HESI LPN
HESI Leadership and Management Test Bank
1. A nurse on a med-surg unit is caring for a group of clients with the assistance of an LPN and an AP. Which of the following tasks should the nurse assign to the LPN?
- A. Reinforce dietary teaching with a client who has heart disease.
- B. Obtaining a urine specimen from an older adult client
- C. Providing postmortem care for a client who has just died.
- D. Accompanying a client who just had a wound debridement to PT.
Correct answer: A
Rationale: The correct answer is to reinforce dietary teaching with a client who has heart disease. This task falls within the LPN's scope of practice as they can provide education and support related to nutrition. Obtaining a urine specimen (Choice B) is typically performed by nursing assistants. Providing postmortem care (Choice C) is a sensitive task usually performed by registered nurses. Accompanying a client to physical therapy (Choice D) is often done by nursing assistants or other supportive staff.
2. When changing a client's colostomy pouch and noticing peristomal skin irritation, which of the following actions should the nurse take?
- A. Change the pouch as needed based on individual requirements.
- B. Apply the pouch only when the skin barrier is completely dry.
- C. Pat the peristomal skin dry after cleaning.
- D. Ensure the pouch is 0.32 cm (1/8 in) larger than the stoma.
Correct answer: D
Rationale: When a nurse observes peristomal skin irritation while changing a client's colostomy pouch, it is crucial to ensure that the pouch is slightly larger (0.32 cm or 1/8 inch) than the stoma. This extra space helps prevent the pouch from rubbing against the stoma and causing further irritation. Option A is correct because colostomy pouches should be changed based on individual needs, not necessarily every 24 hours. Option B is incorrect because applying the pouch only when the skin barrier is completely dry ensures better adhesion. Option C is incorrect as patting the peristomal skin dry after cleaning is more gentle and less likely to cause irritation compared to rubbing.
3. When caring for a pregnant woman with cardiac problems, the nurse must be alert for the signs and symptoms of cardiac decompensation. Which critical findings would the nurse find on assessment of the client experiencing this condition?
- A. Regular heart rate and hypertension.
- B. Increased urinary output, tachycardia, and dry cough.
- C. Shortness of breath, bradycardia, and hypertension.
- D. Dyspnea, crackles, and an irregular, weak pulse.
Correct answer: D
Rationale: In pregnant women with cardiac problems, signs of cardiac decompensation include dyspnea, crackles, an irregular, weak, and rapid pulse, rapid respirations, a moist and frequent cough, generalized edema, increasing fatigue, and cyanosis of the lips and nailbeds. Choice A is incorrect as a regular heart rate and hypertension are not typically associated with cardiac decompensation. Choice B is incorrect as increased urinary output and dry cough are not indicative of cardiac decompensation, only tachycardia is. Choice C is incorrect as bradycardia and hypertension are not typically seen in cardiac decompensation; dyspnea is a critical sign instead.
4. As of 2002, the following data was obtained from municipality X: No. of live births - 750, No. of infant deaths - 10, No. of maternal deaths - 6, Total population - 25,000. The 2002 maternal mortality rate of municipality X is:
- A. 15/1000 live births
- B. 12.5/1000 live births
- C. 6/1000 live births
- D. 8/1000 live births
Correct answer: C
Rationale: The maternal mortality rate is calculated as 6 maternal deaths per 1000 live births. The correct answer is C because to calculate the maternal mortality rate, you divide the number of maternal deaths by the number of live births and then multiply by 1000. Choices A, B, and D are incorrect as they do not match the given data on maternal deaths and live births for municipality X.
5. When should a glucagon emergency kit be used for a client with Type 1 diabetes?
- A. During episodes of hypoglycemia
- B. At the onset of signs of diabetic ketoacidosis
- C. Before meals to prevent hyperglycemia
- D. When signs of severe hypoglycemia occur
Correct answer: D
Rationale: A glucagon emergency kit is used when signs of severe hypoglycemia occur in a client with Type 1 diabetes. Glucagon helps raise blood glucose levels in cases of severe hypoglycemia when the individual is unable to take oral glucose. It is crucial to administer glucagon promptly to prevent serious complications associated with low blood sugar levels. Choices A, B, and C are incorrect because a glucagon emergency kit is specifically indicated for severe hypoglycemia, not for general episodes of hypoglycemia, diabetic ketoacidosis, or prevention of hyperglycemia.