HESI LPN- Entrance exam Questions and Answers

HESI LPN- Entrance exam Questions and Answers 2 days after an abdominal hysterectomy, an elderly client with diabetes Mellitus Type II has a syncopal episode. Her vital signs are within normal limits and her sugar is 325 mg/dL. what intervention should the nurse implement first? administer regular insulin per sliding scale A 3-week-old infant is admitted for surgical repair of Pyloric Stenosis. What interventions should the nurse expect to implement to establish hydration in the immediate postoperative period? nipple feedings with glucose water a 3 year-old admitted with fever of unknown (FUO) has begun vomiting in the past half hour. The child's temp. is 101.8F, and the last does of antipyretic medication was given 5 hours ago. the child has prescriptions of acetaminophen (Tylenol) 160 mg per 5 mL elixir or 16o mg suppositories PRN fever or pain. what action should the nurse take at this time? make the child NPO and hold all mediations until the vomiting has stopped. 4 hours after administration of 20U of regular insulin, the client becomes shaky and diaphoretic. what action should the nurse take? give the client crackers and milk a 6-month child with bronchiolitis is admitted to the hospital. In monitoring the respiratory status of this child, which symptom indicates the nurse that he is experiencing respiratory distress? A high pitched cry. An 8-year-old recovering from a Celiac Crisis requests a bowl of cereal for breakfast. Which cereal should the nurse provide? rice total number of confirmed pregnancies regardless of the outcome Gravida number of births after 20 weeks Para pregnant for the first time primigravida a 26 year old gravida-4, para-0 had a spontaneous abortion at 9 weeks gestation. at one house post dilation and curettage (D&C) the nurse assess the vital signs and vaginal bleeding. the client begins to cry softly. how should the nurse intervene? express sorrow for the clients grief and offer to sit with her. A 26 year-old primigravida who delivered a 7-pound male infant 26 hours ago tells the nurse that she is confused about when she and her husband can return to having sexual intercourse. What info should the nurse reinforce with this client? they can have intercourse when the episiotomy is healed and the lochial flow has stopped 36 hours after delivery, the nurse determines a clients fundus is just above the umbilicus and displaced to the right of midline. what action should the nurse take first? palpate the bladder for distention a 60 year old client with cancer of the liver is in hepatic coma and unresponsive. what should the nurse say to family members were inquiring about the condition of their loved one? "Your loved ones condition is very critical, and there has been no response in the last 24 hours" a 67 year old woman who lives alone tripped on a rug in her home and fractured her right hip. the nurse knows that which predisposing factor contributes to the occurrence of hip fractures among elderly women. osteoporosis resulting from hormonal changes. a 75 year old male client with Alzheimer disease is admitted to an extended care facility. what intervention should the nurse include into the his clients Nursing care plan? plan to have the same nursing staff provide care for the client whenever possible. an 82-year old client is admitted to the hospital with a fractured right hip. following surgical repair, a footboard is placed at the clients feet. what is the reason the nurse will offer concerning the footboard? footboard is used to prevent foot drop. An adult female client is admitted to the psychiatric unit with diagnosis of major depression. After 2 weeks of antidepressant medication therapy, the nurse notices the client has more energy, is giving her belongings away to her visitors, and is in an overall better mood. Which intervention is best for the nurse to implement? ask the client if she has had any recent thoughts of harming herself. an adult male client tells the nurse that he believes someone is trying to obtain his cpu records, which his wife reports are recreational in nature. the client insist that an elaborate alarm system needs to be installed in his home. the nurse knows that this client is exhibiting which signs or symptoms? delusions of persecution After a change of shift report, the nurse makes rounds on a postoperative unit. Which client finding necessitates the immediate attention of the nurse? A. A client who is having bright red drainage from the rectum following a colonoscopy with a polyp removal After a client returns from Hemodialysis, the nurse measures the client's weight and notes a 3-poundweight loss from the pre-dialysis weight. The client reports feeling weak and fatigued. What action should the nurse take next? A. Measure the client's blood pressure After morning dressing changes are completed, a male client who has paraplegia contaminates his ischial decubiti dressing with a diarrheal stool. What activity is best for the nurse to assign to the unlicensed assistive personnel? B. Provide perianal care and collect clean linens for the dressing change After report, the nurse receives the laboratory values for 4 clients. Which client requires the nurse's immediate intervention? The client who is..... D. Trembling and has a glucose level of 50 mg/dL An ambulatory client with an indwelling urinary catheter (Foley) is requesting to take a shower for the first time. What is the best intervention for the nurse to implement? B. Keep the catheter intact and assist the client with a shower At 7AM, a Diabetic client is conscious with a serum glucose level of 50mg/dL. To manage this client's care effectively, what should the nurse administer? A. Orange juice Augmentin (amoxicillin/clavulante) 500mg suspension is prescribed for an older adult client who has trouble swallowing . The suspension is available in 125mg/5mL solution. How many ml should the client receive? (enter the numberic value only) 20 Based on the documentation in the medical record, which action should the nurse implement next? A. Give the rubella vaccine subcutaneously Based on the Nursing diagnosis of "Potential for infection related to second and third degree burns," which intervention has the highest priority? B. Use of careful hand washing technique Based on the Nursing diagnosis of, "Risk for Infection," which intervention should the nurse implement when providing care for an elderly client with Urinary incontinence? A. Maintain standard precautions The care plan for a male client with amyotrophic lateral sclerosis includes the Nursing diagnosis, "Decisional conflict related to concerns about mechanical ventilation." When assigned to care for this client, what intervention should the nurse implement based on this diagnosis ? D. Encourage the client to discuss his feelings and concerns related to the use of mechanical ventilation The cervix is the opening into the uterine cavity. What is its function in reproduction? B. Secretes mucus to facilitate sperm transport The charge nurse brings a #18fr urinary catheter (Foley) with a 30 mL balloon to the nurse who is preparing to insert a catheter in a female client who weighs 50 kg. What action should the nurse take first? D. Consult with the charge nurse about the catheter A child with Chronic Asthma is scheduled for Chest Physiotherapy. When should the nurse administer the meter-dosed inhaler (MDI) puff of bronchodilator relative to postural drainage treatments? After postural drainage A client asks the nurse to explain the location of the prostate gland. What is the best response? A. Close the rectal wall the prostate gland sits behind the symphysis pubis extending around thebeginning of the urethra A client at 28 weeks gestation is admitted to the antepartum unit and is being treated for preterm labor. She has a prescription for brethine (Terbutaline) 250 micrograms subcutaneously q4h. The medication is available for injection in 1 mg per ML vials. How many mL should the nurse administer? C. 0.25 A client begins an antidepressant drug during the second day of hospitalization. Which assessment is most important for the nurse to include in this client's plan of care while the client is taking the antidepressant? Mood a client comes to the antepartal clinic and tells the nurse that she is 6 weeks pregnant. which sign is the most likely to report? amenorrhea A client complains of kidney pain. The nurse understands that the kidneys are located where? A. On the retroperitoneal posterior abdominal wall at the costovertebral angle A client has a prescription for a Transcutaneous Electrical Nerve Stimulator (TENS) unit for pain management during the postoperative period following a lumber Laminectomy. What information should the nurse reinforce about the action of this adjuvant pain modality? B. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus A client has a prescription for enteric-coated (EC) aspirin 325mg PO daily. The medication drawer contains one 325mg aspirin. What action should the nurse take? C. Administer the aspirin with a full glass of water or a small snack A client has a prescription for lorazepam (ativan) 1 mg for anxiety. The medication is supplied as 0.5mg tablets. How many tablets should the client take? (enter numeric value only. 2 A client is admitted to the hospital with a diagnosis of Pneumonia. Which intervention should the nurse implement to prevent complications associated with Pneumonia? A. Encourage mobilization and ambulation A client is admitted for observation after experiencing a Transient Ischemic Attack (TIA). The nurse anticipates implementing care for which client problem? B. Altered breathing patterns A Client is admitted to the hospital with second and third degree burns to the face and neck. How should the nurse best position the client to maximize function of the neck and face and prevent contracture? A. The neck extended backward using a rolled towel behind the neck A client is admitted to the rehabilitation unit after a Thrombotic Cerebrovascular Accident (CVA) with Right Hemiplegia and expressive aphasia. What intervention should the nurse implement to communicate with the client? D. Dysphagia precautions A client is admitted with a fever of undermined origin (FUO). During rounds, the nurse finds the client diaphoretic, and the linens are damp. What should the nurse do first? B. Check the client's vital signs and pain scale A client is admitted with a newly diagnosed case of active tuberculosis (TB). Which intervention should the nurse teach the client about controlling transmission of tuberculosis (TB)? A. Proper disposal of tissues when coughing A client is complaining of muscle fatigue in the lower extremities. What is the physiological cause of muscle fatigue? A. The depletion of glycogen and energy stores A client is diagnosed with Clostridium Difficile (CDIFF). What action should the nurse implement to prevent the spread of the organism? B. Don non-sterile gloves when performing direct care A client is diagnosed with Pericarditis after a Myocardial Infarction (MI) and asks the nurse, "Why did this happen?" What explanation should the nurse offer? A. The sac surrounding the heart has become inflamed from the cells damaged by the heart attack A client is having Radical Mastectomy. What is the position of choice during the immediate postoperative period? C. Semi-Fowler's position with the arm on the operative side elevated A client is receiving 0.5 grams of a prescription medication that is dispensed as 500 mg/5mL. How many ml should the PN administer? (enter the numeric value only. If rounding is required, round to the nearest tenth.) 5 A client is receiving dexamethasone (Hexadrol, Decadron). What symptoms should the nurse recognize as Cushioned side effects? A. Moon face, Slow wound healing, muscle wasting sodium and water retention A client is receiving nitroglycerin sublingual tablets for angina. What response should the nurse expect the client to manifest in response to the administration of this drug during an acute anginal episode? B. Cessation of acute chest pain A client is returning to the surgical unit after a total right knee replacement. Which assessment findings are most important for the nurse to include in this client's record? A. Pedal pulses, pallor, pain, paresthesia or paralysis A client is using an incentive spirometer on the first postoperative day after an inguinal Herniorrhaphy. The nurse should re-teach the proper use of the spirometer when the client demonstrates what action? C. Blowing forcefully into the mouthpiece A client presents in the clinic because of generalized swelling after a bee sting. What intervention should the nurse implement first? C. Determine respiratory status and apply a pulse oximeter A client receives a new prescription for the angiotensin II receptor antagonist losartan (Cozaar). Which client instruction should the nurse encourage this client to follow? A. Move slowly when getting up to prevent sudden dizziness A client requires application of an eye shield to the right eye. What should the nurse do in order to apply tape in which direction to anchor the shield most effectively? B. Longitudinally from the right forehead to the right cheek A client returns to the postoperative unit following an open reduction and internal fixation of a hip fracture. The practical nurse applies the prescribed sequential compression devise (SCD) to both lower extremities. (BLE). What action is important when turning the client to a lateral position? D. Observe the SCDs continue to inflate and deflate when the client is turned