HESI LPN
HESI PN Exit Exam 2023
1. Which statement by a mature adult client with advanced prostate cancer best indicates that he has reached a level of acceptance of his prognosis?
- A. I don't have any use for those who say the disease is going to win
- B. I've found the support I need from my faith and family
- C. I think I've had this disease for a long time, but the doctor did not find it
- D. I understand that this is a disease that occurs mostly in older men
Correct answer: B
Rationale: The correct answer is B because finding support in faith and family is a common way for individuals to cope with serious illnesses and come to terms with their prognosis. This statement indicates that the client has found a source of strength and comfort to deal with their situation. Choice A reflects defiance rather than acceptance. Choice C suggests denial or disbelief in the diagnosis. Choice D shows factual knowledge about the disease but does not necessarily indicate acceptance of the prognosis.
2. When administering an analgesic to a client with low back pain, which intervention should the practical nurse implement to promote the effectiveness of the medication?
- A. Massage the lower back and position the client in proper alignment
- B. Encourage the client to ambulate frequently and take deep breaths
- C. Assist the client in performing passive and active range of motion exercises
- D. Give medication with a full glass of water and offer high-fiber foods
Correct answer: A
Rationale: Massaging the lower back and positioning the client in proper alignment can help relieve muscle tension and enhance the effectiveness of analgesics by providing additional comfort and promoting better pain management. This intervention directly addresses the site of pain and can improve the medication's efficacy. Choices B, C, and D are incorrect because while they may have benefits in other situations, they are not directly related to promoting the effectiveness of analgesics in clients with low back pain. Encouraging ambulation and deep breathing, assisting with range of motion exercises, and offering water and high-fiber foods are important for overall patient care but are not specific to enhancing analgesic effectiveness in this context.
3. The nurse is teaching a pregnant client how to distinguish prelabor contractions from true labor contractions. Which statement about prelabor contractions is accurate?
- A. They are irregular
- B. They are usually felt in the abdomen
- C. They start in the back and radiate to the abdomen
- D. They become more intense during walking
Correct answer: B
Rationale: The correct statement about prelabor contractions (Braxton Hicks contractions) is that they are usually felt in the abdomen. They are irregular in nature and do not intensify with movement. Choice A is incorrect because prelabor contractions are irregular, not regular. Choice C is incorrect as prelabor contractions do not start in the back and radiate to the abdomen. Choice D is incorrect as prelabor contractions do not become more intense during walking.
4. When caring for a client with colostomy, which topical skin preparation should the PN apply around the stoma?
- A. Antiseptic cream
- B. Petroleum jelly
- C. Cornstarch
- D. Stomadhesive
Correct answer: D
Rationale: The correct answer is 'Stomadhesive.' Stomadhesive is a protective barrier used around the stoma to prevent skin irritation and to secure the colostomy bag. This preparation helps to maintain skin integrity and prevent complications such as skin breakdown. Antiseptic cream (Choice A) is not typically used around the stoma as it can irritate the skin. Petroleum jelly (Choice B) is also not recommended as it can interfere with the adhesive properties of the colostomy appliance. Cornstarch (Choice C) is not suitable for application around the stoma as it can promote moisture and lead to skin irritation.
5. The PN notes that an older female client has developed a nonproductive cough and seems more confused than the previous day. Vital signs are temperature 99.8°F, pulse 94, respirations 22, and B/P 108/54. Which intervention is most important for the PN to implement?
- A. Report the findings to the charge nurse
- B. Monitor the client's temperature hourly
- C. Offer the client fluids frequently
- D. Provide care to moisten oral mucosa
Correct answer: A
Rationale: The change in the client’s condition, especially confusion and a new cough, may indicate the onset of an infection such as pneumonia, which requires immediate attention. Reporting to the charge nurse ensures prompt evaluation and intervention. Monitoring the client's temperature hourly (Choice B) could be important but not the most critical at this point. Offering the client fluids frequently (Choice C) and providing care to moisten oral mucosa (Choice D) are not the priority interventions when facing potential signs of infection and confusion in the client.
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