HESI LPN
HESI Fundamentals Exam
1. In an emergency department, a nurse is assessing a client who reports right lower quadrant pain, nausea, and vomiting for the past 48 hours. Which of the following actions should the nurse take first?
- A. Auscultate bowel sounds.
- B. Administer an antiemetic.
- C. Offer pain medication.
- D. Palpate the abdomen.
Correct answer: A
Rationale: The correct action the nurse should take first is to auscultate bowel sounds. This step is crucial to assess bowel activity before proceeding with palpation or administering medications. Assessing bowel sounds can provide valuable information about bowel motility and potential obstructions. Administering an antiemetic or offering pain medication may be necessary but should come after assessing bowel sounds to ensure appropriate treatment. Palpating the abdomen should be avoided initially to prevent potential discomfort or complications, especially if there is suspected abdominal pathology.
2. A healthcare professional is teaching about home safety with a client. Which of the following instructions should the healthcare professional include?
- A. Unplug electronics by holding the plug
- B. Use electrical tape to secure extension cords next to baseboards on the floor
- C. To use a fire extinguisher, aim at the base of the flames
- D. Install slip-resistant rugs on tile floors
Correct answer: B
Rationale: The correct answer is to use electrical tape to secure extension cords next to baseboards on the floor. This practice helps prevent tripping and electrical hazards by keeping cords out of the way. Option A is incorrect as unplugging electronics should be done by holding the plug, not the cord itself. Option C is incorrect because when using a fire extinguisher, it should be aimed at the base of the flames, not at the top. Option D is not directly related to home safety teaching and may not be necessary for all clients, as it suggests an unnecessary change that may not improve safety.
3. A nurse is preparing an infusion for a client who was hospitalized with deep-vein thrombosis. The orders read: 25,000 units of heparin in 250 mL of 0.9% sodium chloride to infuse at 800 units/hr. At what rate should the nurse set the infusion pump?
- A. 8 mL/hr
- B. 10 mL/hr
- C. 12 mL/hr
- D. 15 mL/hr
Correct answer: A
Rationale: To calculate the infusion rate, use the formula: (Desired units/hr / Total units) × Volume. In this case, it would be (800 units/hr / 25,000 units) × 250 mL = 8 mL/hr. Therefore, the nurse should set the infusion pump at 8 mL/hr. Choice B, 10 mL/hr, is incorrect because it does not match the calculated rate. Choices C and D, 12 mL/hr and 15 mL/hr respectively, are also incorrect as they do not align with the correct calculation based on the provided data.
4. A client who is receiving chemotherapy for cancer treatment is experiencing nausea and vomiting. What is the best intervention for the LPN/LVN to implement?
- A. Offer the client small, frequent meals.
- B. Provide antiemetic medication as prescribed.
- C. Encourage the client to drink clear liquids.
- D. Assist the client with oral care.
Correct answer: B
Rationale: The best intervention for a client experiencing chemotherapy-induced nausea and vomiting is to provide antiemetic medication as prescribed. This medication helps in managing and reducing nausea and vomiting, providing relief to the client. Offering small, frequent meals (Choice A) may not address the underlying cause of the symptoms. Encouraging clear liquid intake (Choice C) may not be effective in controlling nausea and vomiting associated with chemotherapy. Assisting with oral care (Choice D) is important for overall comfort but may not directly address the symptoms of nausea and vomiting.
5. The healthcare provider is teaching a patient about contact lens care. Which instructions will the healthcare provider include in the teaching session?
- A. Use tap water to clean soft lenses.
- B. Wash and rinse the lens storage case daily.
- C. Reuse storage solution for no longer than a week.
- D. Keep the lenses in a cool, dry place when not in use.
Correct answer: B
Rationale: The correct answer is B. Washing and rinsing the lens storage case daily is essential to prevent contamination and infections. Choice A is incorrect as tap water should not be used to clean soft lenses due to the risk of introducing harmful microorganisms. Choice C is incorrect as the storage solution should not be reused for longer than recommended to maintain its effectiveness and prevent eye infections. Choice D is incorrect because lenses should be stored in a clean, disinfected case, not just in a cool, dry place, to avoid contamination.
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