HESI LPN
HESI PN Exit Exam
1. During a clinic visit for a sore throat, a client's basal metabolic panel reveals a serum potassium of 3.0 mEq/L. Which intervention should the PN recommend to the client based on this finding?
- A. Increase intake of dried peaches and apricots
- B. Reduce intake of red meats
- C. Encourage use of a soft toothbrush
- D. Force fluid intake to 1500 mL daily
Correct answer: A
Rationale: The correct answer is to recommend increasing the intake of dried peaches and apricots. A serum potassium level of 3.0 mEq/L is considered low. Increasing the intake of potassium-rich foods can help raise the serum potassium level, preventing complications such as muscle weakness and cardiac arrhythmias. Choice B, reducing intake of red meats, is incorrect because red meats are not specifically related to potassium levels. Choice C, encouraging the use of a soft toothbrush, is unrelated to addressing low potassium levels. Choice D, forcing fluid intake to 1500 mL daily, is not the appropriate intervention for low serum potassium; instead, increasing potassium-rich foods is more beneficial.
2. A new mother who is breastfeeding her newborn for the first time after delivery reports nipple pain when the baby sucks. Based on this client problem, which action should the PN take?
- A. Ensure that all the areolar tissue of the nipple is in the infant's mouth
- B. Have the mother reposition the infant from the cradle to the football hold
- C. Check for engorgement and assess the nipples for cracks or lesions
- D. Apply a warm compress to the breast for 10 minutes before each feeding
Correct answer: A
Rationale: Proper latch, including all the areolar tissue in the infant's mouth, is essential to prevent nipple pain and ensure effective breastfeeding. Option A is correct because ensuring that all the areolar tissue of the nipple is in the infant's mouth helps achieve a good latch, reducing nipple pain. Option B is incorrect as repositioning the infant may not address the root cause of the pain related to latch issues. Option C is incorrect because while checking for engorgement and nipple issues is important, it does not directly address the latch concern causing the pain. Option D is incorrect as applying a warm compress is not recommended for breastfeeding mothers; a warm compress can help with pain associated with engorgement, but it does not address latch issues.
3. The client diagnosed with HIV is taught by the nurse that the condition is transmitted through
- A. the infection passed from a mother to her baby
- B. Tears
- C. human bites
- D. insect bites
Correct answer: A
Rationale: HIV can be transmitted from a mother to her baby during childbirth or breastfeeding, making choice A the correct answer. Tears, human bites, and insect bites are not common modes of HIV transmission. While human bites can potentially transmit the virus, it is less common compared to mother-to-child transmission.
4. When caring for a child with sickle cell disease, the PN expects that the child will most likely describe which symptom when experiencing a sickle cell crisis?
- A. Decreased hemoglobin
- B. Joint pain
- C. Fatigue
- D. Infection
Correct answer: B
Rationale: During a sickle cell crisis, a child with sickle cell disease is most likely to describe joint pain. Sickle cell disease leads to the blockage of blood flow by sickled red blood cells, causing ischemia and pain, often felt in the joints and other body parts. Fatigue (choice C) is a nonspecific symptom that can occur in various conditions but is not a characteristic symptom of a sickle cell crisis. While decreased hemoglobin (choice A) can be observed in sickle cell disease, it is not a symptom typically described by a child during a sickle cell crisis. Infection (choice D) can trigger a sickle cell crisis but is not the symptom most likely to be described by the child during the crisis.
5. While performing an inspection of a client's fingernails, the PN observes a suspected abnormality of the nail's shape and character. Which finding should the PN document?
- A. Clubbed nails
- B. Splinter hemorrhages
- C. Longitudinal ridges
- D. Koilonychia or spoon nails
Correct answer: A
Rationale: The correct answer is A: Clubbed nails. Clubbed nails are a significant finding often associated with chronic hypoxia or lung disease. The presence of clubbed nails should be documented for further evaluation. Splinter hemorrhages (Choice B) are tiny areas of bleeding under the nails and are associated with conditions like endocarditis. Longitudinal ridges (Choice C) are common and often a normal finding in older adults. Koilonychia or spoon nails (Choice D) refer to nails that are concave or scooped out, often seen in conditions like iron deficiency anemia or hemochromatosis. These conditions are not typically associated with chronic hypoxia or lung disease, making them less likely findings in this situation.
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