HESI LPN
Practice HESI Fundamentals Exam Questions
Question 1 of 5
An older adult male client is admitted to the medical unit following a fall at home. When undressing him, the nurse notes that he is wearing an adult diaper and skin breakdown is obvious over his sacral area. What action should the nurse implement first?
Correct Answer: D
Rationale: The first action the nurse should implement is to determine the size and depth of the skin breakdown over the sacral area. This initial assessment will provide crucial information on the extent of the damage and guide appropriate care interventions. Option A is not the priority in this scenario as the immediate concern is addressing the existing skin breakdown. Option B, completing a functional assessment, is important but should come after addressing the acute issue of skin breakdown. Option C, applying a barrier ointment, may be beneficial later but does not address the primary need of assessing the extent of the current skin damage.
Question 2 of 5
A client enters the emergency department unconscious via ambulance from the client's workplace. What document should be given priority to guide the direction of care for this client?
Correct Answer: C
Rationale: In this scenario, when the client is unconscious and unable to make decisions, a notarized original of advance directives brought in by the partner should be given priority to guide the direction of care. Advance directives provide legal documentation of the client's wishes regarding healthcare decisions in situations where they cannot express their preferences. The statement of client rights and the client self-determination act (Choice A) outlines general principles but does not provide specific guidance on the client's care. Orders written by the healthcare provider (Choice B) are important but may not reflect the client's preferences. Clinical pathway protocols (Choice D) are useful for standard care pathways but do not address individual client wishes.
Question 3 of 5
A nurse is preparing to administer ketorolac 0.5 mg/kg IV bolus every 6 hr to a school-age child who weighs 66 lb. The available ketorolac injection is 30 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: A
Rationale: To calculate the dose, first convert the weight from pounds to kilograms. The child weighs 66 lb, which is approximately 30 kg. The prescribed dose is 0.5 mg/kg, so for a 30 kg child, the dose would be 0.5 mg/kg x 30 kg = 15 mg. Since the available ketorolac injection is 30 mg/mL, the nurse should administer 15 mg � 30 mg/mL = 0.5 mL per dose. Therefore, choice A (0.5 mL) is the correct answer. Choices B, C, and D are incorrect as they do not accurately calculate the correct dose based on the child's weight and the concentration of the ketorolac injection.
Question 4 of 5
A client with chronic kidney disease is receiving epoetin alfa (Epogen). Which laboratory value should the LPN/LVN monitor to determine the effectiveness of this medication?
Correct Answer: B
Rationale: The correct answer is B: Hemoglobin. Monitoring hemoglobin levels is essential to assess the effectiveness of epoetin alfa in clients with chronic kidney disease. Epoetin alfa is a medication that stimulates red blood cell production, aiming to increase hemoglobin levels and improve symptoms of anemia in these patients. Monitoring serum potassium (Choice A) is important in clients with kidney disease, but it is more related to assessing electrolyte balance rather than the direct effectiveness of epoetin alfa. Serum creatinine (Choice C) and blood urea nitrogen (Choice D) are kidney function tests that help evaluate kidney health but do not specifically reflect the effectiveness of epoetin alfa therapy.
Question 5 of 5
When assessing a client reporting increased pain after physical therapy, which question should the nurse ask to evaluate the quality of the pain?
Correct Answer: A
Rationale: The correct question to ask when assessing the quality of a client's pain is whether the pain is sharp or dull. This helps in understanding the characteristics of the pain being experienced. Choice B, asking if the pain radiates to other areas, focuses more on pain distribution rather than quality. Choice C, inquiring if the pain increases with movement, pertains to aggravating factors rather than pain quality. Choice D, requesting the client to rate pain on a scale of 1 to 10, is related to pain intensity rather than quality.
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