HESI LPN
HESI PN Exit Exam 2024
1. Which of the following is the most effective way to prevent the spread of infection in a healthcare setting?
- A. Using sterile gloves
- B. Wearing a face mask
- C. Performing hand hygiene
- D. Using disposable equipment
Correct answer: C
Rationale: Performing hand hygiene is the most effective way to prevent the spread of infection in a healthcare setting. Hand hygiene helps remove pathogens that could be transmitted through direct contact, making it a crucial practice in infection control. While using sterile gloves and disposable equipment are important in certain situations, they do not address the potential transmission of pathogens through direct contact, unlike hand hygiene. Wearing a face mask is important for respiratory precautions but may not be as effective as hand hygiene in preventing the spread of infections through direct contact.
2. The nurse is teaching a pregnant client how to distinguish prelabor contractions from true labor contractions. Which statement about prelabor contractions is accurate?
- A. They are irregular
- B. They are usually felt in the abdomen
- C. They start in the back and radiate to the abdomen
- D. They become more intense during walking
Correct answer: B
Rationale: The correct statement about prelabor contractions (Braxton Hicks contractions) is that they are usually felt in the abdomen. They are irregular in nature and do not intensify with movement. Choice A is incorrect because prelabor contractions are irregular, not regular. Choice C is incorrect as prelabor contractions do not start in the back and radiate to the abdomen. Choice D is incorrect as prelabor contractions do not become more intense during walking.
3. The PN is reviewing instructions for the use of pilocarpine eye drops with a client who has glaucoma. The client replies that the drops are used to anesthetize the eye if eye pain is experienced. What action should the PN implement?
- A. Document in the chart that the client understands the correct action and use of eye drops
- B. Reassure the client that the drops will not be needed often since eye pain in glaucoma is not common
- C. Reteach the client about the action of the eye drops to decrease pressure in the eyes
- D. Explain to the client that the eye drops do not anesthetize the eyes but reduce pressure
Correct answer: C
Rationale: Pilocarpine eye drops are used to reduce intraocular pressure in glaucoma, not to anesthetize the eye. The PN should reteach the client about the purpose of the medication to ensure proper use and understanding, which is crucial for effective treatment. Choice A is incorrect because just documenting understanding without addressing the client's misconception is not enough. Choice B is incorrect as it provides incorrect information about the purpose of the eye drops and may lead to further misunderstanding. Choice D is incorrect as it provides inaccurate information stating that the drops provide pain relief, which is not their primary purpose.
4. During a routine prenatal visit at the antepartal clinic, a multipara at 35-weeks gestation presents with 2+ edema of the ankles and feet. Which additional information should the PN report to the RN?
- A. Due date
- B. Blood pressure
- C. Gravida and parity
- D. Fundal height
Correct answer: B
Rationale: Blood pressure is the most critical information to report to the RN in this scenario. The presence of edema, along with high blood pressure, can be indicative of preeclampsia, a severe condition in pregnancy. Monitoring blood pressure is essential for assessing the patient's condition and taking appropriate actions if necessary. Choices A, C, and D are not as urgent in this situation. The due date, gravida, and parity are important for overall assessment but do not address the immediate concern of potential preeclampsia. Fundal height is used to assess fetal growth and position but is not the priority when edema and high blood pressure are present.
5. A client post-coronary artery bypass graft (CABG) surgery is concerned about the risk of infection. What is the most important preventive measure the nurse should emphasize during discharge teaching?
- A. Avoid touching the incision sites with bare hands.
- B. Take all prescribed antibiotics as directed.
- C. Report any signs of infection to the healthcare provider immediately.
- D. Keep the incision sites clean and dry.
Correct answer: D
Rationale: The correct answer is D: 'Keep the incision sites clean and dry.' After CABG surgery, maintaining the cleanliness and dryness of the incision sites is crucial to prevent infections. This practice reduces the risk of introducing harmful microorganisms to the surgical wound, promoting healing and preventing complications. Option A, while important, does not fully encompass the preventive measures necessary to avoid infections post-surgery. Option B is significant if antibiotics are prescribed, but ensuring cleanliness directly addresses infection prevention. Option C is reactive and focuses on addressing infection after it occurs, rather than proactively preventing it.
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