HESI LPN
HESI Fundamental Practice Exam
1. A healthcare professional is preparing to administer dextrose 5% in water (D5W) 1,000-mL IV to infuse over 10 hr. How many mL/hr should the IV infusion pump be set to deliver? (Round the answer to the nearest whole number. Do not use a trailing zero.)
- A. 100 mL/hr
- B. 150 mL/hr
- C. 75 mL/hr
- D. 50 mL/hr
Correct answer: A
Rationale: To infuse 1,000 mL over 10 hr, the IV pump should be set to deliver 100 mL/hr. This calculation is derived by dividing the total volume (1,000 mL) by the total time in hours (10 hr), resulting in the infusion rate of 100 mL/hr. Choices B, C, and D are incorrect as they do not accurately reflect the correct calculation for this scenario.
2. At a mobile screening clinic, a nurse is assessing a client who reports a history of a heart murmur due to aortic stenosis. To auscultate the aortic valve, where should the nurse place the stethoscope?
- A. Second intercostal space to the right of the sternum
- B. Fifth intercostal space to the left of the sternum
- C. Third intercostal space to the left of the sternum
- D. Fourth intercostal space at the midclavicular line
Correct answer: A
Rationale: The correct location to auscultate the aortic valve is the second intercostal space to the right of the sternum. This area corresponds to the aortic valve area where aortic valve sounds are best heard. Choices B, C, and D are incorrect for auscultating the aortic valve. The fifth intercostal space to the left of the sternum is where the mitral valve is best heard, the third intercostal space to the left of the sternum is where the pulmonic valve is best heard, and the fourth intercostal space at the midclavicular line is where the tricuspid valve is best auscultated.
3. When transferring a postoperative client from the PACU following abdominal surgery, what action should the nurse take to move the client from the stretcher to the bed?
- A. Lock the wheels on both the bed and stretcher
- B. Adjust the bed to a low position
- C. Ask the client to assist in the transfer
- D. Use a transfer sheet without locking the wheels
Correct answer: A
Rationale: Locking the wheels on both the bed and stretcher is crucial for ensuring stability during the transfer process. This action is essential to prevent unexpected movement of the bed or stretcher, reducing the risk of injury to the client and facilitating a safe transfer. Adjusting the bed to a low position is important for the client's comfort and safety but does not directly address the immediate need for stability during the transfer. Asking the client to assist in the transfer may not be feasible immediately postoperatively, depending on their condition and the type of surgery they underwent. Using a transfer sheet without locking the wheels can introduce potential safety hazards as the bed or stretcher may move during the transfer, undermining the stability needed for a safe and effective transfer.
4. A client who is confused and pulling at the tubing of her IV is being cared for by a nurse. Which of the following actions should the nurse take before requesting a prescription for restraints from the provider?
- A. Place the client in a room away from the nurses’ station.
- B. Limit the client’s visitors.
- C. Give the client washcloths to fold.
- D. Close the door of the client’s room.
Correct answer: C
Rationale: Providing the client with washcloths to fold is a non-restrictive intervention that can help distract and engage the client, potentially reducing the need for restraints. This action promotes a therapeutic and calming environment for the confused client. Placing the client in a room away from the nurses’ station (Choice A) may not address the underlying issue of confusion and agitation. Limiting the client’s visitors (Choice B) may not directly assist in managing the client's behavior. Closing the door of the client’s room (Choice D) does not actively engage the client in a therapeutic intervention to address the behavior.
5. During a dressing change, a healthcare professional observes granulation tissue in a client's wound. Which of the following findings should be documented?
- A. Stringy, white tissue
- B. Translucent, red tissue
- C. Soft, yellow tissue
- D. Thick, black tissue
Correct answer: B
Rationale: Granulation tissue is a hallmark of healing in wounds. It appears as translucent and red, indicating angiogenesis and the formation of new blood vessels in the wound bed. This tissue is vital for wound healing as it provides a scaffold for cell migration and promotes re-epithelialization. Choices A, C, and D do not describe granulation tissue accurately. Stringy, white tissue may suggest fibrin, soft, yellow tissue could indicate slough, and thick, black tissue may imply necrotic tissue, all of which are not synonymous with granulation tissue and do not signify the healing process.
Similar Questions
Access More Features
HESI LPN Basic
$69.99/ 30 days
- 50,000 Questions with answers
- All HESI courses Coverage
- 30 days access @ $69.99
HESI LPN Premium
$149.99/ 90 days
- 50,000 Questions with answers
- All HESI courses Coverage
- 30 days access @ $149.99