HESI LPN-ADN MOBILITY Questions And Answers
Practice Questions with Solutions Newest | Already
Graded A+
1. A nurse is caring for a patient with a history of chronic heart failure who is admitted with acute
pulmonary edema. The patient's vital signs are: BP 160/90 mm Hg, HR 110 bpm, RR 28
breaths/min, SpO2 88% on room air. The provider orders furosemide 40 mg IV push. Which
additional assessment finding would most strongly indicate the need for immediate intervention
before administering the furosemide?
A. Serum potassium level of 3.2 mEq/L
B. Urine output of 20 mL over the past hour
C. Jugular venous distention to 8 cm above the sternal angle
D. Bilateral crackles in the lung bases
Answer: A
Rationale: Hypokalemia (3.2 mEq/L) is critical because furosemide exacerbates potassium loss,
increasing the risk of cardiac dysrhythmias. The other findings are consistent with pulmonary edema
and support furosemide use. Potassium must be replaced before or concurrently with furosemide.
2. A nursing team is implementing a new evidence-based protocol for preventing
catheter-associated urinary tract infections (CAUTI). Which combination of interventions reflects
the most current evidence-based practice?
A. Use of silver-alloy catheters, daily meatal care with antiseptic solution, and changing the catheter every 7
days
B. Use of antimicrobial-impregnated catheters, daily meatal care with soap and water, and removing the catheter
as soon as possible
C. Use of standard latex catheters, daily meatal care with povidone-iodine, and changing the catheter every 14
days
D. Use of silicone catheters, twice-daily meatal care with chlorhexidine, and maintaining a closed drainage
system
Answer: B
Rationale: Current evidence supports antimicrobial-impregnated catheters for short-term use, daily
meatal hygiene with soap and water (not antiseptics), and prompt catheter removal to reduce CAUTI
risk. Silver-alloy catheters have mixed evidence; antiseptic meatal care is not recommended; routine
scheduled changes are unnecessary.
Page 1
,3. A patient with type 2 diabetes mellitus has been prescribed metformin 1000 mg twice daily. The
patient also takes lisinopril for hypertension and atorvastatin for hyperlipidemia. The patient
reports recent onset of muscle pain and weakness. Which laboratory value is most important for
the nurse to monitor?
A. Serum creatinine and eGFR
B. Hemoglobin A1c
C. Creatine kinase (CK) level
D. Liver function tests (ALT/AST)
Answer: A
Rationale: Metformin is contraindicated in renal impairment (eGFR <30 mL/min) due to risk of lactic
acidosis. Muscle pain and weakness could indicate lactic acidosis, but the immediate concern is renal
function. CK elevation suggests statin-induced myopathy, but metformin's renal clearance is the priority.
A1c is for long-term control; LFTs are less urgent.
4. A nurse is preparing to administer a blood transfusion to a patient with severe anemia. The
patient's blood type is O negative, and the available unit is A positive. Which action should the
nurse take?
A. Administer the A positive blood because it is the only available unit
B. Refuse to administer the blood and notify the provider for type-specific crossmatch
C. Administer O negative packed red blood cells if available, otherwise use A positive with crossmatch
D. Administer O negative whole blood if available, otherwise administer A positive plasma
Answer: B
Rationale: O negative is the universal donor for RBCs, but A positive blood contains A antigens that will
react with anti-A antibodies in the O negative recipient, causing a hemolytic transfusion reaction. The
nurse must not administer incompatible blood; the provider must order type-specific crossmatched
blood. Emergency release O negative is appropriate only if crossmatched blood is unavailable.
5. A charge nurse is delegating tasks to a licensed practical nurse (LPN) and a nursing assistant
(NA) on a medical-surgical unit. Which task is most appropriate for the charge nurse to assign to
the LPN?
A. Administering a blood transfusion to a stable patient
B. Performing a sterile dressing change on a surgical wound with a drain
C. Assessing a patient with chest pain who just returned from cardiac catheterization
D. Developing the plan of care for a patient with a new diagnosis of diabetes
Answer: B
Rationale: LPNs are licensed to perform sterile dressing changes and wound care under RN supervision.
Blood transfusions require RN monitoring for adverse reactions. Assessment and care planning are RN
responsibilities. The NA cannot perform sterile procedures. The LPN's scope includes reinforcement of
teaching, but initial teaching and plan development are RN duties.
Page 2
,6. A patient with advanced cirrhosis is admitted with hepatic encephalopathy. The nurse notes that
the patient is confused, has asterixis, and has an elevated serum ammonia level. Which
prescription should the nurse question?
A. Lactulose 30 mL orally every 6 hours
B. Rifaximin 550 mg orally twice daily
C. Furosemide 40 mg intravenously twice daily
D. Fresh frozen plasma 2 units intravenously
Answer: D
Rationale: Fresh frozen plasma is not indicated for hepatic encephalopathy; it is used for coagulopathy
with active bleeding. Lactulose and rifaximin are standard therapies to reduce ammonia. Furosemide
may be used for ascites but can precipitate encephalopathy if electrolyte imbalances occur; however, it is
not immediately questioned. FFP is unnecessary and may worsen fluid overload.
7. A nurse is evaluating the effectiveness of interventions for a patient with acute respiratory
distress syndrome (ARDS). Which finding indicates that the treatment plan is effective?
A. PaO2 of 55 mm Hg on 100% FiO2
B. Plateau pressure of 35 cm H2O
C. PaO2/FiO2 ratio of 250
D. SpO2 of 92% on 40% FiO2
Answer: C
Rationale: A PaO2/FiO2 ratio >200 indicates improvement from severe ARDS (<100) or moderate
(100-200). A ratio of 250 suggests moderate ARDS improving. PaO2 55 on 100% FiO2 is critical;
plateau pressure >30 cm H2O increases barotrauma risk; SpO2 92% on 40% FiO2 could be acceptable
but does not directly reflect ARDS severity as well as the ratio.
8. A nurse is reviewing the laboratory results of a patient who is receiving heparin therapy for a
deep vein thrombosis. The patient's activated partial thromboplastin time (aPTT) is 90 seconds
(therapeutic range 60-80 seconds). What is the nurse's priority action?
A. Administer the next scheduled dose of heparin as prescribed
B. Hold the heparin infusion and notify the provider
C. Increase the heparin infusion rate per protocol
D. Administer protamine sulfate immediately
Answer: B
Rationale: An aPTT of 90 seconds is above the therapeutic range, indicating increased bleeding risk. The
nurse should hold the heparin and notify the provider for dose adjustment. Continuing or increasing
heparin would worsen the risk. Protamine sulfate is used for severe bleeding or reversal, not for
asymptomatic supratherapeutic aPTT.
9. A nurse is assessing a patient who has just undergone a thoracentesis for pleural effusion. Which
finding requires immediate intervention?
A. Oxygen saturation of 95% on room air
B. Chest pain that worsens with deep inspiration
Page 3
, C. Blood-tinged sputum
D. Tracheal deviation toward the unaffected side
Answer: D
Rationale: Tracheal deviation away from the side of the effusion suggests tension pneumothorax, a
life-threatening emergency requiring needle decompression. Oxygen saturation of 95% is acceptable;
pleuritic chest pain is common after thoracentesis; blood-tinged sputum may occur from minor trauma
but is less urgent.
10. A patient with chronic kidney disease (stage 4) is admitted with hyperkalemia (serum
potassium 6.2 mEq/L). The electrocardiogram shows peaked T waves. Which sequence of
interventions is most appropriate?
A. Administer sodium polystyrene sulfonate, then calcium gluconate, then insulin with dextrose
B. Administer calcium gluconate, then insulin with dextrose, then sodium polystyrene sulfonate
C. Administer insulin with dextrose, then sodium polystyrene sulfonate, then calcium gluconate
D. Administer albuterol nebulized, then calcium gluconate, then insulin with dextrose
Answer: B
Rationale: In hyperkalemia with ECG changes, calcium gluconate is given first to stabilize the cardiac
membrane. Then insulin with dextrose shifts potassium into cells. Sodium polystyrene sulfonate is a
slower-acting potassium-removing agent given after acute stabilization. Albuterol is an adjunct but not
first-line. The sequence must prioritize cardiac protection.
11. A patient with chronic kidney disease (CKD) stage 4 is admitted with hyperkalemia (K+ 6.8
mEq/L) and ECG changes showing peaked T waves. The patient is on lisinopril and
spironolactone. Which of the following interventions should the nurse implement first?
A. Administer intravenous calcium gluconate
B. Hold the spironolactone and lisinopril
C. Give oral sodium polystyrene sulfonate
D. Start hemodialysis via temporary catheter
Answer: A
Rationale: Calcium gluconate is given first to stabilize the cardiac membrane and prevent arrhythmias in
severe hyperkalemia with ECG changes. Holding medications and other treatments are important but
secondary to immediate cardiac protection.
12. A nurse is caring for a patient with acute respiratory distress syndrome (ARDS) on
volume-controlled mechanical ventilation. The latest arterial blood gas shows pH 7.25, PaCO2 55
mm Hg, PaO2 70 mm Hg on FiO2 0.8. Which adjustment should the nurse anticipate?
A. Increase FiO2 to 1.0
B. Increase positive end-expiratory pressure (PEEP)
C. Decrease tidal volume to 6 mL/kg
D. Increase respiratory rate to 24 breaths/min
Answer: B
Rationale: The PaO2/FiO2 ratio (70/0.8 = 87.5) indicates severe hypoxemia; increasing PEEP recruits
alveoli and improves oxygenation. Increasing FiO2 may help but is not the primary adjustment; the pH
Page 4
Practice Questions with Solutions Newest | Already
Graded A+
1. A nurse is caring for a patient with a history of chronic heart failure who is admitted with acute
pulmonary edema. The patient's vital signs are: BP 160/90 mm Hg, HR 110 bpm, RR 28
breaths/min, SpO2 88% on room air. The provider orders furosemide 40 mg IV push. Which
additional assessment finding would most strongly indicate the need for immediate intervention
before administering the furosemide?
A. Serum potassium level of 3.2 mEq/L
B. Urine output of 20 mL over the past hour
C. Jugular venous distention to 8 cm above the sternal angle
D. Bilateral crackles in the lung bases
Answer: A
Rationale: Hypokalemia (3.2 mEq/L) is critical because furosemide exacerbates potassium loss,
increasing the risk of cardiac dysrhythmias. The other findings are consistent with pulmonary edema
and support furosemide use. Potassium must be replaced before or concurrently with furosemide.
2. A nursing team is implementing a new evidence-based protocol for preventing
catheter-associated urinary tract infections (CAUTI). Which combination of interventions reflects
the most current evidence-based practice?
A. Use of silver-alloy catheters, daily meatal care with antiseptic solution, and changing the catheter every 7
days
B. Use of antimicrobial-impregnated catheters, daily meatal care with soap and water, and removing the catheter
as soon as possible
C. Use of standard latex catheters, daily meatal care with povidone-iodine, and changing the catheter every 14
days
D. Use of silicone catheters, twice-daily meatal care with chlorhexidine, and maintaining a closed drainage
system
Answer: B
Rationale: Current evidence supports antimicrobial-impregnated catheters for short-term use, daily
meatal hygiene with soap and water (not antiseptics), and prompt catheter removal to reduce CAUTI
risk. Silver-alloy catheters have mixed evidence; antiseptic meatal care is not recommended; routine
scheduled changes are unnecessary.
Page 1
,3. A patient with type 2 diabetes mellitus has been prescribed metformin 1000 mg twice daily. The
patient also takes lisinopril for hypertension and atorvastatin for hyperlipidemia. The patient
reports recent onset of muscle pain and weakness. Which laboratory value is most important for
the nurse to monitor?
A. Serum creatinine and eGFR
B. Hemoglobin A1c
C. Creatine kinase (CK) level
D. Liver function tests (ALT/AST)
Answer: A
Rationale: Metformin is contraindicated in renal impairment (eGFR <30 mL/min) due to risk of lactic
acidosis. Muscle pain and weakness could indicate lactic acidosis, but the immediate concern is renal
function. CK elevation suggests statin-induced myopathy, but metformin's renal clearance is the priority.
A1c is for long-term control; LFTs are less urgent.
4. A nurse is preparing to administer a blood transfusion to a patient with severe anemia. The
patient's blood type is O negative, and the available unit is A positive. Which action should the
nurse take?
A. Administer the A positive blood because it is the only available unit
B. Refuse to administer the blood and notify the provider for type-specific crossmatch
C. Administer O negative packed red blood cells if available, otherwise use A positive with crossmatch
D. Administer O negative whole blood if available, otherwise administer A positive plasma
Answer: B
Rationale: O negative is the universal donor for RBCs, but A positive blood contains A antigens that will
react with anti-A antibodies in the O negative recipient, causing a hemolytic transfusion reaction. The
nurse must not administer incompatible blood; the provider must order type-specific crossmatched
blood. Emergency release O negative is appropriate only if crossmatched blood is unavailable.
5. A charge nurse is delegating tasks to a licensed practical nurse (LPN) and a nursing assistant
(NA) on a medical-surgical unit. Which task is most appropriate for the charge nurse to assign to
the LPN?
A. Administering a blood transfusion to a stable patient
B. Performing a sterile dressing change on a surgical wound with a drain
C. Assessing a patient with chest pain who just returned from cardiac catheterization
D. Developing the plan of care for a patient with a new diagnosis of diabetes
Answer: B
Rationale: LPNs are licensed to perform sterile dressing changes and wound care under RN supervision.
Blood transfusions require RN monitoring for adverse reactions. Assessment and care planning are RN
responsibilities. The NA cannot perform sterile procedures. The LPN's scope includes reinforcement of
teaching, but initial teaching and plan development are RN duties.
Page 2
,6. A patient with advanced cirrhosis is admitted with hepatic encephalopathy. The nurse notes that
the patient is confused, has asterixis, and has an elevated serum ammonia level. Which
prescription should the nurse question?
A. Lactulose 30 mL orally every 6 hours
B. Rifaximin 550 mg orally twice daily
C. Furosemide 40 mg intravenously twice daily
D. Fresh frozen plasma 2 units intravenously
Answer: D
Rationale: Fresh frozen plasma is not indicated for hepatic encephalopathy; it is used for coagulopathy
with active bleeding. Lactulose and rifaximin are standard therapies to reduce ammonia. Furosemide
may be used for ascites but can precipitate encephalopathy if electrolyte imbalances occur; however, it is
not immediately questioned. FFP is unnecessary and may worsen fluid overload.
7. A nurse is evaluating the effectiveness of interventions for a patient with acute respiratory
distress syndrome (ARDS). Which finding indicates that the treatment plan is effective?
A. PaO2 of 55 mm Hg on 100% FiO2
B. Plateau pressure of 35 cm H2O
C. PaO2/FiO2 ratio of 250
D. SpO2 of 92% on 40% FiO2
Answer: C
Rationale: A PaO2/FiO2 ratio >200 indicates improvement from severe ARDS (<100) or moderate
(100-200). A ratio of 250 suggests moderate ARDS improving. PaO2 55 on 100% FiO2 is critical;
plateau pressure >30 cm H2O increases barotrauma risk; SpO2 92% on 40% FiO2 could be acceptable
but does not directly reflect ARDS severity as well as the ratio.
8. A nurse is reviewing the laboratory results of a patient who is receiving heparin therapy for a
deep vein thrombosis. The patient's activated partial thromboplastin time (aPTT) is 90 seconds
(therapeutic range 60-80 seconds). What is the nurse's priority action?
A. Administer the next scheduled dose of heparin as prescribed
B. Hold the heparin infusion and notify the provider
C. Increase the heparin infusion rate per protocol
D. Administer protamine sulfate immediately
Answer: B
Rationale: An aPTT of 90 seconds is above the therapeutic range, indicating increased bleeding risk. The
nurse should hold the heparin and notify the provider for dose adjustment. Continuing or increasing
heparin would worsen the risk. Protamine sulfate is used for severe bleeding or reversal, not for
asymptomatic supratherapeutic aPTT.
9. A nurse is assessing a patient who has just undergone a thoracentesis for pleural effusion. Which
finding requires immediate intervention?
A. Oxygen saturation of 95% on room air
B. Chest pain that worsens with deep inspiration
Page 3
, C. Blood-tinged sputum
D. Tracheal deviation toward the unaffected side
Answer: D
Rationale: Tracheal deviation away from the side of the effusion suggests tension pneumothorax, a
life-threatening emergency requiring needle decompression. Oxygen saturation of 95% is acceptable;
pleuritic chest pain is common after thoracentesis; blood-tinged sputum may occur from minor trauma
but is less urgent.
10. A patient with chronic kidney disease (stage 4) is admitted with hyperkalemia (serum
potassium 6.2 mEq/L). The electrocardiogram shows peaked T waves. Which sequence of
interventions is most appropriate?
A. Administer sodium polystyrene sulfonate, then calcium gluconate, then insulin with dextrose
B. Administer calcium gluconate, then insulin with dextrose, then sodium polystyrene sulfonate
C. Administer insulin with dextrose, then sodium polystyrene sulfonate, then calcium gluconate
D. Administer albuterol nebulized, then calcium gluconate, then insulin with dextrose
Answer: B
Rationale: In hyperkalemia with ECG changes, calcium gluconate is given first to stabilize the cardiac
membrane. Then insulin with dextrose shifts potassium into cells. Sodium polystyrene sulfonate is a
slower-acting potassium-removing agent given after acute stabilization. Albuterol is an adjunct but not
first-line. The sequence must prioritize cardiac protection.
11. A patient with chronic kidney disease (CKD) stage 4 is admitted with hyperkalemia (K+ 6.8
mEq/L) and ECG changes showing peaked T waves. The patient is on lisinopril and
spironolactone. Which of the following interventions should the nurse implement first?
A. Administer intravenous calcium gluconate
B. Hold the spironolactone and lisinopril
C. Give oral sodium polystyrene sulfonate
D. Start hemodialysis via temporary catheter
Answer: A
Rationale: Calcium gluconate is given first to stabilize the cardiac membrane and prevent arrhythmias in
severe hyperkalemia with ECG changes. Holding medications and other treatments are important but
secondary to immediate cardiac protection.
12. A nurse is caring for a patient with acute respiratory distress syndrome (ARDS) on
volume-controlled mechanical ventilation. The latest arterial blood gas shows pH 7.25, PaCO2 55
mm Hg, PaO2 70 mm Hg on FiO2 0.8. Which adjustment should the nurse anticipate?
A. Increase FiO2 to 1.0
B. Increase positive end-expiratory pressure (PEEP)
C. Decrease tidal volume to 6 mL/kg
D. Increase respiratory rate to 24 breaths/min
Answer: B
Rationale: The PaO2/FiO2 ratio (70/0.8 = 87.5) indicates severe hypoxemia; increasing PEEP recruits
alveoli and improves oxygenation. Increasing FiO2 may help but is not the primary adjustment; the pH
Page 4
