HESI LPN-TO-ADN EXAM 350 QUESTIONS
AND CORRECT ANSWERS WITH
RATIONALES
Section 1: Fundamentals of Nursing (Questions 1-50)
1. A client is prescribed 500 mg of a medication. The pharmacy supplies a
liquid with a concentration of 250 mg/5 mL. How many mL will the nurse
administer?
A. 5 mL
B. 10 mL
C. 15 mL
D. 20 mL
Correct Answer: B. 10 mL
Rationale: Use the formula: Desired / Available x Quantity. 500 mg / 250 mg =
2. 2 x 5 mL = 10 mL.
2. A client with a diagnosis of pneumonia is having difficulty expectorating
thick, tenacious secretions. Which nursing intervention is most appropriate to
assist this client?
A. Administer a cough suppressant.
B. Increase oral fluid intake to 3000 mL/day.
C. Place the client in a supine position.
D. Instruct the client to breathe shallowly.
Correct Answer: B. Increase oral fluid intake to 3000 mL/day.
,Rationale: Increasing fluid intake helps to liquefy secretions, making them
easier to expectorate. Cough suppressants would inhibit the cough reflex.
Supine positioning can worsen respiratory effort and shallow breathing is not
effective.
3. The nurse is preparing to insert a nasogastric (NG) tube for a client with a
bowel obstruction. What is the most important action to verify correct
placement of the tube after insertion?
A. Auscultate for a "whoosh" of air over the epigastrium.
B. Aspirate gastric contents and check pH.
C. Check the tube's length marking at the nose.
D. Ask the client if they can talk and swallow.
Correct Answer: B. Aspirate gastric contents and check pH.
Rationale: The most reliable method for confirming NG tube placement is
measuring the pH of the aspirated fluid. Gastric fluid typically has a pH of 5.0
or less. The "whoosh" test is considered unreliable and is no longer
recommended.
4. The nurse is assessing a client's peripheral intravenous (IV) site. Which
finding indicates that the IV has infiltrated?
A. A blood return is noted upon aspiration.
B. The skin around the site is red and warm.
C. The area around the site is edematous and cool.
D. The client reports a sharp, shooting pain.
Correct Answer: C. The area around the site is edematous and cool.
Rationale: Infiltration occurs when IV fluid leaks into the surrounding tissue,
causing edema, coolness, and pallor. Redness and warmth indicate phlebitis or
infection. Blood return indicates the catheter is in the vein. Sharp pain may
indicate nerve irritation or a problem with the infusion.
,5. A client is on strict isolation. The nurse is preparing to remove personal
protective equipment (PPE). Which piece of PPE should be removed first?
A. Gloves
B. Goggles
C. Gown
D. Mask
Correct Answer: A. Gloves
Rationale: Gloves are the most contaminated piece of PPE and should be
removed first to prevent contaminating the rest of the PPE or the nurse's
clothing. The sequence is gloves, goggles, gown, mask.
6. The nurse is calculating the intake and output for a client over an 8-hour
shift. The client drank 8 oz of water, 6 oz of soup, and 4 oz of juice. How many
mL of intake should the nurse document?
A. 180 mL
B. 360 mL
C. 540 mL
D. 720 mL
Correct Answer: C. 540 mL
Rationale: The total fluid intake in ounces is 8 + 6 + 4 = 18 oz. Multiply the
total ounces by 30 mL/oz to convert to mL: 18 x 30 = 540 mL.
7. A client who is post-operative day 1 after abdominal surgery complains of
pain at a level of 8 on a 0-10 scale. The nurse administers morphine sulfate 4
mg IV. One hour later, the client rates their pain as a 3. The nurse's next action
should be to:
A. Document the findings and re-assess in 2 hours.
, B. Administer another dose of morphine immediately.
C. Notify the healthcare provider about the persistent pain.
D. Assess the client's level of sedation and respiratory rate.
Correct Answer: D. Assess the client's level of sedation and respiratory rate.
Rationale: Before administering any additional pain medication, the nurse
must first assess for potential side effects, particularly respiratory depression
and excessive sedation, which are major concerns with opioids.
8. The nurse is providing education to a client with a new colostomy. Which
statement by the client indicates a need for further teaching?
A. "I will need to change the pouch when it becomes one-third to one-half full
of stool."
B. "I should avoid gas-forming foods like beans and broccoli to prevent
excessive flatus."
C. "I will be able to irrigate the colostomy to regulate bowel movements."
D. "I should apply skin barrier powder directly to the stoma to protect the
skin."
Correct Answer: D. "I should apply skin barrier powder directly to the stoma
to protect the skin."
Rationale: Skin barrier powder is used to treat denuded or excoriated
*peristomal* skin, not the stoma itself. Applying it directly to the stoma would
prevent the pouch from adhering and could irritate the stoma mucosa.
9. The nurse is assessing a client who is 2 hours post-operative from a
thyroidectomy. Which assessment finding requires immediate action?
A. The client reports a sore throat.
B. The client's voice is hoarse.
C. The client's serum calcium level is 8.0 mg/dL.
AND CORRECT ANSWERS WITH
RATIONALES
Section 1: Fundamentals of Nursing (Questions 1-50)
1. A client is prescribed 500 mg of a medication. The pharmacy supplies a
liquid with a concentration of 250 mg/5 mL. How many mL will the nurse
administer?
A. 5 mL
B. 10 mL
C. 15 mL
D. 20 mL
Correct Answer: B. 10 mL
Rationale: Use the formula: Desired / Available x Quantity. 500 mg / 250 mg =
2. 2 x 5 mL = 10 mL.
2. A client with a diagnosis of pneumonia is having difficulty expectorating
thick, tenacious secretions. Which nursing intervention is most appropriate to
assist this client?
A. Administer a cough suppressant.
B. Increase oral fluid intake to 3000 mL/day.
C. Place the client in a supine position.
D. Instruct the client to breathe shallowly.
Correct Answer: B. Increase oral fluid intake to 3000 mL/day.
,Rationale: Increasing fluid intake helps to liquefy secretions, making them
easier to expectorate. Cough suppressants would inhibit the cough reflex.
Supine positioning can worsen respiratory effort and shallow breathing is not
effective.
3. The nurse is preparing to insert a nasogastric (NG) tube for a client with a
bowel obstruction. What is the most important action to verify correct
placement of the tube after insertion?
A. Auscultate for a "whoosh" of air over the epigastrium.
B. Aspirate gastric contents and check pH.
C. Check the tube's length marking at the nose.
D. Ask the client if they can talk and swallow.
Correct Answer: B. Aspirate gastric contents and check pH.
Rationale: The most reliable method for confirming NG tube placement is
measuring the pH of the aspirated fluid. Gastric fluid typically has a pH of 5.0
or less. The "whoosh" test is considered unreliable and is no longer
recommended.
4. The nurse is assessing a client's peripheral intravenous (IV) site. Which
finding indicates that the IV has infiltrated?
A. A blood return is noted upon aspiration.
B. The skin around the site is red and warm.
C. The area around the site is edematous and cool.
D. The client reports a sharp, shooting pain.
Correct Answer: C. The area around the site is edematous and cool.
Rationale: Infiltration occurs when IV fluid leaks into the surrounding tissue,
causing edema, coolness, and pallor. Redness and warmth indicate phlebitis or
infection. Blood return indicates the catheter is in the vein. Sharp pain may
indicate nerve irritation or a problem with the infusion.
,5. A client is on strict isolation. The nurse is preparing to remove personal
protective equipment (PPE). Which piece of PPE should be removed first?
A. Gloves
B. Goggles
C. Gown
D. Mask
Correct Answer: A. Gloves
Rationale: Gloves are the most contaminated piece of PPE and should be
removed first to prevent contaminating the rest of the PPE or the nurse's
clothing. The sequence is gloves, goggles, gown, mask.
6. The nurse is calculating the intake and output for a client over an 8-hour
shift. The client drank 8 oz of water, 6 oz of soup, and 4 oz of juice. How many
mL of intake should the nurse document?
A. 180 mL
B. 360 mL
C. 540 mL
D. 720 mL
Correct Answer: C. 540 mL
Rationale: The total fluid intake in ounces is 8 + 6 + 4 = 18 oz. Multiply the
total ounces by 30 mL/oz to convert to mL: 18 x 30 = 540 mL.
7. A client who is post-operative day 1 after abdominal surgery complains of
pain at a level of 8 on a 0-10 scale. The nurse administers morphine sulfate 4
mg IV. One hour later, the client rates their pain as a 3. The nurse's next action
should be to:
A. Document the findings and re-assess in 2 hours.
, B. Administer another dose of morphine immediately.
C. Notify the healthcare provider about the persistent pain.
D. Assess the client's level of sedation and respiratory rate.
Correct Answer: D. Assess the client's level of sedation and respiratory rate.
Rationale: Before administering any additional pain medication, the nurse
must first assess for potential side effects, particularly respiratory depression
and excessive sedation, which are major concerns with opioids.
8. The nurse is providing education to a client with a new colostomy. Which
statement by the client indicates a need for further teaching?
A. "I will need to change the pouch when it becomes one-third to one-half full
of stool."
B. "I should avoid gas-forming foods like beans and broccoli to prevent
excessive flatus."
C. "I will be able to irrigate the colostomy to regulate bowel movements."
D. "I should apply skin barrier powder directly to the stoma to protect the
skin."
Correct Answer: D. "I should apply skin barrier powder directly to the stoma
to protect the skin."
Rationale: Skin barrier powder is used to treat denuded or excoriated
*peristomal* skin, not the stoma itself. Applying it directly to the stoma would
prevent the pouch from adhering and could irritate the stoma mucosa.
9. The nurse is assessing a client who is 2 hours post-operative from a
thyroidectomy. Which assessment finding requires immediate action?
A. The client reports a sore throat.
B. The client's voice is hoarse.
C. The client's serum calcium level is 8.0 mg/dL.
