NEWEST HESI LPN-RN ENTRANCE EXAM
MOBILITY &TRANSITION Final Exam Newest
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1. A nurse is planning care for a patient who has undergone a total hip
arthroplasty. Which intervention is most important to prevent
dislocation of the new joint in the immediate postoperative period?
A) Place a pillow between the patient's legs when turning.
B) Maintain the patient in a high Fowler's position.
C) Encourage the patient to cross their legs at the ankles.
D) Position the patient on the affected side.
Answer: A) Place a pillow between the patient's legs when turning.
Explanation: Maintaining the hip in abduction is critical post-
arthroplasty. Placing a pillow between the legs when turning prevents
adduction, which is a primary mechanism for dislocation. High Fowler's
position does not directly address hip precautions. Crossing legs or
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positioning on the affected side is contraindicated as it can lead to
dislocation.
2. The LPN is transferring a patient with left-sided weakness from the
bed to a wheelchair. Where should the LPN position the wheelchair in
relation to the bed?
A) Parallel to the bed on the patient's left side.
B) Perpendicular to the bed on the patient's right side.
C) Parallel to the bed on the patient's right side.
D) At the foot of the bed.
Answer: C) Parallel to the bed on the patient's right side.
Explanation: The wheelchair should be placed on the patient's stronger
side (right side) to facilitate the transfer. This allows the patient to bear
weight on the strong leg and pivot, using the stronger arm for support.
Placing it on the weak side is unsafe and increases fall risk.
Perpendicular placement can complicate the pivot maneuver.
3. A patient with a spinal cord injury at the T6 level is experiencing
autonomic dysreflexia. Which of the following clinical manifestations is
the LPN most likely to observe?
A) Hypotension and bradycardia.
B) Hypertension and bradycardia.
C) Hypotension and tachycardia.
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D) Flaccid paralysis below the level of injury.
Answer: B) Hypertension and bradycardia.
Explanation: Autonomic dysreflexia is a medical emergency
characterized by a massive sympathetic response below the injury level,
leading to severe hypertension. The baroreceptors respond by triggering
a parasympathetic response above the injury, resulting in bradycardia.
The paralysis is typically spastic, not flaccid.
4. A patient is 24 hours post-operative following a right below-knee
amputation. The LPN notes that the residual limb is edematous and
warm to the touch. Which action should the LPN take first?
A) Apply a cold pack to the residual limb.
B) Elevate the foot of the bed.
C) Notify the healthcare provider immediately.
D) Massage the residual limb to promote circulation.
Answer: B) Elevate the foot of the bed.
Explanation: Elevation of the residual limb for the first 24-48 hours is
standard to control edema and reduce pain. Mild warmth and swelling
are expected post-operative findings, so notifying the provider is not the
first action. Cold packs and massage are typically contraindicated in the
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immediate post-op period as they can compromise the delicate skin and
healing tissues.
5. The LPN is reinforcing discharge teaching for a patient with a new
diagnosis of osteoporosis. Which statement by the patient indicates a
need for further teaching?
A) "I will start a walking program three times a week."
B) "I should increase my intake of calcium-rich foods."
C) "I will perform high-impact aerobics to strengthen my bones."
D) "I will take my Vitamin D supplement as prescribed."
Answer: C) "I will perform high-impact aerobics to strengthen my
bones."
Explanation: Weight-bearing exercises like walking are beneficial for
osteoporosis, but high-impact aerobics are contraindicated due to the
high risk of fractures. The other statements reflect correct
understanding of the plan of care.
6. The LPN is caring for a patient with a new cast on the lower leg.
Which assessment finding requires immediate notification of the
healthcare provider?
A) Slight swelling of the toes.
B) Sensation of warmth over the cast.
C) The patient reports a dull ache.