HESI LPN
HESI PN Exit Exam 2023
1. A client who had a hip replacement is being prepared for discharge. What should the nurse include in the discharge teaching to prevent hip dislocation?
- A. Avoid crossing your legs at the knees or ankles.
- B. Do not sleep on the side of the hip that was operated on.
- C. Sit in high chairs and keep your knees higher than your hips.
- D. Do not bend forward at the waist to pick up objects.
Correct answer: A
Rationale: The correct answer is A: 'Avoid crossing your legs at the knees or ankles.' Crossing legs at the knees or ankles can cause excessive stress on the new hip joint, leading to a risk of dislocation. Choice B is incorrect because sleeping on the side of the operated hip can also increase the risk of dislocation. Choice C is incorrect as sitting in low chairs with knees higher than hips is a recommended position to prevent hip dislocation. Choice D is incorrect because bending forward at the waist to pick up objects can strain the hip joint and increase the risk of dislocation.
2. Which electrolyte imbalance is most likely to cause cardiac arrhythmias?
- A. Hyperkalemia
- B. Hypocalcemia
- C. Hypernatremia
- D. Hypokalemia
Correct answer: A
Rationale: Hyperkalemia is the correct answer as it can lead to dangerous cardiac arrhythmias due to its effects on the electrical conduction of the heart. High levels of potassium can disrupt the normal electrical activity of the heart, potentially leading to life-threatening arrhythmias. Hypocalcemia (choice B) is not the most likely cause of cardiac arrhythmias compared to hyperkalemia. Hypernatremia (choice C), referring to high sodium levels, is not directly associated with causing cardiac arrhythmias. While hypokalemia (choice D), low potassium levels, can also lead to cardiac arrhythmias, hyperkalemia is the more likely culprit in causing severe disturbances in heart rhythm.
3. In obtaining an orthostatic vital sign measurement, what action should the nurse take first?
- A. Count the client's radial pulse
- B. Apply a blood pressure cuff
- C. Instruct the client to lie supine
- D. Assist the client to stand upright
Correct answer: C
Rationale: The correct first action when obtaining an orthostatic vital sign measurement is to instruct the client to lie supine. This allows for establishing a baseline measurement of vital signs before any positional changes. Counting the client's radial pulse (Choice A) is a step that follows after the initial supine position to assess changes in pulse rate. Applying a blood pressure cuff (Choice B) and assisting the client to stand upright (Choice D) are actions that come later in the process after the baseline measurements are obtained in the supine position.
4. A dispersion consists of a solute dispersed through a dispersing vehicle. Which of the following dispersions is a liquid for topical application that contains insoluble solids or liquids?
- A. Ointment
- B. Lotion
- C. Paste
- D. Gel
Correct answer: B
Rationale: The correct answer is B, 'Lotion.' A lotion is a liquid dispersion that contains insoluble solids or liquids for topical application. Ointments are more semi-solid and occlusive, pastes are thicker and contain higher concentrations of solids, and gels have a jelly-like consistency due to their three-dimensional network structure. Therefore, among the options, a lotion is the most suitable choice for containing insoluble solids or liquids for topical application.
5. After a laparoscopic cholecystectomy, what is the most important instruction the nurse should give the client regarding post-operative care at home?
- A. Avoid lifting heavy objects for at least a week.
- B. Follow a low-fat diet.
- C. Monitor the incision sites for signs of infection.
- D. Resume normal activities as tolerated.
Correct answer: C
Rationale: Monitoring the incision sites for signs of infection is crucial after a laparoscopic cholecystectomy. Infections can lead to serious complications if not detected early. While avoiding heavy lifting and following a low-fat diet are important aspects of recovery, monitoring for infection takes precedence as it directly impacts the client's immediate post-operative well-being. Therefore, option C is the correct answer as it addresses the most critical aspect of post-operative care.
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