HESI LPN EXIT EXAM MERGED FROM 2019/2020&2021 BEST FOR 2022/2023 ACTUAL EXAM PREP

HESI LPN EXIT EXAMMERGED FROM 2019/2020&2021 ACTUAL EXAMS BEST FOR 2022 ACTUAL EXAM REVIEW HESI PN Comprehensive Exam What intervention should the practical nurse (PN) implement to meet the physiologic integrity of a client during a manic episode of bipolar disorder? A. Provide the client with finger foods. B. Restrict the client's oral fluid intake. C. Give the client low-protein, low-calorie snacks. D. Interrupt the client's performance of rituals. A. Provide the client with finger foods. During the manic phase of bipolar disorder, a client is often unable to sit still long enough to eat, so the client should be provided finger foods that can be eaten while hyperactive. A client with bipolar disorder is being treated with cognitive therapy. Which actions should the practical nurse (PN) implement to reenforce this treatment strategy? Select all that apply. A. Recommend daily physical activity. B. Use affirmations and limit setting. C. Allow the client to talk continuously. D. Report client's suicidal expressions to the therapist. E. Encourage substituting positive thoughts for negative thoughts. F. Reenforce relaxation techniques when experiencing negative thoughts. B. Use affirmations and limit setting. D. Report client's suicidal expressions to the therapist. E. Encourage substituting positive thoughts for negative thoughts. Clients diagnosed with bipolar disorder may experience depressive thoughts and/or attempt suicide. Cognitive therapy sometimes produces relief from troubling symptoms experienced by clients with bipolar disorder. Cognitive therapy allows clients to handle "thought errors" and behaviors to stop negative thoughts. The practical nurse (PN) is evaluating a client's self management of type 1 diabetes mellitus (DM). Which findings provide the best parameter in the client's goals for the prevention of long-term complications of DM? A. Strict adherence to a diabetic diet. B. Participation in a regular exercise program. C. Scheduled administration of accurate insulin doses. D. Consistent hemoglobin A1c levels no greater than 7%. D. Consistent hemoglobin A1c levels no greater than 7%. For optimal diabetic control, evidence-based guidelines recommend an A1c target level no greater than 7% for a client with DM, which is the primary goal and indicator of effective treatment and diabetes management. Which action should the practical nurse (PN) implement for a young girl with pulmonary infection who is receiving chest physiotherapy? A. Encourage to hold her breath and then cough. B. Administer bronchodilators after the procedure. C. Allow the child to sit in a position of choice. D. Percuss the chest wall in a rhythmic fashion. D. Percuss the chest wall in a rhythmic fashion. Thick secretions that are difficult to cough up can be loosened by tapping, or percussing, and vibrating the chest. Percussion is carried out by cupping the hands and lightly striking the chest wall in a rhythmic fashion over the lung segment to be drained The practical nurse (PN) is preparing to administer erythromycin (Ilotycin) 0.5% ophthalmic ointment to a newborn. The father asks the PN the purpose of this medication. What rationale should the PN provide? A. To allow the baby's eyes to focus. B. To lubricate the baby's eyes. C. To prevent infection in the baby's eyes. D. Refer the father to the pediatrician. C. To prevent infection in the baby's eyes. Erythromycin is prescribed in the prophylaxis of ophthalmia neonatorum caused by Neisseria gonorrhea and Chlamydia trachomatis. The PN should explain the ointment is a prophylactic treatment to prevent infection in the baby's eyes. A client's cardiac telemetry reveals sinus bradycardia at 40 beats/minute. An IV dose of atropine is given per protocol. Which finding should the practical nurse (PN) identify as a therapeutic response? A. A decrease in blood pressure. B. A decrease in premature contractions. C. An increase in heart rate. D. An increase in sensorium. C. An increase in heart rate. Atropine increases heart rate (C) by its anticholinergic effects on the sinoatrial (SA) node. A client is admitted with a tumor of the hypothalamus. Which finding should the practical nurse (PN) report to the charge nurse? A. A pulse rate of 98 beats/min. B. Respirations of 20 breaths/min. C. An oral temperature of 101.8° F. D. A blood pressure of 130/80 mm Hg. C. An oral temperature of 101.8° F. The hypothalamus controls body temperature, so variation in the temperature should be reported to determine if the elevation is related to infection or cerebral pathology. The practical nurse (PN) is reinforcing instructions to a client who is scheduled for a bone marrow aspiration. The PN should prepare the client for the procedure at which site? A. The femur. B. The scapula. C. The antecubital fossa. D. The posterior iliac crest. D. The posterior iliac crest. Bone marrow samples are commonly aspirated from the posterior iliac crest or sternum, which are readily accessible obtaining a specimen of bone marrow via the biopsy needle. Which discharge instructions should the practical nurse (PN) reinforce with a client who has acute cholecystitis? A. Limit oral intake to three regular meals per day. B. Drink fluids between meals rather than with meals. C. Consume a low-fat diet in smaller, more frequent meals. D. Limit dietary fat intake to 35% of the daily calorie intake. C. Consume a low-fat diet in smaller, more frequent meals. Clients with acute cholecystitis are placed on small, frequent low-fat meals to decrease contraction of the gallbladder, thus decreasing pain, nausea, and vomiting. A male client draws back when the practical nurse (PN) reaches over the side rails to take his blood pressure. To promote effective communication, what should the PN do? A. Continue to perform the procedure quickly and quietly. B. Apologize for startling the client and explain the need for contact. C. Tell the client that the blood pressure can be taken at a later time. D. Rotate the nurses who are assigned to take the client's blood pressure. B. Apologize for startling the client and explain the need for contact. Nurses often have to enter a client's personal space to provide care, which requires respect for the client's privacy. Apologizing and explaining the need for contact demonstrates respect and provides information so the client may understand the need for personal contact. A client with delirium is confused and disoriented to time and place. He states he is experiencing visual illusions and tactile hallucinations. What actions in the plan of care should the practical nurse (PN) implement? Select all that apply. A. Interact in an energetic manner to dismiss misperceptions. B. Provide a wide variety of environmental stimuli. C. Give simple explanations about nursing care to be given. D. Remove unnecessary furniture and equipment from the room. E. Encourage self care to promote client independence. F. Identify oneself each time the client is approached. C. Give simple explanations about nursing care to be given. D. Remove unnecessary furniture and equipment from the room. F. Identify oneself each time the client is approached. Explanations should be simple, concrete, and concise to ensure the client's understanding and cooperation. Simplifying the environment reduces the potential for sensory-perceptual misinterpretations. The PN should introduce him- or herself with each client contact when providing nursing care. Following a client's bladder surgery, the practical nurse (PN) notes that the ureteral catheter is no longer draining urine. What action should the PN implement? A. Notify the healthcare provider immediately. B. Change the client's position and continue to monitor. C. Clamp the ureteral catheter for 30 minutes. D. Irrigate the ureteral catheter with 30 ml of sterile saline. A. Notify the healthcare provider immediately. When ureteral stents or catheters are placed, patency must be maintained to prevent hydronephrosis. Any significant decrease in drainage should be reported immediately. A male client is being discharged after starting a new prescription of olanzapine (Zyprexa) for paranoid schizophrenia. Which discharge instructions should the practical nurse (PN) reinforce with the client? A. Sit in the sunlight for 20 minutes everyday. B. Avoid the use of antihistamines and alcohol. C. Maintain an average dietary intake of sodium. D. Defer making business decisions for a month. B. Avoid the use of antihistamines and alcohol. Zypexia, an atypical antipsychotic that improves negative symptoms, can produce sedating effects early in therapy, so concomitant use of alcohol or antihistamines should be avoided to minimize synergistic effects. In which position should the practical nurse (PN) place a client after the client has a liver biopsy? A. Prone. B. Supine. C. Left side-lying. D. Right-side lying. D. Right-side lying. The largest lobe of the liver, which is the most frequently biopsied site, lies in the right hypochrondriac region of the abdomen. After a liver biopsy, the client should be turned onto the right side for the first 2 hours to provide local pressure to the puncture site to minimize bleeding. The practical nurse is discussing glucose balance with a client who is newly diagnosed with type 2 diabetes mellitus. Which physiological process supports the movement of glucose into the cells? A. Glucose moves to low concentrations in the cell. B. Blood pressure pushes glucose into cells. C. Insulin is needed to carry glucose into cells. D. Cells absorb glucose when needed. C. Insulin is needed to carry glucose into cells. The transport of glucose occurs because insulin carries glucose across the cell membrane. A mother who is a single parent of three children comes into the well-child clinic and tells the nurse that she needs to start prenatal visits because she unexpectantly is pregnant. To determine how well the client is coping with the pregnancy, which information should the practical nurse obtain? A. The type of work the client is currently doing for employment. B. The client's plans for marriage in the near future. C. The client's support person during this pregnancy. D. The client's use of any type of contraception. C. The client's support person during this pregnancy. An unexpected pregnancy can be a situational crisis for a single-parent family. Personal or family support systems and coping mechanisms should be identified with this mother. Which action should the practical nurse (PN) implement to improve delivery of care by an unlicensed assistive personnel (UAP) who is providing less than optimal hygienic care to older adult clients? A. Give the UAP verbal instructions on how to correctly give baths. B. Ask another staff member to provide special skin care in the afternoon. C. Demonstrate to the UAP how to give a gentle bath to a client. D. Provide the UAP with reading and resources on bathing older clients. C. Demonstrate to the UAP how to give a gentle bath to a client. The PN should demonstrate to the UAP how to provide a gentle bath, which also allows the PN to role model how to convey a sense of caring and respect for the client during the procedure. The practical nurse (PN) explains details of drawing up a dosage of insulin and uses an insulin syringe and vial to show a client how to manipulate the equipment while withdrawing the solution. To evaluate the client's understanding, what action should the PN implement next? A. Review the steps of the procedure with the client the next day. B. Give the client written materials to study and learn the procedure. C. Ask the client to explain the procedure after the demonstration. D. Direct client to use the syringe to withdraw a dose of insulin from the vial. D. Direct client to use the syringe to withdraw a dose of insulin from the vial. Hands-on practice reenforces learning and evaluates the client's understanding about handling equipment after watching a detailed step-by-step demonstration. A male client who had an emergency bowel resection for a ruptured diverticulum 36 hours ago is displaying increased restlessness, and his pulse rate is 110 beats/minute. He is exhibiting gross hand tremors and is plucking at the sheets and gown. During the next 48 hours, it is most important for the practical nurse (PN) to implement what nursing action?