HESI LPN
HESI PN Exit Exam
1. 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.
2. A client who had a thyroidectomy 24 hours ago reports tingling around the mouth and in the fingertips. What should the nurse do first?
- A. Check the client’s calcium levels.
- B. Administer a dose of calcium gluconate.
- C. Assess the client's incision site for bleeding.
- D. Notify the healthcare provider.
Correct answer: A
Rationale: Tingling around the mouth and in the fingertips can indicate hypocalcemia, a potential complication after thyroidectomy due to accidental damage to the parathyroid glands. Checking calcium levels is crucial as it helps in diagnosing hypocalcemia accurately. Administering calcium without knowing the actual calcium levels can be dangerous. Assessing the incision site for bleeding is important but not the priority in this situation. Notifying the healthcare provider can be done after assessing and managing the immediate concern of hypocalcemia.
3. Which of the following is MOST LIKELY to increase the risk of a medication error?
- A. Not using abbreviations for medications
- B. Errors in the calculation of medication dosages
- C. Barcoding medication orders
- D. Utilizing unit dose dispensers
Correct answer: B
Rationale: Errors in the calculation of medication dosages are a significant risk factor for medication errors. When dosage calculations are incorrect, it can lead to administering the wrong amount of medication, posing serious harm to the patient. Avoiding abbreviations for medications, barcoding medication orders, and utilizing unit dose dispensers are all strategies aimed at reducing medication errors by enhancing accuracy and safety. Therefore, choices A, C, and D are incorrect as they are practices that help decrease, rather than increase, the risk of medication errors.
4. A client who had a left hemicolectomy is experiencing a low-grade fever on post-operative day three. What is the nurse's best action?
- A. Encourage deep breathing and the use of the incentive spirometer.
- B. Administer antipyretic medication as prescribed.
- C. Notify the healthcare provider immediately.
- D. Increase the client’s fluid intake.
Correct answer: A
Rationale: A low-grade fever on post-operative day three can be a sign of atelectasis, a common post-operative complication. Encouraging deep breathing and the use of the incentive spirometer can help prevent and treat this condition. Atelectasis is often due to shallow breathing, so option A is the best initial action to promote lung expansion. Administering antipyretic medication (option B) may help reduce the fever but does not directly address the underlying cause. Notifying the healthcare provider immediately (option C) is not necessary at this point unless other concerning symptoms are present. Increasing the client’s fluid intake (option D) is important for overall recovery but is not the priority in this scenario.
5. After adding feeding solution to a client's tube feeding system as seen in the picture, what action should the PN take next?
- A. Remove the air from the solution bag
- B. Obtain a piston syringe and irrigation set
- C. Record the solution added as fluid intake
- D. Calculate the rate of flow of the solution
Correct answer: B
Rationale: After adding feeding solution, obtaining a piston syringe and irrigation set is necessary to flush the feeding tube and ensure patency before starting the feeding. This helps prevent blockages and ensures proper delivery of the nutritional solution. Option A is incorrect because removing air from the solution bag is not the immediate next step after adding the feeding solution. Option C is incorrect as recording the solution added as fluid intake is important but not the immediate next step. Option D is incorrect as calculating the rate of flow of the solution is not the next step after adding the feeding solution.
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