HESI LPN
HESI Leadership and Management Quizlet
1. What is an episiotomy?
- A. A surgical incision of the perineum to prevent tearing during delivery.
- B. Releasing the red plug from the cervix just before crowning occurs.
- C. An incision in the abdomen with which the baby can be delivered through.
- D. The severance of the umbilical cord between mother and child.
Correct answer: A
Rationale: An episiotomy is a surgical incision of the perineum to prevent tearing during delivery. This procedure is performed to widen the vaginal opening and facilitate childbirth. Choice B is incorrect as it describes the expulsion of the mucus plug, not an episiotomy. Choice C is incorrect as it refers to a different procedure, a cesarean section, where the baby is delivered through an incision in the abdomen. Choice D is incorrect as it pertains to cutting the umbilical cord, which is not related to an episiotomy.
2. Do neural tube defects cause an elevation in the alpha-fetoprotein (AFP) level in the mother’s blood?
- A. Yes
- B. No
- C. Possibly
- D. Never
Correct answer: A
Rationale: Yes, neural tube defects can cause an elevation in AFP levels in the mother’s blood. AFP levels are often used as a screening marker during pregnancy to detect neural tube defects. Choice B is incorrect because an elevation in AFP levels can indeed occur in the presence of neural tube defects. Choice C is not the best option as it leaves room for uncertainty when the relationship between neural tube defects and AFP elevation is well-established. Choice D is incorrect as neural tube defects are known to influence AFP levels in the maternal blood.
3. A female client's significant other has been at her bedside providing reassurances and support for the past 3 days, as desired by the client. The client's estranged husband arrives and demands that the significant other not be allowed to visit or be given condition updates. Which intervention should the nurse implement?
- A. Obtain a perception from the healthcare provider regarding visitation privileges
- B. Request a consultation with the ethics committee for resolution of the situation
- C. Encourage the client to speak with her husband regarding his disruptive behavior
- D. Communicate the client's wishes to all members of the multidisciplinary team
Correct answer: D
Rationale: The correct intervention is to communicate the client's wishes to all members of the multidisciplinary team. This action respects the client's autonomy and maintains her comfort by ensuring that her desires regarding visitation and support are known and upheld. Obtaining a perception from the healthcare provider regarding visitation privileges (Choice A) may not fully consider the client's preferences. Requesting a consultation with the ethics committee (Choice B) may be premature and could delay prompt resolution of the issue. Encouraging the client to speak with her husband (Choice C) may not be appropriate, as the husband's demands are disrupting the client's care and comfort, and the client may not feel safe or comfortable doing so.
4. The nurse is preparing an older client for discharge following cataract extraction. Which instruction should be included in the discharge teaching?
- A. Do not read with direct lighting for 6 weeks
- B. Avoid straining during stool passage, bending, or lifting heavy objects
- C. Irrigate conjunctiva with ophthalmic saline after applying antibiotic ointment
- D. Limit exposure to sunlight during the first 2 weeks while the cornea is healing
Correct answer: B
Rationale: The correct instruction to include in the discharge teaching for a client following cataract extraction is to 'Avoid straining during stool passage, bending, or lifting heavy objects.' This is crucial to prevent increased intraocular pressure after surgery, which can be harmful. Reading with direct lighting can strain the eyes but is not the primary concern post-cataract surgery. Irrigating the conjunctiva before applying antibiotic ointment is not a standard practice and may not be necessary. While limiting sunlight exposure is important for eye protection, it is secondary to avoiding activities that can increase intraocular pressure.
5. Heparin 20,000 units in 500 ml D5W at 50 ml/hour has been infusing for 5.5 hours. How much heparin has the client received?
- A. 11,000 units.
- B. 13,000 units.
- C. 15,000 units.
- D. 17,000 units.
Correct answer: A
Rationale: To calculate the total amount of heparin received, multiply the infusion rate (50 ml/hour) by the total infusion time (5.5 hours). This results in 275 ml of the solution infused. Since there are 20,000 units of heparin in 500 ml, there are 800 units per ml. Therefore, 275 ml contains 220,000 units. However, the heparin is diluted in 500 ml, so the client has received half of this amount, which is 110,000 units. Therefore, the correct answer is 11,000 units. Choices B, C, and D are incorrect as they do not reflect the correct calculation based on the provided information.