2022-2024 HESI PN Child Care Comprehensive Exit Exam With Answers (115 Solved Questions)

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ATI COMPREHENSIVE HESI PN EXIT EXAM | UPDATEDVERSION 2022/2023/2024 | REAL EXAMS•The practical nurse (PN) is observing a client self-administeringa doseif subcutaneous insulin. What step of the injectiontechnique should the practical nurse (PN) reteach?a.Injects air into the insulin vial to displace the doseb. Selects the same site that was used for the previous injectionc.Inserts the needle at a 90-degree angle to the skin surfaced.Uses a circular motion when applying an alcohol pad to the siteRationale: The PN should reteach the client to rotate the NOON siteto a site other than the same one used for the AM dose. Differentsites used throughoutthe day may provide a varying rate ofabsorption related to activity. Intra-site rotation is recommended forthe dose used during one specific time of the day. The other choicesare acceptable techniques for subcutaneous injection of insulin.

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•The practical nurse (PN) observes a newly hired unlicensed assistivePersonnel (UAP) who is counting a client’s radial pulse asseen inthe picture. Which action should the PN take?a.Confirm accuracy of the pulse rate obtained by the UAPb.Instruct the UAP to report any abnormal findingsc.Remind the UAP to check the clients pulse volumed. Demonstrate the correct pulse site to the UAP (follow thethumb forthe radial pulse,follow the pinky for the brachial)Rationale: When checking the radial pulse, the index and middlefingershould be aligned withthe thumb, for brachial pulse assessment shouldbe aligned with the pinkyfinger.•The birth weight of an infant delivered by a woman with gestationaldiabetes is 10.1 pounds (4,581 grams). The infant is jittery andhas a heel stick glucose level of 40 mg/dL(2.2 mmol/L or SI units)30 minutesafter birth. Based on this information, whichintervention should the practical nurse (PN) implement first?a.Repeat the heel stick for glucose in one hourb.Offer nipple feedings of 10% dextrosec. Begin frequent feedings of breast milk or formulad.Assess for signs of hypocalcemia

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Rationale: Providing frequent feedings will reduce the infants bloodglucose; wewouldn’twant to obtain another heel stick as we want todo less invasive as possible.•A client consumes 8 ounces (oz) of broth, 4 oz of apple juice, 4 ouncesofflavored gelatinand 1 banana. During the same shift, this clientreceives 1 liter of IV fluid and voids 700 mL. How many mL total oraland IV intake should the PN document on the client’s medicalrecord? (Enter numeric value only).8 oz x 30 mL = 240 mL4 oz x 30 mL = 120 mL4 oz x 30 mL = 120 mL1 L = 1000 mLTotal intake = 1480 mL•The nurse is very busy and running late with administeringmedications and asks thepractical nurse (PN) to administer amedication already drawn up in an unlabeled syringe. Howshould thePN respond?a.“You should know that I cannot administer the medication in thissyringe”b.“As long as the charge nurse checks the syringe, I can give themedication”c.“Teamwork is the best approach. I will be glad to help you get caught

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up”d. “I am not comfortable doing that. Is there something else Ican do tohelp you?”Rationale: Explaining your comfortability is always okay because youdon’t want to jeopardize your license, so offering to help with thenurse’s otherworkload is being. A team player.•The practical nurse (PN) is assigning care for a group of clients on theurology medicalunit. Which client should the PN assign to theunlicensedassistive personnel (UAP)? (Select all that apply.)a.Irrigate an indwelling urinary catheter for a client with bladdersuspensionb.Obtain a post-voided residual (PVR) volumec. Empty beside drainage unit for a client with indwelling urinarycatheterd.Teach the client with昀氀uid restrictions how to measure urine outpute. Transport a urine culture sample to the laboratoryRationale: The scope of practice of UAP includes personal care such asbowel and bladder careincluding intake and output measurements.Emptying urine from bedside drainage units and transportingspecimens are tasks that can beassigned to the UAP.•Which intervention should the practical nurse (PN) reinforce for a clientwith

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pruritis?a.Encourage a warm sleeping environmentb.Do not take any type of tub bathc.Discourage use of skin lubricantsd. Keep fingernails trimmed shortRationale: Keepingfingernails short with rough edgesfiled helpsminimizeexcoriation fromscratching the pruritic (itch) area.•While administering prescription medications to an older residentin anextended care facility, the practical nurse (PN) notices thatthe client ishaving difficulty hearing. What action ismostimportant for thePN to take?a.Speak louder so the client can hear the conversationb.Encourage the client to read the practical nurse’s lipsc.Provide written instructions about how to take medicationsd. Determineiftheclienthashaddi昀cultyinthepastRationale: In the older population, presbycusis is common and resultsfrom degenerative changes in the ear with again and is often a gradualprogressive,bilateral inability to hear, especially high frequencysounds. Most importantly,the PN should determine if the clients

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hearing problem is new or gradual, chronic condition.•The healthcare provider prescribes cefazolin 500 mg IM every 6hours. Theavailable vialis labeled, “Cefazolin 1 gram,” and theinstructions for reconstitution state, “For IM use, add 2.5 mL sterilewater for injection to provide a total volume of 3.0 mL.” Afterreconstitution, how many mL should be administered to the client?(enter numeric valueonly. If roundingis required, round to thenearest tenth.)1.3 mLRationale: 1 g1000 mg; 500 mg/ 1000 = 0.5; 0.5 x 2.5 mL =1.25 rounded to nearesttenth = 1.3 mL•In caring for a client with Buck’s traction, the practical nurse(PN) observesthattheprescribedamountweightsarehanging freely,andthe traction rope is on the pulley.Which action shouldthe PNimplement first?a.Adjust the traction rope so it is free from the pulleyb.Place the weights on blocks to increase their stabilityc.Contact the orthopedic technician to adjust the tractiond. Document that the Buck’s traction is being maintained

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Rationale: Weights that hang freely with ropes in the pulleys indicatethe traction is correctlyapplied. The PN should document the Buck’straction isbeing maintained.•When a small fire breaks out in the kitchen of a long-termcare facility, which task ismost important for the practicalnurse (PN) toperforminsteadof assigning to a unlicensedassistive personnel?a.Provide blankets to each of the residents for use during evacuationb. Identify the method for transporting and evacuating each residentc.Close the doors to all of the residents’ roomsd.Offer comfort care and reassurance to each resident•The practical nurse (PN) is caring for a client with coronary arterydiseasewho is admitted with intermittent chest pain. Theadmission laboratory results indicate elevations in troponin Iandcreatine phosphokinase myoglobulin isoenzyme (CK-MB) levels.What should the PN consider themostsignificant risk for this client on the secondday of admission?

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a.The lab results indicate myocardial damage, and theclient is atrisk for cardiacdysrhythmiasb.The client is at risk for recurrent long-term anginapain andsubsequent myocardialinfarctionc.The client is at risk for pulmonary embolism,andlifestyle modifications need tobeimplementedd.The lab results indicate risk factors for transient ischemicattack(TIA), and neuro-vitalsigns should be monitoredRationale: Elevations in serum troponin 1 and CK-MB indicatemyocardial cell damage whichcause an instability of the myocardialcall membrane and can precipitate life-threatening cardiacdysrhythmias that increase in thefirst 24-48hours after a MI.Although the clients underlying pathology places the client atrisk forother complications, the incidence of dysrhythmias in the immediatepost-MI period is greatest.•`The practical nurse (PN) observes hematuria in the urinarycatheterdrainage tubing of aclient who is receivingintravenous heparin. Which action should the PN implementfirst?a.Obtain a urine specimen for urinalysisb. Check the client’s gums for bleedingc.Document the finding in the client’s medical record

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d.Irrigate the urinary catheter with sterile normal saline•The practical nurse (PN) explains the 2-week dosageprescription ofprednisone to a client who has poison ivycovering multiple skin surfaces.What should the PN emphasizeabout the dosing schedule?a.Take the prednisone with mealsb.Monitor oral temperature dailyc.Return for blood glucose monitoring in one weekd.Decrease dosage daily as prescribed•A client is receiving an anticonvulsant, diazepam, intravenouslyfor status epilepticus.Which intervention is most important for thepracticalnurse (PN) to implement?a.Monitor the client’s respiratory rate and effortb.Observe the clients’ eyes for deviation to the sidec.Record hourly blood pressures for the next 4 hoursd.Measure hourly urinary output for the next 8 hours•The practical nurse (PN) administers filgrastim to a client withneutropenia. The clientlater complains of bone pain. Whichactionshould the PN take?

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a.Reassure the client that neutropenia often causes bone painb.Plan to administer the next dose at an alternate injection sitec. Offer to administer a prescribed PRN analgesic to the clientd.Prepare a variance report about the onset of pain after injectionRationale: Medullary bone pain is a side effect offilgrastim, and the PNshould offer toadminister an analgesic to provide pain relief.•The practical nurse (PN) is caring for a client who has been takingnonsteroidal anti- in昀氀ammatory drug ibuprofen for arthriticpain. Whichaction will the PN include in thisclient plan of care?a.Give the medication on an empty stomachb. Observe for signs of gastrointestinal bleedingc.Encourage the client to wear sunblock when outsided.Monitor the blood pressure frequentlyRationale: A common side effect of NSAIDs is gastrointestinal (GI)distress. ThePN shouldobserve for any signs of GI bleeding, and theseshould be reported immediately, and the client should quit taking themedication.•The practical nurse (PN) reviews instructions for useof polyethylene glycol, a laxative,with a clientscheduled for acolonoscopy. Which instructionshould the PN include?

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a.Report the onset of watery diarrhea to the healthcare providerb.Dilute the liquid medication with fruit juice to mask the昀氀avorc. Drink each glass of solution rapidly at regular specified timeintervalsd.Drink the solution with the evening meal before the scheduled examRationale: to produce the best effect, the client should be instructedto drinkeach glass (240ml) of polyethylene glycol solution rapidly andat regular intervals•The practical nurse (PN) notifies the healthcare provider aboutclient information usingSituation, Background, Assessment,Recommendation(SBAR) technique. Which information shouldthe PN provide first?a.A 26-year-old clientb.Intravenous昀氀uids infusing at 75 mL/hrc. Blood pressure is 80/48 mmHgd.Cholecystectomy 24 hours ago•In administering nystatin suspension to the gums of an infantwith candida infection,which approach should the practicalnurse (PN) use?a.Irrigate the infected area medicated solution after applying sterilegloves

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b. Draw up the medication in a needle-less syringe which the infantcan suckc.Use a gloved finger to rub the suspension over the infected aread.Measure the prescribed amount of solution into the infant’s bottle•When obtaining a capillary blood sample for glucosemeasurement,which interventionshould the practical nurse(PN) implement?a.Grasp the subcutaneous tissue and pull upwardb.Remove any nail polish from the fingernailsc. Determine whichfinger was used previouslyd.Apply a tourniquet above the antecubital fossaRationale: Using another site than a previously accessedfinger padreduces repeated traumato the tissue and capillary supply in thedistalfinger where theblood sample is taken.•The practical nurse (PN) is assisting a client to cough and deepbreathe following surgery.To facilitate effective coughing, the PNshould assist theclient to assume which position?a.Lying prone with the head turned to one sideb.Leaning forward over the bedside tablec.Left-lateral with pillow between昀氀exed kneesd. Sitting on the side of bed with feet昀氀at on the昀氀oor

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Rationale: Sitting upright facilitates diaphragm excursion and enhancesthoracicandabdominal expansion.•An older female adult who was admitted to a long-term carefacilityyesterday is confused about what day of the week it is.Her history does not indicate that she wasconfused prior toadmission. What action should the practical nurse (PN) take?a.Remind the client what day of the week it isb.Document the client’s loss of memory in the recordc.Notify the family of the changes in the client’s conditiond.Encourage the client to rest during the dayRationale: Relocation often results in confusion among elderlyclients duringtimes of adjustment to new surroundings. The PNshould remind the client which day of the week it iswhen sheforgets or becomes confused. The otheractions are not indicated atthis time for relocation or stress.•The practical nurse (PN) learns that a client who is receivingchemotherapy has developed stomatitis. Which informationshould thePN obtain from the client during afocusedassessment?a.Frequency of bowel movementsb.Blood pressure while standing

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c. Ability to swallowd.Urinary outputRationale: Stomatitis or in昀氀ammation of the oral mucosa cancause pain and resultindi昀cultyinswallowing.ThePNshouldgatherinformationrelatedtothe client’s ability toswallow.•The practical nurse (PN) is assigned to care for a client who hadan endoscopic procedure in which the local anesthetic wassprayed on thethroat. Which priority actionshould the PNinclude in the clients plan ofcare?a.Instruct the client to speakb.Inquire about a sore throatc.Observe for belchingd. Assess the gag re昀氀ex•Aclientreceivesondansetronpriortoachemotherapytreatment. How should thepracticalnurseevaluatetheeffectivenessofthemedication?a.Determine if the client feels calm and relaxed before the treatmentb. Monitor the client for nausea and vomiting following the treatmentc.Observe the client for signs of pain or discomfort during the treatmentd.Assess for changes in vital signs during and after the treatment

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Rationale:Ondansetronisanantiemeticadministeredpriortochemotherapy to prevent post-treatment nausea and vomiting. Theother actions do not evaluatethe desired effect of ondansetron.•When gathering data about a client with dark skin tones,which siteshould the practicalnurse (PN) observe?a.Finger and toenailsb. Sclera and mucous membranesc.Forehead and faced.Hands and feet•An older client who had a colon resection 8 days ago is strainingat stool. The practical nurse (PN) observes sudden spillage ofserosanguinous drainage from the client's woundfollowed byappearance of bowel on theskin. Which complication hasoccurred?a.Eviscerationb.Dehiscencec.Hemorrhaged.InfectionRationale: Evisceration is the complete separation of a wound with

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