HESI LPN
HESI PN Exit Exam 2024
1. A 12-year-old child is receiving a blood transfusion via an infusion pump and begins to complain of 'itchy' skin 15 minutes after the unit of blood is started. The child appears flushed. What action should the nurse take first?
- A. Apply lotion to the skin
- B. Stop the transfusion
- C. Inspect the infusion site
- D. Obtain the vital signs
Correct answer: B
Rationale: Stopping the transfusion immediately is crucial when signs of a transfusion reaction, such as itching and flushing, occur. This action is taken to prevent further exposure to the potentially harmful transfused blood. Applying lotion to the skin, inspecting the infusion site, or obtaining vital signs can be important but are secondary to stopping the transfusion to ensure the safety of the child. Applying lotion may not address the underlying issue of a possible transfusion reaction. Inspecting the infusion site and obtaining vital signs can be done after stopping the transfusion, as patient safety is the top priority in this situation.
2. You are caring for a patient who just gave birth to a 6 lb. 13 oz. baby boy. The infant gave out a lusty cry, had a pink coloration all over his body, had flexed arms and legs, cried when stimulated, and had a pulse rate of 94. What Apgar score would you expect for this baby?
- A. 10
- B. 8
- C. 7
- D. 9
Correct answer: D
Rationale: The Apgar score is a method used to quickly assess the health of newborns. In this scenario, the baby would receive 2 points for color, reflex irritability, and muscle tone, but only 1 point for a pulse rate of 94, resulting in an Apgar score of 9. An Apgar score of 9 indicates that the baby is in good health overall. Choice A (10) is incorrect because a pulse rate of 94 would only score 1 point. Choices B (8) and C (7) are incorrect as the given criteria would lead to a higher score, indicating the baby's good health.
3. 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.
4. What dietary considerations must the nurse keep in mind for a patient who is an Orthodox Jew?
- A. They can eat any food unless it is Yom Kippur
- B. They cannot mix meat and dairy
- C. They cannot eat meat on Ash Wednesday
- D. They are vegetarian
Correct answer: B
Rationale: Orthodox Jews follow dietary laws (Kashrut) that prohibit mixing meat and dairy products in the same meal. This restriction is known as 'not mixing milk and meat.' Therefore, choice B is the correct answer. Choices A, C, and D are incorrect because being an Orthodox Jew does not mean they can eat any food unless it is Yom Kippur, avoid meat on Ash Wednesday, or are necessarily vegetarian.
5. The PN is reviewing care instructions with a client who has diabetic retinopathy and is experiencing glare around lights. What should the PN reinforce with the client?
- A. Cover eyes with moist, cool compresses to reduce glare
- B. Make adjustments to personal schedule to avoid driving at night
- C. Exert pressure on the inner canthus when tearing occurs
- D. Apply an eye shield at bedtime after instilling eye drops
Correct answer: B
Rationale: The correct answer is B. Avoiding driving at night is recommended for clients experiencing glare around lights due to diabetic retinopathy. This can help reduce the risk of accidents and visual discomfort. Making adjustments to the personal schedule to avoid nighttime driving is a practical approach to manage the glare. Choices A, C, and D are incorrect because covering eyes with compresses, exerting pressure on the inner canthus, or applying an eye shield are not effective strategies for managing glare associated with diabetic retinopathy.
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