LVN Fundamentals Hesi Practice test questions with verified solutions

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. 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. B. 5:30 pm: unable to void. C. 3:30 pm: unable to void. D. 11:30 am: unable to void. B. A client is due to void within 8 hours of catheter removal, so at 5:30 PM. Longer than 8 hours after removal, catheter reinsertion may be necessary. If the bladder is not distended, further action may not be needed Brainpower Read More Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:00 Full screen 3. Which position is best for the practical nurse to place the client in during administration of a rectal suppository for constipation? A. Prone with pillows under the client's abdomen. B. Supine with the client on a bed pan. C. Left Sims' position with upper leg flexed. D. Right-side lying knee-chest position. C. Left side-lying Sims' position lessens the likelihood that the suppository or feces will be expelled, exposes the anus for visualization during insertion, and helps the client to relax the external anal sphincter 4. The practical nurse (PN) is adding tap water to several medications for administration via feeding tube. Which preparation should the PN administer without delay? A. Reconstituted powder. B. Timed release capsule. C. Cherry flavored elixir. D. Flavorless suspension. B. Although the gelatin capsule can be opened to administer the spansule's granules, the PN should not crush or allow the timed-released granules to dissolve before administering this preparation via feeding tube since the timed-release function can be compromised. 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. A. 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. 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 The practical nurse (PN) is preparing to reconstitute a drug from powder form for IM administration. Which step should the PN implement first? A. Verify the drug with the medication administration record. B. Mix the powder with the solution. C. Attach the needle to the syringe. D. Read the label to determine the amount of diluent to use. A. The Five Rights of medication administration include the right drug, right dose, right route, right time, and right client. The first action should be verification of the right drug in the powder form for reconstitution. Which action should the practical nurse (PN) implement when administering a subcutaneous injection to a client who weighs 325 pounds? A. Produce a bleb at the injection site. B. Insert the needle at a 15-degree angle. C. Select a needle with a longer shaft. D. Rub vigorously for a faster response. C. To ensure penetration into the deep layer of subcutaneuos adipose for a client who is obese, the needle length should be longer than the usual needle (preferably 3/8 to 5/8 inch in length) for subcutaneous injection. Which finding indicates to the practical nurse (PN) that an older client who is receiving intravenous therapy is experiencing fluid overload? A. Edema in lower extremities. B. Crackles in the lung fields. C. Pulse rate of 64 beats/min. D. Respirations of 16 breaths/min. B. IV fluid overload in an older client is likely to cause an increase in the workload of the heart causing a decrease in cardiac output The practical nurse (PN) is checking the surgical dressing for a client who arrived on the postoperative unit an hour ago. The dressing has an increase in the accumulation of serosanguinous drainage. What nursing action should the PN take? A. Reinforce the dressing with clean gauze sponges and tape. B. Change the surgical dressing immediately to prevent infection. C. Mark the outlined area of drainage with date, time and initials. D. Collect a sample of the drainage for a culture and sensitivity C. The area of bleeding on the dressing should be outlined, dated, timed and initialed for furture comparison and evaluation A male client who is 2 days postoperative for exploratory abdominal surgery is ambulating in the hall with the practical nurse (PN). The client tells the PN, "I think something in my incision just let go." Which action should the PN implement first? A. Notify the healthcare provider. B. Assist the client to a supine position. C. Instruct the client to avoid deep breathing. D. Request an abdominal binder from a coworker. B. The sensation of the surgical site letting go is characteristic of wound dehiscence in the early postoperative period. The client should be placed into a supine position The practical nurse (PN) is applying a dry, sterile dressing to a client's abdominal wound. Which allergy should the PN verify with the client? A. Tape. B. Antibiotic ointment. C. Povidone-iodine. D. Hydrogen peroxide. A. a dry, sterile dressing includes the use of gauze and tape . Although a client may be allergic to the other substances used in wound care, (B, C, and D) are not used for a dry, sterile dressing. The practical nurse (PN) is changing a postoperative dressing for a client with a horizontal lower abdominal incision. What method should the PN use to remove the tape from the dressing? A. Pull from the left to right across the abdomen. B. Peel across the abdomen from the right to the left. C. Start from the top of the incision moving to the bottom. D. Remove all four sides by moving to the center of the incision. D. The tape should be removed by starting all four sides and moving towards the center of the incision to prevent disruption of the wound. Which action should the practical nurse (PN) follow when applying an elasticized bandage to a client's leg? A. Secure the end with metal clips. B. Overlap turns of the bandage equally. C. Adjust the tension as needed. D. Wrap from the proximal to distal end. B. The overlapping turns of the elasticized bandage should be evenly wrapped. Metal clips (A) may release and cause injury to the client. The bandage should be applied from the distal end to the proximal end of an extremity An older client who has been on bed rest is not eating well and is exhibiting abdominal distension, cramping, and is passing small amounts of liquid stool. Which prescribed action is most important for the practical nurse (PN) to implement? A. Place incontinent pads on the bed. B. Give a PRN dose of a stool softener. C. Digitally remove a fecal impaction. D. Administer a soap suds enema. C. Abdominal distension, cramping, and passage of small amounts of liquid stool are signs and symptoms of fecal impaction, which is relieved by digital removal. Acetaminophen is prescribed for an unconscious client with a temperature of 104° F. Which route should the practical nurse (PN) plan to administer this medication? A. Oral. B. Rectal. C. Buccal. D. Topical. B. The rectal route, ensures absorption and safety for an unconscious client who is at risk for aspiration. (A and C) are contraindicated for an unconscious client who may have a compromised gag reflex and is unable to swallow Which intervention should the practical nurse (PN) implement to help a client cope effectively with chronic pain? A. Administer around-the-clock opiate drugs. B. Give scheduled doses of benzodiazepines. C. Recommend avoiding painful activities. D. Encourage using relaxation techniques. D. Relaxation techniques can be an effective long-term strategy to help a client control tension, anxiety, and cope with chronic pain. (A and B) are not useful for long term management of chronic pain. (C) may not be feasible if activities of daily living are painful. A young woman, who is the primary caregiver for her mother who has Alzheimer's disease, tells the practical nurse (PN), "Sometimes I hate my mother for living this long and my Dad for dying and not caring for her." What response should the PN offer? A. What you do to cope with these feelings? B. Have you told your family how you feel? C. It's normal feel these emotions when you are stressed. D. Don't worry, at least you can talk about your angry. A. a response that invites the client to share feelings and perceptions is the most therapeutic communication (B and C) do not provide the client the options to freely share her distress During insertion of a nasogastric tube (NGT) into the right nares, the client starts to cough. Which action should the practical nurse (PN) implement? A. Notify the healthcare provider and report the inability to insert the NGT. B. Flush the nasogastric tube with 30 ml of tap water to check for patency. C. Withdraw the NGT to the oral pharynx, reposition client's head and reinsert. D. Continue inserting the NGT because coughing is an expected response. C. Difficulty entering the esophagus during insertion of a NGT may cause the client to cough if the tube enters the larynx, which requires stopping the insertion of the NGT. To reintroduce the NGT, it should be withdrawn until its tip is visualized in the oral pharynx, and the client's head repositioned with the chin closer to the chest to prevent the NGT from entering the trachea A client is receiving a continuous tube feeding. While checking the gastric residual volume, the practical nurse (PN) aspirates 150 ml of gastric contents. What action should the PN take? A. Rinse the feeding tube after throwing the aspirated gastric contents away and restart the feeding. B. Replace half of the aspirated gastric contents and slow the rate of the feeding. C. Throw the aspirated gastric contents away and stop the continuous feeding. D. Return all the aspirated contents to the stomach followed with water and consult the agency policy. D. The residual volume should be replaced in order to prevent loss of electrolytes, and the agency policy should be followed to determine the routine actions regarding the volume of the next feeding, the rate of the feeding, or the duration to withhold the continuous feeding. Throwing the aspirate away or only replacing a portion places the client at risk for electrolyte imbalance The practical nurse (PN) is assisting a client plan a balanced vegetarian diet that provides the highest in protein quality. Which selection should the PN recommend to the client? A. Soybeans. B. Peanuts. C. Whole wheat. D. Sesame seeds. A. Soybeans are the highest in protein quality and contain the most nutritive value. (B and D) are sources of protein but provide less nutritive value. Although whole wheat (C), a complex carbohydrate, it is not as a protein source 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. B. The client's fluid loss from protracted vomiting causes a shift in intravascular fluids causing dehydration, hypotension, and tachycardia, which should be reported to the charge nurse. (A, B, and C) are signs consistent with dehydration, but the priority is the client's fluid depletion that is causing a hypotensive state. 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 client's safety when the benefits outweigh the risks. D. Restraints should be used when the benefits outweigh the risks in providing a safe environment for the client, and ensuring the safety of others. Restraints can increase agitation (A) and are not the most effective way to prevent falls (B). Restraints may provide protection, but must be diligently monitored to prevent negligent injury Which action should the practical nurse (PN) implement when supporting an older client who is afraid of dying? A. Ask the client about his belief of a spiritual life after death. B. Provide basic comfort measures to alleviate pain and breathlessness. C. Use open-ended questions to encourage the client to share feelings. D. Talk about common beliefs that others have expressed about death. C. Using open-ended questions gives a client the opportunity to share feelings, fears, and concerns about the process of dying. Although (A and D) provide topics of discussion about death, the client is often self-centered and is best supported by encouragement to express personal feelings about death. (B) provides palliative physical measures, but the client should be supported and allowed to verbally express emotional distress and anxiety. A family member of a dying client asks the practical nurse (PN) if the client knows the family is at the bedside. The PN explains that which of the five senses persists the longest during the dying process? A. Smell. B. Touch. C. Vision. D. Hearing. D. As death approaches, hearing (D) is the sense that persists even when the client is unable to respond. (A, B, and C) decline before the sense of hearing. Which action should the practical nurse (PN) implement to help a male client cope with his fear as he approaches death? A. Tell the client that he will soon find peace and comfort. B. Encourage family members to cry at the client's bedside. C. Hold the client's hand and tell him he is not alone. D. Explain the signs of impending death to the family. D. Therapeutic touch, such as holding the hand of a client who is dying, communicates the presence of others (C) and helps reduce feelings of aloneness, expresses genuine care and concern, and supports a fearful client who is dying or is unable to respond. Telling a client that he is going to find peace and comfort (A) in death may increase a sense of anxiety. Because family dynamics vary considerably, encouraging outward expression of family grief (B) may contribute to the client's anxiety and fears. An older client is receiving nasogastric tube (NGT) feedings for several days. Which finding should the practical nurse (PN) report to the healthcare provider? A. Soft, formed stools. B. Urine output of 2000 ml per day. C. Abdominal distention and nausea. D. Dried mucus around the nasal tube. C. Nausea and abdominal distention indicate a decrease in the rate of stomach emptying or an excessive rate of intake, which requires notification of the healthcare provider for further prescriptions. Soft, formed stools (A), urine output of 2000 ml per day (B), and dried mucus around the nasal tube are normal findings. The practical nurse (PN) is caring for an older client who is NPO after surgery. The client complains that his mouth and mucous membranes are dry. Which intervention should the PN implement to increase the client's comfort? A. Increase oral fluid intake. B. Perform oral hygiene frequently. C. Swab the inside of the mouth with petroleum jelly. D. Report the rate of intravenous fluid administration. B. Frequent oral hygiene moistens the oral cavity and alleviates discomfort for a client who is NPO. Oral fluid intake is contraindicated in a client who is NPO (A). Petroleum jelly is not placed intraorally (C). Although reporting the rate of IV fluids (D) provides data about the current prescription, oral hygiene is an immediate comfort intervention that addresses the client's hydration status. The practical nurse (PN) is giving oral care to an older female client with tender gums that bleed easily because of a medication she is taking. What intervention should the PN implement? A. Encourage the client to massage the gums. B. Tell the client to use mouthwash only. C. Obtain a soft-bristle brush for the client. D. Have the client rinse with warm salt water. C. A client with gum tenderness needs good oral hygiene, so a soft-bristle brush should be used to minimize gingival bleeding. Massaging the gums (A) may contribute to gingival bleeding. The use of a commercial mouthwash only (B) omits good oral hygiene practices, such as brushing. Which time frame should the practical nurse (PN) reposition a client? A. Every 4 hours while awake. B. Twice per shift. C. Every 2 hours. D. With each client request. C. Skin changes due to circulatory impairment begin developing when the skin is compressed for 2 hours or more. A client should be reposition every two hours around the clock. (A and B) provide prolonged pressure that begins tissue necrosis. Although more frequent positions changes are necessary for some clients (D), the maximum time for a client should remain in one position is 2 hours. An older male client tells the practical nurse (PN) that his religion does not permit him to bathe daily. How should the PN respond? A. State that the healthcare provider has prescribed a bath today. B. Offer the client several choices of times to bathe during the day. C. Review the importance of hygienic measures for improved health. D. Request that the client clarify his religious beliefs about bathing. D. A client's religious and cultural preferences should be considered when providing basic hygiene. (A and C) provide valid rationale for daily hygiene, but the client's religious beliefs should be considered in the client's choice. Although offering choices (B) addresses client autonomy, the client's care should be individualized. An older male client who is sedentary complains of not having a formed bowel movement in four days and tells the practical nurse (PN) that he feels rectal pressure and has a constant headache. The PN determines the client is having frequent small, liquid stools. Which nursing action should the PN take first? A. Provide frequent intake of oral liquids. B. Digitally assess for impacted stool. C. Give prescribed stool softener. D. Administer a mild analgesic. B. The presence of liquid stools with a pattern of no formed bowel movement for more than 3 days is indicative of an impaction, which should be determined by digital exam. After digital removal of the impaction, (A, C, and D) should be implemented. The practical nurse (PN) is obtaining information for a male client's psychosocial assessment. Which action should the PN implement first? A. State that the healthcare provider has prescribed a bath today. B. Offer the client several choices of times to bathe during the day. C. Review the importance of hygienic measures for improved health. D. Request that the client clarify his religious beliefs about bathing. D. A client's religious and cultural preferences should be considered when providing basic hygiene. (A and C) provide valid rationale for daily hygiene, but the client's religious beliefs should be considered in the client's choice. Although offering choices (B) addresses client autonomy, the client's care should be individualized. An older male client who is sedentary complains of not having a formed bowel movement in four days and tells the practical nurse (PN) that he feels rectal pressure and has a constant headache. The PN determines the client is having frequent small, liquid stools. Which nursing action should the PN take first? A. Provide frequent intake of oral liquids. B. Digitally assess for impacted stool. C. Give prescribed stool softener. D. Administer a mild analgesic. B. The presence of liquid stools with a pattern of no formed bowel movement for more than 3 days is indicative of an impaction, which should be determined by digital exam. After digital removal of the impaction, (A, C, and D) should be implemented. The practical nurse (PN) is obtaining information for a male client's psychosocial assessment. Which action should the PN implement first? A. Determine the value the client places on his health. B. Establish a therapeutic relationship. C. Determine if he has abnormal behaviors. D. Ask the client to share information about his past. B. A client should feel comfortable sharing information about his psychosocial history, so a therapeutic relationship should be established before interviewing the client about his personal values, behaviors and history 31. 34.ID: Which food should the practical nurse (PN) recommend for a client to increase the dietary intake of potassium? A. Corn. B. Baked potato. C. Popcorn. D. Grape juice. B. A baked potato, including its skin, contains the highest amount of potassium. (A, C, and D) are low in potassium. A male Native American client with tuberculosis is visiting a health care clinic for follow-up treatment. During the interview, the practical nurse (PN) notices that the client keeps his eyes on the floor and does not make eye contact. How should the PN interpret this client's behavior? A. He is uncomfortable with violation of his personal space. B. The client is depressed and concerned about his diagnosis. C. His culture finds sustained eye contact rude or disrespectful. D. The client is reluctant to speak without a tribal shaman present. C. Native Americans usually avoid sustained eye contact as a sign of respect (A) is common in Asian cultures. The client may be depressed or worried (B), but more data is needed. Reluctance to speak (D) is not supported by the client's nonverbal behavior. The practical nurse (PN) observes a client who begins to choke during a meal. After determining that the client cannot speak, what action should the PN implement? A. Initiate cardiopulmonary resuscitation (CPR). B. Administer four upward abdominal thrusts. C. Sweep the airway with a hooked index finger. D. Place a fist halfway between the xiphoid process and umbilicus. D. After confirming a victim with foreign body airway obstruction (FBAO) cannot speak, the first should be placed between the xiphoid process and umbilicus, and a rapid sequence of abdominal thrusts should be administered until the FBAO is relieved, not (B and C). If the victim becomes unresponsive, CPR (A) should be initiated after activating EMS. An older male client who is incontinent receives a prescription for a condom (external) catheter. Which step(s) should the practical nurse implement when applying the external catheter? (Select all that apply.) A. Wrap the adhesive strip in a spiral around the penis. B. Shave the perineal area before beginning. C. Apply skin prep to the penile shaft and allow to dry. D. Leave 1 to 2 inches between the tip of the penis and condom catheter. E. Don sterile gloves prior to application of the condom catheter. (A, C, and D) are correct. Spiral application of the adhesive strip (A) minimizes the risk of constricting blood flow to the penis. A skin prep to the skin of the penile shaft (C) ensures condom adhesion to the skin surface and prevents leakage. Adequate space between the tip of the penis and the end of the condom catheter (D) allows urine to drain. An older female states that the medication tablet brought in a cup looks different from the tablet that she takes at home. Which action should the practical nurse (PN) take? A. Double check the medication with the charge nurse. B. Give the medication because the client is confused. C. Check the written prescription to verify the medication. D. Reassure the client that this medication is correct C. The first line of defense against medication errors is verification of the healthcare provider's prescription, which should be reviewed when a client raises a concern. While taking an adult's vital signs, the practical nurse (PN) notes an irregular radial pulse. What action should the PN implement to obtain the most accurate assessment? A. Use a Doppler for the radial pulse while monitoring the apical. B. Obtain the radial pulse again for one minute followed by the apical. C. Perform an apical-radial pulse assessment with another nurse. D. Verify the finding by counting the apical pulse using a stethoscope. C. An apical-radial pulse provides the most objective comparison when one nurse obtains the radial pulse and another nurse simultaneously auscultates the apical pulse. When one nurse collects both rates, either at the same or separate times (A, B, and D), the data obtained is less accurate. Which interventions 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 sterile distilled water. B. Dilute an antiseptic solution in the perineal wash. C. Cleanse perineum area with soap and water BID and PRN. D. Apply an antibiotic ointment around the urinary meatus BID. C. Daily perineal care BID and PRN should include cleansing of the meatus and catheter junction with soap and water. (A, B, and D) do not support the concept of medical asepsis and catheter care. 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. D. A 2-hour voiding schedule is the best strategy for bladder incontinence management because it provides the client who is confused an opportunity to empty the bladder which minimizes incontinence due to overfilling. Restriction of fluids in the evening (C) is helpful for minimizing nighttime incontinence. Catheter insertion (A) increases the client's risk for infection and should be implemented for associated complications. Although the use of incontinent pads (B) assists with incontinent toileting, the client's episodes of incontinence may continue. The practical nurse (PN) identifies a client's need for spiritual support. What is the first action the PN should take? A. Refer the client to a client advocate or personal chaplain. B. Provide the client with religious literature and references. C. Suggest the client use one's religious faith to cope. D. Determine the client's perceptions and belief system. D. Exploring the client's spirituality may reveal responses to health problems that require nursing intervention. A client's perceptions and belief system should be determined, which may reveal a strong set of resources that enable the client to cope effectively. Once the client's value and belief systems are assessed, then (A, B and C) may be implemented to provide the client with spiritual support. A client is receiving a Mantoux test for tuberculosis screening. Which angle should the practical nurse (PN) insert the needle for injection? A. 15 degrees. B. 30 degrees. C. 45 degrees. D. 90 degrees. A. The Mantoux test is an intradermal (ID) injection, so the angle of needle insertion is 5 to 15 degrees, which deposits the antigen into the dermis. Depending upon the client's amount of adipose tissue, (B, C, and D) may place the medication into subcutaneous or intramuscular tissues, which does not provide the best results for ID testing.