HESI LPN
HESI Fundamentals Exam
1. A healthcare professional is caring for a client who has pharyngeal diphtheria. Which of the following types of transmission precautions should the healthcare professional initiate?
- A. Contact
- B. Droplet
- C. Airborne
- D. Protective
Correct answer: B
Rationale: The correct answer is B: Droplet. Droplet precautions are required for infections that spread via droplets larger than 5 microns in diameter, such as pharyngeal diphtheria. Contact precautions are used for diseases that spread by direct or indirect contact. Airborne precautions are for diseases that spread through small particles in the air. Protective precautions are not a standard precautionary measure for specific infections like pharyngeal diphtheria.
2. The healthcare provider is caring for a patient who has multiple ticks on lower legs and body. What should the healthcare provider do to rid the patient of ticks?
- A. Use blunt tweezers and pull upward with steady pressure.
- B. Burn the ticks with a match or a small lighter.
- C. Allow the ticks to drop off by themselves.
- D. Apply miconazole and cover with plastic.
Correct answer: A
Rationale: Correct answer: When removing ticks, it is essential to use blunt tweezers to grasp the tick as close to the head as possible and pull upward with even, steady pressure to remove the entire tick. Option B is incorrect because burning ticks can increase the risk of infection and is not recommended. Option C is incorrect as waiting for ticks to drop off by themselves prolongs potential exposure to tick-borne diseases. Option D is incorrect as miconazole is an antifungal medication and not used for tick removal.
3. A nurse is preparing to administer multiple medications to a client who has an enteral feeding tube. Which of the following actions should the nurse plan to take?
- A. Dissolve each medication in 5 mL of sterile water.
- B. Draw up each medication separately in the syringe.
- C. Push the syringe plunger gently if feeling resistance.
- D. Flush the tube with 15 mL of sterile water.
Correct answer: D
Rationale: The correct action the nurse should take when administering multiple medications to a client with an enteral feeding tube is to flush the tube with 15-30 mL of sterile water before and between medications, and 30-60 mL after the last medication. This helps prevent clogging and ensures each medication is delivered effectively. Choice A is incorrect as medications should not be dissolved in water for administration through an enteral feeding tube. Choice B is incorrect because each medication should be drawn up and administered separately to prevent any potential interactions. Choice C is incorrect as resistance while pushing the plunger may indicate a problem that needs to be addressed before continuing with the administration.
4. After a renal biopsy, a client has returned to the unit. Which of the following nursing interventions is appropriate?
- A. Ambulate the client 4 hours after the procedure
- B. Maintain the client on NPO status for 24 hours
- C. Monitor vital signs
- D. Change the dressing every 8 hours
Correct answer: C
Rationale: Monitoring vital signs is crucial after a renal biopsy to promptly detect any signs of bleeding or complications. Ambulating the client 4 hours after the procedure may increase the risk of bleeding, so it is not appropriate. Maintaining the client on NPO status for 24 hours is not necessary unless specifically ordered by the healthcare provider. Changing the dressing every 8 hours is not typically indicated unless there is a specific concern or order to do so.
5. During a Weber test, what is an appropriate action for the nurse to take?
- A. Deliver a series of high-pitched sounds at random intervals.
- B. Place an activated tuning fork in the middle of the client's forehead.
- C. Hold an activated tuning fork against the client's mastoid process.
- D. Whisper a series of words softly into one ear.
Correct answer: B
Rationale: During a Weber test, the nurse should place an activated tuning fork in the middle of the client's forehead. This test is used to assess for lateralization of sound in a client with possible hearing issues. Choice A is incorrect because the Weber test does not involve delivering high-pitched sounds at random intervals. Choice C is incorrect as it describes the Rinne test, not the Weber test. Choice D is incorrect as whispering words into one ear is not part of the Weber test procedure.
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