HESI LPN
Practice HESI Fundamentals Exam
1. How should a healthcare professional care for a client approaching death with shortness of breath and noisy respirations?
- A. Turn the client every 2 hours
- B. Provide supplemental oxygen
- C. Use a fan to reduce the feeling of breathlessness
- D. Administer diuretics as prescribed
Correct answer: C
Rationale: In a palliative care setting, when caring for a client approaching death with symptoms of shortness of breath and noisy respirations, using a fan can help alleviate the sensation of breathlessness. This intervention can provide comfort by improving air circulation and reducing the perception of breathlessness. Turning the client every 2 hours may not directly address the respiratory distress caused by noisy respirations. Providing supplemental oxygen may not be indicated or effective in all cases, especially in end-of-life care where the focus is on comfort rather than aggressive interventions. Administering diuretics as prescribed would not be appropriate for addressing noisy respirations and shortness of breath in a dying client, as this may not be related to fluid overload or congestion. Therefore, the most appropriate action to help the client feel more comfortable in this situation is to use a fan to reduce the feeling of breathlessness.
2. The healthcare professional is preparing a presentation to a local community group about genetic disorders and the types of congenital anomalies that can occur. What would the professional include as a major congenital anomaly?
- A. Overlapping digits
- B. Polydactyly
- C. Umbilical hernia
- D. Cleft palate
Correct answer: D
Rationale: Cleft palate is considered a major congenital anomaly due to its significant impact on feeding, speech, and overall health. Overlapping digits (Option A) are a physical anomaly but not typically considered a major congenital anomaly. Polydactyly (Option B) refers to having extra fingers or toes, which is a congenital anomaly but not as major as a cleft palate. Umbilical hernia (Option C) involves a protrusion of abdominal contents through the umbilical ring but is not typically classified as a major congenital anomaly compared to cleft palate.
3. When a nurse from the surgical department is reassigned to the pediatric unit, the charge nurse should recognize that the child at highest risk for cardiac arrest and is the least likely to be assigned to this nurse is which child?
- A. Congenital cardiac defects
- B. An acute febrile illness
- C. Prolonged hypoxemia
- D. Severe multiple trauma
Correct answer: C
Rationale: The correct answer is C, 'Prolonged hypoxemia.' Prolonged hypoxemia is a critical condition that requires specialized pediatric care due to the high risk of cardiac arrest. The other choices, such as congenital cardiac defects, acute febrile illness, and severe multiple trauma, may also require attention, but prolonged hypoxemia poses the highest risk for cardiac arrest and demands specialized expertise in managing pediatric patients with this condition.
4. An elderly male client who suffered a cerebral vascular accident is receiving tube feedings via a gastrostomy tube. The LPN knows that the best position for this client during administration of the feedings is
- A. prone.
- B. Fowler's.
- C. Sims'.
- D. supine.
Correct answer: B
Rationale: Fowler's position is the optimal position for a client receiving tube feedings via a gastrostomy tube because it reduces the risk of aspiration. In Fowler's position, the client is sitting up at a 45- to 60-degree angle, which helps prevent the formula from flowing back into the esophagus and causing aspiration pneumonia. Choice A, prone position (lying face down), would not be suitable for administering tube feedings as it increases the risk of aspiration. Sims' position (lying on the left side with the right knee flexed) and supine position (lying flat on the back) are also not ideal for administering tube feedings as they do not provide the same level of protection against aspiration as Fowler's position does.
5. Inspiratory and expiratory stridor may be heard in a client who:
- A. Is experiencing an exacerbation of goiter
- B. Is experiencing an acute asthmatic attack
- C. Has aspirated a piece of meat
- D. Has severe laryngotracheitis
Correct answer: D
Rationale: Inspiratory and expiratory stridor are high-pitched, wheezing sounds caused by disrupted airflow due to airway obstruction. Severe laryngotracheitis, involving inflammation and swelling of the larynx and trachea, leads to airway obstruction and can produce both inspiratory and expiratory stridor. Exacerbation of goiter, an acute asthmatic attack, and aspiration of a piece of meat are not typically associated with both inspiratory and expiratory stridor. Therefore, choices A, B, and C are incorrect.