HESI LPN
Community Health HESI Exam
1. The nurse manager has a nurse employee who is suspected of having a problem with chemical dependency. Which intervention would be the best approach by the nurse manager?
- A. Confront the nurse about the suspicions in a private meeting
- B. Schedule a staff conference, without the nurse present
- C. Consult the human resources department about the issue and needed actions
- D. Counsel the employee to resign to avoid investigation
Correct answer: C
Rationale: Consulting with human resources is the best approach in this situation. It ensures that the issue is handled according to the organization's policies and that the nurse receives the appropriate support and intervention needed for chemical dependency. Confronting the nurse directly may lead to defensiveness and hinder a constructive resolution. Scheduling a staff conference without the nurse present can create unnecessary speculation and violate the employee's privacy. Counseling the employee to resign is not appropriate and does not address the underlying problem of chemical dependency.
2. A client with heart failure is receiving digoxin (Lanoxin). The nurse should monitor the client for which of the following signs of digoxin toxicity?
- A. Tachycardia
- B. Hypotension
- C. Bradycardia
- D. Hyperglycemia
Correct answer: C
Rationale: The correct answer is C: Bradycardia. Digoxin toxicity often presents with bradycardia, which is a common sign of toxicity associated with this medication. Tachycardia (Choice A) is not typically seen with digoxin toxicity. Hypotension (Choice B) can occur but is less specific to digoxin toxicity. Hyperglycemia (Choice D) is not a typical sign of digoxin toxicity. Therefore, monitoring for bradycardia is crucial in clients receiving digoxin to detect toxicity early.
3. The nurse is caring for a comatose client. Which assessment finding provides the greatest indication that the client has an open airway?
- A. The client has asymmetrical chest expansion
- B. Percussion reveals dullness over the lung area
- C. Bilateral breath sounds can be auscultated
- D. The client has been turned q2h
Correct answer: C
Rationale: The correct answer is C: "Bilateral breath sounds can be auscultated." This finding indicates that air is moving adequately in and out of both lungs, confirming an open airway. Options A, B, and D are incorrect. Asymmetrical chest expansion may indicate lung or chest wall abnormalities, percussion revealing dullness over the lung area may suggest consolidation or fluid, and turning the client q2h is a position change intervention to prevent complications, not a direct assessment of airway patency.
4. A healthcare provider has inserted an indwelling catheter for a male patient. Where should the healthcare provider tape the catheter to prevent pressure on the client's urethra at the penoscrotal junction?
- A. Lower abdomen
- B. Upper thigh
- C. Penoscrotal junction
- D. Mid-abdomen
Correct answer: A
Rationale: Taping the catheter to the lower abdomen is the correct placement to prevent pressure on the urethra at the penoscrotal junction. Securing the catheter at the lower abdomen helps in reducing discomfort and minimizes the risk of trauma to the urethra. Placing the catheter on the upper thigh or penoscrotal junction can lead to tension on the catheter and potential discomfort for the patient. Taping the catheter to the mid-abdomen is not recommended as it does not provide the necessary support to prevent pressure on the urethra at the penoscrotal junction.
5. A RN is preparing the physical environment to interview a new client for admission to the mental health unit. Which environmental setting facilitates the best outcome of the interview?
- A. Dim the lights in the room to help the patient feel calm.
- B. Sit within two feet of the client to enhance the level of safety and security.
- C. Reduce the noise level in the room by turning off the television and radio.
- D. Position a table between the client and the RN for extra personal space.
Correct answer: C
Rationale: Reducing the noise level in the room by turning off the television and radio is the best choice among the options provided. This setting helps create a calm and focused environment, which facilitates better communication and assessment during the interview. Dimming the lights might not be suitable for all clients and could potentially hinder communication. Sitting too close or placing a table between the client and the RN may affect the client's comfort level and openness during the interview.