HESI PN Comprehensive Exam 3
A 17-year-old male comes to the clinic for his pre-college physical examination. During the
interview, he tells the practical nurse (PN) that although he has been actively engaged in sports,
music, and academics, he still does not know what he would like to do after graduation. How
should the PN respond?
A. Encourage him to speak with his parents about his confusion about his future.
B. Recommend that he choose one area on which to focus so that he begins to develop a firmer
sense of identity.
C. Acknowledge the difficulty of this decision-making while supporting his desire to continue to
explore his options.
D. Suggest that he explore different part-time work options while going to college. - ANS - C.
Acknowledge the difficulty of this decision-making while supporting his desire to continue to
explore his options.
Erikson's stage of adolescent sense of identity is a development milestone that often continues
into early young adulthood when career options in college are explored. Acknowledging the
teen's difficulty in deciding about his future offers support that his search is a normal stage.
\A 9-year-old boy who had an emergency appendectomy during the night awakens and starts to
cry when he does not see his parents at the bedside. He has an IV and a dressing covering the
operative site. What action should the practical nurse (PN) implement?
A. Encourage the child to calm down because big boys do not cry.
B. Locate his mother and ask her to stay at the bedside with her son.
C. Ask the child to recall the surgical event and assess his pain level.
D. Call the healthcare provider for a prescription for a different analgesic. - ANS - C. Ask the
child to recall the surgical event and assess his pain level.
A 9-year-old can use cognitive abilities to understand the nurse's explanation which should help
him focus and assess his postoperative pain.
\A client admitted with major depression is placed on suicide precautions. While orienting the
client to the unit, what activity should the practical nurse (PN) implement?
A. Assign the same unlicensed assistive personnel for one on one observations.
,B. Explain the purpose and implementation of suicide precautions.
C. Discuss that visitors will be limited during the client's close observation period.
D. Obtain the client's permission to search his personal items. - ANS - B. Explain the purpose
and implementation of suicide precautions.
A client on suicide precautions should be informed about the purpose and parameters of
suicidal precautions, which include use of selected personal items under direct supervision,
removal of sharp objects, observation at frequent intervals, and restriction to the unit.
\A client has collapsed while getting out of bed, has no pulse, and is not breathing. After calling
for help and an automated external defibrillator (AED), which action should the practical nurse
(PN) take?
A. Give two quick short breaths.
B. Palpate for a carotid pulse.
C. Defibrillate using the AED.
D. Begin cardiac compressions. - ANS - D. Begin cardiac compressions.
Basic Life Support (BLS) for a client who is unconscious and not breathing should begin with
cardiac compressions.
\A client is admitted with a tumor of the hypothalamus. Which finding should the practical nurse
(PN) report to the charge nurse?
A. A pulse rate of 98 beats/min.
B. Respirations of 20 breaths/min.
C. An oral temperature of 101.8° F.
D. A blood pressure of 130/80 mm Hg. - ANS - C. An oral temperature of 101.8° F.
The hypothalamus controls body temperature, so variation in the temperature should be
reported to determine if the elevation is related to infection or cerebral pathology.
\A client is admitted with possible head trauma after a motor vehicle collision. Which action
should the practical nurse (PN) implement?
A. Auscultate heart sounds.
B. Monitor client's weight.
C. Check for verbal and motor response.
D. Auscultate lung and abdominal sounds. - ANS - C. Check for verbal and motor response.
A client experiencing a traumatic closed head injury should be monitored for signs of increased
intracranial pressure (ICP). A neurologic examination, such as the Glasgow Coma Scale, is
performed the detect early signs of ICP, as manifested by changes in verbal and motor
response.
,\A client recently diagnosed with diabetes is very angry about the changed circumstances. How
should the practical nurse (PN) respond?
A. "You appear upset about the diagnosis. Let's talk about your feelings."
B. "Try not to be angry because you are receiving the best care possible."
C. "Anger is only an emotion, but try not to be angry with healthcare providers."
D. "You learn quickly and will probably handle the difficult treatments very well." - ANS - A. "You
appear upset about the diagnosis. Let's talk about your feelings."
(A) demonstrates acceptance of the client's thoughts and feelings and encourages open
communication.
\A client visits the clinic with complaints of sleep loss and wants a prescription for sleeping pills.
The practical nurse (PN) learns that the client is also drinking tea at the evening meals. What
action should the PN implement?
A. Talk to the client about history of changes in sleeping habits.
B. Determine if the tea is caffeinated or has an herbal supplement in it.
C. Instruct the client on the appropriate dose for the sleeping pills.
D. Have a translator interpret all instructions about the sleeping pills. - ANS - B. Determine if the
tea is caffeinated or has an herbal supplement in it.
Determining if the tea is caffeinated is the first action.
\A client who delivered a normal baby 4 hours ago has been unable to void. What nursing
intervention should the practical nurse (PN) implement first?
A. Increase oral fluid intake to 2500 ml.
B. Use urinary catheter to drain bladder.
C. Rinse the perineum with warm water.
D. Palpate suprapubic area for distention. - ANS - C. Rinse the perineum with warm water.
Non-invasive measures, such as pouring warm water over the client's perineum to create the
urge to urinate should be implement first.
\A client who had a cardiac catheterization 2 hours ago has a pressure dressing in the left groin.
The practical nurse (PN) is taking vital signs q2 hours. Which additional assessment should the
PN make?
A. Pedal pulse.
B. Apical pulse.
, C. Femoral pulse.
D. Brachial pulse. - ANS - A. Pedal pulse.
Pedal pulses should be monitored q2 hours post-cardiac catheterization to ensure arterial
perfusion distal to the femoral arterial access is intact.
\A client who is 3 days postoperatively for a coronary artery bypass graft surgery (CABG) has a
serum potassium level of 4.5 mEq/L. What action should the practical nurse (PN) implement
based on this finding?
A. Notify the healthcare provider.
B. Document the finding only.
C. Administer potassium replacement.
D. Decrease the IV solution flow rate. - ANS - B. Document the finding only.
Post CABG can contribute to hypokalemia from hemodilution, nasogastric suction, or diuretic
therapy, so monitoring serum electrolytes is important to determine the client's risk for cardiac
dysrhythmias. The client's serum potassium is within normal limits (norm 3.5 to 5.0 mEq/L) and
requires documentation only.
\A client who is ready for transport from the postanesthesia care unit (PACU) to the
postoperative unit continues to complain of pain at the incision site. What action should the
practical nurse (PN) implement?
A. Administer a dose of analgesic as written in the client's postoperative prescriptions.
B. Give a half-dose of the prescribed postoperative dosage of analgesic medication.
C. Consult with the anesthesia healthcare provider for a prescribed dose of analgesia.
D. Tell the client that pain medication cannot be given until transfer to the postoperative unit. -
ANS - C. Consult with the anesthesia healthcare provider for a prescribed dose of analgesia.
A client who remains in the postanesthesia care unit may still have residual effects of
anesthesia, so the healthcare provider should be consulted for a dose that is reduced or
different than prescribed.
\A client who is recently diagnosed with bipolar disorder receives a new prescription for lithium
(Eskalith). Which information should the practical nurse (PN) reenforce to ensure the client's
understanding?
A. Obtain serum lithium blood levels once a month.
B. Eliminate foods high in salt from the daily diet.
C. Discontinue lithium if fine hand tremors occur.
D. Withhold lithium if fever develops during a "cold." - ANS - A. Obtain serum lithium blood
levels once a month.
A 17-year-old male comes to the clinic for his pre-college physical examination. During the
interview, he tells the practical nurse (PN) that although he has been actively engaged in sports,
music, and academics, he still does not know what he would like to do after graduation. How
should the PN respond?
A. Encourage him to speak with his parents about his confusion about his future.
B. Recommend that he choose one area on which to focus so that he begins to develop a firmer
sense of identity.
C. Acknowledge the difficulty of this decision-making while supporting his desire to continue to
explore his options.
D. Suggest that he explore different part-time work options while going to college. - ANS - C.
Acknowledge the difficulty of this decision-making while supporting his desire to continue to
explore his options.
Erikson's stage of adolescent sense of identity is a development milestone that often continues
into early young adulthood when career options in college are explored. Acknowledging the
teen's difficulty in deciding about his future offers support that his search is a normal stage.
\A 9-year-old boy who had an emergency appendectomy during the night awakens and starts to
cry when he does not see his parents at the bedside. He has an IV and a dressing covering the
operative site. What action should the practical nurse (PN) implement?
A. Encourage the child to calm down because big boys do not cry.
B. Locate his mother and ask her to stay at the bedside with her son.
C. Ask the child to recall the surgical event and assess his pain level.
D. Call the healthcare provider for a prescription for a different analgesic. - ANS - C. Ask the
child to recall the surgical event and assess his pain level.
A 9-year-old can use cognitive abilities to understand the nurse's explanation which should help
him focus and assess his postoperative pain.
\A client admitted with major depression is placed on suicide precautions. While orienting the
client to the unit, what activity should the practical nurse (PN) implement?
A. Assign the same unlicensed assistive personnel for one on one observations.
,B. Explain the purpose and implementation of suicide precautions.
C. Discuss that visitors will be limited during the client's close observation period.
D. Obtain the client's permission to search his personal items. - ANS - B. Explain the purpose
and implementation of suicide precautions.
A client on suicide precautions should be informed about the purpose and parameters of
suicidal precautions, which include use of selected personal items under direct supervision,
removal of sharp objects, observation at frequent intervals, and restriction to the unit.
\A client has collapsed while getting out of bed, has no pulse, and is not breathing. After calling
for help and an automated external defibrillator (AED), which action should the practical nurse
(PN) take?
A. Give two quick short breaths.
B. Palpate for a carotid pulse.
C. Defibrillate using the AED.
D. Begin cardiac compressions. - ANS - D. Begin cardiac compressions.
Basic Life Support (BLS) for a client who is unconscious and not breathing should begin with
cardiac compressions.
\A client is admitted with a tumor of the hypothalamus. Which finding should the practical nurse
(PN) report to the charge nurse?
A. A pulse rate of 98 beats/min.
B. Respirations of 20 breaths/min.
C. An oral temperature of 101.8° F.
D. A blood pressure of 130/80 mm Hg. - ANS - C. An oral temperature of 101.8° F.
The hypothalamus controls body temperature, so variation in the temperature should be
reported to determine if the elevation is related to infection or cerebral pathology.
\A client is admitted with possible head trauma after a motor vehicle collision. Which action
should the practical nurse (PN) implement?
A. Auscultate heart sounds.
B. Monitor client's weight.
C. Check for verbal and motor response.
D. Auscultate lung and abdominal sounds. - ANS - C. Check for verbal and motor response.
A client experiencing a traumatic closed head injury should be monitored for signs of increased
intracranial pressure (ICP). A neurologic examination, such as the Glasgow Coma Scale, is
performed the detect early signs of ICP, as manifested by changes in verbal and motor
response.
,\A client recently diagnosed with diabetes is very angry about the changed circumstances. How
should the practical nurse (PN) respond?
A. "You appear upset about the diagnosis. Let's talk about your feelings."
B. "Try not to be angry because you are receiving the best care possible."
C. "Anger is only an emotion, but try not to be angry with healthcare providers."
D. "You learn quickly and will probably handle the difficult treatments very well." - ANS - A. "You
appear upset about the diagnosis. Let's talk about your feelings."
(A) demonstrates acceptance of the client's thoughts and feelings and encourages open
communication.
\A client visits the clinic with complaints of sleep loss and wants a prescription for sleeping pills.
The practical nurse (PN) learns that the client is also drinking tea at the evening meals. What
action should the PN implement?
A. Talk to the client about history of changes in sleeping habits.
B. Determine if the tea is caffeinated or has an herbal supplement in it.
C. Instruct the client on the appropriate dose for the sleeping pills.
D. Have a translator interpret all instructions about the sleeping pills. - ANS - B. Determine if the
tea is caffeinated or has an herbal supplement in it.
Determining if the tea is caffeinated is the first action.
\A client who delivered a normal baby 4 hours ago has been unable to void. What nursing
intervention should the practical nurse (PN) implement first?
A. Increase oral fluid intake to 2500 ml.
B. Use urinary catheter to drain bladder.
C. Rinse the perineum with warm water.
D. Palpate suprapubic area for distention. - ANS - C. Rinse the perineum with warm water.
Non-invasive measures, such as pouring warm water over the client's perineum to create the
urge to urinate should be implement first.
\A client who had a cardiac catheterization 2 hours ago has a pressure dressing in the left groin.
The practical nurse (PN) is taking vital signs q2 hours. Which additional assessment should the
PN make?
A. Pedal pulse.
B. Apical pulse.
, C. Femoral pulse.
D. Brachial pulse. - ANS - A. Pedal pulse.
Pedal pulses should be monitored q2 hours post-cardiac catheterization to ensure arterial
perfusion distal to the femoral arterial access is intact.
\A client who is 3 days postoperatively for a coronary artery bypass graft surgery (CABG) has a
serum potassium level of 4.5 mEq/L. What action should the practical nurse (PN) implement
based on this finding?
A. Notify the healthcare provider.
B. Document the finding only.
C. Administer potassium replacement.
D. Decrease the IV solution flow rate. - ANS - B. Document the finding only.
Post CABG can contribute to hypokalemia from hemodilution, nasogastric suction, or diuretic
therapy, so monitoring serum electrolytes is important to determine the client's risk for cardiac
dysrhythmias. The client's serum potassium is within normal limits (norm 3.5 to 5.0 mEq/L) and
requires documentation only.
\A client who is ready for transport from the postanesthesia care unit (PACU) to the
postoperative unit continues to complain of pain at the incision site. What action should the
practical nurse (PN) implement?
A. Administer a dose of analgesic as written in the client's postoperative prescriptions.
B. Give a half-dose of the prescribed postoperative dosage of analgesic medication.
C. Consult with the anesthesia healthcare provider for a prescribed dose of analgesia.
D. Tell the client that pain medication cannot be given until transfer to the postoperative unit. -
ANS - C. Consult with the anesthesia healthcare provider for a prescribed dose of analgesia.
A client who remains in the postanesthesia care unit may still have residual effects of
anesthesia, so the healthcare provider should be consulted for a dose that is reduced or
different than prescribed.
\A client who is recently diagnosed with bipolar disorder receives a new prescription for lithium
(Eskalith). Which information should the practical nurse (PN) reenforce to ensure the client's
understanding?
A. Obtain serum lithium blood levels once a month.
B. Eliminate foods high in salt from the daily diet.
C. Discontinue lithium if fine hand tremors occur.
D. Withhold lithium if fever develops during a "cold." - ANS - A. Obtain serum lithium blood
levels once a month.
