HESI LPN
HESI PN Exit Exam
1. In a group therapy setting, one member is very demanding, repeatedly interrupting others and taking most of the group time. The nurse's best response would be:
- A. Will you briefly summarize your point because others need time as well?
- B. Your behavior is obnoxious and drains the group.
- C. I am so frustrated with your behavior.
- D. To ignore the behavior and allow him to vent
Correct answer: A
Rationale: In a group therapy setting, where each member should have the opportunity to participate, it is essential for the nurse to manage disruptive behavior assertively yet respectfully. Choice A is the best response as it addresses the issue of one member dominating the group time by asking them to summarize their point briefly, allowing others to contribute. Choice B is confrontational and may alienate the individual, hindering the therapeutic process. Choice C expresses personal frustration, which is not constructive in managing the situation. Choice D of ignoring the behavior is not effective as it allows the disruptive behavior to continue, impacting the group dynamics negatively.
2. A male client attends a community support program for mentally impaired and chemically abusing clients. The client tells the PN that his drugs of choice are cocaine and heroin. What is the greatest health risk for this client?
- A. Hypertension
- B. Hepatitis
- C. Glaucoma
- D. Diabetes
Correct answer: B
Rationale: The correct answer is B: Hepatitis. Hepatitis is the greatest health risk for this client due to the potential for contracting the disease through needle-sharing, common among drug users. This can lead to serious liver complications. While hypertension, glaucoma, and diabetes are all important health concerns, they are not directly associated with the drug abuse mentioned in the scenario.
3. The PN observes a UAP preparing to exit a client's room. The UAP's hands appear visibly soiled as the UAP uses a hand rub for 19 seconds to cleanse the hands. Which action should the PN take?
- A. Confirm that the UAP completed hand hygiene correctly
- B. Instruct the UAP to wash the hands for one minute
- C. Ask the UAP why the hands were so obviously soiled
- D. Advise the UAP to use the hand rub for 30 seconds
Correct answer: D
Rationale: When hands are visibly soiled, they should be washed with soap and water for at least 20 seconds. However, when using hand rub, it should be applied for at least 30 seconds to be effective. In this scenario, the UAP's hands were visibly soiled, indicating the need for thorough cleaning. Advising the UAP to use the hand rub for 30 seconds is essential to ensure proper hand hygiene and reduce the risk of spreading infection. Choices A, B, and C are incorrect because confirming completion of hand hygiene, instructing to wash for one minute, or asking why the hands were soiled do not address the immediate need for proper hand hygiene in the given situation.
4. There has been a serious explosion at a local factory, and many of the injured are arriving at the hospital. Which of the following patients should a nurse attend to first?
- A. A 30-year-old male who is able to walk into the hospital on his own but has numerous lacerations on the chest and face
- B. A 45-year-old male who was brought in on a stretcher, has been assessed as having respiration and circulation within normal limits, and can follow simple commands
- C. A 50-year-old woman who can walk but has a broken arm and numerous lacerations
- D. A 19-year-old man who has numerous lacerations all over the body and whose respiration exceeds 30 breaths per minute
Correct answer: D
Rationale: The correct answer is D. The 19-year-old man with a respiration rate exceeding 30 breaths per minute is showing signs of respiratory distress, indicating a potentially life-threatening condition that requires immediate attention. Patients with respiratory distress should be prioritized as it is a critical condition. Choices A, B, and C describe patients with injuries that are less immediately life-threatening or who are more stable based on the provided information, so they can be attended to after the patient with respiratory distress. Therefore, the nurse should attend to the 19-year-old man first to address his respiratory distress and ensure his condition does not deteriorate further.
5. The mother of a 9-month-old child diagnosed with respiratory syncytial virus (RSV) yesterday calls the clinic to inquire if it will be all right to take her infant to a friend's child's first birthday party the following day. Which response should the nurse provide?
- A. Do not expose other children as the virus is very contagious even without direct contact
- B. The child will no longer be contagious, no need to take any further precautions
- C. The child can be around other children but should wear a mask
- D. Make sure there are no children under the age of 5 months around the infected child
Correct answer: A
Rationale: The correct response is A: 'Do not expose other children as the virus is very contagious even without direct contact.' RSV is highly contagious, especially in young children. Allowing the infected child to attend a birthday party can put other children at risk of contracting the virus. Choice B is incorrect as RSV can remain contagious for a period of time. Choice C is not sufficient, as wearing a mask may not entirely prevent the spread of the virus. Choice D is inaccurate, as children under 5 months are not the only ones susceptible to RSV; all young children are at risk.
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