HESI LPN
HESI PN Exit Exam 2024
1. 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.
2. The nurse plans to collect a 24-hour urine specimen for a creatinine clearance test. Which instruction should the nurse provide to the adult male client?
- A. Urinate at the specified time, discard this urine, and collect all subsequent urine over the next 24 hours.
- B. Cleanse around the meatus, discard the first portion of voiding, and collect the rest in a sterile bottle.
- C. For the next 24 hours, notify the nurse when the bladder is full, and the nurse will collect catheterized specimens.
- D. Urinate immediately into a urinal, and the lab will collect the specimen every 6 hours for the next 24 hours.
Correct answer: A
Rationale: The correct instruction for the adult male client to follow when collecting a 24-hour urine specimen for a creatinine clearance test is to urinate at the specified time, discard this urine, and collect all subsequent urine over the next 24 hours. This method ensures proper collection for an accurate creatinine clearance measurement. Choice B is incorrect as it describes a different procedure for a clean-catch urine sample, not suitable for creatinine clearance. Choice C is incorrect as it suggests catheterization, which is not typically done for a creatinine clearance test, and it is not necessary for this procedure. Choice D is incorrect as it does not follow the standard procedure for a 24-hour urine collection for creatinine clearance; the urine should be collected continuously over 24 hours, not at specified intervals.
3. Which of these tests with frequency would the nurse expect to monitor for the evaluation of clients with poor glycemic control in persons aged 18 and older?
- A. A glycosylated hemoglobin (A1c) should be performed during an initial assessment and during follow-up assessments, which should occur at no longer than 3-month intervals
- B. A glycosylated hemoglobin should be obtained at least twice a year
- C. A fasting glucose and a glycosylated hemoglobin should be obtained at 3-month intervals after the initial assessment
- D. A glucose tolerance test, a fasting glucose, and a glycosylated hemoglobin should be obtained at 6-month intervals after the initial assessment
Correct answer: A
Rationale: Glycosylated hemoglobin (A1c) testing every 3 months is recommended for clients with poor glycemic control to monitor their average blood sugar levels and adjust treatment as necessary. Choice A is correct as it aligns with the guideline of performing A1c testing every 3 months. Choice B is incorrect because testing at least twice a year may not provide adequate monitoring for clients with poor glycemic control. Choice C is incorrect as it only mentions testing at 3-month intervals without specifying the importance of A1c testing. Choice D is incorrect as it includes unnecessary tests like glucose tolerance test and does not emphasize the importance of more frequent A1c monitoring for clients with poor glycemic control.
4. Which individual is most at risk for Osgood-Schlatter disease?
- A. An elderly female who is hospitalized with a hip fracture and on bed rest
- B. A middle-aged male patient who has been exposed to asbestos in the shipping industry
- C. An adolescent who is physically active and the captain of their soccer team
- D. An infant of low birth weight and a gestational age of 28 weeks
Correct answer: C
Rationale: Osgood-Schlatter disease is a condition that commonly affects adolescents who are physically active, especially during growth spurts. It is caused by overuse of the knee, leading to inflammation of the patellar ligament at the tibial tuberosity. The repetitive stress on the growth plate during activities like running and jumping can trigger this condition. Therefore, an adolescent who is physically active and the captain of their soccer team is most at risk for Osgood-Schlatter disease. Choices A, B, and D are not at high risk for this condition as it is primarily seen in active adolescents.
5. A client with tuberculosis is receiving isoniazid (INH). The nurse should monitor the client for which of the following side effects?
- A. Hepatotoxicity
- B. Hyperglycemia
- C. Hypotension
- D. Hypokalemia
Correct answer: A
Rationale: The correct answer is A: Hepatotoxicity. Isoniazid (INH) can lead to hepatotoxicity, necessitating the monitoring of liver function tests. This adverse effect is characterized by liver damage and dysfunction. Choices B, C, and D are incorrect because isoniazid is not typically associated with hyperglycemia, hypotension, or hypokalemia. Therefore, the nurse should focus on assessing for signs and symptoms of hepatotoxicity in a client receiving isoniazid.