HESI LPN-ADN COMPREHENSIVE
ENTRANCE EXAM QUESTIONS AND
ANSWERS
1. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse notes the patient’s arterial blood gas (ABG) results: pH 7.30,
PaCO2 52 mmHg, and HCO3 26 mEq/L. Which acid-base imbalance is the patient
experiencing?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Answer: B
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (less than
7.35) and an elevated PaCO2 (greater than 45 mmHg). In COPD patients, air trapping leads
to CO2 retention.
2. A client is admitted with a suspected thyroid storm. Which clinical manifestation should
the nurse prioritize for immediate intervention?
A. Dry skin and cold intolerance
,B. Constipation and bradycardia
C. Weight gain and lethargy
D. Hyperthermia and tachycardia
Answer: D
Conceptual Explanation: Thyroid storm is a life-threatening health condition that is
associated with untreatable hyperthyroidism. Key signs include extremely high fever
(hyperthermia), tachycardia, and hypertension.
3. The nurse is preparing to administer heparin subcutaneously. Which action is most
appropriate?
A. Aspirate for blood return before injecting
B. Use a 25-gauge needle and inject at a 45- to 90-degree angle
C. Massage the site after injection to speed absorption
D. Apply a heat pack to the site prior to administration
Answer: B
Conceptual Explanation: Heparin should be injected into the deep subcutaneous fat. A 25-
gauge needle is appropriate, and aspiration or massage is contraindicated as it can cause
hematoma.
, 4. A child is diagnosed with Tetralogy of Fallot. The nurse observes the child squatting during
a cyanotic spell. What is the physiological purpose of this action?
A. To increase systemic vascular resistance
B. To decrease pulmonary vascular resistance
C. To reduce the workload of the left ventricle
D. To increase the heart rate
Answer: A
Conceptual Explanation: Squatting (the ‘tet spell’ position) increases systemic vascular
resistance, which decreases the right-to-left shunt and increases pulmonary blood flow.
5. A pregnant client at 34 weeks gestation presents with sudden-onset, painless vaginal
bleeding. Which condition should the nurse suspect?
A. Abruptio placentae
B. Uterine rupture
C. Ectopic pregnancy
D. Placenta previa
Answer: D
Conceptual Explanation: Painless, bright red vaginal bleeding in the second or third
trimester is a classic sign of placenta previa. Abruptio placentae usually involves painful
bleeding.
ENTRANCE EXAM QUESTIONS AND
ANSWERS
1. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse notes the patient’s arterial blood gas (ABG) results: pH 7.30,
PaCO2 52 mmHg, and HCO3 26 mEq/L. Which acid-base imbalance is the patient
experiencing?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Answer: B
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (less than
7.35) and an elevated PaCO2 (greater than 45 mmHg). In COPD patients, air trapping leads
to CO2 retention.
2. A client is admitted with a suspected thyroid storm. Which clinical manifestation should
the nurse prioritize for immediate intervention?
A. Dry skin and cold intolerance
,B. Constipation and bradycardia
C. Weight gain and lethargy
D. Hyperthermia and tachycardia
Answer: D
Conceptual Explanation: Thyroid storm is a life-threatening health condition that is
associated with untreatable hyperthyroidism. Key signs include extremely high fever
(hyperthermia), tachycardia, and hypertension.
3. The nurse is preparing to administer heparin subcutaneously. Which action is most
appropriate?
A. Aspirate for blood return before injecting
B. Use a 25-gauge needle and inject at a 45- to 90-degree angle
C. Massage the site after injection to speed absorption
D. Apply a heat pack to the site prior to administration
Answer: B
Conceptual Explanation: Heparin should be injected into the deep subcutaneous fat. A 25-
gauge needle is appropriate, and aspiration or massage is contraindicated as it can cause
hematoma.
, 4. A child is diagnosed with Tetralogy of Fallot. The nurse observes the child squatting during
a cyanotic spell. What is the physiological purpose of this action?
A. To increase systemic vascular resistance
B. To decrease pulmonary vascular resistance
C. To reduce the workload of the left ventricle
D. To increase the heart rate
Answer: A
Conceptual Explanation: Squatting (the ‘tet spell’ position) increases systemic vascular
resistance, which decreases the right-to-left shunt and increases pulmonary blood flow.
5. A pregnant client at 34 weeks gestation presents with sudden-onset, painless vaginal
bleeding. Which condition should the nurse suspect?
A. Abruptio placentae
B. Uterine rupture
C. Ectopic pregnancy
D. Placenta previa
Answer: D
Conceptual Explanation: Painless, bright red vaginal bleeding in the second or third
trimester is a classic sign of placenta previa. Abruptio placentae usually involves painful
bleeding.
