HESI LPN
HESI PN Exit Exam
1. Which of the following is a common side effect of opioid analgesics that the nurse should monitor for in patients?
- A. Diarrhea
- B. Hypertension
- C. Constipation
- D. Bradycardia
Correct answer: C
Rationale: Constipation is a common side effect of opioid analgesics due to the slowing of gastrointestinal motility. Opioids bind to receptors in the gastrointestinal tract, leading to decreased peristalsis and increased water absorption, resulting in constipation. Monitoring for constipation is crucial to prevent discomfort or complications like bowel obstruction. Diarrhea (Choice A) is not a common side effect of opioid analgesics. Hypertension (Choice B) and Bradycardia (Choice D) are not typically associated with opioid use.
2. What is the primary role of the sinoatrial (SA) node in the heart?
- A. Pacemaker of the heart
- B. Blood pressure regulation
- C. Electrical conduction delay
- D. Stimulating muscle contraction
Correct answer: A
Rationale: The correct answer is A: Pacemaker of the heart. The SA node, known as the natural pacemaker, initiates the electrical impulses that set the rhythm for the heartbeat. It is responsible for coordinating the heart's contractions by generating electrical signals at regular intervals. Choice B is incorrect as the SA node's primary function is not related to blood pressure regulation. Choice C is incorrect as the SA node does not cause electrical conduction delay but rather initiates and conducts the electrical impulses. Choice D is incorrect as the SA node does not directly stimulate muscle contraction but rather initiates the electrical events that lead to muscle contraction.
3. The nurse observes a UAP performing oral hygiene on an unconscious client who is lying in a flat side-lying position with an emesis basin on a towel under the chin. Which action should the nurse take?
- A. Stop the procedure and tell the UAP to place the client in a Fowler's position
- B. Praise the UAP for doing the oral hygiene but encourage family participation
- C. Tell the UAP to continue because the unconscious client is positioned safely
- D. Enroll the UAP in a hospital education class on conducting safe client care
Correct answer: C
Rationale: The correct answer is to tell the UAP to continue because the unconscious client is positioned safely for oral care. Placing an unconscious client in a side-lying position helps prevent aspiration, and having an emesis basin under the chin is appropriate to catch any fluids. Therefore, the nurse should acknowledge that the UAP is performing the procedure correctly. Choices A, B, and D are incorrect. Placing the client in a Fowler's position is not necessary for this procedure as the client is already positioned safely. Praise and encouragement for family participation are important aspects but not the immediate action needed in this scenario. Enrolling the UAP in a hospital education class is not warranted as the current procedure is being performed correctly.
4. Rehabilitation after illness is classified under which level of healthcare?
- A. Primary
- B. Secondary
- C. Tertiary
- D. All three
Correct answer: C
Rationale: Rehabilitation after illness is classified as tertiary care. Tertiary care aims to help patients recover from illness, injuries, or disabilities, and restore their functionality. Primary care involves preventive measures and early disease detection, while secondary care focuses on diagnosis and treatment of specific conditions. Therefore, choices A, B, and D are incorrect as they do not specifically address the specialized nature of rehabilitation in healthcare.
5. A client who had an abdominal hysterectomy is experiencing minimal urine output despite adequate fluid intake. What should the nurse assess first?
- A. The client's bladder for distension.
- B. The IV catheter insertion site.
- C. The patency of the urinary catheter.
- D. The client's vital signs.
Correct answer: C
Rationale: Assessing the patency of the urinary catheter is crucial in this situation. A blocked catheter could be a common cause of decreased urine output following surgery. While checking the IV catheter insertion site (Choice B) is important, it is not the priority in this case. Examining the client's bladder for distension (Choice A) is relevant, but assessing the patency of the catheter takes precedence in resolving the issue of decreased urine output. Monitoring vital signs (Choice D) is a routine nursing task but not the priority when dealing with decreased urine output post-surgery.
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