HESI LPN
HESI Practice Test for Fundamentals
1. A client scheduled for a hysterectomy has not yet signed the operative consent form. When the nurse approaches the client and asks that she review and sign the form, the client says she no longer wants to have the surgery. At this time, which action should the nurse take?
- A. Ask the client why she has changed her mind
- B. Proceed with the surgery
- C. Notify the surgeon immediately
- D. Document the client’s decision
Correct answer: A
Rationale: The correct action for the nurse to take in this situation is to ask the client why she has changed her mind. By understanding the client's reasons for refusal, the nurse can address any concerns, provide further information, and ensure that the client's decision is respected. Proceeding with the surgery without clarifying the client's decision or notifying the surgeon immediately would not be appropriate. Documenting the client's decision is important, but it should be done after understanding the rationale behind the decision.
2. The pediatric clinic nurse examines a toddler with a tentative diagnosis of neuroblastoma. Findings observed by the nurse that are associated with this problem include which of these?
- A. Lymphedema and nerve palsy
- B. Hearing loss and ataxia
- C. Headaches and vomiting
- D. Abdominal mass and weakness
Correct answer: D
Rationale: Neuroblastoma, a common solid tumor in children, often presents with symptoms related to the mass effect it causes. Abdominal mass and weakness are classic signs of neuroblastoma due to the tumor originating in the adrenal glands near the kidneys and potentially compressing nearby structures. Lymphedema and nerve palsy (Choice A) are not typically associated with neuroblastoma. Hearing loss and ataxia (Choice B) are more common in conditions affecting the central nervous system rather than neuroblastoma. Headaches and vomiting (Choice C) are nonspecific symptoms and are less commonly linked to neuroblastoma compared to the characteristic abdominal findings.
3. When assessing the skin of an immobilized patient, what should the nurse do?
- A. Assess the skin every 4 hours.
- B. Limit the amount of fluid intake.
- C. Use a standardized tool such as the Braden Scale.
- D. Have special times for inspection to not interrupt routine care.
Correct answer: C
Rationale: When assessing the skin of an immobilized patient, it is essential to use a standardized tool like the Braden Scale. This tool helps in systematically evaluating the patient's risk of developing pressure ulcers. Assessing the skin every 4 hours (Choice A) may be too frequent or unnecessary unless there are specific concerns or orders. Limiting fluid intake (Choice B) is not directly related to skin assessment in an immobilized patient. Having special times for inspection to avoid interrupting routine care (Choice D) is not as crucial as using a standardized tool for consistent and comprehensive skin assessment.
4. After completing an assessment and determining that a client has a problem, what should the LPN/LVN do next?
- A. Determine the etiology of the problem.
- B. Prioritize nursing care interventions.
- C. Plan appropriate interventions.
- D. Collaborate with the client to set goals.
Correct answer: A
Rationale: After identifying a problem in a client, the next step for the LPN/LVN is to determine the etiology or cause of the problem. Understanding the root cause of the issue is essential as it guides the development of appropriate interventions. Option B, prioritizing nursing care interventions, is premature without knowing the cause of the problem. Option C, planning appropriate interventions, also relies on knowing the etiology first to ensure the interventions directly address the underlying issue. Collaborating with the client to set goals, as mentioned in option D, is important but typically comes after understanding the cause of the problem to ensure the goals are relevant and effective.
5. When assessing a client's neurologic system, what should the nurse ask the client to close their eyes and identify?
- A. A word whispered by the nurse 30cm from the ear
- B. A number traced on the palm of the hand
- C. The vibration of a tuning fork placed on the foot
- D. A familiar object placed in the hand
Correct answer: B
Rationale: When a nurse asks a client to identify a number traced on the palm of the hand with their eyes closed, it assesses the client's ability to perceive touch sensations. This test specifically evaluates the tactile discrimination of the client. The other options do not test the client's ability to identify sensations accurately with eyes closed. Option A tests auditory perception, option C tests vibratory sense, and option D tests object recognition but not tactile discrimination, making them incorrect choices.
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