HESI FUNDAMENTALS EXAM
1) During the initial physical assessment of a newly admitted client with a pressure ulcer, a LPN observes that the client's
... [Show More] skin is dry and scaly. The nurse applies emollients and reinforces the dressing on the pressure ulcer. Legally, were the nurse's actions adequate?
A The nurse also should have instituted a plan to increase activity.
B The nurse provided supportive nursing care for the well-being of the client.
C Debridement of the pressure ulcer should have been done before the dressing was applied.
D Treatment should not have been instituted until the health care provider's prescriptions were received.
Correct Answer: B
2) A visitor comes to the nursing station and tells the nurse that a client and his relative had a fight and that the client is now lying unconscious
on the floor. What is the most important action the LPN/LVN needs to take? A Ask the client if he is okay.
B Call security from the room.
C Find out if there is anyone else in the room.
D Ask security to make sure the room is safe
Correct Answer: D
3) To ensure the safety of a client who is receiving a continuous intravenous normal saline infusion, the LPN should change the administration set every:
A 4 to 8 hours
B 12 to 24 hours
C 24 to 48 hours
D 72 to 96 hours Correct Answer: D
4) A LPN/LVN is taking care of a client who has severe back pain as a result of a work injury. What nursing considerations should be made when determining the client's plan of care? Select all that apply.
A Ask the client what is the client's acceptable level of pain.
B Eliminate all activities that precipitate the pain.
C Administer the pain medications regularly around the clock.
D Use a different pain scale each time to promote patient education. E Assess the client's pain every 15 minutes
Correct Answer: A, C
5) The LPN/LVN is preparing to administer eardrops to a client that has impacted cerumen. Before administering the drops, the nurse will assess the client for which contraindications? Select all that apply.
A Allergy to the medication
B Itching in the ear canal
C Drainage from the ear canal
D Tympanic membrane rupture
E Partial hearing loss in the affected ear Correct Answer:A,C,D
6) What clinical indicators should the LPN/LVN expect a client with hyperkalemia to exhibit? Select all that apply.
A Tetany
B Seizures
C Diarrhea
D Weakness
E Dysrhythmias Correct Answer:C,D,E
7) A health care provider has prescribed isoniazid (Laniazid) for a client. Which instruction should the LPN give the client about this medication?
A Prolonged use can cause dark concentrated urine.
B The medication is best absorbed when taken on an empty stomach.
C Take the medication with aluminum hydroxide to minimize GI upset.
D Drinking alcohol daily can cause drug-induced hepatitis
Correct Answer:D
8) To minimize the side effects of the vincristine (Oncovin) that a client is receiving, what does the LPN/LVN expect the dietary plan to include?
A Low in fat
B High in iron
C High in fluids
D Low in residue Correct Answer:C
9) A postoperative client says to the nurse, "My neighbor, I mean the person in the next room, sings all night and keeps me awake." The neighboring client has dementia and is awaiting transfer to a nursing home. How can the LPN/LVN best handle this situation?
A Tell the neighboring client to stop singing.
B Close the doors to both clients' rooms at night.
C Give the complaining client the prescribed as needed sedative.
D Move the neighboring client to a room at the end of the hall
Correct Answer:D
10) The nurse is providing postoperative care to a client who had a submucosal resection (SMR) for a deviated septum. The LPN should monitor for what complication associated with this type of surgery?
A Occipital headache
B Periorbital crepitus
C Expectoration of blood
D Changes in vocalization
Correct Answer:C
11) A nurse is reviewing a plan of care for a client who was admitted with dehydration as a result of prolonged watery diarrhea. Which prescription should the LPN/LVN question?
A Oral psyllium (Metamucil)
B Oral potassium supplement
C Parenteral half normal saline
D Parenteral albumin (Albuminar) Correct Answer:D
12) A client is to have mafenide (Sulfamylon) cream applied to burned areas. For which serious side effect of mafenide therapy should the LPN/LVN monitor this client?
A Curling ulcer
B Renal shutdown
C Metabolic acidosis
D Hemolysis of red blood cells Correct Answer:C
13) A LPN is preparing to administer an ophthalmic medication to a client. What techniques should the nurse use for this procedure? Select all that apply.
A Clean the eyelid and eyelashes.
B Place the dropper against the eyelid.
C Apply clean gloves before beginning of procedure.
D Instill the solution directly onto cornea.
E Press on the nasolacrimal duct after instilling the solution. Correct Answer:A,C,E
14) The LPN/LVN recognizes that which are important components of a neurovascular assessment? Select all that apply.
A Orientation
B Capillary refill
C Pupillary response
D Respiratory rate
E Pulse and skin temperature
F Movement and sensation
Correct Answer: B,E,F
15) A client reaches the point of acceptance during the stages of dying. What response should the LPN/LVN expect the client to exhibit?
A Apathy
B Euphoria
C Detachment
D Emotionalism
Correct Answer: C
16) A dying client is coping with feelings regarding impending death. The nurse bases care on the theory of death and dying by Kübler-Ross. During which stage of grieving should the LPN/LVN primarily use nonverbal interventions?
A Anger B Denial
C Bargaining
D Acceptance
Correct Answer: D
17) When a client files a lawsuit against a LPN for malpractice, the client must prove that there is a link between the harm suffered and actions performed by the nurse that were negligent. This is known as:
A Evidence
B Tort discovery
C Proximate cause
D Common cause
Correct Answer:C
18) Following a surgery on the neck, the client asks the LPN why the head of the bed is up so high. The LPN should tell the client that the high-Fowler position is preferred for what reason?
A To avoid strain on the incision
B To promote drainage of the wound
C To provide stimulation for the client
D To reduce edema at the operative site Correct Answer: D
19) The LPN is preparing discharge instructions for a client who has begun to demonstrate signs of early Alzheimer dementia. The client lives alone. The client's adult children live nearby. According to the prescribed medication regimen the client is to take medications six times throughout the day. What is the priority nursing intervention to assist the client with taking the medication?
A Contact the client's children and ask them to hire a private duty aide who will provide round-the-clock care.
B Develop a chart for the client, listing the times the medication should be taken.
C Contact the primary health care provider and discuss the possibility of simplifying the medication regimen.
D Instruct the client and client's children to put medications in a weekly pill organizer
Correct Answer: C
20) The LPN/LVN expects a client with an elevated temperature to exhibit what indicators of pyrexia? Select all that apply.
A Dyspnea
B Flushed face
C Precordial pain
D Increased pulse rate
E Increased blood pressure Correct Answer: B,D
21) The LPN/LVN should instruct a client with an ileal conduit to empty the collection device frequently because a full urine collection bag may:
A Force urine to back up into the kidneys.
B Suppress production of urine.
C Cause the device to pull away from the skin.
D Tear the ileal conduit
Correct Answer: C
22) A LPN is reviewing studies to answer a clinical question as part of an evidence-based practice project. The study design determines the level of evidence. Place each methodology in order from the most reliable to the least reliable.
A Meta-analysis
B Randomized controlled trial
C Expert opinion based on scientific principles
D Cohort study
E Controlled trial without randomization Correct Answer: A
23) Client expresses concern about being exposed to radiation therapy because it can cause cancer. What should the LPN emphasize when informing the client about exposure to radiation?
A The dosage is kept at a minimum.
B Only a small part of the body is irradiated.
C The client's physical condition is not a risk factor.
D Nutritional environment of the affected cells is a risk factor. Correct Answer: B
24) The triage LPN in the emergency department receives four clients simultaneously. Which of the clients should the nurse determine can be treated last?
A Multipara in active labor
B Middle-aged woman with substernal chest pain
C Older adult male with a partially amputated finger
D Adolescent boy with an oxygen saturation of 91%
Correct Answer: C
25) Health promotion efforts with the chronically ill client should include interventions related to primary prevention. What should this include?
A Encouraging daily physical exercise
B Performing yearly physical examinations
C Providing hypertension screening programs
D Teaching a person with diabetes how to prevent complications Correct Answer: A [Show Less]