while providing oral care for a client who is unconscious the nurse positions the client laterally and uses a basin to collect secretions which interv
Logo

Nursing Elites

HESI LPN

HESI PN Exit Exam 2023

1. While providing oral care for a client who is unconscious, the nurse positions the client laterally and uses a basin to collect secretions. Which intervention is best for the nurse to implement?

Correct answer: B

Rationale: Using oral swabs with normal saline is the best intervention in this scenario as it effectively cleans the oral cavity without causing irritation or dryness, which is crucial for an unconscious client. Swabbing the oral cavity with a washcloth may not provide thorough cleaning, and it can potentially cause irritation. Providing a Yankauer tip for oral suction is not necessary unless there are excessive secretions that need to be suctioned. Supporting the head with a small pillow, although important for comfort, is not directly related to oral care in an unconscious client.

2. What is the most appropriate nursing action when a patient on anticoagulant therapy develops sudden, severe back pain?

Correct answer: C

Rationale: When a patient on anticoagulant therapy experiences sudden, severe back pain, the priority nursing action is to assess for signs of internal bleeding. Severe back pain in this context could be indicative of internal bleeding, such as a retroperitoneal bleed, which is a critical condition requiring immediate attention. Administering pain medication or applying a cold compress may mask or delay the identification of a potentially life-threatening situation. Repositioning the patient for comfort is not the priority when internal bleeding needs to be ruled out.

3. Which of the following is MOST LIKELY to increase the risk of a medication error?

Correct answer: B

Rationale: Errors in the calculation of medication dosages are a significant risk factor for medication errors. When dosage calculations are incorrect, it can lead to administering the wrong amount of medication, posing serious harm to the patient. Avoiding abbreviations for medications, barcoding medication orders, and utilizing unit dose dispensers are all strategies aimed at reducing medication errors by enhancing accuracy and safety. Therefore, choices A, C, and D are incorrect as they are practices that help decrease, rather than increase, the risk of medication errors.

4. The nurse is teaching a pregnant client how to distinguish prelabor contractions from true labor contractions. Which statement about prelabor contractions is accurate?

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.

5. Which of the following areas does the Patient’s Bill of Rights cover?

Correct answer: D

Rationale: The Patient’s Bill of Rights encompasses various areas to protect patients' rights. These include ensuring information disclosure, allowing patients to choose their healthcare providers, and giving them options to select plans that suit their needs. Therefore, all the choices - information disclosure, choice of providers, and choice of plans - are covered under the Patient’s Bill of Rights. The option 'Best payment options' is not relevant to the areas typically addressed by the Patient’s Bill of Rights.

Similar Questions

In which stage of Maslow's hierarchy of needs is a young adult attempting to achieve when deciding to change his work hours to devote more time to his community?
A client who is post-operative from a spinal fusion surgery reports a sudden onset of severe headache when sitting up. What is the nurse’s priority action?
Prior to giving digoxin, the PN assesses that a 2-month-old infant's heart rate is 120 beats/minute. Based on this finding, what action should the PN take?
A client on bedrest refuses to wear the prescribed pneumatic compression devices after surgery. Which action should the PN implement in response to the client's refusal?
What disorder closely matches Suzy's symptoms?

Access More Features

HESI LPN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

HESI LPN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

Other Courses