HESI LPN
HESI Fundamentals Practice Questions
1. The healthcare provider is providing postoperative care to a client who had a submucosal resection (SMR) for a deviated septum. The healthcare provider should monitor for what complication associated with this type of surgery?
- A. Occipital headache
- B. Periorbital crepitus
- C. Expectoration of blood
- D. Changes in vocalization
Correct answer: C
Rationale: Expectoration of blood is a potential complication following SMR surgery, as it may indicate bleeding postoperatively. In contrast, occipital headache (choice A) is not a common complication associated with SMR surgery. Periorbital crepitus (choice B) is more related to facial fractures or certain infections rather than SMR surgery. Changes in vocalization (choice D) are not typically associated with complications following SMR surgery.
2. A client enters the emergency department unconscious via ambulance from the client's workplace. What document should be given priority to guide the direction of care for this client?
- A. The statement of client rights and the client self-determination act
- B. Orders written by the healthcare provider
- C. A notarized original copy of advance directives brought in by the partner
- D. The clinical pathway protocol of the agency and the emergency department
Correct answer: C
Rationale: In the scenario described, when a client arrives unconscious, priority should be given to a notarized original copy of advance directives brought in by the partner. Advance directives are legal documents that specify a person's healthcare wishes and decision-making preferences in advance. These directives guide healthcare providers in delivering care according to the client's preferences when the client is unable to communicate. The statement of client rights and the client self-determination act (Choice A) are important but do not provide specific care instructions. Orders written by the healthcare provider (Choice B) may not reflect the client's wishes. Clinical pathway protocols (Choice D) are valuable but do not address the individualized care preferences of the client.
3. When teaching a client and their family how to care for the client’s tracheostomy at home, which of the following should the nurse include?
- A. Use tracheostomy covers when outdoors
- B. Maintain a sterile technique when performing tracheostomy care
- C. Do not remove the outer cannula for routine cleaning
- D. Clean around the stoma with normal saline solution
Correct answer: A
Rationale: The correct answer is to use tracheostomy covers when outdoors. This practice helps protect the stoma from foreign particles and temperature changes, reducing the risk of infection. Maintaining a sterile technique when performing tracheostomy care (choice B) is important to prevent infections but is not specific to outdoor care. Removing the outer cannula for routine cleaning (choice C) is not recommended as it may cause trauma or dislodgment of the tracheostomy tube. Cleaning around the stoma with povidone-iodine (choice D) is not advisable as it can be irritating to the skin and may impair the healing process.
4. When caring for a client with diarrhea due to shigellosis, what precautions should the nurse implement?
- A. Wear a gown when caring for the client.
- B. Wear gloves only.
- C. Use standard precautions only.
- D. Wear a mask and face shield.
Correct answer: A
Rationale: The correct answer is to wear a gown when caring for the client. Shigellosis is highly contagious, and contact precautions are essential to prevent the spread of infection. Wearing gloves alone may not provide adequate protection as the client's diarrhea can contain infectious pathogens that can easily spread. Standard precautions include hand hygiene, but specific precautions for shigellosis require wearing a gown to protect against contact with infectious material. Wearing a mask and face shield are not necessary for shigellosis, as the primary mode of transmission is through the fecal-oral route, and these precautions are not indicated for this type of transmission.
5. A patient requires repositioning every 2 hours. Which task can the nurse delegate to the nursing assistive personnel?
- A. Determining the level of comfort
- B. Changing the patient's position
- C. Identifying immobility hazards
- D. Assessing circulation
Correct answer: B
Rationale: The correct answer is B: 'Changing the patient's position.' Repositioning the patient involves physically moving and adjusting their position in bed, which is a task that can be safely delegated to nursing assistive personnel (NAP). This task does not require clinical judgment or assessment skills beyond the ability to follow guidelines for proper positioning. Choices A, C, and D involve assessments or judgments that require a higher level of training and knowledge, making them more appropriate for a nurse to perform. Choice A involves assessing comfort, which may involve subjective factors and individual preferences. Choice C involves identifying hazards related to immobility, which requires understanding the potential risks and complications associated with immobility. Choice D involves assessing circulation, which requires a higher level of clinical knowledge and understanding of circulatory issues.
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