HESI LPN
Fundamentals of Nursing HESI
1. What is the rate of delivery in mL/hr if a total volume of 750 mL is infused over a period of 7 hours?
- A. 107 mL/hr.
- B. 107 mL/hr.
- C. 107 mL/hr.
- D. 107 mL/hr.
Correct answer: A
Rationale: The correct rate of delivery is 107 mL/hr. To find the rate of delivery, divide the total volume by the total time: 750 mL / 7 hours = 107 mL/hr. Choice B, C, and D are incorrect as they do not match the correct calculation based on the total volume and time provided.
2. A policy requiring the removal of acrylic nails by all nursing personnel was implemented 6 months ago. Which assessment measure best determines if the intended outcome of the policy is being achieved?
- A. Number of staff-induced injuries
- B. Client satisfaction survey
- C. Healthcare-associated infection rate
- D. Rate of needle-stick injuries by nurses
Correct answer: C
Rationale: The correct answer is C: Healthcare-associated infection rate. This measure best indicates the effect of the policy on infection control. By monitoring the healthcare-associated infection rate, it can be determined if the policy of removing acrylic nails has contributed to reducing the risk of infections. Choices A, B, and D are not as directly linked to the outcome of the policy. The number of staff-induced injuries may not be solely due to acrylic nails. Client satisfaction may not be directly impacted by this policy, and needle-stick injuries are more related to a different aspect of healthcare practice.
3. A charge nurse is assigning tasks to a nurse and assistive personnel for a group of clients. Which of the following tasks should the charge nurse delegate to the AP?
- A. Report ABG results to the provider
- B. Instruct a client about how to use an incentive spirometer
- C. Administer an enteral feeding to a client who has an established gastrostomy tube
- D. Monitor the color of a client’s urinary output
Correct answer: D
Rationale: The correct answer is D because monitoring the color of a client's urinary output is a task that can be safely delegated to assistive personnel. This task involves basic observation and does not require specialized nursing knowledge or skills. Choice A is incorrect because reporting ABG results to the provider requires interpretation and critical thinking skills typically performed by a nurse. Choice B is incorrect as instructing a client about how to use an incentive spirometer involves educating and assessing the client, which is a nursing responsibility. Choice C is incorrect as administering enteral feeding to a client with a gastrostomy tube requires nursing expertise to ensure proper technique and monitoring for complications.
4. A home health nurse is planning to provide health promotion activities for a group of clients in the community. Which of the following activities is an example of the nurse promoting primary prevention?
- A. Educating clients about the recommended immunization schedule for adults
- B. Teaching clients how to manage chronic illnesses
- C. Providing counseling for depression
- D. Offering support groups for cancer survivors
Correct answer: A
Rationale: The correct answer is A: Educating clients about the recommended immunization schedule for adults. This activity falls under primary prevention, which aims to prevent the onset of illness or injury. Immunizations are a proactive measure to protect individuals from developing certain diseases. Choices B, C, and D involve managing chronic illnesses, providing counseling for mental health issues, and offering support for individuals who have already experienced cancer, respectively. These activities are more aligned with secondary or tertiary prevention, focusing on managing existing conditions or preventing complications in those already affected.
5. A nurse observes a family member administer a rectal suppository by having the client lie on the left side for the administration. The family member pushed the suppository until the finger went up to the second knuckle. After 10 minutes, the client was told by the family member to turn to the right side. What is the appropriate comment for the nurse to make?
- A. Why don’t we now have the client turn back to the left side?
- B. That was done correctly. Did you have any problems with the insertion?
- C. Let’s check to see if the suppository is in far enough.
- D. Did you feel any stool in the intestinal tract?
Correct answer: B
Rationale: Choice B is the correct answer because the family member's actions in administering the rectal suppository were correct. Providing positive feedback and asking if there were any problems with the insertion is an appropriate response. Choice A is incorrect because there is no need to have the client turn back to the left side after the suppository has been administered. Choice C is incorrect as there is no indication that the suppository was not inserted correctly, so there is no need to check if it is in far enough. Choice D is incorrect because feeling stool in the intestinal tract is not relevant to the administration of a rectal suppository.
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