HESI LPN
HESI Fundamental Practice Exam
1. A dying client is coping with feelings regarding impending death. The nurse bases care on the theory of death and dying by Kübler-Ross. During which stage of grieving should the LPN/LVN primarily use nonverbal interventions?
- A. Anger
- B. Denial
- C. Bargaining
- D. Acceptance
Correct answer: D
Rationale: Nonverbal interventions are primarily used during the acceptance stage according to Kübler-Ross's theory of death and dying. During the acceptance stage, the individual is more likely to be reflective and less communicative, making nonverbal interventions more effective. Choices A, B, and C are incorrect because anger, denial, and bargaining are stages that precede the acceptance stage in Kübler-Ross's model, where verbal communication and processing emotions play a more significant role.
2. A newly hired unlicensed assistive personnel (UAP) is assigned to a home healthcare team along with two experienced UAPs. Which intervention should the home health nurse implement to ensure adequate care for all clients?
- A. Ask the most experienced UAP on the team to partner with the newly hired UAP.
- B. Evaluate the newly hired UAP’s level of competency by observing the UAP deliver care.
- C. Review the UAP’s skills checklist and experience with the person who hired the UAP.
- D. Assign the newly hired UAP to clients who require the least complex level of care.
Correct answer: B
Rationale: Evaluating the newly hired UAP’s competency by observing them deliver care is the most effective intervention to ensure they can provide safe and effective care. This approach directly assesses the UAP's actual performance and allows for immediate feedback. Option A, asking the most experienced UAP to partner with the newly hired one, may not guarantee that the new UAP is competent. Option C, reviewing the UAP’s skills checklist and experience with the hiring person, does not provide a direct assessment of the UAP's current abilities. Option D, assigning the new UAP to less complex cases, does not address the need to evaluate their competency directly.
3. A newly admitted client describes her mission in life as one of saving her son by eliminating the 'provocative sluts' of the world. There are several attractive young women on the unit. What should the LPN/LVN do first?
- A. Ask the client for her definition of 'provocative sluts'
- B. Ask the young female clients on the unit to dress less provocatively
- C. Ask the client to discuss her concerns in the next group session
- D. Ask the client to inform the staff if she has negative thoughts about other clients
Correct answer: D
Rationale: The correct action for the LPN/LVN to take first is to ask the client to inform the staff if she has negative thoughts about other clients. This approach is crucial as it helps in monitoring the client's thoughts and behaviors, potentially preventing any harmful actions towards others on the unit. Asking for the client's definition of 'provocative sluts' (Choice A) may not address the immediate concern of monitoring the client's harmful thoughts. Asking the young female clients to dress less provocatively (Choice B) is inappropriate and victim-blaming. Asking the client to discuss her concerns in the next group session (Choice C) may not be effective in addressing the potential harm the client's thoughts could pose to others on the unit.
4. Which condition is characterized by a progressive loss of muscle strength due to an autoimmune attack on acetylcholine receptors?
- A. Myasthenia gravis
- B. Multiple sclerosis
- C. Amyotrophic lateral sclerosis
- D. Guillain-Barré syndrome
Correct answer: A
Rationale: The correct answer is A: Myasthenia gravis. Myasthenia gravis is characterized by muscle weakness caused by autoimmune attack on acetylcholine receptors at the neuromuscular junction. This results in impaired communication between nerves and muscles. Choice B, Multiple sclerosis, is a condition where the immune system attacks the protective myelin sheath covering the nerves in the central nervous system, leading to communication issues between the brain and the rest of the body. Choice C, Amyotrophic lateral sclerosis, is a progressive neurodegenerative disease affecting motor neurons in the brain and spinal cord, not involving acetylcholine receptors. Choice D, Guillain-Barré syndrome, is an acute condition where the immune system attacks the peripheral nerves, causing muscle weakness and paralysis, but it does not target acetylcholine receptors.
5. A client with eczema is experiencing severe pruritus. Which PRN prescription should the nurse administer?
- A. Topical corticosteroid
- B. Topical scabicide
- C. Topical alcohol rub
- D. Transdermal analgesic
Correct answer: A
Rationale: The correct answer is A: Topical corticosteroid. Topical corticosteroids are commonly used to manage itching in eczema by reducing inflammation and suppressing the immune response. In this case, for severe pruritus in eczema, a topical corticosteroid would be appropriate. Choice B, Topical scabicide, is used to treat scabies, not eczema. Choice C, Topical alcohol rub, is not typically used to manage pruritus in eczema. Choice D, Transdermal analgesic, is more for pain relief and not specifically targeted at managing itching associated with eczema.