HESI LPN
HESI Fundamentals Exam
1. A healthcare professional is planning to collect a liquid stool specimen from a client for ova and parasites. Inaccurate test results may result if the healthcare professional:
- A. Refrigerates the collected specimen
- B. Collects the specimen in a sterile container
- C. Delays the collection of the specimen
- D. Uses a non-contaminated collection container
Correct answer: A
Rationale: Refrigeration can kill the ova and parasites present in the stool specimen, leading to inaccurate test results. Storing the specimen in a cold environment can disrupt the integrity of the parasites and ova, affecting the accuracy of the test. Collecting the specimen in a sterile container (Choice B) is the correct procedure to prevent external contamination. Delaying the collection of the specimen (Choice C) may affect the freshness of the sample but does not directly impact the test results. Using a non-contaminated collection container (Choice D) is essential to maintain the sample's integrity but does not relate to the risk of killing ova and parasites through refrigeration.
2. During the check-up of a 2-month-old infant at a well-baby clinic, the mother expresses concern to the nurse because a flat pink birthmark on the baby's forehead and eyelid has not gone away. What is an appropriate response by the nurse?
- A. Mongolian spots are a normal finding in dark-skinned infants.
- B. Port wine stains are typically associated with other malformations.
- C. Telangiectatic nevi are normal and will disappear as the baby grows.
- D. The child is too young for surgical removal of these at this time.
Correct answer: C
Rationale: The correct answer is C. Telangiectatic nevi, often referred to as 'stork bites,' are common birthmarks in infants and are considered normal. These birthmarks usually fade and disappear as the child grows older. Choices A, B, and D are incorrect because Mongolian spots are bluish-gray birthmarks commonly found in darker-skinned infants, port wine stains are vascular birthmarks that typically do not disappear, and surgical removal is not recommended for telangiectatic nevi as they usually resolve on their own.
3. At 0100 on a male client's second postoperative night, the client states he is unable to sleep and plans to read until feeling sleepy. What action should the nurse implement?
- A. Stay with the client and offer assistance with relaxation techniques
- B. Assess the client's pain level and administer pain medication if needed
- C. Bring the client a prescribed PRN sedative-hypnotic
- D. Encourage the client to engage in a quiet, non-stimulating activity until feeling sleepy
Correct answer: C
Rationale: At 0100 on the client's second postoperative night, the nurse should address the client's inability to sleep. Providing a prescribed PRN sedative-hypnotic is appropriate in this situation to help the client rest. Choice A is incorrect because leaving the room and closing the door does not directly address the client's sleep concern. Choice B is not the priority at this moment since the client's main issue is insomnia, not pain. Choice D, while encouraging a non-stimulating activity, does not provide immediate relief for the client's sleeplessness as a sedative-hypnotic would.
4. A nurse is caring for a client postoperatively. When the nurse prepares to change the dressing, the client says it hurts. Which intervention is the nurse’s priority action?
- A. Administer pain medication 45 minutes prior to dressing change.
- B. Change the dressing quickly to minimize pain.
- C. Provide reassurance to the client that the pain will pass.
- D. Use a less painful dressing technique.
Correct answer: A
Rationale: Administering pain medication before the dressing change is the priority action to help manage the client's pain effectively. This intervention ensures that the client is comfortable during the procedure. Changing the dressing quickly may cause more discomfort to the client. Providing reassurance is important but does not address the immediate pain concern. Using a less painful dressing technique may be helpful, but administering pain medication first is the priority to address the client's pain promptly.
5. A client who is confused and pulling at the tubing of her IV is being cared for by a nurse. Which of the following actions should the nurse take before requesting a prescription for restraints from the provider?
- A. Place the client in a room away from the nurses’ station.
- B. Limit the client’s visitors.
- C. Give the client washcloths to fold.
- D. Close the door of the client’s room.
Correct answer: C
Rationale: Providing the client with washcloths to fold is a non-restrictive intervention that can help distract and engage the client, potentially reducing the need for restraints. This action promotes a therapeutic and calming environment for the confused client. Placing the client in a room away from the nurses’ station (Choice A) may not address the underlying issue of confusion and agitation. Limiting the client’s visitors (Choice B) may not directly assist in managing the client's behavior. Closing the door of the client’s room (Choice D) does not actively engage the client in a therapeutic intervention to address the behavior.
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