HESI PN Comprehensive Exam Graded A+ 2022
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. - correct answer 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. - correct answer 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. - correct answer 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. - correct answer 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 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. - correct
answer 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.
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. - correct
answer 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. - correct answer 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. - correct answer 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. - correct answer 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. - correct answer 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. - correct answer 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.
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. - correct answer 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. - correct answer 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. - correct answer 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. - correct answer 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 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. - correct
answer 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.
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. - correct
answer 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. - correct answer 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. - correct answer 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. - correct answer 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. - correct answer 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. - correct answer 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.
