HESI LPN
HESI Fundamentals Exam Test Bank
1. A client has left lower atelectasis. In which of the following positions should the nurse place the client for postural drainage?
- A. Supine and low Fowler's position
- B. Right lateral in Trendelenburg position
- C. Side lying with the right side of the chest elevated
- D. Prone with pillows under the extremities
Correct answer: B
Rationale: Postural drainage is a technique used to help remove secretions from specific lung segments. For left lower atelectasis, placing the client in the right lateral Trendelenburg position is most effective. This position helps target the affected area, using gravity to assist in drainage. Placing the client in a supine or low Fowler's position (Choice A) may not effectively target the affected area. Side lying with the right side of the chest elevated (Choice C) would not utilize gravity for optimal drainage. Placing the client prone with pillows under the extremities (Choice D) is not ideal for postural drainage of the left lower lobe.
2. What is the primary purpose of a chest tube in a client's care?
- A. To drain air and fluid from the pleural space
- B. To prevent infection in the thoracic cavity
- C. To assist with lung expansion
- D. To monitor intrathoracic pressure
Correct answer: A
Rationale: The correct answer is A: To drain air and fluid from the pleural space. A chest tube is primarily used to remove accumulated air or fluid in the pleural space, preventing lung collapse or compromise of lung function. This intervention aims to re-expand the lung and enhance respiratory function. Choice B is incorrect because preventing infection is not the primary purpose of a chest tube. Choice C is incorrect as lung expansion is a result of draining the pleural space, not the primary goal. Choice D is incorrect as monitoring intrathoracic pressure is not the main objective of a chest tube insertion.
3. An adult client with a broken femur is transferred to the medical-surgical unit to await surgical internal fixation after the application of an external traction device to stabilize the leg. An hour after an opioid analgesic was administered, the client reports muscle spasms and pain at the fracture site. While waiting for the client to be transported to surgery, which action should the nurse implement?
- A. Observe for signs of deep vein thrombosis.
- B. Administer a PRN dose of a muscle relaxant.
- C. Check the client’s most recent electrolyte values.
- D. Reduce the weight on the traction device.
Correct answer: B
Rationale: The correct answer is B: Administer a PRN dose of a muscle relaxant. Muscle spasms and pain might be relieved by muscle relaxants, which are appropriate before surgery. Choice A is incorrect because the client is experiencing muscle spasms, not signs of deep vein thrombosis. Choice C is not the most immediate action needed in this situation. Choice D is incorrect because reducing the weight on the traction device would not directly address the muscle spasms and pain reported by the client.
4. When caring for a neonate with a suspected tracheoesophageal fistula, what nursing care should be included?
- A. Elevating the head and not giving anything by mouth
- B. Elevating the head at all times
- C. Administering glucose water only during feedings
- D. Avoiding suctioning unless the infant is cyanotic
Correct answer: A
Rationale: When caring for a neonate with a suspected tracheoesophageal fistula, it is essential to elevate the head and avoid giving anything by mouth. Elevating the head helps prevent aspiration, and withholding oral intake reduces the risk of complications like aspiration pneumonia. Elevating the head at all times (choice B) is overly restrictive and unnecessary. Administering glucose water only during feedings (choice C) is not recommended as it can still lead to aspiration. Avoiding suctioning unless the infant is cyanotic (choice D) is incorrect because maintaining airway patency may require suctioning, irrespective of cyanosis, in a neonate with a suspected tracheoesophageal fistula.
5. A male client being discharged with a prescription for the bronchodilator theophylline tells the nurse that he understands he is to take three doses of the medication each day. Since timed-release capsules are not available at the time of discharge, which dosing schedule should the LPN advise the client to follow?
- A. 9 a.m., 1 p.m., and 5 p.m.
- B. 8 a.m., 4 p.m., and midnight.
- C. Before breakfast, before lunch, and before dinner.
- D. With breakfast, with lunch, and with dinner.
Correct answer: B
Rationale: The correct dosing schedule for the client to follow is to take the medication at 8 a.m., 4 p.m., and midnight. This timing spaces the doses evenly over the waking hours, ensuring consistent therapeutic levels of the medication. Choice A (9 a.m., 1 p.m., and 5 p.m.) does not evenly distribute the doses throughout the day. Choices C (Before breakfast, before lunch, and before dinner) and D (With breakfast, with lunch, and with dinner) do not provide the required frequency of dosing needed for optimal therapeutic effect.