HESI LPN
HESI Fundamentals Study Guide
1. A healthcare professional is preparing to administer medications to a client. Which of the following client identifiers should the healthcare professional use to ensure medication safety?
- A. Ask the client to state their full name.
- B. Ask the client for their date of birth.
- C. Compare the client's wristband with the medication administration record.
- D. Ask the client for their room number.
Correct answer: C
Rationale: Comparing the client's wristband with the medication administration record is a crucial step in ensuring medication safety. The wristband typically contains unique identifiers such as the client's name, date of birth, and medical record number, which should be cross-checked with the medication administration record to confirm the correct patient. Asking the client to state their name (Choice A) or date of birth (Choice B) may not be as reliable as the information can be misunderstood or miscommunicated. Asking for the room number (Choice D) is not a reliable client identifier for medication administration and does not confirm the patient's identity accurately.
2. When applying an ice bag to a client's ankle following a sports injury, which of the following actions should the nurse take?
- A. Fill the bag two-thirds full with ice.
- B. Apply the ice bag directly to the skin with a barrier.
- C. Keep the ice bag on for more than 30 minutes at a time.
- D. Use a frozen gel pack instead of ice.
Correct answer: A
Rationale: Filling the ice bag two-thirds full is the correct action as it ensures the effectiveness of the ice application while allowing some space for the ice to move and conform to the injury. Choice B is incorrect because the ice bag should be applied with a barrier like a cloth to prevent direct contact with the skin, which can lead to ice burns. Choice C is wrong as ice should typically be applied for 20 minutes at a time to avoid tissue damage. Choice D is also incorrect as ice is preferred over frozen gel packs for immediate sports injury management.
3. A client is admitted with a diagnosis of septicemia. Which assessment finding should the LPN/LVN report to the healthcare provider immediately?
- A. Increased urine output
- B. Decreased blood pressure
- C. Increased heart rate
- D. Increased respiratory rate
Correct answer: B
Rationale: In a client with septicemia, decreased blood pressure is a critical finding that suggests potential septic shock, a life-threatening condition. Septic shock requires immediate medical intervention to prevent further deterioration and organ dysfunction. Increased urine output (Choice A) may indicate adequate fluid resuscitation, which is a positive response. Increased heart rate (Choice C) and increased respiratory rate (Choice D) are common physiological responses to sepsis and do not necessarily indicate immediate life-threatening complications like decreased blood pressure does in septic shock.
4. A client with diabetes mellitus and a new prescription for insulin is being discharged. Which of the following actions should the nurse plan to complete first?
- A. Provide the client with printed information on insulin self-administration.
- B. Obtain printed information on insulin self-administration.
- C. Make a copy of the medication reconciliation form for the client.
- D. Determine whether the client can afford the insulin administration supplies.
Correct answer: B
Rationale: Obtaining printed information on insulin self-administration should be the nurse's first priority. This action ensures that the client has the necessary knowledge to safely self-administer insulin at home. Providing the client with printed information (Choice A) is essential to empower the client with the required knowledge before considering additional resources. Making a copy of the medication reconciliation form for the client (Choice C) is important for documentation purposes but not as urgent as ensuring the client's understanding of insulin administration. Determining the client's ability to afford insulin administration supplies (Choice D) is crucial but should follow after ensuring the client is equipped with the necessary information for safe self-administration.
5. The client is post-operative following abdominal surgery. Which of the following assessment findings would require immediate intervention?
- A. Absent bowel sounds
- B. Saturated abdominal dressing
- C. Pain level of 8/10
- D. Temperature of 100.4°F
Correct answer: B
Rationale: A saturated abdominal dressing is a critical finding that may indicate active bleeding or wound complications. Immediate intervention is necessary to prevent further complications, such as hypovolemic shock or infection. Absent bowel sounds, though abnormal, are a common post-operative finding and do not require immediate intervention. Pain level of 8/10 can be managed effectively with appropriate pain control measures and does not indicate an urgent issue. A temperature of 100.4°F is slightly elevated but may be a normal post-operative response to surgery and does not typically require immediate intervention unless accompanied by other concerning signs or symptoms.
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