HESI LPN
HESI PN Exit Exam 2024 Quizlet
1. When preparing to administer a medication through a nasogastric (NG) tube, what is the first action the nurse should take?
- A. Check the placement of the NG tube
- B. Flush the tube with saline
- C. Position the client in a semi-Fowler's position
- D. Administer the medication slowly
Correct answer: A
Rationale: The correct first action when preparing to administer a medication through a nasogastric (NG) tube is to check the placement of the NG tube. This step is essential to ensure that the tube is correctly positioned in the stomach and not in the lungs, preventing potential complications. Flushing the tube with saline may be required, but it should follow the verification of tube placement. Positioning the client in a semi-Fowler's position is necessary for comfort during the procedure but is not the initial step. Administering the medication can only be done safely after confirming the correct placement of the NG tube.
2. A client post-splenectomy is at risk for infection. What is the most important preventive measure the nurse should emphasize during discharge teaching?
- A. Take all prescribed antibiotics as directed.
- B. Avoid crowded places and people who are sick.
- C. Wash hands frequently and practice good hygiene.
- D. Keep the surgical site clean and dry.
Correct answer: C
Rationale: The correct answer is C: 'Wash hands frequently and practice good hygiene.' After a splenectomy, the client is at an increased risk of infection due to the role of the spleen in the immune system. Maintaining good hand hygiene, such as frequent handwashing, is crucial to prevent infections. While taking prescribed antibiotics as directed (Choice A) is important if prescribed, it is not the most crucial preventive measure in this scenario. Avoiding crowded places and sick people (Choice B) can help reduce the risk of exposure to pathogens but may not always be feasible. Keeping the surgical site clean and dry (Choice D) is important for wound care but is not the primary preventive measure to protect against infections in a post-splenectomy client.
3. While turning and positioning a bedfast client, the PN observes that the client is dyspneic. Which action should the PN take first?
- A. Apply a pulse oximeter
- B. Measure blood pressure
- C. Notify the charge nurse
- D. Observe pressure areas
Correct answer: C
Rationale: Notifying the charge nurse promptly is the priority when a bedfast client is dyspneic. Dyspnea can indicate a serious problem that requires immediate assessment and intervention. Contacting the charge nurse ensures timely assistance and appropriate actions to address the client's condition. Applying a pulse oximeter or measuring blood pressure may provide valuable data, but the priority is prompt communication with the charge nurse to ensure quick intervention. Observing pressure areas, while important for overall client care, is not the most immediate action needed when a client is experiencing dyspnea.
4. Before administering an antibiotic that can cause nephrotoxicity, which lab value is most important for the PN to review?
- A. Hemoglobin and Hematocrit
- B. Serum Calcium
- C. Serum Creatinine
- D. WBC
Correct answer: C
Rationale: Serum creatinine is the most important lab value to review before administering an antibiotic that can cause nephrotoxicity. This is because serum creatinine is a key indicator of kidney function. An elevated serum creatinine level may indicate impaired renal function, and administering nephrotoxic drugs in such situations can further damage the kidneys. Monitoring serum creatinine levels helps healthcare providers assess renal function and make informed decisions regarding drug administration. Choices A, B, and D are not as directly related to kidney function and nephrotoxicity, making them less crucial in this scenario. Hemoglobin and hematocrit levels assess for anemia, serum calcium levels are more related to bone health and nerve function, and WBC count is associated with immune response, none of which directly reflect kidney function or the risk of nephrotoxicity.
5. A client presents to the office with complaints of swelling in the legs, chills, and shortness of breath. During auscultation of the chest, a heart murmur is heard. The client's blood culture reveals a microorganism in the blood. When a microorganism is found in the blood, this condition is called
- A. Bacteremia
- B. Sepsis
- C. Septicemia
- D. Parasitic infection
Correct answer: A
Rationale: When a microorganism is found in the blood, this condition is called bacteremia, which refers to the presence of bacteria in the bloodstream, as indicated by a positive blood culture. If not appropriately treated, bacteremia can progress to septicemia, also known as sepsis. Sepsis is a severe and life-threatening response to an infection, characterized by systemic inflammation and organ dysfunction. Parasitic infections involve pathogens other than bacteria and are not directly related to the scenario described.
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