HESI LPN
Fundamentals HESI
1. Which behavior indicates the nurse is using a team approach when caring for a patient who is experiencing alterations in mobility?
- A. Delegates assessment of lung sounds to nursing assistive personnel
- B. Becomes solely responsible for modifying activities of daily living
- C. Consults physical therapy for strengthening exercises in the extremities
- D. Involves respiratory therapy for altered breathing from severe anxiety levels
Correct answer: C
Rationale: Consulting physical therapy for strengthening exercises in the extremities demonstrates a team approach in caring for a patient with mobility issues. Involving other healthcare professionals like physical therapists ensures a comprehensive and specialized approach to address the patient's mobility needs. This collaborative approach benefits the patient by providing specialized interventions. Choices A, B, and D do not exemplify a collaborative team approach. Delegating assessment tasks to nursing assistive personnel (Choice A) may not address the mobility issue directly. Becoming solely responsible for modifying activities of daily living (Choice B) limits the scope of interventions. Involving respiratory therapy for anxiety-related breathing issues (Choice D) addresses a different aspect of care and does not directly target mobility concerns.
2. A healthcare professional is preparing to insert an IV catheter into a client’s arm prior to initiating IV fluid therapy. Which of the following interventions should the healthcare professional implement to prevent infection?
- A. Thread the catheter up to the hub
- B. Use a sterile technique throughout the procedure
- C. Clean the insertion site with alcohol only
- D. Use gloves but not a mask during the procedure
Correct answer: B
Rationale: Using a sterile technique throughout the procedure is essential to prevent infection when inserting an IV catheter. This includes maintaining aseptic conditions, using sterile equipment, and following proper hand hygiene practices. Choice A is incorrect because threading the catheter up to the hub does not specifically address infection prevention. Choice C is incorrect as cleaning the insertion site with alcohol only may not provide adequate disinfection, as it is essential to use an antiseptic solution to reduce microbial load. Choice D is incorrect as wearing gloves alone is not sufficient protection against infection; a mask should also be worn to prevent the spread of microorganisms through respiratory secretions.
3. A client with Parkinson's disease is being discharged. Which statement by the client indicates a need for further teaching?
- A. I will take my medication at the same time every day.
- B. I will increase my fiber intake to prevent constipation.
- C. I will perform range of motion exercises to maintain mobility.
- D. I will stop taking my medication if I feel better.
Correct answer: D
Rationale: The correct answer is D. Patients with Parkinson's disease should not stop taking their medication if they feel better, as doing so can worsen symptoms. It is crucial for patients to continue their prescribed medication regimen as directed by their healthcare provider. Choices A, B, and C are all appropriate actions that promote the well-being of a client with Parkinson's disease. Choice A emphasizes medication adherence, which is vital for symptom management. Choice B addresses a common issue in Parkinson's patients and shows an understanding of the importance of dietary management. Choice C highlights the significance of physical activity in maintaining mobility, which is essential for overall quality of life in Parkinson's disease.
4. What is the rate of delivery in mL/hr if a total volume of 750 mL is infused over a period of 7 hours?
- A. 107 mL/hr.
- B. 107 mL/hr.
- C. 107 mL/hr.
- D. 107 mL/hr.
Correct answer: A
Rationale: The correct rate of delivery is 107 mL/hr. To find the rate of delivery, divide the total volume by the total time: 750 mL / 7 hours = 107 mL/hr. Choice B, C, and D are incorrect as they do not match the correct calculation based on the total volume and time provided.
5. During a physical assessment on a toddler, what should be the first action?
- A. Perform traumatic procedures
- B. Use minimal physical contact
- C. Proceed from head to toe
- D. Explain the exam in detail
Correct answer: B
Rationale: The correct first action when performing a physical assessment on a toddler is to use minimal physical contact. This approach helps the toddler become comfortable and reduces anxiety during the assessment. Traumatic procedures (Choice A) should never be the first action as they can cause distress. Proceeding from head to toe (Choice C) is a common sequence in physical assessments but does not address the initial need to establish trust and comfort. Explaining the exam in detail (Choice D) is important but should come after establishing a rapport through minimal physical contact.
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