HESI LPN
HESI PN Exit Exam 2024
1. When administering parenteral iron, which action would be inconsistent with proper administration?
- A. Using the Z-track method
- B. Using an air bubble to avoid withdrawing medication into subcutaneous tissue
- C. Not massaging the injection site
- D. Using the deltoid muscle for administration
Correct answer: D
Rationale: The correct answer is D: Using the deltoid muscle for administration. Administering parenteral iron in the deltoid muscle is not recommended due to the risk of irritation and pain. The Z-track method (choice A) is preferred to prevent staining and irritation of the skin when administering irritating medications like iron. Using an air bubble (choice B) to avoid withdrawing medication into subcutaneous tissue is a common practice to ensure accurate administration. Not massaging the injection site (choice C) is also a standard practice to prevent potential irritation or bleeding at the injection site.
2. After a hip replacement surgery, a client is instructed to use an abduction pillow while in bed. What is the primary purpose of this device?
- A. To reduce the risk of blood clots.
- B. To prevent hip dislocation.
- C. To improve circulation in the legs.
- D. To alleviate pain and discomfort.
Correct answer: B
Rationale: The primary purpose of using an abduction pillow after hip replacement surgery is to prevent hip dislocation. The abduction pillow keeps the legs separated, which reduces the risk of hip dislocation by preventing excessive internal rotation and adduction of the hip joint. Choices A, C, and D are incorrect as the main goal of using the abduction pillow is to maintain proper positioning and stability of the hip joint to prevent dislocation, rather than addressing blood clots, circulation, or pain relief.
3. Which disorder is characterized by demyelination of neurons in the central nervous system?
- A. Multiple sclerosis
- B. Parkinson's disease
- C. Alzheimer's disease
- D. Huntington's disease
Correct answer: A
Rationale: Multiple sclerosis is the correct answer. It is an autoimmune disease that specifically targets and damages the myelin sheath surrounding neurons in the central nervous system. This demyelination disrupts the transmission of nerve signals and leads to a variety of neurological symptoms. Parkinson's disease (Choice B), Alzheimer's disease (Choice C), and Huntington's disease (Choice D) are neurodegenerative disorders that do not primarily involve demyelination of neurons in the CNS. Parkinson's disease is characterized by the loss of dopamine-producing neurons, Alzheimer's disease by the formation of plaques and tangles in the brain, and Huntington's disease by a genetic mutation affecting nerve cells.
4. A client who is receiving chemotherapy has developed stomatitis. Which instruction should the nurse provide the UAP who is assisting with the care of this client?
- A. Keep the room environment free of unpleasant odors
- B. Gather supplies for protective environmental precautions
- C. Assist the client with feeding at meal times
- D. Provide gentle and meticulous mouth care
Correct answer: D
Rationale: Providing gentle and meticulous mouth care is critical for a client with stomatitis as it helps prevent further irritation and infection of the mucous membranes. Keeping the room environment free of unpleasant odors (Choice A) is important for the client's comfort but not directly related to managing stomatitis. Gathering supplies for protective environmental precautions (Choice B) is not relevant to addressing stomatitis. Assisting the client with feeding at meal times (Choice C) is important for overall care but does not specifically target the care needed for stomatitis.
5. The nurse determines that a client with cirrhosis is experiencing peripheral neuropathy. What action should the nurse take?
- A. Protect the client's feet from injury
- B. Apply a heating pad to affected area
- C. Keep the client's feet elevated
- D. Assess the feet and legs for jaundice
Correct answer: A
Rationale: Protecting the client's feet from injury is essential when managing peripheral neuropathy in a client with cirrhosis. Peripheral neuropathy can result in reduced sensation, increasing the risk of injury. Applying a heating pad or keeping the client's feet elevated would not address the primary concern of preventing injury. Assessing the feet and legs for jaundice is important for monitoring liver function, but it is not directly related to managing peripheral neuropathy in this case.
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