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 a priority for the nurse to include in the teaching of a client who was recently prescribed alprazolam (Xanax) as an oral medication?
- A. Monitor heart rate before taking the medication
- B. Monitor temperature daily
- C. Avoid unprotected exposure to sunlight
- D. Avoid alcohol
Correct answer: D
Rationale: The correct answer is D: 'Avoid alcohol.' Alprazolam (Xanax) can have central nervous system depressant effects, which are exacerbated by alcohol. It is crucial to avoid alcohol while taking this medication to prevent severe sedation and respiratory depression. Monitoring heart rate (choice A) is not directly related to alprazolam administration. Monitoring temperature daily (choice B) is not a priority teaching point for a client prescribed alprazolam. Avoiding unprotected exposure to sunlight (choice C) is not specifically linked to the use of alprazolam.
3. A homeless male client with a history of alcohol abuse had a CVA 10 years ago that resulted in left hemiparesis. Today he is brought to the clinic reporting pain in his left leg. He is afebrile, has 4+ pitting edema in the lower left leg, and has minimal swelling of the right leg. Which action should the PN implement first?
- A. Obtain a blood alcohol test
- B. Inspect legs for infection or trauma
- C. Complete a mental status exam
- D. Inquire about dietary salt intake
Correct answer: B
Rationale: Inspecting the legs for infection or trauma is the priority to assess the cause of the pain and edema, which could indicate deep vein thrombosis or cellulitis. Checking for signs of infection or trauma is crucial in this scenario to rule out potentially serious conditions. Obtaining a blood alcohol test, completing a mental status exam, or inquiring about dietary salt intake can be considered after addressing the immediate concern of identifying any infection or trauma in the leg.
4. The UAP reports to the nurse that a client refused to bathe for the third consecutive day. Which action is best for the nurse to take?
- A. Explain the importance of good hygiene to the client
- B. Ask family members to encourage the client to bathe
- C. Reschedule the bath for the following day
- D. Ask the client why the bath was refused
Correct answer: D
Rationale: The correct action for the nurse to take is to ask the client why the bath was refused. Understanding the client's reason for refusal is crucial in identifying and addressing any underlying concerns or issues that may be contributing to the refusal. This approach promotes open communication, client-centered care, and helps in developing a plan of care that is tailored to the client's needs and preferences. Choices A, B, and C do not directly address the root cause of the refusal and may not effectively resolve the situation.
5. In what order should the PN implement these steps to provide wound care? (Place in correct order.)
- A. Don procedure gloves
- B. Remove the dressing
- C. Apply prescribed medications to the wound
- D. All of the Above
Correct answer: D
Rationale: The correct answer is 'D - All of the Above.' The PN should first don procedure gloves to maintain aseptic technique, then remove the dressing to assess the wound, and finally apply prescribed medications to the wound. This sequence ensures that non-sterile tasks like donning gloves are done before sterile tasks like applying medications, reducing the risk of wound contamination. Choices A, B, and C are all essential steps in providing effective wound care.
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