HESI LPN
Leadership and Management HESI Test Bank
1. Select the cranial nerve that is accurately paired with its name.
- A. The fourth cranial nerve: The trochlear nerve
- B. The twelfth cranial nerve: The hypoglossal nerve
- C. The tenth cranial nerve: The olfactory nerve
- D. The thirteenth cranial nerve: The auditory nerve
Correct answer: B
Rationale: The twelfth cranial nerve is the hypoglossal nerve, which controls the muscles of the tongue. The other choices are incorrect because the trochlear nerve is the fourth cranial nerve responsible for eye movement, the olfactory nerve is the first cranial nerve responsible for the sense of smell, and there are only twelve cranial nerves, so there is no thirteenth cranial nerve.
2. A client is preparing for an elective mastectomy. The client is wearing a plain gold wedding band. Which of the following is an appropriate procedure for taking care of this client's ring?
- A. Agree to keep the ring for the client until after surgery
- B. Place the ring in the bag with the client's clothing
- C. Tape the ring securely to the client's finger
- D. Place the client's ring in the facility safe
Correct answer: D
Rationale: In this scenario, placing the client's ring in the facility safe is the most appropriate procedure. This ensures the ring is kept secure and prevents any risk of loss or damage during the surgery. Agreeing to keep the ring for the client could raise concerns about accountability, while placing it in the bag with the client's clothing might lead to misplacement. Taping the ring securely to the client's finger is not recommended as it may hinder blood circulation or cause discomfort.
3. A client with terminal cancer is experiencing severe pain. The nurse plans to implement which of the following pain management strategies?
- A. Administer analgesics on a fixed schedule
- B. Administer analgesics only when the client requests
- C. Use non-pharmacological methods only
- D. Increase the dose of analgesics when the client complains of pain
Correct answer: A
Rationale: Administering analgesics on a fixed schedule is the most appropriate pain management strategy for a client with terminal cancer experiencing severe pain. This approach ensures consistent pain control and helps prevent breakthrough pain. Administering analgesics only when the client requests (Choice B) may lead to uncontrolled pain as the client may delay requesting medication until the pain becomes unbearable. Using non-pharmacological methods only (Choice C) may not provide adequate pain relief for a client experiencing severe pain. Increasing the dose of analgesics when the client complains of pain (Choice D) may result in inconsistent pain control and could lead to potential overdose or adverse effects.
4. An outpatient clinic that has been receiving haloperidol (Haldol) for 2 days develops muscular rigidity, altered consciousness, a temperature of 103, and trouble breathing on day 3. The LPN/LVN interprets these findings as indicating which of the following?
- A. Neuroleptic Malignant Syndrome
- B. Tardive dyskinesia
- C. Extrapyramidal adverse effects
- D. Drug-induced parkinsonism
Correct answer: A
Rationale: Neuroleptic Malignant Syndrome (NMS) is a life-threatening condition characterized by hyperthermia, muscle rigidity, altered consciousness, and autonomic dysregulation. It is a rare but serious side effect of antipsychotic medications like haloperidol (Haldol). NMS requires immediate intervention, including discontinuation of the offending medication and supportive care. Tardive dyskinesia (Choice B) is a different condition characterized by involuntary movements of the face and extremities that can occur with long-term antipsychotic use. Extrapyramidal adverse effects (Choice C) encompass a range of movement disorders like dystonia, akathisia, and parkinsonism that can result from antipsychotic medications, but they do not present with hyperthermia and altered consciousness as in NMS. Drug-induced parkinsonism (Choice D) is a form of parkinsonism caused by certain medications, but it typically presents with symptoms similar to Parkinson's disease, such as tremor, bradykinesia, and rigidity, without the severe hyperthermia and autonomic dysregulation seen in NMS.
5. While caring for a client's postoperative dressing, the nurse observes purulent wound drainage. Previously, the wound was inflamed and tender but without drainage. Which is the most important action for the nurse to take?
- A. Determine if the drainage has an unpleasant odor.
- B. Monitor the client's white blood cell count (WBC).
- C. Request a culture and sensitivity of the wound.
- D. Cleanse the wound with a sterile saline solution.
Correct answer: C
Rationale: Requesting a culture and sensitivity of the wound is the most crucial action in this scenario. This will help identify the specific organism causing the infection and determine its sensitivity to antibiotics, guiding appropriate antibiotic therapy. Option A is less critical as odor alone may not provide enough information about the type of infection. Monitoring the client's white blood cell count (WBC) in option B is important but not as immediate as obtaining a wound culture. Cleansing the wound with a sterile saline solution in option D is necessary but should follow after obtaining the culture results to ensure proper treatment.