HESI LPN
HESI Fundamental Practice Exam
1. When a client decides not to have surgery despite significant blockages of the coronary arteries, it is an example of which of the following ethical principles?
- A. Fidelity
- B. Autonomy
- C. Justice
- D. Nonmaleficence
Correct answer: B
Rationale: The correct answer is autonomy. Autonomy is the ethical principle that upholds an individual's right to make decisions about their healthcare, including the choice to refuse treatment or surgery. In this scenario, the client's decision not to have surgery despite the recommendation is an exercise of autonomy. Choice A, fidelity, refers to being faithful and keeping promises, which is not applicable in this situation. Choice C, justice, pertains to fair and equal distribution of resources and treatment, not the individual's right to make decisions. Choice D, nonmaleficence, relates to the obligation to do no harm, which is not directly applicable to the client's decision to refuse surgery.
2. The school nurse is caring for a boy with hemophilia who fell on his arm during recess. What supportive measures should the nurse use until factor replacement therapy can be instituted?
- A. Apply warm, moist compresses
- B. Apply pressure for at least 1 minute
- C. Elevate the area above the level of the heart
- D. Begin passive range-of-motion unless the pain is severe
Correct answer: C
Rationale: Elevating the affected area above the level of the heart is the correct supportive measure for a child with hemophilia who has experienced trauma. This action helps reduce bleeding and swelling by promoting venous return and preventing further pooling of blood in the affected area. Applying warm, moist compresses (Choice A) may not be recommended as it can potentially increase bleeding by dilating blood vessels. Applying pressure for at least 1 minute (Choice B) can be helpful for minor cuts or wounds but may not be as effective in managing bleeding in a child with hemophilia. Beginning passive range-of-motion (Choice D) should be avoided as it can exacerbate bleeding and cause further damage in a child with hemophilia.
3. An adolescent client in an outpatient mental health facility tells the nurse that it is hard to follow his treatment plans because his friends discourage him. Which of the following statements should the nurse make?
- A. Ask, 'Tell me more about how your friends discourage you.'
- B. Say, 'Your friends should support you, not discourage you.'
- C. Respond, 'It sounds like your friends are not supportive.'
- D. Suggest, 'You need to focus on your treatment plans regardless of your friends.'
Correct answer: A
Rationale: The correct approach for the nurse is to ask the client to elaborate on how their friends discourage them. By doing so, the nurse shows empathy, encourages the client to express their feelings, and gains insight into the situation. This open-ended question can help the nurse understand the specific issues the client is facing and work towards finding solutions collaboratively. Choices B, C, and D do not effectively address the client's concerns or encourage further discussion. Choice B is directive and may come off as judgmental, choice C assumes the friends are not supportive without exploring further, and choice D dismisses the client's feelings and the impact of peer influence.
4. A community health nurse is developing a program to decrease the incidence of Type 2 diabetes in the community. Which of the following interventions should be included?
- A. distributing brochures on managing diabetes
- B. conducting exercise classes at the community center
- C. providing free glucose monitors
- D. offering dietary counseling sessions
Correct answer: B
Rationale: The correct answer is B: conducting exercise classes at the community center. Regular physical activity plays a crucial role in preventing Type 2 diabetes by helping to maintain a healthy weight, improve insulin sensitivity, and regulate blood sugar levels. Distributing brochures (choice A) may raise awareness but might not lead to significant behavior change. Providing free glucose monitors (choice C) focuses on monitoring rather than prevention. Offering dietary counseling sessions (choice D) is important but focusing solely on diet may not address the comprehensive approach needed to prevent Type 2 diabetes.
5. The nurse is caring for a client who has just undergone a total hip replacement. Which intervention is most important to prevent postoperative complications?
- A. Encourage early ambulation
- B. Apply ice to the surgical site
- C. Monitor the surgical site for signs of infection
- D. Administer pain medication as prescribed
Correct answer: A
Rationale: Encouraging early ambulation is crucial following a total hip replacement surgery as it helps prevent complications such as deep vein thrombosis (DVT) by promoting circulation. Early ambulation also aids in preventing pneumonia, muscle atrophy, and pressure ulcers. Applying ice to the surgical site may help with pain and swelling, but it is not as critical in preventing complications as early ambulation. While monitoring the surgical site for signs of infection is important, it is not as crucial in preventing postoperative complications compared to early ambulation. Administering pain medication as prescribed is essential for comfort and pain management but does not directly prevent postoperative complications like early ambulation does.