HESI LPN
HESI Fundamental Practice Exam
1. A client with a diagnosis of deep vein thrombosis (DVT) is receiving anticoagulation therapy. Which of the following laboratory values would be most concerning?
- A. INR of 1.5
- B. Platelet count of 200,000/mm³
- C. Hemoglobin of 12 g/dL
- D. aPTT of 70 seconds
Correct answer: A
Rationale: An INR of 1.5 is below the therapeutic range for clients on anticoagulation therapy, increasing the risk of clot formation. A lower INR indicates inadequate anticoagulation, which can lead to thrombus formation and potential complications such as progression or recurrence of deep vein thrombosis. Platelet count, hemoglobin level, and aPTT are important parameters to monitor in a client with DVT. However, in this scenario, the most concerning value is the suboptimal INR level because it signifies a lack of anticoagulation effectiveness and poses a higher risk of clotting issues.
2. The nurse is teaching the parents of a child who has head lice (pediculosis capitis). Which information will the nurse include in the teaching session?
- A. Treatment involves using regular shampoo.
- B. Products containing lindane are not recommended.
- C. Head lice may spread to furniture and other people.
- D. Manual removal is essential in treatment.
Correct answer: C
Rationale: The correct answer is C. Head lice are highly contagious and can spread to furniture and other people if not treated promptly. Informing the parents about the potential spread of head lice emphasizes the importance of thorough treatment and prevention measures. Choice A is incorrect as regular shampoo is not typically effective in treating head lice. Choice B is incorrect as products containing lindane are not recommended due to safety concerns. Choice D is incorrect as manual removal, though labor-intensive, is a crucial step in effectively treating head lice infestations, but it is not the most pertinent information to include in the teaching session.
3. A client who has a new prescription for warfarin (Coumadin) is receiving discharge instructions. Which statement indicates the client understands the teaching?
- A. I will take my warfarin at the same time every day.
- B. I should increase my intake of green leafy vegetables.
- C. I should use a soft-bristled toothbrush while taking this medication.
- D. I should avoid drinking alcohol while taking this medication.
Correct answer: C
Rationale: The correct answer is C: 'I should use a soft-bristled toothbrush while taking this medication.' Using a soft-bristled toothbrush is crucial as it helps prevent bleeding gums, which is a potential side effect of warfarin therapy. Option A about taking warfarin at the same time every day is a good practice but does not directly relate to preventing side effects. Option B suggesting an increase in green leafy vegetables can interfere with warfarin's anticoagulant effects due to their vitamin K content. Option D advising to avoid alcohol is generally recommended but is not directly related to the specific side effects of warfarin.
4. A nurse is collecting data from an older adult client as part of a neurologic examination. Which of the following findings should the nurse expect as changes associated with aging?
- A. Slower light touch sensation
- B. Some vision and hearing decline
- C. Slower fine finger movement
- D. Some short-term memory decline
Correct answer: B
Rationale: As individuals age, it is common to experience changes in vision and hearing, leading to some decline in these senses. Slower light touch sensation and slower fine finger movement are also typical findings associated with aging. However, some short-term memory decline is more closely related to cognitive aging rather than typical age-related changes in the neurologic system. Therefore, the correct answer is the decline in vision and hearing. Decreased risk of depression is not a typical finding in aging; in fact, the risk of depression may increase as individuals age.
5. A client with pneumonia has a decrease in oxygen saturation from 94% to 88% while ambulating. Based on these findings, which intervention should the LPN/LVN implement first?
- A. Assist the ambulating client back to the bed.
- B. Encourage the client to ambulate to resolve pneumonia.
- C. Obtain a prescription for portable oxygen while ambulating.
- D. Move the oximetry probe from the finger to the earlobe.
Correct answer: A
Rationale: The correct intervention is to assist the client back to bed. A decrease in oxygen saturation while ambulating indicates hypoxemia, and the immediate priority is to stabilize oxygen levels. Returning the client to bed allows for rest and decreased oxygen demand, potentially preventing further desaturation. Encouraging continued ambulation (Choice B) may worsen the hypoxemia by increasing oxygen demand. Obtaining portable oxygen (Choice C) is essential but should not delay addressing the low oxygen saturation. Moving the oximetry probe (Choice D) may not address the underlying cause of decreased oxygen saturation and should not be the first intervention.
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