ESTUDYR
(LEADERSHIP) HESI LPN–ADN MOBILITY
EXAM QUESTIONS AND ANSWERS GRADED
A+ WITH RATIONALES
1. The nurse calls the surgeon to report that a male client who transitioned from a PCA to
PO analgesic 1 hour ago is now loudly asking for the PCA pump. The client’s BP rose
from 120/72 to 150/98 and his behavior disturbs his roommate. Which question is best
to include in the recommendation component of the SBAR?
A. Could the behavior be a manifestation of drug seeking?
B. Can the client be transferred to a private room?
C. Can the PCA be restarted and prescribed for an additional 12 hours?
D. Should the roommate be moved?
Rationale: The recommendation section should state the specific action you want
(restarting PCA) so the surgeon can make a prescription decision. Asking about drug
seeking is assessment, not a clear recommendation.
2. After change-of-shift report, which assigned client should the nurse assess first?
A. Diabetic with CAD complaining of increased shortness of breath (SOB).
B. 10-year-old with sickle cell on PCA reporting pain 2–3/10.
C. 29-year-old with CKD who had AV fistula placed yesterday.
D. Older client with COPD, O₂ sat 88% on room air.
A. Diabetic with CAD complaining of increased SOB.
Rationale: Acute worsening SOB in a client with CAD suggests myocardial
ischemia/heart failure — highest priority. (Note: choice D is also urgent, but CAD +
change in SOB is highest risk.)
3. A provider notifies the nurse that new prescriptions were written. What is the first
action the nurse should take?
A. Collect needed forms (labs/radiology requisitions).
B. Clarify prescriptions with unit clerk for transcription accuracy.
C. Document time of provider visit in nursing notes.
D. Read all of the new prescriptions written by the provider.
Rationale: Always read and understand new orders before acting or delegating;
clarifying/transcribing comes after reviewing.
4. RN, PN, and UAP are assembling to provide immediate chest-tube insertion bedside.
Which assignment best uses each person’s skills?
A. RN inserts chest tube immediately after PN cleans skin.
B. UAP listens to breath sounds while RN witnesses consent.
C. PN instructs family about need while RN obtains VS.
D. UAP obtains O₂ sat while RN reports findings to HCP.
Rationale: UAP can obtain basic vitals; RN communicates with HCP and
, ESTUDYR
performs/oversees advanced tasks. PN cannot perform sterile invasive procedures like
chest tube insertion independently.
5. An older woman with long HTN and HF transferred from long-term care has a signed
DNR. What should the nurse do?
A. Transfer to palliative care for supportive care.
B. Consult hospice case manager regarding plan.
C. Confirm current resuscitation wishes with client and family.
D. Ask unit supervisor to meet with family about desired care.
Rationale: Always verify that advance directive/DNR is current and that patient/family
understand before changing settings.
6. When caring for an older adult with septic shock, which intervention is most important
to include?
A. Maintain strict I&O.
B. Assess warmth of extremities.
C. Keep HOB elevated 45°.
D. Monitor blood glucose level.
Rationale: Extremity warmth/perfusion reflects peripheral perfusion and
vasoconstriction in shock—critical assessment finding.
7. A client with COPD reports difficulty eating due to SOB. Which tasks may be delegated
to UAP? (Select all that apply.)
A. Assist client with eating small, frequent high-calorie meals.
B. Offer high-calorie foods (milk, ice cream).
C. Consult with registered dietitian about nutritional needs.
D. Maintain a clean, pleasant environment during meals.
E. Set up food and drink containers within easy reach.
Answers: A, B, D, E.
Rationale: UAP can assist with feeding, offering food, setting up trays, and maintaining
environment. Dietitian consult is an RN/HCP responsibility.
8. UAP brings supplies to assist a male client who had a suprapubic catheter earlier today.
What should the nurse do?
A. Remind UAP to provide warmth and privacy for perineal care.
B. Encourage UAP to offer the client opportunity to perform his own catheter care.
C. Tell UAP that the nurse will perform catheter care while UAP assists with personal
care.
D. Advise UAP that dressing must be removed before cleaning.
Rationale: Catheter (suprapubic) care is a skilled/sterile or clinical task — RN must
perform. UAP may assist with non-sterile personal care.
9. RN observes PN positioning client for lumbar puncture (client on right side with left leg
bent). RN should:
A. Demonstrate to the PN a more effective positioning technique.
B. Arrange a UAP to assist PN during procedure.
C. Assume care of client and reassign PN.
D. Acknowledge PN positioned correctly.
(LEADERSHIP) HESI LPN–ADN MOBILITY
EXAM QUESTIONS AND ANSWERS GRADED
A+ WITH RATIONALES
1. The nurse calls the surgeon to report that a male client who transitioned from a PCA to
PO analgesic 1 hour ago is now loudly asking for the PCA pump. The client’s BP rose
from 120/72 to 150/98 and his behavior disturbs his roommate. Which question is best
to include in the recommendation component of the SBAR?
A. Could the behavior be a manifestation of drug seeking?
B. Can the client be transferred to a private room?
C. Can the PCA be restarted and prescribed for an additional 12 hours?
D. Should the roommate be moved?
Rationale: The recommendation section should state the specific action you want
(restarting PCA) so the surgeon can make a prescription decision. Asking about drug
seeking is assessment, not a clear recommendation.
2. After change-of-shift report, which assigned client should the nurse assess first?
A. Diabetic with CAD complaining of increased shortness of breath (SOB).
B. 10-year-old with sickle cell on PCA reporting pain 2–3/10.
C. 29-year-old with CKD who had AV fistula placed yesterday.
D. Older client with COPD, O₂ sat 88% on room air.
A. Diabetic with CAD complaining of increased SOB.
Rationale: Acute worsening SOB in a client with CAD suggests myocardial
ischemia/heart failure — highest priority. (Note: choice D is also urgent, but CAD +
change in SOB is highest risk.)
3. A provider notifies the nurse that new prescriptions were written. What is the first
action the nurse should take?
A. Collect needed forms (labs/radiology requisitions).
B. Clarify prescriptions with unit clerk for transcription accuracy.
C. Document time of provider visit in nursing notes.
D. Read all of the new prescriptions written by the provider.
Rationale: Always read and understand new orders before acting or delegating;
clarifying/transcribing comes after reviewing.
4. RN, PN, and UAP are assembling to provide immediate chest-tube insertion bedside.
Which assignment best uses each person’s skills?
A. RN inserts chest tube immediately after PN cleans skin.
B. UAP listens to breath sounds while RN witnesses consent.
C. PN instructs family about need while RN obtains VS.
D. UAP obtains O₂ sat while RN reports findings to HCP.
Rationale: UAP can obtain basic vitals; RN communicates with HCP and
, ESTUDYR
performs/oversees advanced tasks. PN cannot perform sterile invasive procedures like
chest tube insertion independently.
5. An older woman with long HTN and HF transferred from long-term care has a signed
DNR. What should the nurse do?
A. Transfer to palliative care for supportive care.
B. Consult hospice case manager regarding plan.
C. Confirm current resuscitation wishes with client and family.
D. Ask unit supervisor to meet with family about desired care.
Rationale: Always verify that advance directive/DNR is current and that patient/family
understand before changing settings.
6. When caring for an older adult with septic shock, which intervention is most important
to include?
A. Maintain strict I&O.
B. Assess warmth of extremities.
C. Keep HOB elevated 45°.
D. Monitor blood glucose level.
Rationale: Extremity warmth/perfusion reflects peripheral perfusion and
vasoconstriction in shock—critical assessment finding.
7. A client with COPD reports difficulty eating due to SOB. Which tasks may be delegated
to UAP? (Select all that apply.)
A. Assist client with eating small, frequent high-calorie meals.
B. Offer high-calorie foods (milk, ice cream).
C. Consult with registered dietitian about nutritional needs.
D. Maintain a clean, pleasant environment during meals.
E. Set up food and drink containers within easy reach.
Answers: A, B, D, E.
Rationale: UAP can assist with feeding, offering food, setting up trays, and maintaining
environment. Dietitian consult is an RN/HCP responsibility.
8. UAP brings supplies to assist a male client who had a suprapubic catheter earlier today.
What should the nurse do?
A. Remind UAP to provide warmth and privacy for perineal care.
B. Encourage UAP to offer the client opportunity to perform his own catheter care.
C. Tell UAP that the nurse will perform catheter care while UAP assists with personal
care.
D. Advise UAP that dressing must be removed before cleaning.
Rationale: Catheter (suprapubic) care is a skilled/sterile or clinical task — RN must
perform. UAP may assist with non-sterile personal care.
9. RN observes PN positioning client for lumbar puncture (client on right side with left leg
bent). RN should:
A. Demonstrate to the PN a more effective positioning technique.
B. Arrange a UAP to assist PN during procedure.
C. Assume care of client and reassign PN.
D. Acknowledge PN positioned correctly.
