HESI LPN
HESI PN Exit Exam
1. What is the function of the epiglottis during swallowing?
- A. Prevents food from entering the trachea
- B. Aids in food propulsion
- C. Enhances taste sensation
- D. Lubricates the esophagus
Correct answer: A
Rationale: The epiglottis is a flap of tissue that closes over the trachea during swallowing to prevent food and liquids from entering the airway. Choice A is correct because the primary function of the epiglottis is to act as a lid over the trachea, ensuring that food goes down the esophagus and not into the windpipe. Choices B, C, and D are incorrect as they do not describe the specific role of the epiglottis during swallowing.
2. A client who is at full-term gestation is in active labor and complains of a cramp in her leg. Which intervention should the nurse implement?
- A. Massage the calf and foot
- B. Elevate the leg above the heart
- C. Check the pedal pulse in the affected leg
- D. Extend the leg and flex the foot
Correct answer: D
Rationale: The correct intervention for a client in active labor complaining of a leg cramp is to extend the leg and flex the foot. This action helps stretch the muscles that are cramping, providing relief. Massaging the calf and foot (Choice A) may not be as effective for relieving the cramp. Elevating the leg above the heart (Choice B) is not indicated for a leg cramp. Checking the pedal pulse in the affected leg (Choice C) is unrelated to addressing the leg cramp.
3. A client who had a hip replacement is being prepared for discharge. What should the nurse include in the discharge teaching to prevent hip dislocation?
- A. Avoid crossing your legs at the knees or ankles.
- B. Do not sleep on the side of the hip that was operated on.
- C. Sit in high chairs and keep your knees higher than your hips.
- D. Do not bend forward at the waist to pick up objects.
Correct answer: A
Rationale: The correct answer is A: 'Avoid crossing your legs at the knees or ankles.' Crossing legs at the knees or ankles can cause excessive stress on the new hip joint, leading to a risk of dislocation. Choice B is incorrect because sleeping on the side of the operated hip can also increase the risk of dislocation. Choice C is incorrect as sitting in low chairs with knees higher than hips is a recommended position to prevent hip dislocation. Choice D is incorrect because bending forward at the waist to pick up objects can strain the hip joint and increase the risk of dislocation.
4. While caring for a client with an AV fistula in the left forearm, the PN observed a palpable buzzing sensation over the fistula. What action should the PN take?
- A. Loosen the fistula dressing
- B. Report the presence of a bounding pulse
- C. Document that the fistula is intact
- D. Apply gentle pressure over the site
Correct answer: C
Rationale: A palpable buzzing sensation, known as a thrill, over an AV fistula indicates proper functioning. The correct action for the PN is to document that the fistula is intact. Choice A is incorrect because there is no need to loosen the fistula dressing when the thrill is felt. Choice B is incorrect as a bounding pulse is not related to the observed buzzing sensation. Choice D is incorrect because applying pressure is unnecessary when a thrill is present, indicating proper AV fistula function.
5. The nurse assigns a UAP to assist with the personal care of a client experiencing an acute exacerbation of multiple sclerosis. Which instruction should the nurse provide the UAP?
- A. Assist the client with a hot bath
- B. Encourage self-care but allow rest periods
- C. Face the client directly when speaking
- D. Keep the head of the bed elevated at all times
Correct answer: B
Rationale: The correct instruction for the UAP to provide when assisting a client experiencing an acute exacerbation of multiple sclerosis is to encourage self-care but allow rest periods. Clients with multiple sclerosis often experience fatigue, so promoting self-care activities while ensuring they have adequate rest periods is crucial for symptom management and maintaining independence. Choice A is incorrect as hot baths can potentially exacerbate symptoms in clients with multiple sclerosis. Choice C is unrelated to the client's care needs during an acute exacerbation of multiple sclerosis. Choice D is not a priority instruction in this situation and may not directly impact the client's immediate care needs.
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