HESI LPN
HESI PN Exit Exam 2024
1. What is the priority intervention for a patient experiencing an acute asthma attack?
- A. Administering a bronchodilator
- B. Encouraging the patient to drink fluids
- C. Applying a high-flow oxygen mask
- D. Performing chest physiotherapy
Correct answer: A
Rationale: Administering a bronchodilator is the priority intervention in an acute asthma attack. Bronchodilators help to quickly open the airways, relieve bronchospasm, and improve breathing. Encouraging the patient to drink fluids may be beneficial for other conditions but is not the priority in an acute asthma attack. Applying a high-flow oxygen mask may be necessary in severe cases of respiratory distress but is not the initial priority when managing an acute asthma attack. Performing chest physiotherapy is not indicated as the primary intervention for an acute asthma attack and may not address the immediate need to open the airways and improve breathing.
2. Which of the following is the most effective way to prevent the spread of infection in a healthcare setting?
- A. Using sterile gloves
- B. Wearing a face mask
- C. Performing hand hygiene
- D. Using disposable equipment
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. Which task could the nurse safely delegate to the UAP?
- A. Oral feeding of a two-year-old child after application of a hip spica cast
- B. Assessment of the placement and patency of an NG tube
- C. Participation in staff rounds to record notes regarding client goals
- D. Evaluation of a client's incisional pain following narcotic administration
Correct answer: A
Rationale: The correct answer is A because oral feeding of a stable child is a task that can be safely delegated to a UAP. This task does not require nursing assessment or clinical judgment. Choice B involves assessment, which requires the nurse's clinical judgment. Choice C involves recording client goals during staff rounds, which may require interpretation and understanding of the goals set. Choice D involves evaluating a client's pain following medication administration, which requires assessment and clinical judgment by a nurse.
4. Which of the following dietary modifications should be recommended for a patient with chronic kidney disease (CKD)?
- A. High protein, low sodium
- B. Low protein, high potassium
- C. Low sodium, low potassium
- D. High calcium, low phosphorus
Correct answer: C
Rationale: A low sodium, low potassium diet is often recommended for patients with CKD to manage fluid balance and prevent electrolyte imbalances that the kidneys can no longer regulate effectively. High protein diets, as mentioned in choice A, can put extra strain on the kidneys, making it an incorrect choice. Choice B, which suggests a low protein, high potassium diet, is also incorrect because high potassium levels can be harmful to individuals with CKD. Choice D, advocating for a high calcium, low phosphorus diet, is not the typical dietary recommendation for CKD patients, even though managing calcium and phosphorus levels is important in their diet.
5. A client is recovering from a below-the-knee amputation (BKA). The client reports phantom limb pain. What should the nurse include in the client’s care plan to manage this type of pain?
- A. Apply heat to the residual limb.
- B. Administer prescribed analgesics.
- C. Elevate the residual limb.
- D. Perform range-of-motion exercises.
Correct answer: B
Rationale: Phantom limb pain is a type of pain that feels like it's coming from a body part that's no longer there. It is essential to understand that phantom limb pain is real and should be managed appropriately. Administering prescribed analgesics is the most effective way to address this discomfort. Applying heat, elevating the residual limb, and performing range-of-motion exercises are not effective in managing phantom limb pain since the pain originates from the brain expecting sensory input from the missing limb, rather than being related to physical factors that heat, elevation, or exercises can address.
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