HESI LPN
HESI PN Exit Exam 2023
1. During a blood transfusion, which sign or symptom should prompt the healthcare provider to immediately stop the transfusion?
- A. Slight increase in blood pressure
- B. Elevated temperature and chills
- C. Mild nausea
- D. Slight headache
Correct answer: B
Rationale: The correct answer is B: Elevated temperature and chills. These symptoms are indicative of a transfusion reaction, which can be severe and life-threatening. It is crucial to stop the transfusion immediately and notify the healthcare provider for further assessment and management. Elevated temperature and chills are classic signs of a transfusion reaction, specifically indicating a possible febrile non-hemolytic reaction. Choice A, a slight increase in blood pressure, is not typically a reason to stop a transfusion unless it is a significant sudden increase. Mild nausea (Choice C) and a slight headache (Choice D) are common side effects of blood transfusions and are not primary indicators of a transfusion reaction that require immediate cessation of the transfusion.
2. Rehabilitation after illness is classified under which level of healthcare?
- A. Primary
- B. Secondary
- C. Tertiary
- D. All three
Correct answer: C
Rationale: Rehabilitation after illness is classified as tertiary care. Tertiary care aims to help patients recover from illness, injuries, or disabilities, and restore their functionality. Primary care involves preventive measures and early disease detection, while secondary care focuses on diagnosis and treatment of specific conditions. Therefore, choices A, B, and D are incorrect as they do not specifically address the specialized nature of rehabilitation in healthcare.
3. A nurse is reviewing the basal body temperature method with a couple. Which of the following statements would indicate that the teaching has been successful?
- A. I don't need to buy a special type of thermometer.
- B. I need to wait 5 minutes after smoking a cigarette before I take my temperature.
- C. I need to take my temperature before I get out of bed in the morning.
- D. I need to take my temperature at least once every day.
Correct answer: C
Rationale: The correct answer is C. Basal body temperature must be taken before getting out of bed in the morning to get an accurate reading, as even slight activity can raise body temperature and affect the results. Choice A is incorrect because a special type of thermometer is not required for basal body temperature measurement. Choice B is incorrect because smoking can affect body temperature, but the timing mentioned is not relevant to basal body temperature measurement. Choice D is incorrect because while it is essential to take the temperature consistently each day, the duration of temperature measurement is not specified, making this choice less specific compared to the correct answer.
4. The nurse is caring for an elderly female client who tells the nurse, 'When I sneeze, I wet my pants.' After discussing the client's complaint with the charge nurse, the nurse plans to reinforce teaching about the importance of Kegel exercises. What muscles are involved in these exercises?
- A. Pectoral muscles
- B. Buttock muscles
- C. Abdominal muscles
- D. Pelvic floor muscles
Correct answer: D
Rationale: Kegel exercises involve the pelvic floor muscles. These muscles help strengthen the muscles controlling urination, potentially reducing symptoms of urinary incontinence. Pectoral muscles (Choice A), responsible for movement of the shoulders and arms, are not involved in Kegel exercises. Buttock muscles (Choice B) are primarily responsible for hip movement and stability, not related to Kegel exercises. Abdominal muscles (Choice C) support the core and trunk but are not the focus of Kegel exercises.
5. At the first dressing change, the PN tells the client that her mastectomy incision is healing well, but the client refuses to look at the incision and refuses to talk about it. Which response by the PN to the client's silence is best?
- A. You will feel better when you see that the incision is not as bad as you may think.
- B. It's OK if you don't want to look or talk about the mastectomy. I will be available when you're ready.
- C. Part of recovery is accepting your new body image, and you will need to look at your incision.
- D. Would you like me to call another nurse to be here while I show you the wound?
Correct answer: B
Rationale: Acknowledging the client's feelings and providing emotional support without pressuring them to look at the incision is important. Choice B is the best response as it respects the client's emotional readiness to confront their body image changes. The client's autonomy and emotional needs are prioritized in this response. Choice A may invalidate the client's feelings by assuming the incision is not as bad as they think, potentially dismissing their emotions. Choice C is insensitive as it imposes a particular view of recovery on the client, disregarding their current emotional state. Choice D may escalate the situation by suggesting the need for another nurse, which could make the client feel uncomfortable and pressured.
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