HESI LPN
HESI PN Exit Exam 2024
1. A client tells the PN that she has a family history of cancer and has increased the amount of dairy products in her diet to reduce her risk of getting cancer. How should the PN respond?
- A. Encourage the client to get plenty of exercise in addition to the dietary change
- B. Provide written information about the seven warning signs of cancer
- C. Remind the client to ensure that the dairy products are fortified with Vitamin D
- D. Suggest that an increase in fruits and vegetables is more beneficial
Correct answer: D
Rationale: Increasing fruits and vegetables in the diet is more beneficial in reducing cancer risk due to their high levels of antioxidants and fiber, which help protect against cancer. While exercise is important for overall health, in this context, focusing on fruits and vegetables is more relevant to reducing cancer risk than exercise alone. Providing information about cancer warning signs is not directly addressing the client's dietary choice. While Vitamin D is essential for various health aspects, the primary focus here should be on a diet rich in fruits and vegetables for cancer risk reduction.
2. While caring for a client with an AV fistula in the left forearm, the nurse observed a palpable buzzing sensation over the fistula. What action should the nurse take?
- A. Loosen the dressing of the fistula
- B. Report the presence of a bounding pulse
- C. Document that the fistula is intact
- D. Apply gentle pressure over the site
Correct answer: C
Rationale: The correct answer is C: Document that the fistula is intact. The palpable buzzing sensation (known as a thrill) over the AV fistula indicates proper functioning. It is essential for the nurse to document this finding to ensure ongoing monitoring of the fistula's status. Choices A, B, and D are incorrect. Choice A is incorrect because there is no indication to loosen the dressing. Choice B is incorrect as a bounding pulse is not associated with the palpable buzzing sensation of a thrill. Choice D is incorrect as applying pressure over the site is not necessary for this situation.
3. A male client with TB returns to the clinic for daily antibiotic injections for a urinary infection. The client has been taking anti-tubercular medications for 10 weeks and states he has ringing in his ears. Which prescribed medication should the PN report to the HCP?
- A. Pyridoxine with a B complex multivitamin
- B. Gentamicin 160 mg IM daily
- C. Rifampin 600 mg PO daily
- D. Isoniazid 300 mg PO daily
Correct answer: B
Rationale: The correct answer is B: Gentamicin 160 mg IM daily. Gentamicin is an aminoglycoside antibiotic that can cause ototoxicity, leading to ringing in the ears (tinnitus). This symptom should be reported to the HCP immediately, as it may indicate a need to adjust or discontinue the medication. Choice A, Pyridoxine with a B complex multivitamin, is not the cause of ototoxicity. Choices C and D, Rifampin and Isoniazid, are anti-tubercular medications but are not associated with causing ringing in the ears.
4. A client is recovering from a right-sided mastectomy and is concerned about lymphedema. What should the nurse include in the discharge teaching to minimize this risk?
- A. Encourage wearing tight clothing on the affected arm.
- B. Advise against lifting heavy objects with the affected arm.
- C. Recommend the client sleep on the affected side.
- D. Suggest frequent massage of the affected arm.
Correct answer: B
Rationale: The correct answer is B: Advise against lifting heavy objects with the affected arm. Lifting heavy objects with the affected arm can increase the risk of lymphedema. It is important for clients to avoid activities that strain the affected arm to minimize the risk of developing lymphedema. Choices A, C, and D are incorrect because wearing tight clothing on the affected arm, sleeping on the affected side, and frequent massage of the affected arm can potentially worsen lymphedema or impede the recovery process. Tight clothing can impede lymphatic flow, sleeping on the affected side can restrict circulation, and frequent massage can exacerbate swelling in the arm.
5. What is the best thing to say to a patient scheduled for cataract surgery who is concerned that the physician works on the correct eye?
- A. You are wearing an ID bracelet that will let the medical team know which eye to work on.
- B. When you are taken to the surgery area, the medical staff will confirm which eye needs the surgery.
- C. The surgeon will mark the correct eye before the cataract surgery based on your medical records.
- D. You will wear an ID bracelet, and the nurse will verify the eye scheduled for surgery by comparing it with your records and marking it with a permanent marker.
Correct answer: D
Rationale: The best response reassures the patient by explaining the process of verifying and marking the correct eye, a safety measure to prevent wrong-site surgery, directly addressing the patient’s concern. Choice A is close but implies the ID bracelet alone determines the correct eye, missing the verification process. Choice B talks about confirmation but lacks details about marking the correct eye. Choice C mentions the surgeon's record but does not specify the direct verification and marking process, unlike Choice D.
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