2023 HESI LPN LATEST COMPREHENSIVE FINAL EXIT EXAM

2023 HESI LPN LATEST COMPREHENSIVE FINAL EXIT EXAM A newborn with apnea is being discharged from the hospital with home monitoring. What information concerning the infant's care should the practical nurse review with the parents? - ANSWERS-A. Cardiopulmonary resuscitation (CPR). Rationale: Apnea of infancy (AOI) engenders great anxiety in parents, and the initiation of home monitoring presents additional emotional stress. When home monitoring is required the parents should receive instructions that include cardiopulmonary resuscitation(A). (B) does not indicate Apnea Which protocol regarding standard policies about prescriptions should the practical nurse (PN) question? - ANSWERS-D. Preoperative prescriptions should be resumedafter a client returns from surgery. Which task could the practical nurse assign to an unlicensed assistive personnel (UAP)? - ANSWERS-C. Verify identification arm bands when infant is left in mom's room. Rationale: Delivering an infant from the nursery to the mother's room and verifying the identification on both arm bands is a task that could be assigned to a UAP (C). The taskis a predictable, routine task on a unit. Reinforcing teaching about infant sleeping positions When reviewing the safety precautions regarding newborns, what information should the syndrome (SIDS) declines when infants are positioned on their backs practical nurse communicate to the parents? . - ANSWERS-A. Position the infant to sleep on the baby's back.Rationale: The incident of sudden infant death When reviewing the safety precautions regarding newborns, what information should thesyndrome (SIDS) declines when infants are positioned on their backs Which action is most important for the practical nurse (PN) to implement for a client whohas a Stage I pressure ulcer? - ANSWERS-D. Monitor client's serum pre-albumin levels. Which action should the practical nurse implement when administering an 8 ounce can of a concentrated nutritional formula via a client's gastrostomy tube (GT)? - ANSWERSD. Give 30 ml of tap water after administration of formula. A 14-year-old female arrives in the school nurse's office seeking information about healthcare agencies in the community. The practical nurse (PN) understands the client can make an autonomous healthcare decision if she has which circumstance? - ANSWERS-A. Pregnancy. 023 HESI LPN LATEST COMPREHENSIVE FINAL EXIT EXAM 2023 Rationale: According to the supreme court a minor who is pregnant (A) can make an autonomous healthcare decision A child is admitted for severe abdominal pain and possible appendicitis. Laboratory and x-ray studies are prescribed. During the diagnostic period, the practical nurse should implement which nursing actions? (Check all that apply.) - ANSWERS-A. Maintain child's comfort. B. Relieve parent and child's anxiety. C. Prepare for surgery. A child who is currently undergoing chemotherapy (CT) for leukemia is brought to the clinic for a possible broken ankle. What priority action should the practical nurse implement? - ANSWERS-B. Place a mask on the child. Rationale: The child who is receiving CT for leukemia is immunosuppressed and should be protected from airborne pathogens and other sick children in the clinic. Placing a mask on the child A client arrives in the clinic complaining of radiating back pain. Which finding related to a possible dissecting aneurysm should the practical nurse (PN) report to the healthcare provider? - ANSWERS-A. Ripping chest pain and blood pressures of 150/90 in right arm and 120/70 in left arm. Rationale: A dissecting aneurysm is a tearing of the intima of a major artery, such as the ascending aorta, and classically presents with the onset of sudden, severe, ripping pain that moves. Depending on the location, as the intima of the artery tears, a difference in the extremity perfusion (A), deceased urine output, or petechiae on the feet occur. (ation A client in a nursing home becomes violent and verbally threatens an unlicensed assistive personnel (UAP). Which is the best way for the practical nurse (PN) in charge during the shift to handle the staff's reaction to the incident? - ANSWERS-B.Offer a group discussion session so staff can share their thoughts and feelings Rationale: A critical incident stress debriefing evolves expression of personal feelings, discussion, and working on unresolved emotional issues to minimize post traumatic stress for the staff member. A CISD is the best action for the PN in charge to take (B) in conjunction with the guidance and assistance of the nursing supervisor in the facility A client is being discharged after repair of a retinal detachment. The practical nurse (PN) reviews the written discharge information with the client and family. Which instruction should the PN emphasize to the client when arriving at home? - ANSWERS-B. Take a PRN antiemetic with early signs of nausea. HESI LPN LATEST COMPREHENSIVE FINAL EXIT EXAM Rationale: To minimize increased intraocular pressure, it is most important that the client take an antiemetic as soon as nausea is experienced A client receives a prescription for diltiazem (Cardizem) at 5 mg/hour. The drug is dispensed as 125 mg in 100 ml D5W. How many ml/hour should the practical nurse (PN) program the infusion pump? - ANSWERS-•4 125 mg divided by 100 ml = 1.25 mg/ml = concentration of the Cardizem solution Using the formula, D/H x Q, 5 mg/1.25 mg x 1 ml = 4 ml/hour A client who had a total knee arthroplasty (TKA) three days ago is being transferred to the rehabilitation center. The healthcare provider prescribes activity as tolerated. Which action should the practical nurse (PN) take? A. Ask someone to follow the client with a wheelchair. B. Obtain clarification of prescription about weight bearing. C. Inquire about routine physical therapy progression. D. Ask the client what he did yesterday for activity. ANSWERS B. Obtain clarification of prescription about weight bearing. Rationale: The healthcare provider should indicate the amount of weight bearing the client should safely be able to tolerate after TKA, so the PN should clarify the prescription (B). (A) is a safety measure to prevent falls while the client begins mobilization. (C) may be helpful but does not provide individualized care for the client. (D) provides a comparison for the client's progression with activity as tolerated A client who is 39-weeks gestation arrives at the clinic asks the practical nurse if she is ready to have her baby soon. Which finding should the practical nurse (PN) respond to first? - ANSWERS-B. Reports feeling wet and warm as if she is voiding involuntarily. Rationale: Rupture of the membranes that may leak at first and is often reported as a sensation of perineal wetness (B), A client who is pregnant arrives at an urgent care clinic and complains of feeling very uncomfortable. The client states she feels a strong urge to have a bowel movement. Which action is most important for the practical nurse (PN) to implement? - ANSWERSA. Place the client in a room with a precipitous delivery tray. Rationale: The client is manifesting signs of an imminent delivery, which includes regular contractions that are very uncomfortable, a strong urge to defecate, and pushing, so she should be immediately placed in the room with a precipitous delivery tray (A) to ensure a safe, sterile environment for delivery. HESI LPN LATEST COMPREHENSIVE FINAL EXIT EXAM A client who is receiving continuous oxygen is going home after discharge from the hospital. The practical nurse (PN) discovers that oxygen has not been delivered to the client's home. What priority action should the PN implement? - ANSWERS-D. Delay the time of the client's discharge. Rationale: The client should not be released until the necessary equipment or supplies are delivered to the client's home to safely continue the client's necessary treatment (D). Sending the client home with a hospital tank A client who is receiving oxygen (O2) at 35% per mask receives a prescription for a trial weaning of O2 to 4 liters/minute per nasal cannula. The practical nurse (PN) notes the client's pulse oximeter reading goes from 96% to 90% after two minutes with the change in O2 administration. What action should the PN take? - ANSWERS-C. Reapply the O2 at 35% per mask. A client who sustained a C4 injury in a head-on automobile collision is admitted to the neurological unit. Which priority assessment should the practical nurse (PN) monitor? - ANSWERS-A. Depth of respirations. A client who was struck by a baseball on the right temple is admitted for 24-hour observation. What finding should the practical nurse (PN) report to the nurse immediately? - ANSWERS-D. Right pupil size 9 mm; left pupil size 6 mm. Rationale: Anisocoria, or unequal pupil size (D), is a sign of intracranial compression after head injury and should be reported immediately for follow-up management. A client with "fever of undetermined origin" awakens with right periorbital swelling. Which action should the practical nurse take first? A. Apply warm moist compress to the right eye. B. Check for conjunctival erythemia and drainage. C. Determine if the client has nasal congestion. D. Ask the client about history of drug reactions. - ANSWERS-B. Check for conjunctival erythemia and drainage. Rationale: Unilateral periorbital swelling is most likely a local infection, so the PN should assess the client for additional findings of eye infection, such as conjunctival erythemia and drainage (B) from the eye. The findings should be reported to the charge nurse for additional actions before (A) is implemented. Although (C and D) may provide additional information related to the client's swollen eye, a focused assessment of the eye should be completed first HESI LPN LATEST COMPREHENSIVE FINAL EXIT EXAM A group of practical nurses (PNs) who work on a medical-surgical unit believe they are understaffed. Which data should the PNs consider when preparing the justification for additional staff? - ANSWERS-B. Client acuity and census. Rationale: When presenting the need for increased staff, the PNs should present the request using staffing guidelines that consider client acuity, number of clients, and length of stay(B). A healthcare provider begins screaming at the practical nurse (PN) who is standing at the nurses' station and demands that the laboratory results be made available immediately. Which action should the PN take first? - ANSWERS-A. Suggest moving to a private area to discuss further. Rationale: Moving to a private area to discuss the issues away from public display is the first action (A), which may help de-escalate the situation. (B) may be indicated after the nursing supervisor is called to assist with resolving the incident. Although (C) is indicated, a setting that provides privacy should be used first to minimizing further disruptive interaction. The nursing supervisor (D) should be called to assist with the situation but privacy for further discussion should be suggested first A male child who hit his face on the sidewalk after falling off his bike presents in the school nurse's office with noticeable swelling around the mouth and nose and is carrying his front teeth in a tissue. Which action should the practical nurse (PN) take first? - ANSWERS-B. Obtain the respiratory rate and effort. R A male client is eating at his bedside table and suddenly starts gagging, is unable to talk, and places both hands over his throat. Which action should the practical nurse implement? - ANSWERS-D. Apply successive abdominal thrusts. Rationale: Abdominal thrusts, also known as the Heimlich maneuver (D), should be performed to loosen the obstructing foreign body. The client's airway is obstructed and (A) is ineffective. Back blows A male client who is paraplegic due to a diving accident is admitted to the rehabilitation unit. Which finding is most important for the practical nurse (PN) to report to the interdisciplinary team? - ANSWERS-D. Repeated refusals to see any visitors. A male client who receives albuterol (Ventolin) nebulizing treatment PRN is asking the practical nurse (PN) for his breathing treatment. Which assessment should the PN implement before administering the PRN prescription? HESI LPN LATEST COMPREHENSIVE FINAL EXIT EXAM Rationale: In older clients, nausea and vomiting (A) are early signs of digoxin toxicity, which can occur due to cumulative effects, even with subtoxic digoxin levels. Bradycardia, not tachycardia (B) is a sign of digoxin toxicity. Constipation (C) is not related to digoxin toxicity. Tinnitus (D) is a symptom of aspirin toxicity. An older male client who drove himself to the emergent care clinic with chest pain is placed on a cardiac monitor with oxygen per nasal cannula at 2 liters/minute as an IV access is obtained. Which intervention should the practical nurse implement first? - ANSWERS-C. Apply telemetry electrodes to the client's chest. An older male client with a history of hypertension presents in the urgent care center with an elevated blood pressure and tachycardia. Which finding should the practical nurse report to the healthcare provider immediately?. - ANSWERS-A. Tearing pain that has moved to his low back. Rationale: The client has classic findings, such as age and history of hypertension, for a possible dissecting aneurysm. Severe tearing pain that moves from the client's chest to the back (A) is symptomatic of this life threatening and requires immediate treatment and must be reported immediately. ( An unemployed female client who is receiving chemotherapy shares with the practical nurse (PN) that it has been devastating for her to become bald. What action should the PN take? - ANSWERS-C. Investigate potential resources to help obtain a wig. At the beginning of the shift, the practical nurse (PN) is reconciling a client's medication administration record, the prescriptions, and the dispensed drugs. Which available medication should the PN give? - ANSWERS-C. Prescribed albuterol (Proventil); dispensed albuterol (Ventolin). Rationale: Albuterol (Ventolin and Proventil) are the same drug, and should be administered as prescribed. ( Following hip replacement surgery, an older male client tells the practical nurse (PN) that he lives alone in a second story apartment. What action is most important for the PN to take? - ANSWERS-C. Contact a hospital case manager. Rationale: Living on a second floor apartment impacts the client's ability to return home. The PN should report the finding to the case manager (C), who can best assist the client by ensuring that a safe plan is in place for the care of the client after discharge. The healthcare provider prescribes ketorolac (Toradol) 15 mg IM for a client in pain. The available concentration is 30 mg/ml. How many ml should the practical nurse (PN) t-A HESI LPN LATEST COMPREHENSIVE FINAL EXIT EXAM The practical nurse (PN) assigns the task of obtaining vital signs for all the clients on a 24-bed unit to an experienced unlicensed assistive personnel (UAP). What action should the PN take to ensure the clients are receiving safe care? - ANSWERS-B. Take vital signs for any client with abnormal findings. Rationale: To ensure safe care, the PN should take the vital signs for any client with abnormal results to evaluate the client's condition (B). Trends should be evaluated on an ongoing basis, not just at the end of the shift The practical nurse (PN) enters a client's room at 0900 to administer a heparin injection that is prescribed BID. The physical therapist is in the middle of providing bedside therapy. What action should the PN take? - ANSWERS-C. Leave with the medication and come back after the therapist is finished. The practical nurse (PN) is assigned to assist with receiving clients in the Emergency Department (ED) following a community disaster. Which client finding should the PN recognize as the highest priority for care? - ANSWERS-B. Sucking chest wound with protruding glass shard in chest Rationale: In any disaster, an immediate threat to life is the priority. The highest priority client is oxygenation, so the client with a sucking chest wound should receive immediate care. The care of the other clients (A, C, and D) should be imminently given, but do not have the priority of (B). The practical nurse (PN) is assisting the nurse with the care of a client with end stage emphysema who is on a mechanical ventilator. The PN auscultates decreased breath sounds in the right lung fields and notices that the client's neck veins are distended. Which additional assessment should the PN implement to report a tension pnuemothorax to the nurse? - ANSWERS-C. Inspect the trachea to see if it is midline. Rationale: Tension pnuemothorax can occur when an emphysematic bullae or blebs ruptures causing air to accumulate in the pleural space and collapsing the lung. Additional findings are needed to differentiate the onset of right sided heart failure versus tension pneumothorax, which is manifested by worsening respiratory status, decreased breath sounds on the affected side, distended neck veins, and tracheal deviation from midline (C). The client's findings are due to a pneumothorax, not resisting the ventilator The practical nurse (PN) is assisting the nurse with the care of a newborn immediately after delivery. Which action should the PN perform first? - ANSWERS-A. Dry the infant and wrap in a warming blanket 023 HESI LPN LATEST COMPREHENSIVE FINAL EXIT EXAM Rationale: Maceration around the stoma (B) may indicate that the ileostomy bag is leaking and the peristomal skin is irritated by liquid stool from the ileum. The practical nurse (PN) is monitoring a client who is 3 hours post-cardiac catheterization of the right femoral artery. Which client finding requires further action by the PN? - ANSWERS-C. Loss of right pedal pulse. The practical nurse (PN) is participating in a group interview of an applicant who will work in the clinic as a staff PN. Which question is best to ask the applicant? - ANSWERS-A. "This position requires working on-call every fourth weekend. Can you do that?" Rationale: Job interview questions must be specifically job related (A) The practical nurse (PN) is preparing to administer azithromycin (Zithromax) 500 mg PO for a client with pneumonia. The medication is available as a suspension that is labeled, 200 mg/5 ml. How many ml should the PN administer? (Enter numeric value only. If rounding is required, round to the nearest tenth - ANSWERS-•12.5 Using ratio and proportion calculation, 200 mg : 5 ml :: 500 mg : X 200X = 2500 X = 12.5 ml The practical nurse (PN) is reviewing the morning laboratory results for a group of assigned clients. Which finding should the PN report to the healthcare provider first? - ANSWERS-C. An older client who has received heparin for two weeks with a platelet count of 15,500/mm3. Rationale: The client in with thrombocytopenia (normal platelets 150,000 to 400,000/mm3) (C) is likely experiencing a complication due to heparin therapy, and requires timely intervention to prevent bleeding. The practical nurse (PN) is using bag-mask device to administer artificial ventilation for a three-year-old child. Which method is best to use to create a seal while holding the mask in place? - ANSWERS-B. Place the mask over nose and mouth using a c-e one-hand technique. The practical nurse (PN) is visiting a client with a colostomy and notes excoriated skin around the stoma opening. What information should the PN provide? - ANSWERS-D. Cut a smaller opening in the adhesive. Rationale: The most common cause of skin excoriation is from the adhesive appliance opening that is cut too large and allows fecal matter to come in contact with the skin (D). Excoriated skin is not related to diet intake ( HESI LPN LATEST COMPREHENSIVE FINAL EXIT EXAM Rationale: After administering formula additional water should be given to prevent obstruction of the GT and provide the client with additional hydration Which action should the practical nurse perform first for a child who is injured on the school grounds and has an obvious mis-alignment of the lower forearm? - ANSWERS-A. Remove the child's finger rings. Rationale: The child is a risk for swelling in the distal areas of the affected arm and hand. Removal of finger rings (A) should be implemented first to remove any potential constriction that may occur after tissue injury or fracture of the lower arm Which client should the practical nurse (PN) obtain a Glasgow Coma Scale (GCS) score? - ANSWERS-B. An adolescent male who hit his head due to alcohol toxicity. Rationale: The GCS score evaluates a client's neurological responses after experiencing an acute head injury. Although alcohol toxicity may alter the adolescent's responses, the GCS score should be implemented during and after alcohol detoxification to screen for neurological changes characteristic of a head injury (B). Which client who arrives at the urgent care clinic should be seen first by the practical nurse (PN)? - ANSWERS-C. A thirteen-year-old with asthma who just vomited following a spell of coughing. Rationale: Particularly in pediatric clients with asthma, coughing until vomiting (C) can be a sign of an asthma exacerbation and requires further assessment. Diarrhea is a common side effect of amoxicillin ( Which directions should the practical nurse (PN) provide to an unlicensed assistive personnel (UAP)? - ANSWERS-A. Report the total urine output for the client on intake and output. Which early finding for a client with a new cast for a fractured leg should the practical nurse report to the charge nurse? - ANSWERS-C. Paresthesia of affected leg. Which finding in a 4-month-old infant warrants further investigation by the practical nurse? - ANSWERS-B. Grunts with expiration. Rationale: Grunting on expiration (B) is a sign of respiratory distress and requires immediate attention. Which individual should the practical nurse (PN) respond to first? - ANSWERS-A. A visitor is lying still on the floor in the middle of the unit hallway. n