HESI LPN
HESI Fundamentals Test Bank
1. The healthcare provider is planning care for a 14-year-old client returning from scoliosis corrective surgery. Which of the following actions should receive priority in the plan?
- A. Administer antibiotic therapy for 10 days
- B. Teach the client isometric exercises for legs
- C. Assess movement and sensation of extremities
- D. Assist the client to stand up at the bedside within the first 24 hours
Correct answer: C
Rationale: Assessing movement and sensation of extremities is the priority after scoliosis corrective surgery as it helps in early detection of any neurological deficits that may have occurred during the procedure. This assessment is essential for prompt intervention if any issues are identified. Administering antibiotics, teaching exercises, and assisting the client to stand up are important aspects of care but assessing neurological status takes precedence to ensure the client's safety and recovery.
2. A client who has recently started using a behind-the-ear hearing aid is being cared for by a nurse. Which of the following statements should the nurse identify as an indication that the client understands the use of assistive devices?
- A. “I will be sure to remove my hearing aid before taking a shower.”
- B. “I will keep my hearing aid in at all times, even when sleeping.”
- C. “I will clean my hearing aid with alcohol.”
- D. “I will turn off my hearing aid when not in use.”
Correct answer: A
Rationale: The correct answer is A. It is crucial for the client to remove the hearing aid before showering to prevent damage from moisture. Choice B is incorrect as wearing the hearing aid all the time, including during sleep, is not recommended and can cause discomfort or harm. Choice C is incorrect as alcohol can damage hearing aids; they should be cleaned with a solution recommended by the manufacturer to prevent harm. Choice D is incorrect because hearing aids should not be turned off when not in use; instead, they should be stored properly following the manufacturer's instructions to maintain functionality and battery life.
3. A nurse is preparing to administer methylprednisolone 10 mg by IV bolus. The amount available is methylprednisolone injection 40-mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Do not use a trailing zero.)
- A. 0.3 mL
- B. 0.25 mL
- C. 0.4 mL
- D. 0.5 mL
Correct answer: A
Rationale: To calculate the mL to administer, use the formula: Dose required (mg) ÷ Stock concentration (mg/mL) = Volume to administer (mL). In this case, 10 mg ÷ 40 mg/mL = 0.25 mL. However, when rounding to the nearest tenth, the answer should be 0.3 mL. Therefore, the nurse should administer 0.3 mL. Choice A is the correct answer. Choice B (0.25 mL) is the result obtained before rounding. Choice C (0.4 mL) and Choice D (0.5 mL) are incorrect calculations.
4. A client with a terminal illness is expected to pass away within 24 hours. The family asks the nurse about what to expect at this time. Which of the following findings should the nurse include?
- A. Regular breathing pattern
- B. Warm extremities
- C. Increased urine output
- D. Decreased muscle tone
Correct answer: D
Rationale: As death approaches, decreased muscle tone and other signs like decreased blood pressure, irregular breathing patterns, cold extremities, and decreased urine output are common. Warm extremities (choice B) would not be expected as circulation may be compromised. Increased urine output (choice C) is unlikely as organ function declines. A regular breathing pattern (choice A) is also unlikely as irregular breathing patterns are common near death.
5. The nurse is preparing the teaching plan for a group of parents about risks to toddlers. The nurse plans to explain proper communication in the event of accidental poisoning. The nurse should plan to tell the parents to first state what substance was ingested and then what information should be the priority for the parents to communicate?
- A. The parents' name and telephone number
- B. The currency of the immunization and allergy history of the child
- C. The estimated time of the accidental poisoning and a confirmation that the parents will bring the containers of the ingested substance
- D. The affected child's age and weight
Correct answer: D
Rationale: In the event of accidental poisoning, it is crucial to know the child's age and weight to determine the appropriate treatment. This information helps healthcare providers calculate the correct dosage of antidotes or medications needed based on the child's size and age. The child's age and weight play a significant role in managing accidental poisoning cases. Therefore, this information should be a priority for parents to communicate in such emergencies. Choices A, B, and C are not as critical as the child's age and weight when it comes to immediate treatment decisions for accidental poisoning.
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