HESI LPN
HESI PN Exit Exam
1. You have a patient who has just had a diagnostic arthroscopy. You are instructing him about what to do when he gets home. Which of the following would you NOT instruct him to do?
- A. Resume normal activities within 12 hours so as to help reduce the swelling
- B. Elevate the extremity for 24 – 48 hours
- C. Apply ice to the area involved intermittently
- D. Report severe pain to the physician immediately
Correct answer: A
Rationale: Patients should rest and avoid normal activities for a short period after arthroscopy to allow healing and prevent swelling, which could worsen with early activity. Elevation and icing are recommended post-procedure to reduce swelling and pain. Instructing the patient to resume normal activities within 12 hours could lead to increased swelling and delayed healing. Reporting severe pain is crucial as it could indicate a complication. Therefore, the correct instruction is not to resume normal activities immediately after arthroscopy.
2. The nurse and unlicensed assistive personnel (UAP) are providing care for a client who exhibits signs of neglect syndrome following a stroke affecting the right hemisphere. What action should the nurse implement?
- A. Demonstrate to the UAP how to approach the client from the client's left side
- B. Ask the UAP to leave the room and assess the client's body for bruising
- C. Carefully observe the interaction between the client and family members
- D. Instruct the UAP to protect the client's left side when transferring to a chair
Correct answer: A
Rationale: The correct action for the nurse to implement is to demonstrate to the UAP how to approach the client from the client's left side. Approaching the client from the neglected side (left side) can help in retraining the brain and improving awareness of the affected side, which is crucial in the management of neglect syndrome. Choice B is incorrect as assessing the client's body for bruising is not directly related to managing neglect syndrome. Choice C is incorrect as observing the interaction between the client and family members does not address the specific intervention needed for neglect syndrome. Choice D is incorrect because protecting the client's left side when transferring to a chair does not actively involve retraining the brain and improving awareness of the neglected side, which is the primary goal in managing neglect syndrome.
3. An older postoperative client has the nursing diagnosis 'impaired mobility related to fear of falling.' Which desired outcome best directs the PN's actions for the client?
- A. The client will ambulate with assistance every 4 hours
- B. The physical therapist will instruct the client in the use of a walker
- C. The client will use self-affirmation statements to decrease fear
- D. The PN will place a gait belt on the client prior to ambulation
Correct answer: C
Rationale: The correct answer is C. Using self-affirmation statements helps the client reduce fear and regain confidence in mobility, which is essential for improving impaired mobility. Choice A focuses more on the frequency of ambulation rather than addressing the fear of falling. Choice B involves the physical therapist and the use of a walker, which may not directly address the client's fear. Choice D is a safety measure but does not specifically target the client's fear of falling.
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. What is the priority intervention for a patient experiencing an acute asthma attack?
- A. Administering a bronchodilator
- B. Encouraging the patient to drink fluids
- C. Applying a high-flow oxygen mask
- D. Performing chest physiotherapy
Correct answer: A
Rationale: Administering a bronchodilator is the priority intervention in an acute asthma attack. Bronchodilators help to quickly open the airways, relieve bronchospasm, and improve breathing. Encouraging the patient to drink fluids may be beneficial for other conditions but is not the priority in an acute asthma attack. Applying a high-flow oxygen mask may be necessary in severe cases of respiratory distress but is not the initial priority when managing an acute asthma attack. Performing chest physiotherapy is not indicated as the primary intervention for an acute asthma attack and may not address the immediate need to open the airways and improve breathing.
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