HESI LPN
Fundamentals of Nursing HESI
1. When teaching adult cardiopulmonary resuscitation (CPR) to a group of newly licensed nurses, what should the charge nurse instruct as the initial response in CPR?
- A. Confirm unresponsiveness
- B. Check for a pulse
- C. Begin chest compressions
- D. Call for emergency help
Correct answer: A
Rationale: The correct initial response in CPR is to confirm unresponsiveness. This step is crucial to ensure that the person actually needs CPR before proceeding with further actions. Checking for unresponsiveness is essential to determine if the individual is in need of immediate assistance. Checking for a pulse or beginning chest compressions without confirming unresponsiveness could waste valuable time and potentially harm the individual. Calling for emergency help is important, but it should follow the confirmation of unresponsiveness to ensure timely activation of emergency services.
2. The healthcare provider prescribes the diuretic metolazone (Zaroxolyn) 7.5 mg PO. Zaroxolyn is available in 5 mg tablets. How much should the LPN/LVN plan to administer?
- A. 1/2 tablet.
- B. 1 tablet.
- C. 1 1/2 tablets.
- D. 2 tablets.
Correct answer: C
Rationale: To administer 7.5 mg of metolazone (Zaroxolyn), the LPN/LVN should plan to give 1 1/2 tablets since each tablet contains 5 mg. Choice A (1/2 tablet) would not provide the full prescribed dose. Choice B (1 tablet) would only deliver 5 mg, which is less than the prescribed dose. Choice D (2 tablets) would exceed the prescribed dose, resulting in 10 mg instead of the required 7.5 mg. Therefore, the correct answer is to administer 1 1/2 tablets to achieve the prescribed 7.5 mg.
3. When responding to a call light and finding a client on the bathroom floor, what should the nurse do FIRST?
- A. Check the client for injuries
- B. Call for additional help
- C. Move the client to a sitting position
- D. Assist the client back to bed
Correct answer: A
Rationale: Checking the client for injuries is the priority when finding them on the bathroom floor. This action ensures the client's safety as it allows for immediate assessment of any potential harm. Calling for help may be necessary, but assessing for injuries takes precedence to address any immediate threats to the client's well-being. Moving the client to a sitting position or assisting them back to bed should only be done after ensuring there are no serious injuries requiring prompt medical attention. Therefore, the correct first action is to check the client for injuries.
4. During an eye irrigation for a client exposed to smoke and ash, which nursing action should receive the highest priority?
- A. Wearing gloves during the procedure
- B. Using a sterile solution
- C. Irrigating from the inner to the outer canthus
- D. Positioning the client's head properly
Correct answer: A
Rationale: The highest priority during an eye irrigation for a client exposed to smoke and ash is wearing gloves during the procedure. This action is crucial as it helps prevent contamination and protects both the client and the nurse. Using a sterile solution is important but not as critical as ensuring the nurse's safety by wearing gloves. Irrigating from the inner to the outer canthus and positioning the client's head properly are essential steps in eye irrigation, but they are not the highest priority in this scenario compared to ensuring infection control by wearing gloves.
5. A nurse prepares to admit a client who is immediately postoperative to the unit following abdominal surgery. When transferring the client from the gurney to the bed, what should the nurse do?
- A. Lock the wheels on the bed and gurney
- B. Adjust the bed height
- C. Use a slide sheet
- D. Ask for assistance from another nurse
Correct answer: A
Rationale: The correct action for the nurse to take when transferring a postoperative client from the gurney to the bed is to lock the wheels on both the bed and the gurney. Locking the wheels ensures stability and prevents accidents during the transfer. Adjusting the bed height may be necessary for comfort but is not the primary concern during the transfer process. Using a slide sheet may be helpful in repositioning the client once on the bed but is not essential for the initial transfer. Asking for assistance from another nurse is always a good practice, but the immediate action to ensure safety during the transfer is to lock the wheels.
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