HESI LPN
PN Exit Exam 2023 Quizlet
1. What is the correct order of steps in the nursing process?
- A. Assessment, Diagnosis, Planning, Implementation, Evaluation
- B. Planning, Implementation, Evaluation, Diagnosis, Assessment
- C. Diagnosis, Assessment, Planning, Implementation, Evaluation
- D. Implementation, Planning, Evaluation, Diagnosis, Assessment
Correct answer: A
Rationale: The correct order in the nursing process is Assessment, Diagnosis, Planning, Implementation, and Evaluation. Assessment involves gathering information about the patient, Diagnosis is identifying the problem, Planning involves setting goals and outcomes, Implementation is carrying out the plan, and Evaluation is assessing the outcomes. Choices B, C, and D have the steps in the incorrect order, not following the standard nursing process framework. Therefore, the correct answer is option A.
2. When a woman in early pregnancy is leaving the clinic, she blushes and asks the nurse if it is true that sex during pregnancy is bad for the baby. What is the best response for the nurse to give?
- A. The baby is protected by the sac. Sex is perfectly alright.
- B. It is unlikely to harm the baby. What you do with your personal life is your concern.
- C. Intercourse during pregnancy is usually alright, but you need to ask the doctor if it is acceptable for you.
- D. In a normal pregnancy, intercourse will not harm the baby. However, many women experience a change in desire. How are you feeling?
Correct answer: D
Rationale: Choice D is the best response as it reassures the patient that intercourse in a normal pregnancy will not harm the baby. It also shows empathy by acknowledging that many women experience changes in sexual desire during pregnancy. This response validates the patient's concerns and opens up a dialogue about her feelings. Choice A is incorrect as it lacks information about changes in sexual desire and oversimplifies the situation. Choice B is dismissive of the patient's concerns and does not provide adequate information. Choice C is not the best response as it suggests asking the doctor without offering immediate reassurance or addressing the patient's worries.
3. What is the best thing to say to a patient scheduled for cataract surgery who is concerned that the physician works on the correct eye?
- A. You are wearing an ID bracelet that will let the medical team know which eye to work on.
- B. When you are taken to the surgery area, the medical staff will confirm which eye needs the surgery.
- C. The surgeon will mark the correct eye before the cataract surgery based on your medical records.
- D. You will wear an ID bracelet, and the nurse will verify the eye scheduled for surgery by comparing it with your records and marking it with a permanent marker.
Correct answer: D
Rationale: The best response reassures the patient by explaining the process of verifying and marking the correct eye, a safety measure to prevent wrong-site surgery, directly addressing the patient’s concern. Choice A is close but implies the ID bracelet alone determines the correct eye, missing the verification process. Choice B talks about confirmation but lacks details about marking the correct eye. Choice C mentions the surgeon's record but does not specify the direct verification and marking process, unlike Choice D.
4. While ambulating in the hallway following an appendectomy yesterday, a client complains of chest tightness and shortness of breath. Which action should the nurse implement first?
- A. Administer sublingual nitroglycerin
- B. Assist the client back to the room
- C. Have the client sit down in the hall
- D. Obtain a 12-lead electrocardiogram
Correct answer: C
Rationale: Having the client sit down in the hallway is the first action the nurse should implement. This is crucial to prevent further strain on the heart and to provide a safer environment for assessment and potential emergency intervention. Administering sublingual nitroglycerin (Choice A) may be appropriate later but should not precede ensuring the client's immediate safety. Assisting the client back to the room (Choice B) may not be advisable if the client is experiencing chest tightness and shortness of breath. Obtaining a 12-lead electrocardiogram (Choice D) is important but would not be the initial action to address the client's immediate symptoms.
5. Which type of isolation is required for a patient with measles?
- A. Contact isolation
- B. Airborne isolation
- C. Droplet isolation
- D. Reverse isolation
Correct answer: B
Rationale: The correct answer is B: Airborne isolation. Measles is highly contagious and can be transmitted through airborne particles, so airborne isolation is necessary to prevent its spread. Choice A, Contact isolation, is incorrect because measles is not primarily transmitted through direct contact. Choice C, Droplet isolation, is also incorrect as measles is not transmitted through large droplets but through smaller airborne particles. Choice D, Reverse isolation, is used to protect a patient from outside infections, not to prevent the spread of a contagious disease like measles.
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