (choice
A) can be helpful for managing mild anxiety but may not be sufficient during an acute anxiety attack. Providing a quiet environment (choice
B) is beneficial to reduce stimuli, but it may not address the immediate distress of an ongoing anxiety attack. Engaging the client in conversation (choice
D) is generally not recommended during an anxiety attack as it can potentially exacerbate the symptoms by increasing stimulation.
Question 2 of 5
The nurse is caring for a client with a tracheostomy who is on mechanical ventilation. What is the priority nursing intervention?
Correct Answer: A
Rationale: The priority nursing intervention for a client with a tracheostomy on mechanical ventilation is to suction the tracheostomy as needed. Suctioning is essential to maintain a clear airway and prevent respiratory distress. While ensuring tracheostomy ties are secure (choice
B) is important, it is not as urgent as airway maintenance. Providing humidified oxygen (choice
C) is beneficial but does not address the immediate need for airway clearance. Cleaning exudate around the tracheostomy site (choice
D) is important for hygiene but takes precedence over ensuring airway patency through suctioning.
Question 3 of 5
The nurse observes that a post-operative client's surgical wound has reddened edges and is oozing. What is the appropriate nursing action?
Correct Answer: D
Rationale: The correct action when a post-operative client's surgical wound has reddened edges and is oozing is to notify the surgeon immediately. Reddened, oozing wound edges can indicate an infection that requires prompt evaluation and intervention by the surgical team. Applying an antibiotic ointment (
Choice
A) without proper assessment and guidance can be inappropriate. Cleaning the wound with sterile saline (
Choice
B) and covering it with a sterile dressing (
Choice
C) may not address the potential infection adequately, and the client may require more specialized care that the surgeon can provide.
Question 4 of 5
The nurse is caring for a client with Myasthenia Gravis. What time of day is best for the nurse to schedule physical exercises with the physical therapy department?
Correct Answer: B
Rationale: Scheduling physical exercises after breakfast is the optimal choice for a client with Myasthenia Gravis. This timing allows the client to benefit from renewed energy levels after overnight rest and intake of morning nourishment, enhancing the effectiveness of the therapy session.
Choices A (Before bedtime, at 2000) is not suitable as energy levels are likely lower at night, affecting the client's ability to engage effectively in physical exercises.
Choices C (Before the evening meal) and D (After lunch) may not be ideal as the client may experience fatigue or weakness later in the day, making it harder to participate actively in therapy.
Question 5 of 5
What is the priority nursing action during the immediate postoperative period for a client who just underwent a coronary artery bypass graft?
Correct Answer: D
Rationale: Maintaining a patent airway is the priority nursing action during the immediate postoperative period for a client who just underwent a coronary artery bypass graft. This is crucial to ensure adequate oxygenation, especially in the early recovery phase. Monitoring for signs of infection, ensuring the client is pain-free, and assessing for bleeding and arrhythmias are important aspects of postoperative care but maintaining a clear airway takes precedence in this scenario to prevent hypoxia and respiratory compromise. In the immediate postoperative period, maintaining a patent airway is essential to prevent complications such as airway obstruction, hypoxia, and respiratory distress, which are critical in ensuring the client's safety and recovery.