HESI Fundamentals Exam Test Bank

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What action should the LPN/LVN take to prevent postoperative complications in a client who has undergone abdominal surgery?

  • A. Encourage the client to use an incentive spirometer regularly.
  • B. Assist the client in ambulating as soon as possible.
  • C. Position the client in high Fowler's position.
  • D. Encourage the client to cough and deep breathe regularly.
Correct Answer: A

Rationale: Encouraging the client to use an incentive spirometer regularly is crucial in preventing postoperative complications after abdominal surgery. This action helps prevent atelectasis by promoting lung expansion and improving air exchange in the lungs, reducing the risk of respiratory complications. Assisting the client in ambulating early is important for preventing issues like deep vein thrombosis but may not directly address respiratory concerns postoperatively. Positioning the client in high Fowler's position can help with respiratory distress but is not as specific to preventing postoperative respiratory complications as using an incentive spirometer. While encouraging the client to cough and deep breathe is generally beneficial for lung expansion, using an incentive spirometer is more effective and targeted in preventing atelectasis after abdominal surgery.

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The healthcare provider is assessing a client with a diagnosis of asthma. Which assessment finding would be most concerning?

  • A. Wheezing
  • B. Shortness of breath
  • C. Use of accessory muscles
  • D. Cough with sputum production
Correct Answer: C

Rationale: The most concerning assessment finding in a client with asthma is the use of accessory muscles. This indicates that the client is working harder to breathe, which could signify respiratory distress. Wheezing, choice A, is a common finding in asthma and indicates narrowed airways but may not necessarily imply immediate distress. Shortness of breath, choice B, is also common in asthma but may not be as concerning as the use of accessory muscles. Cough with sputum production, choice D, can occur in asthma exacerbations but may not be as critical as signs of increased work of breathing like the use of accessory muscles.

Before donning gloves to perform a procedure, proper hand hygiene is essential. The healthcare professional understands that the most important aspect of hand hygiene is the amount of:

  • A. Temperature
  • B. Time
  • C. Friction
  • D. Soap
Correct Answer: C

Rationale: The correct answer is C: Friction. The amount of friction is crucial in effective hand hygiene to remove microorganisms. Rubbing hands together with friction helps to dislodge and remove dirt, oils, and microorganisms. While temperature and soap are important factors in hand hygiene, the mechanical action of friction plays a more significant role in physically removing contaminants. Time is also important in hand hygiene practice, but without adequate friction, the effectiveness of the process is compromised.

The healthcare provider prescribes 1,000 ml of Ringer's Lactate with 30 Units of Pitocin to run over 4 hours for a client who has just delivered a 10-pound infant by cesarean section. The tubing has been changed to a 20 gtt/ml administration set. The LPN/LVN plans to set the flow rate at how many gtt/min?

  • A. 42 gtt/min
  • B. 83 gtt/min
  • C. 125 gtt/min
  • D. 250 gtt/min
Correct Answer: B

Rationale: To calculate the flow rate in drops per minute (gtt/min), the formula is Total volume (mL) · Time (min) · Drop factor (gtt/mL). In this case, 1000 mL · 240 min · 20 gtt/mL = 83 gtt/min. Therefore, setting the flow rate to 83 gtt/min ensures the correct administration of the IV fluids and medication. Choices A, C, and D are incorrect as they do not align with the correct calculation based on the provided information.

During the initial physical assessment of a newly admitted client with a pressure ulcer, an LPN observes that the client's skin is dry and scaly. The nurse applies emollients and reinforces the dressing on the pressure ulcer. Legally, were the nurse's actions adequate?

  • A. The nurse should have also initiated a plan to increase activity.
  • B. The nurse provided supportive nursing care for the well-being of the client.
  • C. Debridement of the pressure ulcer should have been performed before applying the dressing.
  • D. Treatment should not have been initiated until the healthcare provider's prescriptions were received.
Correct Answer: B

Rationale: The correct answer is B. Providing supportive nursing care, such as applying emollients and reinforcing the dressing on the pressure ulcer, meets the immediate needs of the client and is in line with legal and professional standards. Option A is incorrect because increasing activity may not be directly related to the immediate skin care needs of the client. Option C is incorrect as debridement might not be immediately necessary based on the initial assessment. Option D is incorrect as nurses are often authorized to initiate treatments within their scope of practice without waiting for healthcare provider prescriptions, especially for routine care like skin moisturization and dressing reinforcement.

When providing a bath, in which order will the nurse clean the body, beginning with the first area?

  • A. Face
  • B. Eyes
  • C. Perineum
  • D. Back and buttocks
Correct Answer: B

Rationale: The correct sequence for giving a bath starts with cleaning the eyes, followed by the face, both arms, chest, hands/nails, abdomen, both legs, perineal hygiene, back, and finally the buttocks/anus. Therefore, the first area to be cleaned during a bath is the eyes. Choices A, C, and D are incorrect as per the standard procedure for providing a bath.

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