Practice HESI Fundamentals Exam

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A nurse on a medical unit is preparing to discharge a client to home. Which of the following actions should the nurse take as part of the medication reconciliation process?

  • A. Compare prescriptions with medications the client received during hospitalization.
  • B. Only review the client's current medications.
  • C. Provide a list of medications without checking for interactions.
  • D. Discuss the client's medication history without verification.
Correct Answer: A

Rationale: The correct answer is A: Compare prescriptions with medications the client received during hospitalization. This step is crucial in ensuring the accuracy of medication reconciliation. By comparing the current prescriptions with the medications administered during the hospital stay, the nurse can identify any discrepancies, omissions, or duplications in the medications. This comprehensive comparison helps prevent medication errors and ensures that the client's home medications align with the treatment received in the hospital. Choice B is incorrect because solely reviewing the client's current medications may overlook important changes or additions made during the hospitalization. Choice C is incorrect as providing a list of medications without checking for interactions can lead to potential adverse effects or drug interactions. Choice D is incorrect as discussing the client's medication history without verification may not provide an accurate representation of the medications the client actually received during the hospital stay.

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A client on a telemetry unit is being cared for by a nurse after a myocardial infarction. The client expresses, 'All this equipment is making me nervous.' Which of the following responses should the nurse make?

  • A. 'All of this equipment can be frightening.'
  • B. 'The equipment is necessary to monitor your condition.'
  • C. 'You should try to ignore the equipment.'
  • D. 'Try to relax; the equipment is not harmful.'
Correct Answer: A

Rationale: Choice A is the most appropriate response as it acknowledges the client's feelings, showing empathy and understanding. It validates the client's experience, which can help reduce anxiety and build rapport. Choice B provides information but may not address the client's emotional needs. Choice C dismisses the client's concerns and does not offer support. Choice D minimizes the client's feelings and may not effectively address their anxiety.

During a client admission, how should the nurse conduct medication reconciliation?

  • A. Compare the client's home medications to the provider's prescriptions.
  • B. Review the client's medical history.
  • C. Assess the client's current medications.
  • D. Ask the client about their allergies.
Correct Answer: A

Rationale: During medication reconciliation, the nurse should compare the client's home medications with the provider's prescriptions to ensure accuracy and prevent medication errors. Reviewing the client's medical history (Choice B) is important but not the primary focus of medication reconciliation. Assessing the client's current medications (Choice C) is also vital but is not specific to the comparison between home and prescribed medications during reconciliation. Asking the client about their allergies (Choice D) is relevant for ensuring safe medication administration but is not the primary step in medication reconciliation, which involves comparing actual medications.

A 73-year-old female client had a hemiarthroplasty of the left hip yesterday due to a fracture resulting from a fall. In reviewing hip precautions with the client, which instruction should the LPN/LVN include in this client's teaching plan?

  • A. You will be able to bend at the waist to reach items on the floor in 8 weeks.
  • B. Place a pillow between your knees while lying in bed to prevent hip dislocation.
  • C. It is safe to use a walker to get out of bed, but you need assistance when walking.
  • D. Take pain medication 30 minutes after your physical therapy sessions.
Correct Answer: B

Rationale: The correct instruction to include in the teaching plan for a client who had a hemiarthroplasty of the left hip is to 'Place a pillow between your knees while lying in bed to prevent hip dislocation.' This technique helps maintain proper hip alignment and prevents dislocation during the postoperative recovery period. Choice A is incorrect because bending at the waist to reach items on the floor can strain the hip joint and is not recommended following hip surgery. Choice C is incorrect because using a walker alone without assistance can increase the risk of falls and injury, especially in the immediate postoperative period. Choice D is incorrect because pain medication should be taken as prescribed by the healthcare provider, not specifically timed after physical therapy sessions.

A client has an indwelling urinary catheter. Which of the following actions should the nurse take to prevent infection?

  • A. Ensure the catheter tubing is free of kinks.
  • B. Clean the perineal area with antiseptic solution daily.
  • C. Irrigate the catheter with normal saline every shift.
  • D. Secure the catheter to the client's leg.
Correct Answer: B

Rationale: Cleaning the perineal area with antiseptic solution daily is essential to prevent infection when caring for a client with an indwelling urinary catheter. This practice helps reduce the risk of introducing pathogens into the urinary tract. Ensuring the catheter tubing is free of kinks (Choice A) is important for maintaining proper urine flow but is not directly related to preventing infection. Irrigating the catheter with normal saline every shift (Choice C) is not a routine practice and can increase the risk of introducing pathogens. Securing the catheter to the client's leg (Choice D) is important for stability but does not directly prevent infection.

While instructing a male client's wife in the performance of passive range-of-motion exercises to his contracted shoulder, the nurse observes that she is holding his arm above and below the elbow. What nursing action should the LPN/LVN implement?

  • A. Acknowledge that she is supporting the arm correctly.
  • B. Encourage her to keep the joint covered to maintain warmth.
  • C. Reinforce the need to grip directly under the joint for better support.
  • D. Instruct her to grip directly over the joint for better motion.
Correct Answer: A

Rationale: Acknowledging that the client's wife is supporting the arm correctly is the appropriate nursing action in this scenario. By doing so, the nurse reinforces correct technique and promotes confidence. Choice B is incorrect as the issue is not about maintaining warmth. Choice C is incorrect as gripping directly under the joint is not necessary in this case. Choice D is incorrect as instructing to grip directly over the joint may not provide the best support for passive range-of-motion exercises.

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