HESI LPN
HESI Fundamentals Exam Test Bank
1. When preparing an injection for opioid medication, a nurse draws 1mL from a 2mL vial. What should the nurse do next?
- A. Ask another nurse to observe medication wastage
- B. Document the amount of medication drawn on the MAR
- C. Dispose of the remaining medication in a sharps container
- D. Administer the entire vial of medication to avoid wastage
Correct answer: A
Rationale: When drawing medication from a vial, especially for controlled substances like opioids, any wastage must be witnessed by another healthcare professional to ensure accuracy, prevent diversion, and maintain safety standards. This process is crucial for proper documentation and accountability. Recording the amount drawn on the Medication Administration Record (MAR) is important for tracking administered doses and preventing errors. Disposing of the remaining medication in a sharps container is not recommended as it does not address proper wastage documentation. Administering the entire vial of medication just to avoid wastage is inappropriate and can lead to potential harm or overdose in the patient.
2. A nurse receives a report about a client receiving IV fluids infusing at 125 mL/hr but notes they have only received 80 mL over the last 2 hours. What should the nurse do first?
- A. Check IV tubing for obstruction
- B. Increase the flow rate
- C. Change the IV site
- D. Notify the physician
Correct answer: A
Rationale: The correct first action for the nurse to take is to check the IV tubing for obstruction. This step is crucial in ensuring that the IV fluids are flowing properly and that there are no blockages preventing the correct infusion rate. Increasing the flow rate (Choice B) without confirming the tubing's status could lead to potential complications if there is indeed an obstruction. Changing the IV site (Choice C) is not the priority in this situation unless there are specific clinical indications. Notifying the physician (Choice D) can be done after checking the tubing for obstruction, as the physician may need to be informed depending on the findings.
3. A client with diabetes mellitus is experiencing polyuria, polydipsia, and polyphagia. What is the most important action for the LPN/LVN to take?
- A. Encourage the client to increase fluid intake.
- B. Monitor the client's blood glucose level.
- C. Administer insulin as prescribed.
- D. Assess the client's urine output.
Correct answer: B
Rationale: The correct answer is to monitor the client's blood glucose level. When a client with diabetes mellitus presents with symptoms of polyuria, polydipsia, and polyphagia, it indicates hyperglycemia. Monitoring blood glucose levels is crucial to assess and manage the client's condition effectively. Option A, encouraging the client to increase fluid intake, may exacerbate polyuria. Option C, administering insulin, should be done based on the healthcare provider's prescription after assessing the blood glucose level. Option D, assessing the client's urine output, is important but not the most immediate action needed in this scenario; monitoring blood glucose levels takes precedence.
4. A healthcare provider is providing discharge teaching to a client who does not speak the same language. Which of the following actions should the healthcare provider take?
- A. Use proper medical terms when providing instructions to the client.
- B. Offer written instructions in the client’s language.
- C. Direct verbal discharge instructions to the interpreter.
- D. Request that an assistive personnel interpret instructions for the client.
Correct answer: B
Rationale: The correct action for the healthcare provider when providing discharge teaching to a client who does not speak the same language is to offer written instructions in the client’s language. This approach helps ensure better comprehension and adherence to the instructions as the client can refer back to the written material for clarification. Choice A is incorrect because using proper medical terms may not be effective if the client does not understand the language. Choice C is incorrect since verbal instructions should be directed to the client for better understanding. Choice D is incorrect as assistive personnel may not be qualified or trained to provide accurate interpretation, risking miscommunication and potential errors in the instructions.
5. What is the rate of delivery in mL/hr if a total volume of 750 mL is infused over a period of 7 hours?
- A. 107 mL/hr.
- B. 107 mL/hr.
- C. 107 mL/hr.
- D. 107 mL/hr.
Correct answer: A
Rationale: The correct rate of delivery is 107 mL/hr. To find the rate of delivery, divide the total volume by the total time: 750 mL / 7 hours = 107 mL/hr. Choice B, C, and D are incorrect as they do not match the correct calculation based on the total volume and time provided.
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