the pn observes a uap bathing a bedfast client with the bed in the high position which action should the pn take
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Nursing Elites

HESI LPN

HESI PN Exit Exam

1. The PN observes a UAP bathing a bedfast client with the bed in the high position. Which action should the PN take?

Correct answer: D

Rationale: The correct action for the PN to take in this situation is to instruct the UAP to lower the bed for safety. Keeping the bed in the lowest position during care activities is crucial for preventing falls and injuries to both the client and the caregiver. Instructing the UAP to lower the bed addresses the immediate safety concern. Choice A is incorrect because simply supervising the UAP without addressing the unsafe bed height does not ensure the client's safety. Choice B is incorrect as the priority is to address the safety concern rather than offering assistance to the UAP. Choice C is incorrect as assuming care of the client immediately does not address the root issue of the high bed position.

2. Which of the following is the most effective way to prevent the spread of infection in a healthcare setting?

Correct answer: C

Rationale: Performing hand hygiene is the most effective way to prevent the spread of infection in a healthcare setting. Hand hygiene helps remove pathogens that could be transmitted through direct contact, making it a crucial practice in infection control. While using sterile gloves and disposable equipment are important in certain situations, they do not address the potential transmission of pathogens through direct contact, unlike hand hygiene. Wearing a face mask is important for respiratory precautions but may not be as effective as hand hygiene in preventing the spread of infections through direct contact.

3. An 8-year-old is placed in 90-90 traction for a fractured femur resulting from a motor vehicle collision. Which finding requires further action by the nurse?

Correct answer: C

Rationale: The correct answer is C. In 90-90 traction, the weights should hang freely and not touch the foot of the bed to maintain proper traction and bone alignment. Option A is not necessarily a concern as bowel movements can be influenced by various factors, including diet changes and pain medication. Option B indicates good caregiver involvement, promoting comfort and preventing complications. Option D demonstrates neurovascular function, which is a positive finding. Therefore, the weights touching the foot of the bed is the finding that requires immediate attention to ensure the effectiveness of the traction.

4. During a clinic visit for a sore throat, a client's basal metabolic panel reveals a serum potassium of 3.0 mEq/L. Which intervention should the PN recommend to the client based on this finding?

Correct answer: A

Rationale: The correct answer is to recommend increasing the intake of dried peaches and apricots. A serum potassium level of 3.0 mEq/L is considered low. Increasing the intake of potassium-rich foods can help raise the serum potassium level, preventing complications such as muscle weakness and cardiac arrhythmias. Choice B, reducing intake of red meats, is incorrect because red meats are not specifically related to potassium levels. Choice C, encouraging the use of a soft toothbrush, is unrelated to addressing low potassium levels. Choice D, forcing fluid intake to 1500 mL daily, is not the appropriate intervention for low serum potassium; instead, increasing potassium-rich foods is more beneficial.

5. The PN is caring for a client who had an acute brain attack with resulting expressive aphasia and urinary incontinence. To ensure care for the client, which task should the PN delegate to the UAP?

Correct answer: C

Rationale: Assisting the client to the bedside commode is an appropriate task for the UAP as it involves basic patient care and mobility assistance, which are within the UAP's scope of practice. Options A and B involve communication techniques and documentation, which are more appropriate for licensed nursing staff. Option D involves establishing a bladder training schedule, which requires assessment and planning skills beyond the UAP's role.

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