HESI LPN
HESI PN Exit Exam 2023
1. Patients are coming into the emergency room as a result of an apartment house fire. You are examining a patient who is in distress but has no visible burn marks. You suspect that she is suffering from inhalation burns. Which of the following signs would NOT be associated with inhalation burns?
- A. Singed nasal hairs
- B. Conjunctivitis
- C. Hoarseness
- D. Clear sputum
Correct answer: D
Rationale: Clear sputum would not be associated with inhalation burns. Inhalation burns typically present with symptoms like singed nasal hairs, conjunctivitis, hoarseness, and possibly soot in sputum due to smoke inhalation. Clear sputum suggests that there is no significant inflammation or injury to the respiratory tract, which is not consistent with the typical findings in inhalation burns. The other choices are associated with inhalation burns: singed nasal hairs can occur due to exposure to hot air or gases, conjunctivitis can result from irritating substances in smoke, and hoarseness can be due to airway irritation.
2. A 50-year-old female is in the hospital with peripheral artery disease. In the nursing care plan, the nurse lists the following nursing diagnosis: Ineffective tissue perfusion: peripheral related to venous stasis. Which of the following would not be an appropriate nursing action to list in the implementation of this diagnosis?
- A. Keep the client's extremities cold
- B. Check for strength and symmetry of peripheral pulses
- C. Keep the client's legs elevated
- D. Monitor for any constrictions, such as clothes or covers that are too tight around the legs
Correct answer: A
Rationale: Keeping the client’s extremities cold would worsen perfusion issues and is not recommended. In peripheral artery disease, maintaining warmth is crucial to promote vasodilation and improve blood flow. Checking peripheral pulses for strength and symmetry, keeping the client's legs elevated to reduce venous stasis, and monitoring for constrictions that may impair circulation are appropriate nursing actions to enhance tissue perfusion in this case. Thus, option A is incorrect as it would hinder perfusion in the affected extremities.
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. You are teaching students about how hyperosmotic agents (osmotic diuretics) are used to treat intracranial pressure. Which of the following is NOT one of the functions of hyperosmotic agents?
- A. Reduces brain metabolism and systemic blood pressure
- B. Reduces cerebral edema
- C. Dehydrates the brain
- D. Draws fluids from extravascular spaces into the plasma
Correct answer: A
Rationale: Hyperosmotic agents primarily work by reducing cerebral edema, dehydrating the brain, and drawing fluids from extravascular spaces into the plasma. However, they do not have a direct effect on reducing brain metabolism or systemic blood pressure. Therefore, the correct answer is A. Choice B is correct as hyperosmotic agents do help in reducing cerebral edema. Choice C is accurate as hyperosmotic agents dehydrate the brain. Choice D is also true as these agents draw fluids from extravascular spaces into the plasma.
5. At what age does a 9-year-old child typically lose which of the following teeth?
- A. Central incisor
- B. Second molar
- C. Lateral incisor
- D. Cuspid
Correct answer: A
Rationale: A 9-year-old child typically loses their central incisors, not the lateral incisors or second molars. The central incisors are usually among the first teeth that children lose around 6 to 7 years of age, as part of the natural process of shedding primary teeth to make way for permanent teeth. The second molars and cuspids are typically lost later in the mixed dentition phase. Therefore, option A, 'Central incisor,' is the correct answer.
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