HESI LPN
Fundamentals of Nursing HESI
1. A healthcare provider is providing range of motion to the shoulder and must perform external rotation. Which action will the provider take?
- A. Moves the patient's arm in a full circle.
- B. Moves the patient's arm across the body as far as possible.
- C. Moves the patient's arm behind the body, keeping the elbow straight.
- D. Moves the patient's arm until the thumb is upward and lateral to the head with the elbow flexed.
Correct answer: D
Rationale: The correct action for external rotation of the shoulder involves moving the patient's arm until the thumb is upward and lateral to the head with the elbow flexed. This position maximizes external rotation at the shoulder joint. Choices A, moving the arm in a full circle, B, moving the arm across the body, and C, moving the arm behind the body with the elbow straight, do not describe external rotation and are incorrect. Therefore, Choice D is the correct action for performing external rotation.
2. A nurse is preparing to administer multiple medications to a client who has an enteral feeding tube. Which of the following actions should the nurse plan to take?
- A. Dissolve each medication in 5 mL of sterile water.
- B. Draw up each medication separately in the syringe.
- C. Push the syringe plunger gently if feeling resistance.
- D. Flush the tube with 15 mL of sterile water.
Correct answer: D
Rationale: The correct action the nurse should take when administering multiple medications to a client with an enteral feeding tube is to flush the tube with 15-30 mL of sterile water before and between medications, and 30-60 mL after the last medication. This helps prevent clogging and ensures each medication is delivered effectively. Choice A is incorrect as medications should not be dissolved in water for administration through an enteral feeding tube. Choice B is incorrect because each medication should be drawn up and administered separately to prevent any potential interactions. Choice C is incorrect as resistance while pushing the plunger may indicate a problem that needs to be addressed before continuing with the administration.
3. A healthcare provider is providing discharge teaching to a client about self-administering heparin.
- A. Administer medication in the abdomen.
- B. Administer medication in the thigh.
- C. Administer medication in the upper arm.
- D. Administer medication in the buttock.
Correct answer: A
Rationale: Heparin is typically administered in the abdomen for self-injection to avoid muscle tissue and for better absorption. The subcutaneous tissue in the abdomen provides a larger area for injection and is usually recommended for heparin administration. Administering heparin in the thigh, upper arm, or buttock may not be as effective or safe as the abdomen due to variations in absorption rates and potential risks associated with muscle injection.
4. Which statement by the nurse indicates culturally responsive care for a client following Islamic practices?
- A. “I will make sure the menu includes halal options.â€
- B. “I will ask the client if they want to schedule prayer times during the day.â€
- C. “I will avoid discussing care when the client’s family is around.â€
- D. “I will make sure daily communion is available for this client.â€
Correct answer: B
Rationale: The correct answer is B. Asking the client if they want to schedule prayer times during the day demonstrates respect and consideration for Islamic practices. Providing halal options (choice A) is important for dietary requirements in Islam, but it may not address the client's spiritual needs. Avoiding discussing care in front of the client's family (choice C) is not directly linked to Islamic practices and may not necessarily enhance cultural responsiveness. Offering daily communion (choice D) is associated with Christian religious practices, not Islamic practices, and may not meet the client's religious needs.
5. A client will require oxygen therapy at home. Which of the following statements should the nurse identify as an indication that the client understands how to manage this therapy at home?
- A. I'll make sure that, when my friend comes by, they smoke at least 6 feet away from my oxygen tank.
- B. I'll use a cotton blanket if I get chilly while I'm using my oxygen.
- C. I'll check the wires and cables on my oxygen equipment to make sure they are in good working order.
- D. I'll secure my oxygen tank in an upright position to prevent it from being knocked over.
Correct answer: C
Rationale: The correct answer is C. Ensuring the oxygen equipment's wires and cables are in good working order is crucial to prevent sparks in an oxygen-rich environment, which could lead to a fire. Choices A, B, and D are incorrect because smoking near an oxygen tank, using a cotton blanket near oxygen (as cotton is less likely to generate static electricity than wool), and laying the oxygen tank down on the floor pose significant safety risks and are not appropriate practices for managing oxygen therapy at home.
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