HESI LPN
HESI CAT Exam 2022
1. A premature infant weighing 1,200 grams at birth receives a prescription for beractant (Survanta) 120 mg endotracheal now and q6 hr for 24 hr. The recommended dose for beractant is 100 mg/kg birth weight per dose. Single-use vials of Survanta are labeled 100 mg/4 ml. What action should the nurse take?
- A. Give 4.8 ml q6 hr
- B. Notify the healthcare provider that the dose is too high
- C. Notify the healthcare provider that the dose is too low
- D. Give 1.2 ml q6 hr
Correct answer: A
Rationale: The correct answer is to give 4.8 ml q6 hr. To calculate the dose, you divide the prescribed dose of 120 mg by the concentration of Survanta, which is 100 mg per 4 ml. This results in 4.8 ml per dose, as 120 mg ÷ 100 mg/4 ml = 4.8 ml. Option B suggesting to notify the healthcare provider that the dose is too high is incorrect because the calculated dose of 4.8 ml is based on the recommended dose of 100 mg/kg birth weight. Option C suggesting to notify the healthcare provider that the dose is too low is incorrect as the calculated dose is based on the correct dosage calculation. Option D suggesting to give 1.2 ml q6 hr is incorrect because it doesn't align with the correct calculation.
2. The healthcare provider receives a report on four clients who are complaining of increased pain. Which client requires immediate attention by the healthcare provider?
- A. Burning pain due to a Morton’s neuroma
- B. Sharp pain related to a crushed femur
- C. Paresthesia of fingers due to carpal tunnel syndrome
- D. Stinging pain related to plantar fasciitis
Correct answer: B
Rationale: Sharp pain related to a crushed femur indicates a severe condition and potential serious complications that require immediate attention. Crushed femur can lead to severe bleeding, nerve damage, or compartment syndrome, which are critical and life-threatening. The other choices, although painful, are less likely to present immediate life-threatening issues. Morton’s neuroma, carpal tunnel syndrome, and plantar fasciitis are painful conditions but are not typically associated with urgent, life-threatening complications like a crushed femur.
3. The nurse administers an oral antiviral to a client with shingles. Which finding is most important for the nurse to report to the healthcare provider?
- A. Decreased white blood cell count
- B. Pruritus and muscle aches
- C. Elevated liver function tests
- D. Vomiting and diarrhea
Correct answer: C
Rationale: The correct answer is C: Elevated liver function tests. When administering antivirals, especially orally, monitoring liver function tests is crucial as it may indicate liver toxicity. This finding should be reported promptly to the healthcare provider to prevent further complications. Choice A, decreased white blood cell count, may be expected with certain antivirals but is not the most critical finding in this scenario. Pruritus and muscle aches (choice B) are common side effects of antivirals and do not require immediate reporting. Vomiting and diarrhea (choice D) are also common side effects that may not be as concerning as elevated liver function tests.
4. A postpartum client who is bottle feeding develops breast engorgement. What is the best recommendation for the nurse to provide this client?
- A. Take a prescribed analgesic and expose breasts to air
- B. Place warm packs on both breasts
- C. Avoid stimulation of the breasts and wear a tight bra
- D. Express a small amount of breast milk by hand
Correct answer: C
Rationale: For a postpartum client who is bottle feeding and develops breast engorgement, the best recommendation is to avoid stimulation of the breasts and wear a tight bra. This helps reduce engorgement by decreasing blood flow to the breasts. Option A is incorrect because exposing the breasts to air can further stimulate them, worsening engorgement. Option B is incorrect as warm packs can increase blood flow and exacerbate engorgement. Option D is incorrect as expressing breast milk can lead to further stimulation and increased engorgement.
5. A newly hired unlicensed assistive personnel (UAP) is assigned to a home healthcare team along with two experienced UAPs. Which intervention should the home health nurse implement to ensure adequate care for all clients?
- A. Ask the most experienced UAP on the team to partner with the newly hired UAP.
- B. Evaluate the newly hired UAP’s level of competency by observing the UAP deliver care.
- C. Review the UAP’s skills checklist and experience with the person who hired the UAP.
- D. Assign the newly hired UAP to clients who require the least complex level of care.
Correct answer: B
Rationale: Evaluating the newly hired UAP’s competency by observing them deliver care is the most effective intervention to ensure they can provide safe and effective care. This approach directly assesses the UAP's actual performance and allows for immediate feedback. Option A, asking the most experienced UAP to partner with the newly hired one, may not guarantee that the new UAP is competent. Option C, reviewing the UAP’s skills checklist and experience with the hiring person, does not provide a direct assessment of the UAP's current abilities. Option D, assigning the new UAP to less complex cases, does not address the need to evaluate their competency directly.
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