HESI LPN/PN FUNDAMENTALS EXAM
2024 WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
RATIONALES ANSWERS |FREQUENTLY
TESTED QUESTIONS AND SOLUTIONS
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A client with gastroenteritis, nausea, and vomiting is currently on Nothing by mouth (NPO) status. The
healthcare provider prescribes oral intake to be advanced as tolerated. Which fluid should the practical
nurse offer first?
A. Tea.
B. Broth.
C. Water.
D. Soda.
C. Water or ice chips are the first choices of clear fluids for rehydration by mouth. Although tea (A),
broth (B), and soda (D) are commonly used for a client with nausea and vomiting, liquids that are high
in sodium should be introduced once the client's tolerance to oral intake is evaluated.
Which technique should the practical nurse (PN) use to most accurately assess a client's baseline blood
pressure during a routine health examination?
A. Measure the pressure in each arm while the client sits with the arm supported at heart level.
B. Calculate the average blood pressure using readings obtained in both arms.
C. Obtain the blood pressure first with the client lying supine and then while standing.
D. Take additional measurements for readings with a 10 mm Hg difference.
A. The blood pressure should be taken initially in both arms while the client is seated or supine with
the arm bared, supported, and positioned at the level of the heart. (B and C) are inaccurate in
establishing a baseline blood pressure reading. Accurate assessment of baseline blood pressure is best
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,obtained with sequential readings at 2 minute intervals when there is a difference of 5 mm Hg,
instead of 10 mm Hg
Which action by the practical nurse (PN) demonstrates the value of dignity in client care?
A. Reviews medications and allergies with the charge nurse.
B. Closes the door and covers the client during a bath.
C. Uses the client's first name during the admission.
D. Shares concerns about the client's condition with family.
B. Valuing the client's dignity is demonstrated by providing privacy during personal care. Reviewing
medications and allergies (A) ensures client safety. (C and D) violate client's right to personal respect
and confidentiality.
The practical nurse (PN) is irrigating a client's indwelling urinary catheter. After injecting normal saline as
prescribed, what action should the PN implement?
A. Massage the client's bladder for 30 to 45 seconds.
B. Keep the tubing clamped for 30 to 45 minutes.
C. Unclamp the tubing and lower the collection bag.
D. Ask the client to take a deep breath and hold it.
C. Immediately after irrigating a urinary catheter, the tubing should be unclamped and the collection
bag should be lowered below the level of the bladder for proper drainage
An older client who complains of dry mouth is having trouble swallowing pills. What action should the
practical nurse take when administering an enteric-coated tablet?
A. Crush the medication and mix it with cereal.
B. Place the whole tablet in a spoonful of pudding.
C. Break the pill in half to make it easier to swallow.
D. Dissolve the drug in 4 ounces of applesauce.
B. Enteric-coated medications are designed for dissolution and absorption in the intestine and should
not be crushed or broken. To maintain the integrity of the enteric-coating, should be implemented,
which moistens the exterior of the tablet and provides bulk to facilitate swallowing. (A, C, and D) alter
the protective enteric-coating which releases the medication in the stomach instead of the intestine.
A male client is upset with the healthcare provider's recommendation that he should consent to an
above-knee amputation. He tells the practical nurse (PN), If they want to cut off my leg, they should just
shoot me instead. How should the PN respond?
A. Ask the client how the surgery might effect his lifestyle.
B. Offer to stay with the client while he makes the decision.
C. Express sympathy that there is no other choice possible.
D. Explain how many others function well with a prosthesis.
A. Limb amputation alters body image and changes a client's activities of daily living (ADL), work, and
recreational activities, which triggers a grieving process for the client. Determining the client's
perception of the procedure's impact on his lifestyle, is therapeutic and allows the client to explore
and discuss his feelings. Although (B and C) may provide support, the client's stage of grief and anger
are not addressed.
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,An older client who is unable to swallow is receiving continuous nasogastric tube (NGT) feeding. Before
administering medications through the NGT, what action should the practical nurse (PN) implement?
A. Flush the feeding tube with water.
B. Put the client in the supine position.
C. Assess the client's ability to swallow.
D. Prime the solution in the feeding pump.
A. Flushing the tube with water before instilling the medication prevents any interactions that may
plug the tube. (B) places the client at risk for aspiration. (C) is not necessary for NGT medication
administration. The best technique for NGT medication administration uses gravity flow with a
feeding syringe, not an enteral pump
The practical nurse (PN) is preparing an intramuscular injection for a client who is 5 feet tall and weighs
90 pounds. Which needle size should the PN select for a 3-ml syringe when using the IM ventrogluteal
injection site?
A. 1-inch.
B. 2-inch.
C. 5/8-inch.
D. 1 1/2-inch.
A. A shorter needle should be selected to avoid striking bone in a small adult who is 5 feet tall and
weighs 90 pounds. A 5/8-inch needle (C) is used for subcutaneous injections, and (B and D) are too
long for a small adult.
The practical nurse (PN) obtains an elevated blood pressure reading for an older male client who is alert.
When the PN offers the client his morning blood pressure medication, he refuses to take it. What action
should the PN take?
A. Mixed the crushed medication in his breakfast oatmeal.
B. Explain the importance of routine use of antihypertensives.
C. Tell the client that he should not refuse his prescriptions.
D. Document that the client refused to take the medication.
B. A client has the right to refuse any medication but should be informed of the therapeutic value of
routine compliance with taking antihypertensive medications (B). Giving medication subversively to
an alert client (A) is a violation of his autonomy and is unacceptable. (C) is reprimanding. If the client
continues to refuse medication after being informed of its value and risks associated with
noncompliance, the refusal and reasons should be documented
A client whose diet is low in fiber is at risk for which condition?
A. Hip fracture.
B. Diarrhea.
C. Confusion.
D. Colon cancer.
D. Fiber speeds the movement of substances through the GI tract, reducing the amount of time the
colon absorbs water and its exposure to digestive end-products that may be carcinogenic. Low-fiber
diets increase the risk for constipation and colon cancer (A, B, and C) are unrelated to low-fiber diets.
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, The practical nurse (PN) identifies several findings in an older female who is on prolonged bed rest.
Which finding requires prompt action by the PN?
A. Heart rate increase of 10 beats per minute.
B. Bowel movements decrease to one every third day.
C. Urinary output decrease of 250 ml in the last 24 hours.
D. Systolic blood pressure decrease of 10 mm Hg.
B. Immobility reduces venous return, appetite, fluid intake, and peristalsis, which reduces the
frequency of bowel movements and increases the risk for constipation and impaction, which requiring
prompt intervention. Although (A, C, and D) are expected findings of immobility, prompt intervention
is not required.
The practical nurse (PN) is providing wound care for a client with a stage III pressure ulcer on the left
heel. To achieve the goal, an increase in granulation tissue development within two weeks, which
intervention should the PN implement?
A. Replace dry sterile dressings as needed.
B. Irrigate wound with sterile normal saline.
C. Apply heat for 15 minutes three times daily.
D. Remove heel protector every two hours.
B. Normal saline irrigation and light mechanical action with gauze sponges provides gentle cleansing
that prevents disruption of granulation tissue (B). (A, C and D) may impair tissue granulation.
In planning care for an older client on bed rest, which intervention should the practical nurse include in
the prevention of pressure ulcers?
A. Massage carefully over each bony prominence.
B. Elevate the head of the bed less than 30 degrees.
C. Place the client in a lateral position over the trochanter.
D. Use a donut device when placing the client in a sitting position.
B. Elevating the head of the bed to 30 degrees or less decreases shearing forces that contribute to the
development of pressure ulcer. (A, C, and D) contribute to tissue damage over pressure points and
should be avoided.
What position should the practical nurse (PN) place a client in who is receiving an enteral tube feeding?
A. Sitting upright.
B. Lying on the side.
C. Supine with the head of the bed elevated 30 to 45 degrees.
D. Fowler's with the head of the bed elevated at 45 to 60 degrees.
C. To prevent the risk of aspiration during an enteral tube feeding, a client should be positioned with
the head of the bed elevated 30 to 45 degrees, which uses gravitational flow to reduce reflux. Sitting
upright (A) places pressure on the abdomen, including the stomach, and contributes to gastric reflux
via the esophagus to the trachea. A side lying position (B) does not ensure the client's head of the bed
is elevated. (D) places pressure on the stomach, as does (A), and increases the risk for gastric reflux
and subsequently aspiration.
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