HESI LPN
HESI Test Bank Medical Surgical Nursing
1. A child has developed a diaper rash, and the parents are using zinc oxide to treat it. What does the nurse suggest to aid in the removal of the zinc oxide?
- A. Mild soap and water
- B. A cotton ball
- C. Mineral oil
- D. Alcohol swabs
Correct answer: C
Rationale: To completely remove ointment, especially zinc oxide, mineral oil should be used. Mineral oil helps in gently breaking down and lifting the ointment without causing irritation. Mild soap and water (Choice A) may not be effective in completely removing zinc oxide. A cotton ball (Choice B) may not provide the necessary lubrication to aid in the removal process. Alcohol swabs (Choice D) can be harsh on the skin and are not recommended for this purpose.
2. Parents of a school-age child ask the nurse for suggestions in helping the child who is demonstrating school avoidance. What is an appropriate suggestion by the nurse?
- A. Take the child to the healthcare provider for testing.
- B. Be firm and insist the child go to school.
- C. Allow the child to stay home and rest.
- D. Consult with the teacher at school.
Correct answer: B
Rationale: When a child is demonstrating school avoidance, it is important for parents to be firm and insist that the child go to school. This helps establish a routine and prevents the behavior from becoming a pattern. Taking the child to the healthcare provider for testing (Choice A) may not be necessary at this stage as school avoidance is a behavioral issue. Allowing the child to stay home and rest (Choice C) may reinforce the avoidance behavior. While consulting with the teacher at school (Choice D) is important, the immediate focus should be on addressing the avoidance behavior at home.
3. The healthcare provider is assessing a client with a chest tube. Which finding indicates that the chest tube is functioning properly?
- A. Continuous bubbling in the water seal chamber
- B. Tidaling in the water seal chamber
- C. Absence of drainage in the collection chamber
- D. Fluid level in the suction control chamber is below the prescribed level
Correct answer: B
Rationale: Tidaling in the water seal chamber indicates proper chest tube function. Tidaling refers to the rise and fall of fluid in the water seal with inhalation and exhalation, demonstrating the patency of the system. Continuous bubbling (Choice A) in the water seal chamber indicates an air leak. Absence of drainage in the collection chamber (Choice C) is not a desired finding as it suggests no drainage is occurring. A fluid level below the prescribed level in the suction control chamber (Choice D) may indicate inadequate suction.
4. Parents of a 5-year-old child diagnosed with cognitive impairment have come to the nurse to discuss different approaches to the ongoing care of their child. The nurse should suggest focusing on what activity?
- A. Acquiring job skills
- B. Making decisions
- C. Performing self-care activities
- D. Reading and doing simple math
Correct answer: C
Rationale: The correct answer is C: Performing self-care activities. For a 5-year-old child diagnosed with cognitive impairment, it is crucial to focus on teaching them basic self-care skills. This includes activities like dressing themselves, feeding, and personal hygiene. These skills are fundamental for their daily living and independence. Choices A, B, and D are not appropriate for a young child with cognitive impairment. Acquiring job skills is not developmentally suitable at this age, making decisions may be challenging due to cognitive limitations, and reading and doing simple math may be too advanced for their current cognitive abilities.
5. The healthcare provider writes several prescriptions for a client diagnosed with hospital-acquired pneumonia (HAP) that include a combination of broad-spectrum antibiotics. Which intervention should the nurse implement first?
- A. Administer the first dose of antibiotics.
- B. Obtain a chest X-ray.
- C. Administer oxygen therapy.
- D. Collect blood specimens for culture prior to starting antibiotic therapy.
Correct answer: D
Rationale: Collecting blood specimens for culture prior to starting antibiotic therapy is the priority intervention in a client diagnosed with hospital-acquired pneumonia. This step is crucial to identify the causative organism responsible for the infection and ensure that the antibiotics prescribed are appropriate for effective treatment. Administering antibiotics before collecting cultures may interfere with the accuracy of culture results, potentially leading to inappropriate treatment. While administering the first dose of antibiotics is important, obtaining a chest X-ray and administering oxygen therapy are secondary interventions compared to identifying the causative organism through blood cultures.
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