2022 HESI PN EXAM QUESTIONS AND ANSWERS

2022 HESI PN EXAM QUESTIONS AND ANSWERS An 80 year old male client who has arthritis and who is having difficulty walking tells the practical nurse (PN). ''It's awful to be old. It seems as though every day a struggle. No one cares about an old person." What is the best response for the PN to provide. A. "its true. We are a youth- oriented society." B. Oh, lets not focus on the negative. Tell me something good." C. "It sounds as though you're having a difficult time. Tell me about it." D. "You're still able to get around, and your mind is as sharp as a tack." - CORRECT ANSWERC. "It sounds as though you're having a difficult time. Tell me about it." An essential component of the nurse-client relationship is communicating empathy, which indicates to a client that his feelings are important, so acknowledging the clients difficulty (C) best allows the client to express his feelings. (A,B,D) dismiss the client's verbal and nonverbal communication and do not reflect an understanding of the despair the client is communicating. A client's indwelling urinary catheter is removed at 9:30am. The practical nurse (PN) assesses the client every 2 hours for the desire to void. Which documented assessment requires further intervention by the PN? A. 1:30pm- unable to void. B. 5:30pm- unable to void C. 3:30pm- unable to void D 11:30 am- unable to void. - CORRECT ANSWERB. 5:30pm- unable to void. A client is due to void within 8 hours of catheter removal, so at 5:30pm (B), longer than 8 hours after removal, catheter reinsertion may be necessary. If the bladder is not distended, further action may not be needed at times indicated in (A,C, D) The practical nurse (PN) is assessing a client with dark skin who is in respiratory distress. Which client response should the PN evaluate to determine cyanosis in the client? A. Cyanosis in a client with dark skin is seen only in the sclera. B. Abnormal skin color changes in a client with dark skin cannot be determined. C. The lips and mucous membranes of a client with dark skin are dusky in color. D. Blanching the soles of the feet in a client with dark skin reveals cyanosis. - CORRECT ANSWERC. The lips and mucous membranes of a client with dark skin are dusky in color Causes of cyanosis include hypoxemia and decreased cardiac output, which provided clues to respiratory status with changes in skin color and mucous membranes. Cyanosis, a late sign of hypoxia, is best observed in the tissue that has superficial capillary supply, such as mucous membranes, the conjunctivae, lips, palms and under the tongue (C), which is readily visible in dark skin. (A,B,D) do not provide accurate assessment. What action should the practical nurse (PN) take when drawing medication from an ampule? A. Aspirate with a filter needle and syringe B. Tap the bottom of the ampule lightly. C. Snap the neck of ampule towards nurse. D. Use an alcohol swab to open ampule. - CORRECT ANSWERA. Aspirate with a filter needle and syringe An ampule is made of glass with a constricted neck that is snapped off to allow access to the medication. Medications are easily withdrawn from the ampule by aspirating the fluid with a filter needle and syringe. Filter needles are used when withdrawing medication from a glass ampule to prevent glass particles from being drawn into the syringe with the medication (A). Tap the top, not the bottom (B) of the ampule lightly to allow all of the medication to drop to the bottom. When opening the ampule, the top should be snapped away from the nurse's face and body (C). An opened alcohol swab wrapped around the top of the ampule may allow alcohol to leak into the ampule (D). The healthcare provider prescribes a cleansing enema for an adult prior to bowel surgery. Which intervention(s) should the practical nurse implement to ensure adequate bowel cleansing? (Select all that apply.) A. Place the client on left side in Sim's position. B. Use enema fluid that is near 105F C. Repeat enemas until expelled fluid is clear D. Instill 500ml to 1,000 ml fluids slowly. E. Raise the enema container 20 inches above anus. F. Encourage the client to retain 10 to 15 minutes. - CORRECT ANSWERA. Place the client on left side in Sim's position. B. Use enema fluid that is near 105F D. Instill 500ml to 1,000 ml fluids slowly. F. Encourage the client to retain 10 to 15 minutes. Placing the client in an optimal position (A), using a sufficient fluid temperature (B) and volume (D) that stimulates peristalsis for an adequate retention time (F) ensures maximal bowl evacuation and cleansing. (C) is not included in the prescription. Fluid instilled at the height of 20 inches (E) can causes excessive pressure and pain, which compromise the client's ability to retain the fluid for proper bowl cleansing. Which food should the practical (PN) recommend for a client to increase the dietary intake of potassium? A. Corn B. Baked potato C. Popcorn D. Grape juice - CORRECT ANSWERB. Baked potato A baked potato (B), including its skin, contains the highest amount of potassium. (A,B,D) are low in potassium. A client receiving supplemental oxygen needs to be suctioned to remove excess secretions from the airway. Which intervention should the practical nurse implement to maximize the client's oxygenation? A. Encourage deep breathing prior to suctioning. B. Increase the oxygen flow rate during suctioning attempts. C. Provide oxygen during rest periods between suctioning. D. Limit suctioning attempts to 5 second intervals. - CORRECT ANSWERC. Provide oxygen during rest periods between suctioning. When a client is unable to effectively clear respiratory tract secretions with coughing, suctioning with oxygen during rest periods of 10 to 15 seconds between suction attempts (C) should be provided to ensure maximal oxygenation. (B,D) are incorrect. Although encouraging the client to deep breathe (A) increases the effectiveness of hyperoxygenation, suctioning removes oxygen from the airways and is best compensated for with oxygen between suction attempts. Which intervention should the practical nurse (PN) implement to reduce the incidence of urinary tract infections in a client with an indwelling catheter? A. Irrigate the catheter with an sterile distilled water. B. Dilute an antiseptic C. Cleanse perineum area with soap and water BID and PRN. D. Apply an antibiotic ointment around the urinary meatus BID. - CORRECT ANSWERC. Cleanse perineum area with soap and water BID and PRN. Daily perineal care BID and PRN should include cleansing of the meatus and catheter junction with soap and water (C). (A,B,D) do not support the concept of medical asepsis and catheter care. An older female recently diagnosed with coronary artery disease (CAD) cooks at home using saturated fats. Which intervention should the practical nurse implement to help the client reduce modifiable risk factor(s)? A. Recommend adoption of a low sodium vegetarian diet. B. Encourage food preparation with various vegetable oils. C. Explain the benefits of a modified exercise program. D. Provide pamphlets which outline CAD risk factors. - CORRECT ANSWERB. Encourage food preparation with various vegetable oils. Dietary saturated fats and cholesterol are modifiable risk factors for CAD, so encouraging the use of vegetable oils (B) that are low in saturated fats should help the client learn ways to reduce this contributing factor. (A) may not provide the older clients need for other nutrient's, such as protein and calcium. Although (C,D) provide additional ways for healthy heart living, they do not specifically address the client's dietary habits. The practical nurse (PN) is caring for a client who is admitted with influenza and vomiting for 3 days. The client's skin turgor is poor and oral mucous membranes are dry. Which finding is most important for the practical nurse (PN) to report to the charge nurse? A. Weight loss of 4 pounds in last 3 days. B. Hypotension and tachycardia. C. Nausea and anorexia. D. Dark amber urine output at 30 ml/hour. - CORRECT ANSWERB. Hypotension and tachycardia. The client's fluid loss from protracted vomiting causes a shift in intravascular fluids causing dehydration, hypotension and tachycardia (B), which should be reported to the charge nurse. (A,B,C) are signs consistent with dehydration, but the priority is the client's fluid depletion that is causing hypotensive state. A client whose diet is low in fiber is at risk for which condition? A. Hip fracture B. Diarrhea C. Confusion. D. Colon cancer - CORRECT ANSWERD. Colon cancer Fiber speeds the movement of substances through the GI tract, reducing the amount of time the colon absorbs water and its exposure to digestive end-products that may be carcinogenic. Low-fiber diets increase the risk for constipation and colon cancer (D). (A,B,C) are unrelated to low-fiber diets. The practical nurse (PN) contacts the healthcare provider about an older client who is agitated and aggressive with the staff. Which reason should the PN use to request a prescription for wrist restraints? A. To decrease the client's agitation and acting-out behaviors. B. To provide an effective way to prevent falls when the client is alone. C. To protect the client and reduce the likelihood of lawsuits. D. To ensure the