HESI LPN
Medical Surgical Assignment Exam HESI Questions
Question 1 of 5
The nurse prepares a teaching plan for an adult client with metabolic syndrome. Which findings should the nurse address to help the client reduce the risk for diabetes mellitus and vascular disease? (Select all that apply)
Correct Answer: D
Rationale: The correct answer is D, as all the listed factors - abdominal obesity, high blood pressure, and increased triglyceride levels - are components of metabolic syndrome. Addressing these findings is crucial to help reduce the client's risk for developing diabetes mellitus and vascular disease. Abdominal obesity is a key feature of metabolic syndrome, high blood pressure (150/96 mmHg) is a risk factor, and increased triglyceride levels are also indicative of the syndrome. Educating the client on lifestyle modifications, such as healthy eating habits, regular physical activity, and monitoring these parameters, is essential in managing metabolic syndrome and preventing associated complications. Choices A, B, and C are all correct, making choice D the correct answer.
Question 2 of 5
The nurse assesses an adult male client 24 hours following abdominal surgery and finds that his blood pressure is 98/40 mm Hg, he is tachycardic, restless, and irritable. Which action should the nurse take first?
Correct Answer: D
Rationale: In this scenario, the nurse should first check under the client for evidence of bleeding. A blood pressure of 98/40 mm Hg, along with tachycardia, restlessness, and irritability, could indicate internal hemorrhage following abdominal surgery. Checking for bleeding under the back is crucial to rule out this life-threatening complication. Notifying the healthcare provider, ensuring IV infusion, or listening to lung sounds can be important but are secondary to ruling out immediate life-threatening conditions like internal bleeding.
Question 3 of 5
A male client with acquired immune deficiency syndrome (AIDS) and Pneumocystis carinii pneumonia has a CD4+ T cell count of 200 cells/microliter. The client asks the nurse why he keeps getting these massive infections. Which pathophysiologic mechanism should the nurse describe in response to the client's question?
Correct Answer: D
Rationale: The correct answer is D) Inadequate numbers of T lymphocytes are available to initiate cellular immunity and macrophages. In individuals with AIDS and a low CD4+ T cell count, the body's ability to mount an effective immune response is compromised. T lymphocytes play a crucial role in coordinating the immune response by activating other immune cells, such as macrophages, to destroy pathogens. With low T cell counts, the body's ability to fight off infections is severely impaired, leading to recurrent and severe infections like Pneumocystis carinii pneumonia. Option A is incorrect because bone marrow suppression primarily affects the production of white blood cells, not their ability to phagocytize organisms. Option B is incorrect because while exposure to environmental agents can contribute to infections, the primary issue in AIDS is the immune system's failure due to T cell depletion. Option C is incorrect because B cells are involved in the humoral immune response, which is separate from the cellular immune response primarily affected in AIDS. In an educational context, understanding the pathophysiologic mechanisms underlying infections in clients with AIDS is crucial for nurses caring for these individuals. By grasping how T cell depletion impacts the immune response, nurses can provide effective education and support to clients, helping them better manage their condition and prevent complications.
Question 4 of 5
A client with chronic obstructive pulmonary disease (COPD) presented with shortness of breath. Oxygen therapy was started at 2 liters/minute via nasal cannula. The arterial blood gases (ABGs) after treatment were pH 7.36, PaO2 52, PaCO2 59, HCO3 33. Which statement describes the most likely cause of the simultaneous increase in both PaO2 and PaCO2?
Correct Answer: B
Rationale: Oxygen therapy can reduce the hypoxic drive in COPD patients, leading to increased PaCO2 levels while improving oxygenation (PaO2). In this case, the increase in PaO2 and PaCO2 is due to the reduction of the hypoxic drive by the supplemental oxygen. Choice A is incorrect because hyperventilation would lead to decreased PaCO2. Choice C is incorrect as the ABG values do not indicate respiratory alkalosis. Choice D is incorrect as the ABG values do not support metabolic acidosis.
Question 5 of 5
A woman with chronic osteoarthritis is complaining of knee pain. Which pathophysiological process is contributing to her pain?
Correct Answer: C
Rationale: The correct answer is C. In osteoarthritis, the breakdown of cartilage in the joints leads to chondrocyte injury, which results in the destruction of joint cartilage and the production of osteophytes. This process causes joint inflammation and pain. Choice A is incorrect because osteoarthritis primarily involves the articular cartilage rather than the synovial membrane. Choice B is incorrect as it describes the degeneration of cartilage but does not explain the specific pathophysiological process contributing to pain in osteoarthritis. Choice D is incorrect as the formation of uric acid crystals is characteristic of gout, not osteoarthritis.