HESI LPN
HESI Fundamental Practice Exam
1. A client with chronic kidney disease is being assessed. Which laboratory value would be most concerning?
- A. Serum creatinine of 3.0 mg/dL
- B. Blood urea nitrogen (BUN) of 45 mg/dL
- C. Serum potassium of 6.5 mEq/L
- D. Hemoglobin of 10 g/dL
Correct answer: C
Rationale: In a client with chronic kidney disease, an elevated serum potassium level (hyperkalemia) is the most concerning finding. Hyperkalemia can lead to life-threatening cardiac dysrhythmias due to its effect on the electrical conduction system of the heart. Monitoring and managing serum potassium levels are crucial in patients with chronic kidney disease to prevent serious complications. While elevated serum creatinine (Choice A) and Blood Urea Nitrogen (BUN) levels (Choice B) indicate impaired kidney function, hyperkalemia poses an immediate risk of cardiac complications. Hemoglobin levels (Choice D) are typically lower in chronic kidney disease due to decreased erythropoietin production, but they do not present an immediate life-threatening risk like hyperkalemia.
2. A 5-year-old child is admitted to the hospital with a diagnosis of bacterial meningitis. What is the priority nursing intervention?
- A. Administering antibiotics
- B. Isolating the child
- C. Monitoring vital signs
- D. Administering fluids
Correct answer: B
Rationale: The priority nursing intervention for a 5-year-old child admitted to the hospital with bacterial meningitis is to isolate the child. Isolating the child is crucial to prevent the spread of infection to others, as bacterial meningitis is highly contagious. Administering antibiotics (Choice A) is important in the treatment of bacterial meningitis, but isolating the child takes precedence to protect others. Monitoring vital signs (Choice C) and administering fluids (Choice D) are essential aspects of care for a child with meningitis but are not the priority intervention to prevent the spread of the infection.
3. A nurse is developing a teaching plan for an 8-year-old child who has recently been diagnosed with type 1 diabetes. What developmental characteristic of a child this age should the nurse consider?
- A. Child is in the concrete operational stage of cognition.
- B. Child’s dependence on peer influence is increasing.
- C. Child will welcome opportunities for participation in self-care.
- D. Child’s developmental stage involves achieving a sense of autonomy.
Correct answer: C
Rationale: The correct answer is C. At the age of 8, children are typically in the stage of industry vs. inferiority according to Erikson's psychosocial theory. This stage is characterized by a desire to engage in productive activities and take on responsibilities. Thus, the child will likely welcome opportunities for participation in self-care related to their diabetes management. Choices A, B, and D are incorrect. Choice A is inaccurate as children at this age are usually in the concrete operational stage of cognitive development, not abstract. Choice B is incorrect because while peer influence is significant, it has not reached its peak at this age. Choice D is wrong as achieving a sense of identity is a developmental task more commonly associated with adolescence, not 8-year-old children.
4. A client with chronic kidney disease has an arteriovenous (AV) fistula in the left forearm. Which observation by the nurse indicates that the fistula is patent?
- A. Distended, tortuous veins in the left hand
- B. The left radial pulse is 2+ bounding
- C. Auscultation of a thrill on the left forearm
- D. Assessment of a bruit on the left forearm
Correct answer: C
Rationale: Auscultation of a thrill on the left forearm is the correct observation indicating that the AV fistula is patent. A thrill is a palpable vibration or buzzing sensation felt over the fistula, indicating the presence of blood flow. Choices A, B, and D do not directly assess the patency of the fistula. Distended, tortuous veins in the left hand may indicate venous hypertension; a bounding radial pulse could suggest increased blood flow through an artery, but it does not confirm fistula patency; assessment of a bruit indicates turbulent blood flow, but it does not confirm patency.
5. In the implementation of the national family planning program, the government assumes the role of a:
- A. decision-maker in the practice of family planning methods
- B. regulator
- C. facilitator
- D. dictator
Correct answer: C
Rationale: The correct answer is C: 'facilitator.' In the implementation of a national family planning program, the government plays a role as a facilitator, meaning it helps to support and enable the access to family planning services and information. The government's role is to ensure that services are available, accessible, and of good quality, rather than making decisions for individuals or regulating them. Choices A, B, and D are incorrect because the government's role is not to make decisions on behalf of individuals (decision-maker), strictly regulate family planning practices (regulator), or impose decisions without considering individual choices (dictator).