HESI LPN
HESI PN Exit Exam 2024
1. At one minute after birth, an infant is crying, has a heart rate of 140, has acrocyanosis, resists the suction catheter, and keeps his arms extended and his legs flexed. What is the Apgar score?
- A. 4
- B. 6
- C. 8
- D. 10
Correct answer: C
Rationale: The Apgar score is based on five components: heart rate, respiratory effort, muscle tone, reflex irritability, and color. In this case, the infant has a heart rate over 100 (2 points), is crying (2 points indicating good respiratory effort), resists the catheter (2 points for good reflex irritability), but has acrocyanosis (partial point deduction of 1). Thus, the Apgar score at one minute after birth would be 8. Choice A is incorrect as the given signs indicate a higher score. Choice B is incorrect as the signs described support a score above 6. Choice D is incorrect as it represents a perfect score which is not the case here due to acrocyanosis.
2. What is the most common genetic cause of intellectual disability?
- A. Down syndrome
- B. Fragile X syndrome
- C. Prader-Willi syndrome
- D. Turner syndrome
Correct answer: B
Rationale: The correct answer is Fragile X syndrome because it is the most common inherited cause of intellectual disability, resulting from a mutation in the FMR1 gene. Down syndrome, Prader-Willi syndrome, and Turner syndrome are not the most common genetic causes of intellectual disability. Down syndrome is caused by the presence of an extra chromosome 21, Prader-Willi syndrome results from specific genetic abnormalities on chromosome 15, and Turner syndrome is characterized by the absence of part or all of one of the X chromosomes.
3. A client who had a left hemicolectomy is experiencing a low-grade fever on post-operative day three. What is the nurse's best action?
- A. Encourage deep breathing and the use of the incentive spirometer.
- B. Administer antipyretic medication as prescribed.
- C. Notify the healthcare provider immediately.
- D. Increase the client’s fluid intake.
Correct answer: A
Rationale: A low-grade fever on post-operative day three can be a sign of atelectasis, a common post-operative complication. Encouraging deep breathing and the use of the incentive spirometer can help prevent and treat this condition. Atelectasis is often due to shallow breathing, so option A is the best initial action to promote lung expansion. Administering antipyretic medication (option B) may help reduce the fever but does not directly address the underlying cause. Notifying the healthcare provider immediately (option C) is not necessary at this point unless other concerning symptoms are present. Increasing the client’s fluid intake (option D) is important for overall recovery but is not the priority in this scenario.
4. A female client who has been taking oral contraceptives for the past year comes to the clinic for an annual exam. Which finding is most important for the PN to report to the HCP?
- A. Breast tenderness
- B. Change in menstrual flow
- C. Left calf pain
- D. Weight gain of 5 pounds
Correct answer: C
Rationale: Left calf pain could indicate deep vein thrombosis (DVT), a serious side effect of oral contraceptives. Reporting this finding to the healthcare provider is critical for further evaluation and treatment. Breast tenderness and change in menstrual flow are common side effects of oral contraceptives and may not be as urgent as left calf pain. Weight gain of 5 pounds, while noteworthy, is not as concerning as a possible indication of DVT.
5. Which of the following is the most effective way to prevent the spread of infection in a healthcare setting?
- A. Using sterile gloves
- B. Wearing a face mask
- C. Performing hand hygiene
- D. Using disposable equipment
Correct answer: C
Rationale: Performing hand hygiene is the most effective way to prevent the spread of infection in a healthcare setting. Hand hygiene helps remove pathogens that could be transmitted through direct contact, making it a crucial practice in infection control. While using sterile gloves and disposable equipment are important in certain situations, they do not address the potential transmission of pathogens through direct contact, unlike hand hygiene. Wearing a face mask is important for respiratory precautions but may not be as effective as hand hygiene in preventing the spread of infections through direct contact.
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