HESI LPN/PN FUNDAMENTALS ACTUAL
EXAM NEWEST 2024 ACTUAL EXAM
420 QUESTIONS AND CORRECT
DETAILED ANSWERS
The nurse is assessing a client with dark skin who is in Respiratory
Distress. Which client response should the
nurse evaluate to determine
cyanosis in this particular client?
A. Cyanosis in a client with dark skin is seen in the sclera
B. Abnormal skin color changes in a client with dark skin cannot be
determined
C. The lips and mucus 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 - ANSWER -C. The lips and mucus membranes of a client
with dark skin are dusky in color
Causes of cyanosis include hypoxemia and decreased cardiac
output, which provides clues to respiratory status with changes in
skin color and mucous membranes. Cyanosis, a late sign of
hypoxemia, is best observed in tissue that has superficial capillary
supply, such as mucous membranes, the conjunctiva, lips, palms,
and under the tongue, which is readily visible in dark skin
,Which technique should the PN use to most accurately assess a
client's baseline BP during a routine health exam?
A. Measure the pressure in each arm while the client sits with both
arms supported at heart level
B. Calculate avg BP using readings obtained in both arms
C. Obtain BP first with client lying supine and then when standing
D. Take additional measurements for readings with a 10 mm Hg
difference - ANSWER -A. Measure the pressure in each arm while
the client sits with both arms supported at heart level
BP should be taken initially in both arms while the client is seated
or supine with the arm bared, supported, and
positioned at the
level of the heart
A client with gastroenteritis, nausea, and vomiting is currently on
Nothing by mouth (NPO) status. The healthcare
provider prescribes oral intake to be advanced as tolerated.
Which fluid should the practical nurse offer first?
A. Tea
B. Broth
C. Water
D. Soda - ANSWER -C. Water
,Water or ice chips are the first choices of clear fluids for rehydration
by mouth
An older client who is admitted to the hospital with dehydration and
electrolyte imbalance is confused and incontinent of urine. Which
action provides the best strategy for the practical nurse (PN) to
implement for the client's incontinence?
A. Insert an indwelling urinary catheter
B. Apply absorbent incontinence pads
C. Restrict fluids after the evening meal
D. Establish a 2-hour voiding schedule - ANSWER -D. Establish a 2-
hour voiding schedule
A 2 hour voiding schedule is the best strategy for urinary
incontinence management b/c it provides the client who is
confused an opportunity to empty the bladder which
minimizes incontinence due to overfilling
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 cath with sterile distilled water
B. Dilute an antiseptic solution in the perineal wash
C. Cleanse perineal area with soap and water BID and PRN
D. Apply an antibiotic ointment around urinary meatus BID - ANSWER
-C. Cleanse perineal 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
1. A client with cancer who has been taking opioid analgesics for two
years now requires increased doses to obtain pain relief. The client
expresses fear about becoming addicted to these drugs. What
information should the practical nurse (PN) provide?
A. Opioid use with cancer does not cause addiction.
B. Addiction is easily reversed if it occurs during pain management.
C. Prescribed opiates for cancer pain relief improve qualify of life.
D. Opioid dosages can be tapered if a client fears addiction. -
ANSWER -C. Prescribed opiates for cancer pain relief improve
qualify of life
The goal of pain management for clients with cancer using opiates is
to minimize pain and maintain quality of life
2. A client's indwelling urinary catheter is removed at 9:30 AM. The
practical nurse (PN) assesses the client every two hours for the
desire to void. Which documented assessment requires further
intervention by the PN? A. 1:30 pm: unable to void.
EXAM NEWEST 2024 ACTUAL EXAM
420 QUESTIONS AND CORRECT
DETAILED ANSWERS
The nurse is assessing a client with dark skin who is in Respiratory
Distress. Which client response should the
nurse evaluate to determine
cyanosis in this particular client?
A. Cyanosis in a client with dark skin is seen in the sclera
B. Abnormal skin color changes in a client with dark skin cannot be
determined
C. The lips and mucus 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 - ANSWER -C. The lips and mucus membranes of a client
with dark skin are dusky in color
Causes of cyanosis include hypoxemia and decreased cardiac
output, which provides clues to respiratory status with changes in
skin color and mucous membranes. Cyanosis, a late sign of
hypoxemia, is best observed in tissue that has superficial capillary
supply, such as mucous membranes, the conjunctiva, lips, palms,
and under the tongue, which is readily visible in dark skin
,Which technique should the PN use to most accurately assess a
client's baseline BP during a routine health exam?
A. Measure the pressure in each arm while the client sits with both
arms supported at heart level
B. Calculate avg BP using readings obtained in both arms
C. Obtain BP first with client lying supine and then when standing
D. Take additional measurements for readings with a 10 mm Hg
difference - ANSWER -A. Measure the pressure in each arm while
the client sits with both arms supported at heart level
BP should be taken initially in both arms while the client is seated
or supine with the arm bared, supported, and
positioned at the
level of the heart
A client with gastroenteritis, nausea, and vomiting is currently on
Nothing by mouth (NPO) status. The healthcare
provider prescribes oral intake to be advanced as tolerated.
Which fluid should the practical nurse offer first?
A. Tea
B. Broth
C. Water
D. Soda - ANSWER -C. Water
,Water or ice chips are the first choices of clear fluids for rehydration
by mouth
An older client who is admitted to the hospital with dehydration and
electrolyte imbalance is confused and incontinent of urine. Which
action provides the best strategy for the practical nurse (PN) to
implement for the client's incontinence?
A. Insert an indwelling urinary catheter
B. Apply absorbent incontinence pads
C. Restrict fluids after the evening meal
D. Establish a 2-hour voiding schedule - ANSWER -D. Establish a 2-
hour voiding schedule
A 2 hour voiding schedule is the best strategy for urinary
incontinence management b/c it provides the client who is
confused an opportunity to empty the bladder which
minimizes incontinence due to overfilling
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 cath with sterile distilled water
B. Dilute an antiseptic solution in the perineal wash
C. Cleanse perineal area with soap and water BID and PRN
D. Apply an antibiotic ointment around urinary meatus BID - ANSWER
-C. Cleanse perineal 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
1. A client with cancer who has been taking opioid analgesics for two
years now requires increased doses to obtain pain relief. The client
expresses fear about becoming addicted to these drugs. What
information should the practical nurse (PN) provide?
A. Opioid use with cancer does not cause addiction.
B. Addiction is easily reversed if it occurs during pain management.
C. Prescribed opiates for cancer pain relief improve qualify of life.
D. Opioid dosages can be tapered if a client fears addiction. -
ANSWER -C. Prescribed opiates for cancer pain relief improve
qualify of life
The goal of pain management for clients with cancer using opiates is
to minimize pain and maintain quality of life
2. A client's indwelling urinary catheter is removed at 9:30 AM. The
practical nurse (PN) assesses the client every two hours for the
desire to void. Which documented assessment requires further
intervention by the PN? A. 1:30 pm: unable to void.
