HESI LPN
Maternity HESI Test Bank
1. Examination reveals that the laboring client's cervix is dilated to 2 centimeters, 70% effaced with the presenting part at -2 station. The client tells the nurse, 'I need my epidural now, this hurts.' The nurse's response to the client is based on which information?
- A. The client will need to be catheterized before the epidural can be administered.
- B. Administering an epidural at this point would slow down the labor process.
- C. The client should be dilated to at least 8 centimeters before receiving an epidural.
- D. The baby needs to be at a zero station before an epidural can be administered.
Correct answer: B
Rationale: Administering an epidural too early in labor, especially at 2 cm dilation, can slow down the progress of labor. It is usually recommended to wait until labor is more established. Choice A is incorrect because catheterization is not a prerequisite for epidural administration. Choice C is incorrect as waiting until 8 cm dilation is not a standard requirement for epidural administration. Choice D is incorrect because the baby's station being at zero is not a strict criterion for epidural administration.
2. A client with diabetes mellitus is prescribed insulin glargine. What information should the practical nurse (PN) provide to the client about this medication?
- A. Administer the insulin at mealtimes.
- B. Do not mix this insulin with other insulins.
- C. Shake the vial well before use.
- D. Store the insulin in the freezer.
Correct answer: B
Rationale: Insulin glargine is a long-acting insulin that should not be mixed with other insulins in the same syringe. Mixing it with other insulins can alter its pharmacokinetics and effectiveness. Insulin glargine is usually administered at the same time each day, often at bedtime, to provide a consistent basal level of insulin over 24 hours.
3. What is the primary purpose of a placebo in an experiment?
- A. To reduce the cost of the experiment.
- B. To make the experiment double-blind.
- C. To increase the number of participants.
- D. To serve as a control for comparison with the treatment group.
Correct answer: D
Rationale: The correct answer is D. A placebo serves as a control for comparison with the treatment group, helping to eliminate bias and ensure the results are due to the treatment itself. Placebos are crucial in research to distinguish the actual effect of the treatment from psychological or subjective factors. Choice A is incorrect because the purpose of a placebo is not related to reducing the cost of the experiment. Choice B is incorrect because while placebos are used in double-blind studies, their primary purpose is not to make the experiment double-blind. Choice C is incorrect because the purpose of a placebo is not to increase the number of participants but rather to serve as a comparison group for the treatment being tested.
4. A client diagnosed with bipolar disorder tells the nurse that she wants to stop taking her lithium. She states, 'I feel fine, and I don't think I need it anymore.' What should the nurse do first?
- A. Agree with the client that she seems fine now.
- B. Remind the client of the importance of lithium.
- C. Ask the healthcare provider to discontinue the lithium prescription.
- D. Arrange for a psychiatric evaluation for the client.
Correct answer: B
Rationale: When a client with bipolar disorder expresses a desire to stop taking lithium because they feel fine, the nurse's initial action should be to remind the client of the importance of lithium. This approach helps educate the client about the necessity of medication adherence in managing bipolar disorder. Agreeing with the client or immediately arranging a psychiatric evaluation may not address the root issue of medication non-adherence. Asking the healthcare provider to discontinue the prescription without further assessment and intervention could potentially jeopardize the client's stability and treatment plan.
5. An elderly female client with advanced dementia is admitted to the hospital with a fractured hip. The client repeatedly tells the staff, 'Take me home. I want my Mommy.' Which response is best for the nurse to provide?
- A. Orient the client to the time, place, and person.
- B. Tell the client that the nurse is there and will help her.
- C. Remind the client that her mother is no longer living.
- D. Explain the seriousness of her injury and need for hospitalization.
Correct answer: B
Rationale: Those with dementia often refer to home or parents when seeking security and comfort. The nurse should use the techniques of 'offering self' and 'talking to the feelings' to provide reassurance (B). Clients with advanced dementia have permanent physiological changes in the brain (plaques and tangles) that prevent them from comprehending and retaining new information, so choices A, C, and D are likely to be of little use to this client and do not address the emotional needs expressed by the client. Option B acknowledges the client's feelings, offers support, and provides reassurance, which can help comfort the client during this distressing time.