HESI LPN
HESI PN Exit Exam
1. The home health PN suspects elder abuse after observing fresh lacerations on the arms and legs of an older adult male client who lives with his daughter. Which action is most important for the PN to take?
- A. Document the lacerations in the client's record
- B. Report findings to the supervisor for referral to adult protective services
- C. Ask the daughter who has been taking care of the client on a daily basis
- D. Apply dry dressings after cleansing the wounds
Correct answer: B
Rationale: The most important action for the PN to take in this situation is to report the findings to the supervisor for referral to adult protective services. Suspected elder abuse must be reported promptly to ensure the safety and protection of the client. Documenting the lacerations in the client's record is important but not as critical as reporting the suspected abuse. Asking the daughter who is the potential abuser may not yield accurate information and could compromise the safety of the client. Applying dressings to the wounds is a lower priority compared to addressing the suspected elder abuse.
2. What is the primary function of surfactant in the lungs?
- A. Reduce surface tension
- B. Enhance oxygen absorption
- C. Facilitate carbon dioxide release
- D. Increase lung volume
Correct answer: A
Rationale: The primary function of surfactant in the lungs is to reduce surface tension in the alveoli. This reduction in surface tension prevents lung collapse and allows for easier breathing. It is particularly crucial in premature infants to help with lung expansion. Choice B is incorrect because surfactant primarily affects surface tension, not oxygen absorption. Choice C is incorrect because surfactant's main role is not in facilitating carbon dioxide release. Choice D is incorrect because surfactant does not directly increase lung volume; its main role is in reducing surface tension.
3. 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.
4. Which action should the PN implement when using standard precautions to provide client care?
- A. Apply sterile gloves to obtain a finger stick blood sample
- B. Wear clean exam gloves to perform perineal catheter care
- C. Replace the needle cap after giving an intramuscular injection
- D. Wear a paper gown to prevent transmission of droplet pathogens
Correct answer: B
Rationale: The correct answer is B. When using standard precautions, healthcare providers should wear clean exam gloves to perform perineal catheter care. This approach helps prevent the transmission of pathogens and ensures the safety of both the client and the healthcare provider. Choice A is incorrect because applying sterile gloves for a finger stick blood sample is unnecessary when non-sterile gloves would suffice. Choice C is incorrect because replacing the needle cap after giving an intramuscular injection is not directly related to standard precautions. Choice D is incorrect because wearing a paper gown is not a standard precaution for preventing the transmission of droplet pathogens.
5. When preparing a sterile field for a procedure, which action should the nurse take to maintain sterility?
- A. Place sterile items around the sterile field
- B. Keep hands below waist level to avoid contamination
- C. Open the sterile package away from the body
- D. Avoid reaching over the sterile field
Correct answer: D
Rationale: To maintain sterility when preparing a sterile field, it is essential to avoid reaching over the sterile field. This action can introduce contaminants from the nurse's clothing or unsterile areas, compromising the sterility of the field. Placing sterile items around the sterile field (choice A) is incorrect as it may increase the risk of contamination by extending the area where non-sterile items may come in contact. Keeping hands below waist level (choice B) is also incorrect as it does not prevent contamination effectively. Opening the sterile package away from the body (choice C) is incorrect since it exposes the contents to the nurse's body, which is not sterile.
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