HESI LPN
HESI Fundamentals Study Guide
1. The client has been diagnosed with deep vein thrombosis (DVT). Which symptom would be most concerning?
- A. Pain in the affected leg
- B. Redness and warmth in the affected leg
- C. Shortness of breath
- D. Swelling in the affected leg
Correct answer: C
Rationale: Shortness of breath is the most concerning symptom in a client with deep vein thrombosis (DVT) because it could indicate a pulmonary embolism, a life-threatening complication where a blood clot travels to the lungs. This condition requires immediate medical attention. While pain, redness, warmth, and swelling in the affected leg are common symptoms of DVT, shortness of breath suggests a more critical situation that necessitates urgent intervention.
2. The female is caring for a male patient who is uncircumcised but not ambulatory and has full function of all extremities. The nurse is providing the patient with a partial bed bath. How should perineal care be performed for this patient?
- A. Should be postponed because it may cause embarrassment.
- B. Should be unnecessary because the patient is uncircumcised.
- C. Should be done by the patient.
- D. Should be done by the nurse.
Correct answer: C
Rationale: Perineal care should be encouraged to be done by the patient if they are capable of performing self-care. In this scenario, the patient is not ambulatory and has full function of all extremities, indicating that the patient can independently perform perineal care. Encouraging self-care promotes independence and maintains the patient's dignity. Postponing perineal care (Choice A) is incorrect because it is essential for hygiene. Choice B is incorrect as perineal care is necessary for all patients regardless of circumcision status. Choice D is incorrect as the patient is capable of performing the care independently, and promoting self-care is a priority in nursing practice.
3. A healthcare professional is preparing to administer IV fluids to a client. The professional notes sparks when plugging in the IV pump. Which of the following actions should the professional take first?
- A. Label the pump with a defective equipment sticker.
- B. Unplug the pump.
- C. Obtain a replacement pump.
- D. Notify the maintenance department to fix the pump.
Correct answer: B
Rationale: Unplugging the pump is the correct initial action in this situation to prevent any potential fire hazards. Sparks when plugging in the IV pump indicate an electrical issue that can lead to a fire. By immediately unplugging the pump, the healthcare professional ensures the safety of the client and prevents any further risks. Labeling the pump with a defective equipment sticker (Choice A) is not the priority as the immediate concern is safety. Obtaining a replacement pump (Choice C) can be considered after addressing the safety issue. Notifying the maintenance department (Choice D) is important but should follow the immediate action of unplugging the pump to mitigate the risk.
4. The healthcare provider is caring for a patient who has multiple ticks on lower legs and body. What should the healthcare provider do to rid the patient of ticks?
- A. Use blunt tweezers and pull upward with steady pressure.
- B. Burn the ticks with a match or a small lighter.
- C. Allow the ticks to drop off by themselves.
- D. Apply miconazole and cover with plastic.
Correct answer: A
Rationale: Correct answer: When removing ticks, it is essential to use blunt tweezers to grasp the tick as close to the head as possible and pull upward with even, steady pressure to remove the entire tick. Option B is incorrect because burning ticks can increase the risk of infection and is not recommended. Option C is incorrect as waiting for ticks to drop off by themselves prolongs potential exposure to tick-borne diseases. Option D is incorrect as miconazole is an antifungal medication and not used for tick removal.
5. The nurse admits a 7 year-old to the emergency room after a leg injury. The x-rays show a femur fracture near the epiphysis. The parents ask what will be the outcome of this injury. The appropriate response by the nurse should be which of these statements?
- A. The injury is expected to heal quickly because of thin periosteum.
- B. In some instances the result is a retarded bone growth.
- C. Bone growth is stimulated in the affected leg.
- D. This type of injury shows more rapid union than that of younger children.
Correct answer: B
Rationale: A fracture near the epiphysis can result in retarded bone growth, so this should be communicated to the parents.
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