HESI EXIT PRACTICE
The Practical Nurse (PN) is assigned to care for four children which should be assessed first?
18 month old who has cystic fibrosis is wheezing
The practical nurse (PN) is obtaining fetal heart rates on a client in their third trimester of pregnancy what fetal heart rate should be reported to the registered nurse?
180
A male client tells the practical nurse (PN) that the pill he has been taking at home is different color and size then the one the PN is trying to give him now how should the nurse respond ?
Explain that the pharmacy often substitutes generic for more expensive brands
The spouse of a hospitalized client asks the practical nurse (PN) for acetaminophen for a tension headache, its ok to give Tylenol as long as you don't give a narcotic.
False
When gathering data about a client with dark skin tones which site should the practical nurse (PN) observe?
Finger and toe nails
The practical nurse (PN) ask the UAP for feedback about assigned client instead the UAP walks away from the PN ignoring the question what action is best for the PN to take?
In a private setting ask the other nurses for feedback about UAP behaviors
On the first day after a cesarean section, a client who is a primipara is being assisted to the bathroom for the first time. The client experiences a sudden gush of vaginal blood and notices that several blood clots are in the toilet. Which action should the practical nurse (P) take?
Massage the funds and avoid direct pressure on the cesarean incision
The most significant side effect that a practical nurse (PN) should check for after administering an epidural to a client during labor is observation of the side effect.
Maternal hypotension
A client receives ondansetron prior to chemotherapy treatment how should the practical nurse evaluate the effectiveness of the medication?
Monitor the client for nausea or vomiting following the treatment
The response of the practical nurse (PN) is based on understanding which prevalent manifestations of the illness. The PN overhears the female client with crushing syndrome telling her family to leave her room and not return.
Mood adherence
The practical nurse (PN) views the midline episiotomy of a client who reports pain in her stiches. What action should the action should the PN take first?
Observe suture line for separation and hematoma formation
The practical nurse (PN) is caring for a client following a carotid endarterectomy. To assess for hemorrhage, what action is most important for the PN to implement?
Observe the area under the neck and shoulders.
A child receiving chemotherapy develops a cough that productive of yellow tinged sputum after determine that the client is afebrile which priority action for the practice nurse (PN) to take?
Provide oral hygiene
What kind of intervention should the PN use when engaging a client who is hospitalized with obsessive compulsive disorder and is repeatedly wiping off door knobs?
Provide time for the behaviors then guide the client to other actives
A client with hypertension complains of a persistent dry cough the practical nurse (PN) should tell the client that this is a common side effect with what medication?
Quinapril
What steps should you take for an older female client who was just admitted to a long-term facility and is confused about the day of the week?
Remind the client what day of the week it is
While assisting the RN with the admission of a toddler which intervention should the practical nurse (PN) implement to make the experience lease stressful for the client
Remove child's clothing down to the diaper
When a practical nurse (PN) instructs a client on how to clean sputum, the client signals that they have understood the process. The client collects the sputum after the PN has left the room and alerts the PN. What steps ought to the PN take?
The PN should teach the client how to obtain a sputum specimen and the client does not correctly collect the specimen the PN should assist the client is obtaining another specimen cough directly into a sterile cup
A client diagnosed with c-diff which action should the practical nurse (PN) implement to prevent the spread of the organism?
Hand washing
Which foot care instruction is most important for the practical nurse (PN) to reinforce for a patient newly diagnose with type 2 diabetes?
Make sure the shoe size fits, minimizing rubbing and blisters
Influenza precautions ppe
Mask and Gloves
What important intervention does the nurse need to ensure?
Measure head circumference
What is the most crucial thing for PN to give to UAP while caring for a client who has pitting edema of the feet and ankles and is taking spironolactone (a potassium sparing diuretic)?
Maintain accurate intake and output
Meat sources of B12
Beef patty
What patients with increase risk of developing breast cancer?
Mother had breast cancer
How do you communicate with blind clients? Standing where
Stand in front
A homecare client has a sodium level of 125 . What is to determine the cause of this level ?
The amount of salt used in meal preparation
The practical nurse (PN) is assigned to care for a client who had an endoscopic procedure in which a local anesthetic was sprayed on their throat which priority action should the PN include in this care of plan?
Assess the gag reflexes
Main source of Vitamin k
green leafy vegetables
A client afraid of getting cancer plans to stop smoking and use smokeless tobacco. What should you provide?
provide info of risks of smokeless tobacco
The practical nurse (PN) is assigning tasks to unlicensed assistive personnel (UAP) who is giving basic care to a group of residents in a long-term care facility. Which client's task should be completed by a PN, rather than the UAP?
A client with continuous urinary bladder irrigation via a 3-way catheter
Which person has the highest risk of developing laryngeal cancer?
A older male who drinks a 6 pack of beer nightly and smokes heavily
A pleural effusion is visible on the chest x-ray of a patient who has been admitted with pneumonia. When auscultating the upper lobe, what should the PN listen for?
A rubbing pleural sound
Which interventions is within the scope of practice for a practical nurse (PN)?
Demonstrating deep breathing and coughing to a post operative client
The practical nurse (PN) learns that the client whos receiving chemotherapy has developed stomatitis which information should the PN obtain from the client during focused assessment
Ability to swallow
After a routine vaginal delivery of a healthy newborn, a client who is pregnant is taken to the recovery room. You notice the client is shaking asks if she's cold. What's next?
Apply light warm blanket and assure her that this is normal following delivery
Client expresses concern about receiving proper care in accordance with the client's religion. Which action is best for the practical nurse (PN) to take?
Ask the client about individual care preferences.
The practical nurse (PN) is assessing an older client with left sided heart failure what intervention is most important for the PN to implement
Auscultate all the lung fields
Which location should the practical nurse palpate to determine if a client submandibular lymph node are enlarged?
Beneath the lower jaw
Prior to administering pain medication to an older adult post operative client what information should the practical nurse (PN) obtain?
Clients pain rating 1-10 scale Time of last administration of pain medication Effectives of last pain8 medication administration
The practical nurse is caring for a client with influenza who requires droplet precautions which action should the PN take after entering the room to provide care?
Close the door to the client's room
The practical nurse (PN) is monitoring a client's neurologic status following a closed head injury. Which assessments should the PN include?
Consciousness level. Pupillary reactions Vital sign measurement.
An older adult client with cancer of the liver is in a hepatic coma and unresponsive. How should the practical nurse respond to family members who are inquiring about the condition of their loved one?
Convey that their loved one's condition is extremely critical, and there has been no response in the last 24 hours
The practical nurse (PN) observes a newly hired UAP who's counting client radial pulse. Which action should the PN take?
Demonstrate the correct pulse side to the UAP
In obtaining a series of stool specimens for occult blood, which instructions should the practical nurse (PN) provide the client?
Defecate into the container separately from urinating in the toilet.
What is the most crucial step for the practical nurse to take while giving prescription medication to an elderly resident of an extended care home who is having trouble hearing?
Determine if client has had difficulty hearing in the past
The practical nurses client last bowel movement occurred days ago, which action should the PN implement first?
Determine the clients usual bowel patterns
When getting a blood glucose, what intervention should the practical nurse implement ?
Determine what finger was used previously
In caring for a client following a below-the-knee amputation, which task is best for the practical nurse (PN) to assign to the unlicensed assistive personnel (UAP) who is assisting with the care of this client?
Empty and measure the drainage in the suction drainage device.
Which problem has happened in an older client with these issues?
Evisceration
The practical nurse finds a client who is assigned to another nurse bleeding from an intravenous (IV) site and the IV tubing and fluid are on the floor. The PN immediately applies a dressing to stop the bleeding. Which action should the PN take next?
Enter computer documentation of the findings and the application of a dressing
What is a appropriate task for a UAP assisting the nurse for a dressing change?
Gather supplies
The practical nurse (PN) is caring for a group of clients on a postpartum unit. After shift report, which client should the PN assess first?
Gravida 3 Para 3 who delivered vaginally 2 hours ago.
A postoperative male client has been refusing pain medicine for the previous six hours because he thought he could "tough it out." The client has trouble achieving a reasonable degree of comfort when an opioid analgesic is given. What technique should the practical nurse (PN) employ to help this client manage his pain?
Guide the client through slow, rhythmic breathing
Which intervention should the practice nurse (PN) include in the client's care if the client has broken metatarsals as a result of slamming a hand in a car door after taking the hydrocodone/acetaminophen prescription for pain?
Implement ongoing assessments for signs of shortness or slowed breathing
Which symptoms are the parents of a kid with acute glomerulonephritis describing to the practical nurse (PN) as the ones that initially prompted them to seek medical attention?
Hematuria
A man client participates in a community support program for people with mental illness and substance abuse issues. The client informs the practical nurse (PN) that cocaine and heroin are his preferred substances. What is the client's biggest health risk?
Hepatitis
Which action by a practical nurse (PN) indicates the best understanding of the principles related to medical asepsis and effective handwashing?
Hold your hands lower than your elbows to promote microbe removal.
Which of the following statements made by an older female client should alert the practical nurse (PN) that the client could require treatment counseling? The client lost her spouse 3 years ago.
I realized that life must go on but sometimes I wonder why
When explaining how to correctly utilize assistive equipment to an elderly client who is recuperating from a stroke, the practical nurse (PN) plans to reinforce where the client should position the cane. Where should the PN instruct the client to place the cane?
Ineffective side
The Glasgow scale is being used to monitor a client who experienced a traumatic brain injury what primary assessment should the PN evaluate
Level of consciousness
Which information about end-of-life care should a practical nurse (PN) ensure the client has?
Instructions for care should be included in the clients living will (Advance directives)
What is the behavior that the nurse should document with a client having cocaine withdrawal?
Intense cravings
A woman visits the clinic for a medical examination, the practical nurse (PN) notices a purple bruise on the client's upper arm and a yellow bruise under her right eye. What should the nurse ask the client?
Is anyone hurting you
Which interventions should the practical nurse (PN) reinforce for a client with pruritis?
Keep fingernails trimmed short.
Short leg cast applied 2 hours ago cap refill is 5 second. What should PN do?
Notify provider and charge nurse
When a male preop client who has already given informed consent for a surgical procedure informs the PN that he is particularly terrified and anxious about having the surgery, what priority action should you take?
Notify the charge nurse of the clients concerns
An older client tells the home health care practical nurse (PN) about experiencing dizziness when standing, whats most important for the PN to obtain?
Obtain orthostatic blood pressures.
A client with cancer eats only 10% of the food on the meal tray provided for lunch, stating everything tastes "funny" and "the meat is bitter." Which action should the practical nurse (PN) take?
Offer alternative food and flavoring options.
If a baby is born to a diabetic mother what should the nurse encourage?
Offer nipple feedings or 10% dextrose
What do you do before giving medication?
Pain scare Effectiveness of pain Last given
An older male client is returning to the surgical unit after a total right knee replacement. Which assessment findings are most important for the practical nurse (PN) to document in this client's electronic medical record (EMR)?
Paresthesia, paralysis, pedal pulses, pallor, and pain.
What is the best course of action for the practical nurse (PN) to take when the parents of a child with pre-diabetes inform the PN that the youngster wants to join the soccer team?
Reassure the patents that increased physical activity reduces risk for diabetes
The practical nurse (PN) administers a anticonvulsant that causes photosensitivity which action should the PN take after admitting the medication?
Remind the client to protect skin from sunlight
A home health practical nurse (PN) visits and older client living with offspring who exhibits fear unkept and has lost a lot of weight which action should the PN take>
Report suspected abuse to supervisor and protective services
A client had surgery 2 days ago complains of difficulty sleeping which initial intervention is best for the practical nurse to implement?
Reposition the client and provide a back rub
What information should the practical nurse (PN) review with a client who has symptoms of orthostatic hypotension
Rise slowly from sitting or lying positions.
In a noisy voice that the client and visitors might overhear, a practical nurse (Pn) is recounting her social life, sexual activities, and alcohol use at the nurses station.
Suggest going to the nurses lounge to discuss these topics
The parents of a 4-week-old male infant report that he eats well but vomits after each feeding. Which finding should the practical nurse (PN) identify if the baby is receiving inadequate nutrition?
Sunken fontanels
A new protocol for fall prevention is being implemented on the medical unit during safety rounds the practical nurse (PN) identifies that the UAP had omitted a vital component of the protocol after implementing the missing component which action should the nurse take?
Supervise the UAP after reviewing the protocol
The practical nurse (PN) observes two unlicensed assistive personnel (UAP) turning an older client who had a hip arthroplasty with prosthesis placement 4 hours ago. Which observation by the PN indicates that the UPs need additional information about the turning procedure?
The client is told to keep both legs straight and together while turning
The practical nurse (PN) is changing the abdominal dressing of a male client who was discharged home following a colon resection which information should the PN report to the health care provider?
The client reports the wound care is painful and would like a prescription for an analgesic
What is pupil accomodation?
The function of the accommodation reflex is to coordinate visual attention to near objects
The mother of an 8-year-old boy tells the practical nurse (PN) that he fell out of a tree and hurt his arm and shoulder. Which assessment finding should the practical nurse (PN) note as the most significant indicator of child abuse
The story of the injury given by the mother differs from the child's.
The practical nurse (PN) palpates a client's radial pulse and notes that the pulse disappears when light pressure is applied. How should the PN document this finding?
Thready pulse volume
A full term 24 hour old infant in the nursery regulates and suddenly turns cyanotic which immediate interventions should the practical nurse (PN) take?
Turn the infant to the right side
Which condition does the State Nurse Practice Act provide for revocation of the license PN?
Under influence of drugs and alcohol
Where is the center of gravity on the older adult?
Upper torso
Which technique should the practical nurse (PN) employ while giving nystatin suspension to an infant whose gums have a candida infection?
Use a gloved finger to suspension over the infected area
How to care for the feet of the diabetic patient"?
Wash and dry feet good
What assessment questions are most crucial for a client with schizophrenia who has auditory hallucinations when they are brought to the hospital?
What is the voices altering
What standard of care is acceptable in a nursing malpractice case?
What would a responsible prudent nurse have done under similar circumstances
The practical nurse is auscultating a clients lungs sounds. What sound is this?
Wheezing
An older female resident in a long-term care facility experiences frequent urinary incontinence, which focused assessment is MOST important?
appearance of skin in perineal area
Client slumped in chair with no visible signs of life. What should you do?
shake and shout to determine LOC
At 1000, a fresh prescription is given to a patient that calls for stopping IV fluids and IV antibiotics. Why should the practical nurse (PN) administer the medication Pantoprazole at 1300?
treat acid reflux
What information is most crucial for the practical nurse (PN) to find out when a female client with bipolar illness tells them they haven't taken their medication?
mind frame
The practical nurse (PN) plans to use distraction technique while client undergoes a brief painful procedure which action should the PN implement during the procedure?
ncourage the client to reminisce about a favorite past family event
The practical nurse (PN) and unlicensed assistive personal (UAP) enters a clients room and finds the client lying on the bed the PN determines that the client is unresponsive which action should the PN give the UAP first .
obtain emergency help
A client unconscious with weak thready pulse, cool, moisten skin cyanosis of nail bed, Kussmaul respirations. Whats next?
provide oxygen
