HESI LPN
HESI Fundamentals Study Guide
1. The nurse is preparing to administer a subcutaneous injection of insulin to a client with diabetes. What is the best site for the nurse to select for this injection?
- A. Ventrogluteal site
- B. Dorsogluteal site
- C. Deltoid site
- D. Abdomen
Correct answer: D
Rationale: The correct answer is 'D: Abdomen.' The abdomen is the best site for insulin injections as it provides a larger area with consistent absorption rates due to the high vascularity of the area. The subcutaneous tissue in the abdomen allows for a more predictable and consistent absorption of insulin compared to other sites. Ventrogluteal and dorsogluteal sites are not commonly used for insulin injections due to the risk of hitting the sciatic nerve or causing tissue damage. The deltoid site is more commonly used for intramuscular injections rather than subcutaneous injections like insulin.
2. A client requires a 24-hour urine collection. Which statement by the client indicates an understanding of the teaching?
- A. "I had a bowel movement, but I was able to save the urine."
- B. "I have a specimen in the bathroom from about 30 minutes ago."
- C. "I flushed what I urinated at 7 a.m. and have saved all urine since."
- D. "I drink a lot, so I will fill up the bottle and complete the test quickly."
Correct answer: C
Rationale: The correct answer is C because for a 24-hour urine collection, the first void is discarded, and all subsequent urine should be saved. Choice A is incorrect because bowel movements do not contribute to a urine collection. Choice B indicates a single specimen rather than continuous collection over 24 hours. Choice D is incorrect as it incorrectly suggests rushing the test by drinking excessively.
3. When providing oral care to an unconscious patient, what action should the nurse take to protect the patient from injury?
- A. Moisten the mouth using lemon-glycerin sponges.
- B. Hold the patient's mouth open with gloved fingers.
- C. Use foam swabs to help remove plaque.
- D. Suction the oral cavity.
Correct answer: D
Rationale: When caring for an unconscious patient, it is crucial to prevent choking and aspiration. Suctioning the oral cavity helps in removing secretions and preventing potential harm. Moisten the mouth using lemon-glycerin sponges may not effectively clear secretions. Holding the patient's mouth open with gloved fingers can cause discomfort and potential harm. Using foam swabs to remove plaque may not address the immediate risk of aspiration.
4. A healthcare professional is preparing to perform denture care for a client. Which of the following actions should the professional plan to take?
- A. Pull down and out at the back of the upper denture to remove.
- B. Brush the dentures with a toothbrush and denture cleaner.
- C. Rinse the dentures with hot water after cleaning them.
- D. Place the dentures in a clean, dry storage container after cleaning them.
Correct answer: B
Rationale: The correct answer is to brush the dentures with a toothbrush and denture cleaner. This action ensures effective cleaning of the dentures. Dentures should be rinsed with cool or lukewarm water, not hot water, to prevent damage. Placing the dentures in a clean, dry storage container is not the immediate next step after cleaning; they should be kept moist to prevent warping.
5. While documenting in a client’s medical record, which of the following entries should the nurse record?
- A. “Incision without redness or drainage”
- B. “Drank adequate amounts of fluid with meals”
- C. “Administered pain medication”
- D. “Oral temperature slightly elevated at 0800”
Correct answer: D
Rationale: The correct answer is D because documenting specific observations, such as an oral temperature being slightly elevated at a specific time, is crucial for monitoring the client's health status accurately. This type of information helps in assessing trends and changes in the client's condition over time. Choice A is incorrect as it lacks specificity and does not provide measurable data about the client's condition. Choice B is incorrect because it is a general statement related to client behavior rather than a specific health observation. Choice C is incorrect as it reflects an action taken by the nurse and not a direct client's condition or observation.
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