HESI LPN
HESI Fundamentals Exam
1. Which statement by the nurse indicates culturally responsive care for a client following Islamic practices?
- A. “I will make sure the menu includes halal options.”
- B. “I will ask the client if they want to schedule prayer times during the day.”
- C. “I will avoid discussing care when the client’s family is around.”
- D. “I will make sure daily communion is available for this client.”
Correct answer: B
Rationale: The correct answer is B. Asking the client if they want to schedule prayer times during the day demonstrates respect and consideration for Islamic practices. Providing halal options (choice A) is important for dietary requirements in Islam, but it may not address the client's spiritual needs. Avoiding discussing care in front of the client's family (choice C) is not directly linked to Islamic practices and may not necessarily enhance cultural responsiveness. Offering daily communion (choice D) is associated with Christian religious practices, not Islamic practices, and may not meet the client's religious needs.
2. By the second postoperative day, a client has not achieved satisfactory pain relief. Based on this evaluation, which of the following actions should the nurse take, according to the nursing process?
- A. Reassess the client to determine the reasons for inadequate pain relief.
- B. Wait to see whether the pain lessens during the next 24 hours.
- C. Change the plan of care to provide different pain relief interventions.
- D. Teach the client about the plan of care for managing pain.
Correct answer: A
Rationale: Reassessing the client is crucial to identify the reasons for inadequate pain relief. This action allows the nurse to gather more information, evaluate the current pain management interventions, and make necessary adjustments to the care plan. Waiting for the pain to lessen without taking action delays appropriate pain management. Changing the plan of care without reassessment may lead to ineffective interventions. Teaching the client about the plan of care should be based on a reassessment of the current pain relief status to ensure tailored and effective pain management strategies.
3. A nurse is developing an individualized plan of care for a patient. Which action is important for the nurse to take?
- A. Establish goals that are measurable and realistic.
- B. Set goals that are a little beyond the capabilities of the patient.
- C. Use the nurse's own judgment and not be swayed by family desires.
- D. Explain that without taking alignment risks, there can be no progress.
Correct answer: A
Rationale: When developing an individualized plan of care for a patient, the nurse must set goals that are specific, measurable, achievable, realistic, and time-bound (SMART). Choice A is correct as it emphasizes the importance of establishing goals that are measurable and realistic, ensuring they are attainable within a specific timeframe. Setting goals that are beyond the capabilities of the patient (Choice B) can lead to frustration and lack of progress. Using only the nurse's judgment and disregarding family desires (Choice C) may not consider important aspects of the patient's social support and preferences. Explaining that progress requires taking alignment risks (Choice D) is not a standard approach in nursing care planning and may confuse the patient or hinder trust in the nurse's decision-making.
4. When responding to a call light and finding a client on the bathroom floor, what should the nurse do FIRST?
- A. Check the client for injuries
- B. Call for additional help
- C. Move the client to a sitting position
- D. Assist the client back to bed
Correct answer: A
Rationale: Checking the client for injuries is the priority when finding them on the bathroom floor. This action ensures the client's safety as it allows for immediate assessment of any potential harm. Calling for help may be necessary, but assessing for injuries takes precedence to address any immediate threats to the client's well-being. Moving the client to a sitting position or assisting them back to bed should only be done after ensuring there are no serious injuries requiring prompt medical attention. Therefore, the correct first action is to check the client for injuries.
5. A healthcare professional is caring for a client who has a new prescription for antihypertensive medication. Prior to administering the medication, the healthcare professional uses an electronic database to gather information about the medication and the effects it might have on this client. Which of the following components of critical thinking is the healthcare professional using when reviewing the medication information?
- A. Knowledge
- B. Experience
- C. Intuition
- D. Competence
Correct answer: A
Rationale: The correct answer is A: Knowledge. In this scenario, the healthcare professional is utilizing knowledge by gathering and applying information about the medication. Choice B, Experience, is not the best option as the focus is on accessing information about the medication rather than personal experience. Choice C, Intuition, refers to a gut feeling or instinct, which is not evident in the scenario. Choice D, Competence, relates more to overall ability and proficiency rather than the specific act of seeking information.
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