HESI LPN
HESI Fundamentals Practice Questions
1. A client with a history of chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 liters per minute via nasal cannula. The client is short of breath and has a pulse oximetry reading of 88%. What action should the LPN take first?
- A. Increase the oxygen flow rate to 4 liters per minute.
- B. Reposition the client to a high Fowler's position.
- C. Notify the healthcare provider of the client's condition.
- D. Encourage the client to use pursed-lip breathing.
Correct answer: B
Rationale: Repositioning the client to a high Fowler's position should be the first action taken by the LPN. This position helps improve oxygenation by maximizing lung expansion, making it easier for the client to breathe. Increasing the oxygen flow rate without addressing positioning may not fully optimize oxygen delivery. Notifying the healthcare provider should come after immediate interventions. Encouraging pursed-lip breathing is beneficial but should follow the initial positioning to further assist the client in managing their breathing difficulty.
2. The nurse is admitting a child with a Wilms tumor. Which is the initial assessment finding associated with this tumor?
- A. Abdominal swelling
- B. Weight gain
- C. Hypotension
- D. Increased urinary output
Correct answer: A
Rationale: Abdominal swelling is frequently the initial assessment finding associated with a Wilms tumor. This swelling is caused by the tumor's mass in the kidney, leading to abdominal distension. Weight gain (Choice B) is less likely as a primary finding, as it may occur later due to tumor growth or fluid retention. Hypotension (Choice C) is not typically associated with Wilms tumor unless severe complications like hemorrhage develop. Increased urinary output (Choice D) is not a common initial finding; instead, hematuria or other urinary changes may be observed later in the disease process.
3. What should be monitored closely in a child receiving chemotherapy?
- A. Blood glucose levels
- B. White blood cell count
- C. Blood pressure
- D. Heart rate
Correct answer: B
Rationale: The correct answer is B: White blood cell count. During chemotherapy, it is crucial to monitor the white blood cell count closely to detect potential neutropenia (low white blood cell count) and the associated risk of infections. Monitoring blood glucose levels (Choice A) is important for diabetic management and not directly related to chemotherapy. Blood pressure (Choice C) and heart rate (Choice D) are essential vital signs to monitor but are not the primary focus when monitoring a child receiving chemotherapy.
4. The healthcare provider is caring for a client with a history of hypertension. Which assessment finding would be most concerning?
- A. Blood pressure of 150/90 mmHg
- B. Irregular heart rate
- C. Shortness of breath
- D. Headache
Correct answer: C
Rationale: Shortness of breath in a client with a history of hypertension is a critical assessment finding as it may indicate heart failure, pulmonary edema, or other severe complications. The development of shortness of breath suggests that the client's condition may be rapidly deteriorating and requires immediate medical attention. Elevated blood pressure (150/90 mmHg) is concerning but not as acute as the potential complications associated with shortness of breath. An irregular heart rate and headache can also be symptoms of hypertension, but in this scenario, shortness of breath poses a higher risk of severe cardiovascular or respiratory issues.
5. A client with HIV/AIDS is receiving zidovudine (Retrovir). The nurse should monitor the client for which of the following adverse effects?
- A. Hyperglycemia
- B. Anemia
- C. Hypertension
- D. Hypercalcemia
Correct answer: B
Rationale: The correct answer is B: Anemia. Zidovudine (Retrovir) can cause bone marrow suppression, leading to anemia. Monitoring for signs of anemia, such as fatigue, pallor, and shortness of breath, is crucial. Choice A, Hyperglycemia, is not a common adverse effect of zidovudine. Choice C, Hypertension, is not directly associated with zidovudine use. Choice D, Hypercalcemia, is also not a typical adverse effect of zidovudine.