HESI LPN
HESI PN Exit Exam 2023
1. A post-operative client is recovering from a total knee replacement and is prescribed patient-controlled analgesia (PCA). What is the primary advantage of PCA for managing post-operative pain?
- A. It allows for consistent pain control without overmedication.
- B. It eliminates the need for oral pain medication.
- C. It reduces the risk of opioid addiction.
- D. It requires less monitoring by nursing staff.
Correct answer: A
Rationale: The primary advantage of PCA for managing post-operative pain is that it allows the client to control the administration of pain medication, leading to consistent pain control without overmedication. Choice B is incorrect as PCA does not eliminate the need for oral pain medication; it supplements it. Choice C is incorrect because while PCA can help reduce opioid consumption, it does not directly reduce the risk of opioid addiction. Choice D is incorrect as PCA actually requires close monitoring by nursing staff to ensure proper use and prevent complications.
2. What should the nurse do to complete a focused assessment for a female client with inflamed and painful hemorrhoids?
- A. Determine if the client uses any over-the-counter preparations for hemorrhoids
- B. Place the client in a standing position, leaning over the exam bed for inspection
- C. Position the client in the left lateral position to inspect the perineal area for fissures or sacs
- D. Ask the client how long she has experienced discomfort related to hemorrhoids
Correct answer: D
Rationale: Asking the client about the duration of discomfort related to hemorrhoids is the best intervention to implement for a focused assessment. This information provides important context for assessing the severity and chronicity of the condition, which is crucial for developing an appropriate care plan. Choices A, B, and C do not directly address the need to gather information about the duration of symptoms, which is essential for understanding the client's condition.
3. What is the first step in using an automated external defibrillator (AED) on a patient who has collapsed?
- A. Apply the pads to the chest
- B. Turn on the AED and follow the voice prompts
- C. Check the patient's pulse
- D. Ensure the area is clear before delivering a shock
Correct answer: B
Rationale: The correct answer is B: Turn on the AED and follow the voice prompts. This is the first step in using an AED as the device will guide you through the process of analyzing the heart rhythm and delivering a shock if necessary. Choice A, applying the pads to the chest, comes after turning on the AED. Checking the patient's pulse (Choice C) is not necessary before using an AED as the device is specifically designed to assess the need for defibrillation. Ensuring the area is clear (Choice D) is important for safety but is not the initial step in using an AED.
4. In which type of cardiomyopathy does septal involvement occur?
- A. Congestive
- B. Dilated
- C. Hypertrophic
- D. Restrictive
Correct answer: C
Rationale: Septal involvement is a characteristic feature of hypertrophic cardiomyopathy, where the septal wall of the heart thickens. This thickening can obstruct blood flow out of the heart, leading to complications such as arrhythmias and heart failure. This differentiates it from other types of cardiomyopathy. In congestive cardiomyopathy (choice A), the heart's chambers become enlarged and weakened, but there is no specific mention of septal involvement. Dilated cardiomyopathy (choice B) involves dilation and impaired contraction of the heart chambers, not specifically septal thickening. Restrictive cardiomyopathy (choice D) is characterized by stiffening of the heart muscle, affecting its ability to fill properly, without direct involvement of the septum.
5. A client who is at full-term gestation is in active labor and complains of a cramp in her leg. Which intervention should the PN implement?
- A. Massage the calf and foot
- B. Elevate the leg above the heart
- C. Check the pedal pulse in the affected leg
- D. Extend the leg and flex the foot
Correct answer: D
Rationale: During labor, muscle cramps are common due to prolonged muscle tension. The correct intervention to alleviate a cramp in the leg is to extend the leg and flex the foot. This action helps relieve the muscle spasm by stretching and contracting the muscles. Massaging the calf and foot (Choice A) may not be as effective in relieving the cramp as extending and flexing the leg. Elevating the leg above the heart (Choice B) is not necessary and may not directly address the cramp. Checking the pedal pulse (Choice C) is important for assessing circulation, but it does not directly address the muscle cramp.
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