HESI LPN
HESI Fundamentals Test Bank
1. A healthcare provider is providing teaching about health promotion guidelines to a group of young adult male clients. Which of the following guidelines should the healthcare provider include?
- A. Obtain a tetanus booster every 5 years.
- B. Obtain a herpes zoster immunization by age 50.
- C. Have a dental examination every 6 months.
- D. Have a testicular examination every 2 years.
Correct answer: C
Rationale: Having a dental examination every 6 months is crucial for young adult males as it helps in maintaining good oral health and detecting any potential issues early on. Tetanus booster every 10 years is recommended for adults, not every 5 years (Choice A). Herpes zoster immunization is typically recommended for individuals aged 60 and older, not by age 50 (Choice B). While testicular self-examination is important for detecting testicular cancer, routine clinical testicular examinations are not generally needed every 2 years (Choice D). Therefore, the correct answer is to have a dental examination every 6 months.
2. During the initial physical assessment of a newly admitted client with a pressure ulcer, an LPN observes that the client's skin is dry and scaly. The nurse applies emollients and reinforces the dressing on the pressure ulcer. Legally, were the nurse's actions adequate?
- A. The nurse should have also initiated a plan to increase activity.
- B. The nurse provided supportive nursing care for the well-being of the client.
- C. Debridement of the pressure ulcer should have been performed before applying the dressing.
- D. Treatment should not have been initiated until the healthcare provider's prescriptions were received.
Correct answer: B
Rationale: The correct answer is B. Providing supportive nursing care, such as applying emollients and reinforcing the dressing on the pressure ulcer, meets the immediate needs of the client and is in line with legal and professional standards. Option A is incorrect because increasing activity may not be directly related to the immediate skin care needs of the client. Option C is incorrect as debridement might not be immediately necessary based on the initial assessment. Option D is incorrect as nurses are often authorized to initiate treatments within their scope of practice without waiting for healthcare provider prescriptions, especially for routine care like skin moisturization and dressing reinforcement.
3. What are the correct steps used for abdominal assessment?
- A. Inspection, auscultation, percussion, palpation
- B. Palpation, inspection, auscultation, percussion
- C. Percussion, palpation, inspection, auscultation
- D. Auscultation, palpation, percussion, inspection
Correct answer: A
Rationale: The correct order for abdominal assessment is inspection, auscultation, percussion, and palpation. Inspection allows the nurse to visually assess the abdomen for any abnormalities or distension. Auscultation follows to listen for bowel sounds and vascular sounds. Percussion helps to assess the density of underlying structures and detect any abnormal masses. Palpation is performed last to assess tenderness, organ size, and detect any masses. Choices B, C, and D have the steps in the incorrect order, making them the wrong choices.
4. A nurse on a surgical unit is receiving a client who had abdominal surgery from the postanesthesia care unit. Which of the following assessments should the nurse make first?
- A. Airway
- B. Blood pressure
- C. Surgical site
- D. Level of consciousness
Correct answer: A
Rationale: The correct answer is to assess the airway first. Ensuring a clear and patent airway is crucial to maintaining adequate oxygenation and ventilation post-surgery. Assessing the airway takes precedence over other assessments as a compromised airway can lead to hypoxia and respiratory distress. Checking blood pressure, the surgical site, or level of consciousness are important but are secondary to ensuring the airway is clear and the client can breathe effectively.
5. When a nurse instructs a client with hearing loss about cleaning their new hearing aids, which statement indicates that the client understands the instructions?
- A. I use a damp cloth to clean the outside part of my hearing aids.
- B. I clean my hearing aids' ear molds with rubbing alcohol.
- C. I always keep the volume of my hearing aids turned up for better hearing.
- D. I remove the batteries from my hearing aids when not in use at night.
Correct answer: A
Rationale: The correct answer is A because cleaning the outside part of hearing aids with a damp cloth is an appropriate method. Rubbing alcohol can damage ear molds, so choice B is incorrect. Keeping the volume of hearing aids turned up high may lead to discomfort, making choice C incorrect. Removing batteries when not in use at night is good practice for battery life, but it does not directly relate to understanding cleaning instructions, so choice D is less relevant in this context.
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