HESI LPN COMPREHENSIVE EXIT
COMPREHENSIVE EXAM 2026 STUDY
GUIDE Q&A UPDATED MULTIPLE CHOICES
⩥ What action should the PN implement to facilitate speech for a client
who has a fenestrated tracheostomy tube?
A. Show the client how to use a tracheostomy plug.
B. Determine the client's ability to swallow.
C. Remove the inner cannula.
D. Give oxygen at 6 L/minute via tracheostomy collar. Answer: B.
Determine the client's ability to swallow.
A fenestrated tracheostomy has an opening or hole on the posterior
aspect of the outer cannula that allows airflow over the vocal cords and
speech in a client who is spontaneously breathing. It does not have a
cuff, so the client's risk for aspiration should be determined.
⩥ A male client scheduled for a total laryngectomy and radical neck
dissection for cancer of the larynx asks the PN if he will ever be able to
speak. Which response is bets for the PN to provide?
A. Breathing occurs through a permanent neck opening which prevents
normal speech.
,B. Permanent removal of the voice box requires rehabilitation for
esophageal speech.
C. Due to removal of the vocal cords, communication requires the use of
sign language.
D. Once the breathing hole in the neck heals, the ability to speak
requires a device. Answer: B. Permanent removal of the voice box
requires rehabilitation for esophageal speech.
A total laryngectomy includes removal of the larynx and pre-epiglottis
region resulting in a permanent tracheostomy and loss of normal speech
abilities. Rehab is required to learn to speak using a prosthesis,
esophageal speech, or an electrolarynx.
⩥ A client is wearing a continuous 24-hour Holter monitor for elevation
of heart rhythm disturbances. What info should the PN reinforce with
this client?
A. Remove the electrodes to shower or bathe
B. Keep a diary of activities as long as the monitor is worn.
C. Exercise as much as possible while the monitor is in place.
D. Call the assigned number if an episode of irregular heartbeats occurs.
Answer: B. Keep a diary of activities as long as the monitor is worn.
Nursing care for a client with a Holter monitor includes preparation of
the skin, placement of the electrodes and leads, and activities of daily
,living, so the client should be informed of the importance of keeping an
accurate record of activities and symptoms
⩥ The PN is caring for a client who is receiving a therapeutic dose of
warfarin (Coumadin). The client asks the PN to explain the effect of
eating green leafy vegetables. What info should the PN provide?
A. The high content of vitamin K in green leafy vegetables decreases
Coumadin's action.
B. Green vegetables are high in fiber and cellulose that decrease the
absorption of Coumadin.
C. These foods have a natural anticoagulant effect that potentiates the
effect of Coumadin.
D. Dietary intake of green leafy vegetables alters the bowel bacteria's
production of vitamin K. Answer: A. The high content of vitamin K in
green leafy vegetables decreases Coumadin's action.
Coumadin works as an anticoagulant by blocking hepatic utilization of
vitamin K in the production of prothrombin, which is a component of the
blood clotting cascade. Green leafy vegetables are high in vitamin K,
which counteracts the anticoagulant effect of Coumadin.
⩥ The PN is reviewing the effects of NSAIDs (nonsteroidal anti-
inflammatory drugs) with a client who has acute gastritis. What info is
correct about the action of NSAIDs?
, A. Causes histamine receptor stimulation that increases the release of
hydrochloric acid.
B. Inhibits the synthesis of prostaglandins that normally protect the
stomach lining.
C. Activates an inflammatory response which increases the drug's
absorption.
C.
D. Stimulates parietal cells to release pepsin leading to digestion of
ingested foods. Answer: B. Inhibits the synthesis of prostaglandins that
normally protect the stomach lining
NSAIDs inhibit the synthesis of prostaglandins which protect the
stomach lining.
⩥ After undergoing exploratory laparotomy and bowel resection, a client
with an NG tube to suction complains of nausea and stomach distention.
The PN irrigates the tube, but the irrigating fluid does not return. What
action should the PN implement?
A. Notify the healthcare provider.
B. Auscultate for bowel sounds.
C. Reposition the tube and check for placement.
D. Remove the tube and replace it with a new one. Answer: C.
Reposition the tube and check for placement.
COMPREHENSIVE EXAM 2026 STUDY
GUIDE Q&A UPDATED MULTIPLE CHOICES
⩥ What action should the PN implement to facilitate speech for a client
who has a fenestrated tracheostomy tube?
A. Show the client how to use a tracheostomy plug.
B. Determine the client's ability to swallow.
C. Remove the inner cannula.
D. Give oxygen at 6 L/minute via tracheostomy collar. Answer: B.
Determine the client's ability to swallow.
A fenestrated tracheostomy has an opening or hole on the posterior
aspect of the outer cannula that allows airflow over the vocal cords and
speech in a client who is spontaneously breathing. It does not have a
cuff, so the client's risk for aspiration should be determined.
⩥ A male client scheduled for a total laryngectomy and radical neck
dissection for cancer of the larynx asks the PN if he will ever be able to
speak. Which response is bets for the PN to provide?
A. Breathing occurs through a permanent neck opening which prevents
normal speech.
,B. Permanent removal of the voice box requires rehabilitation for
esophageal speech.
C. Due to removal of the vocal cords, communication requires the use of
sign language.
D. Once the breathing hole in the neck heals, the ability to speak
requires a device. Answer: B. Permanent removal of the voice box
requires rehabilitation for esophageal speech.
A total laryngectomy includes removal of the larynx and pre-epiglottis
region resulting in a permanent tracheostomy and loss of normal speech
abilities. Rehab is required to learn to speak using a prosthesis,
esophageal speech, or an electrolarynx.
⩥ A client is wearing a continuous 24-hour Holter monitor for elevation
of heart rhythm disturbances. What info should the PN reinforce with
this client?
A. Remove the electrodes to shower or bathe
B. Keep a diary of activities as long as the monitor is worn.
C. Exercise as much as possible while the monitor is in place.
D. Call the assigned number if an episode of irregular heartbeats occurs.
Answer: B. Keep a diary of activities as long as the monitor is worn.
Nursing care for a client with a Holter monitor includes preparation of
the skin, placement of the electrodes and leads, and activities of daily
,living, so the client should be informed of the importance of keeping an
accurate record of activities and symptoms
⩥ The PN is caring for a client who is receiving a therapeutic dose of
warfarin (Coumadin). The client asks the PN to explain the effect of
eating green leafy vegetables. What info should the PN provide?
A. The high content of vitamin K in green leafy vegetables decreases
Coumadin's action.
B. Green vegetables are high in fiber and cellulose that decrease the
absorption of Coumadin.
C. These foods have a natural anticoagulant effect that potentiates the
effect of Coumadin.
D. Dietary intake of green leafy vegetables alters the bowel bacteria's
production of vitamin K. Answer: A. The high content of vitamin K in
green leafy vegetables decreases Coumadin's action.
Coumadin works as an anticoagulant by blocking hepatic utilization of
vitamin K in the production of prothrombin, which is a component of the
blood clotting cascade. Green leafy vegetables are high in vitamin K,
which counteracts the anticoagulant effect of Coumadin.
⩥ The PN is reviewing the effects of NSAIDs (nonsteroidal anti-
inflammatory drugs) with a client who has acute gastritis. What info is
correct about the action of NSAIDs?
, A. Causes histamine receptor stimulation that increases the release of
hydrochloric acid.
B. Inhibits the synthesis of prostaglandins that normally protect the
stomach lining.
C. Activates an inflammatory response which increases the drug's
absorption.
C.
D. Stimulates parietal cells to release pepsin leading to digestion of
ingested foods. Answer: B. Inhibits the synthesis of prostaglandins that
normally protect the stomach lining
NSAIDs inhibit the synthesis of prostaglandins which protect the
stomach lining.
⩥ After undergoing exploratory laparotomy and bowel resection, a client
with an NG tube to suction complains of nausea and stomach distention.
The PN irrigates the tube, but the irrigating fluid does not return. What
action should the PN implement?
A. Notify the healthcare provider.
B. Auscultate for bowel sounds.
C. Reposition the tube and check for placement.
D. Remove the tube and replace it with a new one. Answer: C.
Reposition the tube and check for placement.
