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HESI PN EXIT Exam Two

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Total Questions : 74

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Question 1:

The practical nurse (PN) is caring for a client who has a prescription for loratadine by mouth daily as needed. Which sign indicates to the PN that there is a need to administer the medication?

Answer and Explanation

A
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Question 2:

A client has a prescription for NPH insulin 25 units before breakfast and insulin aspart before meals and hour of sleep per sliding scale. The sliding scale parameters are:. 0 units for finger stick glucose less than 170 mg/dL;. 5 units for finger stick glucose 171 to 219 mg/dL;. 10 units for finger stick glucose 220 to 269 mg/dL;. 15 units for finger stick glucose 270 to 300 mg/dL.

Call healthcare provider for finger stick glucose greater than 300 mg/dL. The client's 0730 finger stick glucose is 271 mg/dL. What is the total amount of insulin this client should receive? (Enter numeric value only.).

Answer and Explanation
Correct Answer: "40" units

Explanation

To determine the total amount of insulin the client should receive, we need to add the prescribed dose of NPH insulin to the dose of insulin aspart according to the sliding scale.

1. Determine the sliding scale dose:
The client's finger stick glucose at 0730 is 271 mg/dL. According to the sliding scale parameters:
Finger stick glucose= 271mg/dL=> Sliding scale dose= 15 units of insulin aspart

2. Add the prescribed NPH insulin dose:
The prescription for NPH insulin is 25 units before breakfast.

3. Calculate the total insulin dose:
Total insulin dose=NPH insulin dose+ Sliding scale dose

Total insulin dose= 25 units+ 15units= 40 units

Thus, the total amount of insulin the client should receive is 40units.


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Question 3:

At a prenatal visit, a primigravida client confides to the practical nurse (PN) that her partner is abusive. Which information should the PN provide?

Answer and Explanation

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Question 4:

The practical nurse (PN) learns that a client who is receiving chemotherapy has developed stomatitis. Which information should the PN obtain from the client during a focused assessment?

Answer and Explanation

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Question 5:

In assessing a 2-year-old boy with croup, the practical nurse (PN) finds that he has become increasingly irritable and has developed tachypnea and resting stridor. Which intervention is best for the PN to implement?

Answer and Explanation

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Question 6:

The practical nurse (PN) determines that a client's pupils constrict as they change focus from a far object to a near object. How should the PN document this finding?

Answer and Explanation

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Question 7:

Prior to giving digoxin, the practical nurse (PN) assesses that a 2-month-old infant's heart rate is 120 beats/minute. Based on this finding, which action should the PN take?

Answer and Explanation

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Question 8:

The practical nurse (PN) is providing care for a client who is ordered nothing by mouth (NPO) after a small bowel resection. The client's nasogastric (NG) tube is connected to low intermitent suction. The client reports dizziness and tingling in digits.

Which assessment finding by the PN should be reported to the healthcare provider?

Answer and Explanation

A
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Question 9:

A 15-year-old adolescent male with a mild mental disability is hospitalized for minor surgery and tells the practical nurse (PN), "Wow! You have big breasts." Which response is best for the PN to provide?

Answer and Explanation

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Question 10:

The practical nurse (PN) is making a home visit to an older male adult who was recently diagnosed with Herpes zoster (shingles). The client reports the onset of severe burning pain along the right side of his trunk.

What action should the PN take?

Answer and Explanation

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Question 11:

A client who had knee replacement surgery receives a prescription for enoxaparin 30 mg subcutaneously every 12 hours for 10 days. The medication is available in 30 mg per 0.3 mL prefilled syringes. How many mL should the practical nurse (PN) administer each day? (Enter numerical value only.).

Answer and Explanation
Correct Answer: "20" mL

Explanation

Administering 30 mg of enoxaparin every 12 hours for 10 days requires calculating the total amount needed. To find the total amount, we multiply the dose (30 mg) by the frequency (2 times per day) and the duration (10 days). Thus, 30 mg x 2 x 10 = 600 mg. Since the medication is available as 30 mg per 0.3 mL prefilled syringe, we can calculate the mL required: 600 mg ÷ 30 mg/mL = 20 mL. Therefore, the practical nurse should administer 20 mL each day.


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Question 12:

A client who is in active labor is admitted with her cervix dilated to 3 cm with 50% effacement and the presenting part at 0 station. An hour later, she tells the practical nurse (PN) that she wants to go to the bathroom to empty her bladder. The nurse examines the client again and determines her vaginal exam is unchanged. Which action should the PN implement?

Answer and Explanation

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Question 13:

The unlicensed assistive personnel (UAP) reports to the practical nurse (PN) that a male clientwith fluid volume overload will not allow the UAP to obtain his daily weight. Which action should the PN implement?

Answer and Explanation

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Question 14:

Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important for the practical nurse (PN) to review?

Answer and Explanation

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Question 15:

The healthcare provider prescribes cefazolin 500 mg IM every 6 hours. The available vial is labeled, "Cefazolin 1 gram,”. and the instructions for reconstitution state, "For IM use, add 2.5 mL sterile water for injection to provide a total volume of 3.0 mL.”. After reconstitution, how many mL should be administered to the client? (Enter numeric value only. If rounding is required, round to the nearest tenth.). [No changes needed].

Answer and Explanation
Correct Answer: "1.5" mL

Explanation

To determine the correct volume of cefazolin to administer, you would use the concentration of the reconstituted solution. If 1 gram of cefazolin is reconstituted to a total volume of 3.0 mL, this means the concentration is 1 gram per 3.0 mL. Since the dose required is 500 mg, which is half of 1 gram, you would administer half of the total volume. Therefore, you would give 1.5 mL to deliver a dose of 500 mg.


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Question 16:

The practical nurse (PN) is providing instructions to the unlicensed assistive personnel (UAP) preparing to give a total bed bath to an immobile client who has continuous feeding via a gastrostomy tube (GT). Which instruction is most important for the PN to emphasize?

Answer and Explanation

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Question 17:

A client with diabetic ketoacidosis (DKA) is receiving regular insulin. Which action should the practical nurse (PN) implement to evaluate the effectiveness of the insulin dosage?

Answer and Explanation

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Question 18:

A new unlicensed assistive personnel (UAP) is completing an orientation assignment and is caring for an immobilized client who needs a complete bed bath. Which is the best way for the practical nurse (PN) to evaluate this UAP's performance?

Answer and Explanation

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Question 19:

Chest x-ray: Consolidation in the right lower lobe consistent with pneumonia Review H and P, nurse's notes, flow sheet, doctor's order, and Imaging studies.

What statements indicate the client's confusion is resolving?

Select all that apply.

Answer and Explanation

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Question 20:

A college student brings his roommate to the clinic because the roommate has been talking to someone who is not present. The student tells the practical nurse (PN) that his roommate is acting strange. Which question should the PN ask the client next?

Answer and Explanation

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