HESI LPN
Fundamentals HESI
1. A guardian reports that a 4-year-old child is waking up with nightmares. Which of the following interventions should the nurse suggest?
- A. Offer the child a large snack before bedtime.
- B. Allow the child to watch an extra 30 minutes of TV in the evening.
- C. Have the child go to bed at a consistent time every day.
- D. Increase physical activity before bedtime.
Correct answer: C
Rationale: The correct answer is to have the child go to bed at a consistent time every day. Consistent bedtime routines can help reduce nightmares by providing the child with a sense of security and stability. Offering a large snack before bedtime or allowing extra TV time may disrupt sleep patterns and lead to nightmares. Increasing physical activity before bedtime could have the opposite effect and make it harder for the child to fall asleep.
2. The nurse manager is reviewing medication documentation. Which of the following statements should the nurse plan to include in teaching?
- A. Use the complete name of the medication magnesium sulfate.
- B. Avoid abbreviating medication names to prevent errors.
- C. Use generic names only for medications.
- D. Document the dosage, route of administration, and complete medication name.
Correct answer: A
Rationale: The correct answer is A: 'Use the complete name of the medication magnesium sulfate.' When documenting medications, it is crucial to use the complete name to avoid confusion and errors. Abbreviating medication names (choice B) can lead to misinterpretation and errors in medication administration. Using generic names only for medications (choice C) may not provide enough specificity, leading to potential medication errors. While documenting the dosage and route of administration is important, it is also vital to include the complete medication name (choice D) for accurate record-keeping and to ensure clarity in medication administration.
3. A nurse is reviewing evidence-based practice principles about the administration of oxygen therapy with a newly licensed nurse. Which of the following actions should the nurse include?
- A. Regulate oxygen via nasal cannula at a flow rate no more than 6 L/min
- B. Administer oxygen at a higher flow rate for better saturation
- C. Use a high-flow nasal cannula for all clients
- D. Adjust oxygen flow based on client comfort
Correct answer: A
Rationale: The correct answer is A. Regulating oxygen flow at no more than 6 L/min via nasal cannula is a safe practice to prevent potential complications such as oxygen toxicity. Option B suggesting administering oxygen at a higher flow rate for better saturation is incorrect as it can lead to adverse effects. Option C is incorrect because using a high-flow nasal cannula for all clients is not necessary and should be based on individual client needs. Option D is incorrect as adjusting oxygen flow solely based on client comfort without considering the prescribed flow rate can compromise the effectiveness of oxygen therapy.
4. The healthcare provider is caring for a client who has just been diagnosed with myasthenia gravis. Which symptom should the healthcare provider expect to observe?
- A. Muscle weakness
- B. Joint pain
- C. Vision changes
- D. Skin rash
Correct answer: A
Rationale: Muscle weakness is a hallmark symptom of myasthenia gravis, a neuromuscular disorder characterized by impaired neuromuscular transmission. This results in muscle weakness, particularly in skeletal muscles that control eye movements, facial expressions, chewing, swallowing, and speaking. Joint pain (Choice B) is not a typical symptom of myasthenia gravis and is more commonly associated with conditions like arthritis. Vision changes (Choice C) may occur in conditions affecting the eyes, but they are not specific to myasthenia gravis. Skin rash (Choice D) is also not a typical manifestation of myasthenia gravis. Therefore, the correct answer is muscle weakness (Choice A).
5. A client is contemplating retirement and expresses uncertainty about wanting to retire. Which of the following responses should the nurse make?
- A. Let’s talk about how the change in your job status will affect you.
- B. Have you considered the financial implications of retirement?
- C. What are your thoughts on retirement and how it may impact your life?
- D. Would you like to discuss potential activities you could engage in during retirement?
Correct answer: A
Rationale: Choosing option A, 'Let’s talk about how the change in your job status will affect you,' is the most appropriate response in this scenario. By discussing how retirement might affect the client, the nurse can address the client's concerns and emotions about the impending change. Option B, 'Have you considered the financial implications of retirement?' is not the best response as it focuses solely on financial aspects and does not address the client's emotional readiness for retirement. Option C, 'What are your thoughts on retirement and how it may impact your life?' is more open-ended and may not address the immediate concerns of the client expressing uncertainty. Option D, 'Would you like to discuss potential activities you could engage in during retirement?' assumes the client is certain about retiring and focuses on activities rather than addressing the client's feelings of uncertainty.
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