HESI LPN
Fundamentals HESI
1. When administering an otic medication to an older adult client, which action should the nurse take to ensure that the medication reaches the inner ear?
- A. Press gently on the tragus of the client's ear
- B. Pack a small piece of cotton deep into the client's ear canal
- C. Move the client's auricle down and back toward their head
- D. Tilt the client's head backward for 5 minutes
Correct answer: A
Rationale: The correct action to ensure that otic medication reaches the inner ear is to press gently on the tragus. The tragus is a small cartilaginous projection in front of the ear canal. Pressing on it helps to straighten the ear canal, allowing the medication to reach the inner ear. Packing cotton or moving the auricle can obstruct the ear canal and prevent proper medication delivery. Tilting the client's head backward is not necessary and may not facilitate the medication reaching the inner ear as effectively as pressing on the tragus.
2. A home health nurse is teaching a new caregiver how to care for a client who has had a tracheostomy for 1 year. Which of the following instructions should the nurse include?
- A. Use tracheostomy covers when going outdoors.
- B. Maintain sterile technique when performing tracheostomy care.
- C. Do not remove the outer cannula for routine cleaning.
- D. Clean around the stoma with normal saline.
Correct answer: A
Rationale: The correct answer is to use tracheostomy covers when going outdoors. This instruction is important as it helps protect the airway from dust and other particles, reducing the risk of infection or irritation. Choice B is incorrect because maintaining sterile technique is crucial during tracheostomy care to prevent infections, but it is not the most pertinent instruction in this scenario. Choice C is incorrect as removing the outer cannula is not a routine cleaning procedure and should only be done by healthcare professionals when necessary. Choice D is incorrect because cleaning around the stoma with normal saline is not recommended as it can cause irritation to the skin and stoma site.
3. A client is crying while reading from a religious book and asks to be left alone. Which of the following actions should the nurse take?
- A. Contact the hospital’s spiritual services.
- B. Ask what is making the client cry.
- C. Ensure no visitors or staff enter the room for a short time period.
- D. Turn on the television for a distraction.
Correct answer: C
Rationale: The correct action for the nurse to take in this situation is to ensure no visitors or staff enter the room for a short time period. Respecting the client's wish for privacy during emotional moments is crucial for providing patient-centered care. Contacting spiritual services or asking about the reason for crying may intrude on the client's privacy and emotional space. Turning on the television for a distraction is not appropriate as it does not address the client's emotional needs or request for privacy.
4. The healthcare provider is caring for a client with a wound infection. Which type of dressing is most appropriate to use to promote healing by secondary intention?
- A. Dry gauze dressing
- B. Wet-to-dry dressing
- C. Transparent film dressing
- D. Hydrocolloid dressing
Correct answer: D
Rationale: Hydrocolloid dressings are ideal for promoting healing by secondary intention in wound infections. These dressings create a moist environment that supports autolytic debridement and facilitates the healing process. Dry gauze dressings (Option A) may lead to adherence, causing trauma upon removal and disrupting the wound bed. Wet-to-dry dressings (Option B) are primarily used for mechanical debridement and can be painful during dressing changes. Transparent film dressings (Option C) are more suitable for superficial wounds with minimal exudate and are not typically used for wound infections requiring healing by secondary intention.
5. A healthcare professional is admitting a client who has tuberculosis. Which of the following types of transmission precautions should the healthcare professional plan to initiate?
- A. Contact
- B. Droplet
- C. Airborne
- D. Protective environment
Correct answer: C
Rationale: Tuberculosis is transmitted through airborne particles, so airborne precautions are necessary to prevent the spread of the disease. Airborne precautions (Choice C) involve measures such as negative pressure rooms and N95 respirators to prevent the transmission of infectious agents that remain infectious over long distances when suspended in the air. Contact precautions (Choice A) are used for diseases that spread through direct contact with the patient or their environment. Droplet precautions (Choice B) are for diseases transmitted through respiratory droplets, typically over short distances. Protective environment (Choice D) is used for clients who are immunocompromised to protect them from environmental pathogens, not for diseases like tuberculosis that spread through the air.
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