HESI LPN
HESI PN Exit Exam 2024
1. Which condition is commonly screened for in newborns using the Guthrie test?
- A. Phenylketonuria (PKU)
- B. Cystic fibrosis
- C. Down syndrome
- D. Sickle cell anemia
Correct answer: A
Rationale: The Guthrie test is specifically designed to screen newborns for phenylketonuria (PKU), a metabolic disorder that can lead to intellectual disability if left untreated. Phenylketonuria is caused by the deficiency of an enzyme required to metabolize the amino acid phenylalanine. Screening for PKU in newborns is crucial as early diagnosis and intervention can prevent the severe consequences associated with the condition. Choices B, C, and D are incorrect as the Guthrie test is not used to screen for cystic fibrosis, Down syndrome, or sickle cell anemia.
2. Which assessment finding would most likely indicate a complication of enteral tube feeding?
- A. Abdominal distension
- B. Weight gain
- C. Decreased bowel sounds
- D. Diarrhea
Correct answer: A
Rationale: Abdominal distension in a patient receiving enteral tube feeding may indicate a complication such as intolerance to feeding, delayed gastric emptying, or obstruction. Abdominal distension is a common sign of gastrointestinal issues related to enteral tube feeding. Weight gain is typically an expected outcome if the patient is receiving adequate nutrition. Decreased bowel sounds may indicate decreased motility but are not specific to enteral tube feeding complications. Diarrhea can occur due to various reasons, including infections, medications, or dietary changes, but it is not the most likely indication of a complication in enteral tube feeding.
3. During the immediate postoperative period following a total hip replacement, which intervention is most important for the nurse to implement?
- A. Encourage the client to use a walker or cane when ambulating
- B. Keep the client's hip aligned with knees abducted
- C. Teach the client to sit on the side of the bed before standing
- D. Monitor urinary flow via an indwelling catheter
Correct answer: B
Rationale: Keeping the client's hip aligned with the knees abducted is crucial to prevent dislocation of the prosthesis, which is a priority immediately after total hip replacement surgery. This position helps maintain the stability of the new hip joint. Encouraging the client to use a walker or cane (Choice A) is important but not as critical as ensuring proper hip alignment. Teaching the client to sit on the side of the bed before standing (Choice C) is a good practice but not as essential as maintaining hip alignment. Monitoring urinary flow via an indwelling catheter (Choice D) is not directly related to preventing complications immediately after a total hip replacement.
4. 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.
5. The PN and UAP enter a client's room and find the client lying on the bed. The PN determines that the client is unresponsive. Which instruction should the PN give the UAP first?
- A. Obtain emergency help
- B. Feel for a carotid pulse
- C. Bring a glucometer to the room
- D. Check the blood pressure
Correct answer: A
Rationale: The correct answer is to instruct the UAP to obtain emergency help first. When a client is unresponsive, it could indicate a life-threatening condition that requires immediate intervention. Ensuring emergency help is on the way is the priority to address the potentially critical situation. Feeling for a carotid pulse, bringing a glucometer, or checking the blood pressure are important assessments but should come after taking steps to secure immediate assistance.
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