HESI LPN
PN Exit Exam 2023 Quizlet
1. A client has a prescription for a transcutaneous electrical nerve stimulator (TENS) unit for pain management during the postoperative period following a lumbar laminectomy. Which information should the PN reinforce about the action of the adjuvant pain modality?
- A. The discharge of electricity will distract the client's focus from the pain.
- B. An infusion of medication into the spinal canal will block pain perception.
- C. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus.
- D. A mild electrical stimulus on the skin surface closes the gates of nerve conduction for severe pain.
Correct answer: D
Rationale: The TENS unit works by providing a mild electrical stimulus to the skin, which helps to 'close the gate' on pain signals, reducing the perception of pain. Choice A is incorrect because distraction is not the primary mechanism of action for TENS. Choice B is incorrect as it describes a different method of pain management involving medication infusion into the spinal canal. Choice C is incorrect as it inaccurately describes the location of pain perception modulation by the TENS unit.
2. The nurse enters a male client's room to administer routine morning medications, and the client is on the phone. Which action is best for the nurse to take?
- A. Ask another nurse to return with the medication when the client has hung up the phone
- B. Wait for the client to excuse himself from the telephone conversation, and observe the client taking the medication
- C. Return the medication to the client's drawer on the cart and document that the client refused the dose
- D. Leave the medication with the client and let him take it when he finishes the conversation
Correct answer: B
Rationale: The best action for the nurse to take in this situation is to wait for the client to excuse himself from the telephone conversation and then observe the client taking the medication. This approach ensures that the client takes the medication as prescribed, promoting compliance and safety. Choice A is not ideal as it involves unnecessary delegation and may lead to confusion. Choice C is incorrect because assuming refusal without direct communication can compromise patient care. Choice D is not recommended as leaving the medication with the client unsupervised may result in non-compliance or potential errors.
3. A client with a prescription for a transcutaneous electrical nerve stimulator (TENS) unit for pain management asks how it works. What information should the nurse reinforce?
- A. The discharge of electricity will distract the client's focus from the pain
- B. An infusion of medication in the spinal canal will block pain perception
- C. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus
- D. A mild electrical stimulus on the skin surface closes the gates of nerve conduction for severe pain
Correct answer: D
Rationale: The correct answer is D. TENS works by delivering a mild electrical stimulus that can block pain signals from reaching the brain, effectively reducing the perception of pain. Choice A is incorrect because TENS does not distract from pain but rather interferes with pain signals. Choice B is incorrect as TENS does not involve infusing medication into the spinal canal. Choice C is also incorrect because TENS does not target the cerebral cortex to dull pain perception but rather works at the level of nerve conduction.
4. The PN assigns a UAP to assist with the personal care of a client experiencing an acute exacerbation of multiple sclerosis. Which instruction should the PN provide the UAP?
- A. Assist the client with a hot bath
- B. Encourage self-care but allow rest periods
- C. Face the client directly when speaking
- D. Keep the head of the bed elevated at all times
Correct answer: B
Rationale: During an acute exacerbation of multiple sclerosis, it is important to encourage self-care to maintain the client's independence. Allowing rest periods helps prevent fatigue, which is crucial in managing MS exacerbations. Choice A is incorrect as hot baths can exacerbate symptoms in MS. Choice C is about communication techniques and not directly related to client care during an exacerbation. Choice D is not a priority intervention during an MS exacerbation.
5. Which of the following is the best method for confirming nasogastric tube placement?
- A. Auscultating over the stomach while injecting air
- B. Checking the pH of the aspirate
- C. Observing the patient’s response during feeding
- D. Measuring the external length of the tube
Correct answer: B
Rationale: Checking the pH of the aspirate is the most reliable method to confirm nasogastric tube placement as it provides direct evidence of the tube's location in the stomach. When the pH is acidic (pH < 5), it indicates that the tube is correctly placed in the stomach. Auscultating over the stomach while injecting air may not always be accurate, as the sound can be misleading due to various factors. Observing the patient’s response during feeding is not a definitive method for confirming tube placement, as it can be influenced by other factors. Measuring the external length of the tube does not ensure correct placement within the GI tract and can be affected by external factors like patient anatomy.
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