HESI LPN
HESI Fundamentals Test Bank
1. When obtaining a urine specimen for a culture and sensitivity from an indwelling catheter, the nurse should:
- A. Cleanse the entry port prior to withdrawing urine.
- B. Use a sterile syringe to collect urine from the collection bag.
- C. Obtain the specimen from the drainage tubing.
- D. Replace the catheter before obtaining the specimen.
Correct answer: A
Rationale: The correct procedure when obtaining a urine specimen from an indwelling catheter for culture and sensitivity is to cleanse the entry port before withdrawing urine. This step helps reduce the risk of contamination and ensures the accuracy of the results. Option B is incorrect because using a sterile syringe to collect urine from the collection bag is not the recommended method for obtaining a catheter specimen. Option C is incorrect as obtaining the specimen from the drainage tubing is not the appropriate technique for collecting a urine sample from an indwelling catheter. Option D is incorrect because replacing the catheter before obtaining the specimen is not necessary and may introduce unnecessary complications.
2. Nurse talking with a client’s partner. She is having frustrations about managing responsibilities and care. What type of role performance stress is this?
- A. Role overload
- B. Role conflict
- C. Role ambiguity
- D. Role strain
Correct answer: A
Rationale: Role overload occurs when a person feels overwhelmed by the demands placed upon them.
3. A client with a history of heart failure presents with increased shortness of breath and swelling in the legs. What is the most important assessment for the LPN/LVN to perform?
- A. Monitor the client's oxygen saturation level.
- B. Assess the client's apical pulse.
- C. Check for jugular vein distention.
- D. Measure the client's urine output.
Correct answer: C
Rationale: Checking for jugular vein distention is crucial in assessing fluid overload in clients with heart failure. Jugular vein distention indicates increased central venous pressure, which can be a sign of worsening heart failure. Monitoring oxygen saturation (Choice A) is important but may not provide immediate information on fluid status. Assessing the apical pulse (Choice B) is relevant for monitoring heart rate but may not directly indicate fluid overload. Measuring urine output (Choice D) is essential for assessing renal function and fluid balance but does not provide immediate information on fluid overload in this scenario.
4. A nurse is in a public building when someone cries out, 'Help! I think he is having a heart attack!' The nurse responds to the scene and finds the unconscious adult lying on the floor. Another bystander has obtained an AED. The nurse's first action, after ensuring someone has called for EMS, should be to:
- A. Administer cardiac compressions
- B. Attach the AED pads to the client
- C. Check for a pulse
- D. Perform rescue breaths
Correct answer: A
Rationale: In a scenario where a person is unconscious and there is an indication of a possible heart attack, the immediate priority for the nurse should be to administer cardiac compressions. This action helps maintain circulation and ensures oxygenated blood reaches vital organs until the AED is available. Checking for a pulse or performing rescue breaths may delay essential circulation support, and attaching AED pads should follow the initial step of administering compressions to maximize the chances of a successful resuscitation.
5. A client is admitted with acute pyelonephritis. Which symptom should the nurse expect the client to report?
- A. Flank pain
- B. Pedal edema
- C. Hypotension
- D. Weight gain
Correct answer: A
Rationale: Flank pain is a classic symptom of acute pyelonephritis, which is a bacterial infection of the kidney. It occurs due to inflammation and irritation of the renal capsule, leading to pain in the flank region. Pedal edema (swelling in the feet and ankles) is more commonly associated with conditions like heart failure or kidney disease, not typically seen in acute pyelonephritis. Hypotension (low blood pressure) is a systemic symptom that may occur with severe infections but is not a specific hallmark of pyelonephritis. Weight gain is also not a typical symptom of acute pyelonephritis; instead, patients may experience weight loss due to decreased appetite and systemic effects of infection.
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