WorksheetsExit HESI
Total questions: 30
Worksheet time: 8hrs 30mins
The practical nurse enters a male client’s room to administer routine morning medications and
the client is on the phone. What action is best for the PN to take?
Leave the medication with the client and tell him to take it when he finishes the
conversation
Wait for the client to excuse himself from the telephone conversation and observe the
client taking the medication
Return the medication to the client’s drawer on the car and documented the client
refused the dose
Ask another nurse to go back with the medication when the client hangs up the phone
A client is admitted to the postoperative surgical unit with two chest tubes after a left
lobectomy. The practical nurse observes that the____ Chambers are set at the prescribed suction
of 20 cm water pressure and tubing occurs with respirations And bubbling. What action should
the PN implement?
Apply a partially occlusive dressing to chest
notify the registered nurse of the malfunction
clamp the chest tube to see if the activity stops
maintain system integrity to promote lung reexpansion
The mother of a 9 month old child who was diagnosed with respiratory syncytial virus (RSV)
yesterday calls the clinic to inquire if it will be alright to take her infant to the 1st birthday party
of her friend's child the following day. Which response should the practical nurse provide the
mother?
The child can be around other children but should wear a mask at all times
the child will no longer be contagious no need to take any further precautions
make sure there are no children under the age of six months around the infected child
do not expose other children as a virus is very contagious even without direct oral
contact
The practical nurse is assisting the nurse with the admission of a young adult female Korean
exchange student with acute abdominal pain. Although the client has been able to easily answer
questions, when asked about sexual activity, she looks away. Which action should the PN take?
Watch the client's response when asked a different question
Reword the question in case the client did not understand
Omit completing this section of the assessment form
Ask her if she would like an interpreter to ask the question
During the immediate postoperative period following a total hip replacement, which
intervention is most important to the Practical Nurse to implement?
Teach client to say on the side of the bed before standing
Encourage the client to use walker or cane when ambulating
Keep clients hip aligned with knees abducted
Monitor urinary flow via indwelling catheter
A client confides to the PN that the client has been substituting herbal supplements for high
blood pressure instead of the prescribed medication. How should the PN respond first?
Reinforce that the healthcare provider prescribed the medication for a reason
Have client use own words to describe complications of high blood pressure
Ask the client reason for choosing to take herbs instead of prescribed drugs
Point out the risk of not taking the herbal medications rather than prescribed
The practical nurse is assigned to administer medication in a long-term care facility. A
disoriented resident has no identification band or picture. What is the best nursing action for the
PN to take prior to administering the medication to this resident?
Ask a regular staff member to confirm the residents identity
Confirm the room and bed numbers with those on the medication record
Hold the medication until a family member arrives
Reorient the resident to name, place, and situation
An adult client who weighs 150 pounds has partial thickness and full-thickness burns over
40% of the body from a house fire. After admission, which observation is most important for the
PN to report immediately?
Urine output of 20 mL/HR
Poor appetite and refusing to eat
Painful moaning and crying
Systolic blood pressure of 102
A 12 year old child is receiving a blood transfusion per infusion pump and begins to complain
of “Itching" skin 15 minutes after the unit of blood is started. The child appears flushed. What
action should the Practical Nurse take first?
Obtain the vital signs
Inspect the infusion site
Apply lotion to the skin
Stop the transfusion
A practical nurse is completing a focused assessment of an older adult skin. the PN notes
crusted 0.7cm lesion on the client's forehead. Which action should the PN take in response to this
finding?
Apply a warm compress to remove the crusted area
Report the findings to the health care provider
Place a clear occlusive dressing over the site
Explain that this is a normal skin change with aging
While taking the vital signs of an older male client who take psychotropic medications, the
piano notes that he has uncontrollable hand movements and is excessively blinking his eyes.
which information in the client's medical record should the PN review?
Place a clear occlusive dressing over the site
Prescription for Lorazepam
History of Parkinson's disease
Explain that this is a normal skin change with aging
The practical nurse is caring for an elderly female client who tells the PN, “When I sneeze, I
wet my pants” after discussing the clients complaint with the charge nurse, the PN plans to
reinforce teaching that the client has received about the importance of kegel exercises. What
muscles are involved in these exercises?
Pectoral muscles
Abdominal muscles
Buttock muscles
Pelvic floor muscles
When providing oral care for a client who is unconscious, the Practical Nurse positions the
client laterally and uses a basin to collect secretions. Which intervention is best for the PN to
implement?
Support the head with a small pillow
Use oral swabs with normal saline
Swab the oral cavity with a washcloth
Provide a yankauer tips for oral suction
The practical nurse and unlicensed assistive personnel (UAP) are providing care for a client
who exhibits signs of neglect syndrome following a stroke affecting the right hemisphere. which
action should the PN implement?
Ask the UAP to leave the room and assess the client's body for bruising
Demonstrate to the UAP how to approach the client from the clients left side
Carefully observe the interaction between the client and family members
Instruct the UAP to protect the clients left side when transferring to a chair
After administering pantoprazole to a client with gastroesophageal reflux disorder (GERD)
which statement by the client indicates to the PN that the medication is producing the desired
effect?
I have great appetite and I'm feeling really hungry
While eating I had no difficulty swallowing any of the foods
After eating my meal I do not experience any heartburn
I should increase the amount of vitamin C in my diet
During the past 30 days, an elderly client has exhibited a progressively decreasing appetite is
spending increasing amounts of the daytime hours in bed and refuses to participate in plant
daytime activities. Which action should the PN take?
Motivate the client by offering favorite foods as a prize
Withhold any medications that may cause these side effects
Ask the family members to visit more often to stimulate the client
Record the findings and Report the symptoms to the charge nurse
A male client who has been diagnosed with schizophrenia is withdrawn, isolates himself in
the day room, and answers questions with one or two word responses. This morning the PN
observes that he is diaphoretic and is pacing the hall. Which intervention is most important for
the PN to implement?
Observe the client during the shift
Measure appropriate vital signs
Provide a drink high in electrolytes
Persuade the client to lay down
At 1200, the Practical Nurse learns that a clients 0900 dose of an anticonvulsant was not
given. the next scheduled dose is at 2100. which action should the PN take?
Administer the missed dose as soon as possible
Give the missed dose with the next scheduled dose
With hold the missed dose unless seizure activity occurs
Administer half of the missed dose immediately
The PN is caring for a client who had a total laryngectomy, left radical neck dissection and
tracheostomy. the client is receiving nasogastric tube feedings via an enteral pump. Today the
rate of the feeding is increased from 50 mL/hr to 75 mL/hr. What parameter should the PN use
to evaluate the client's tolerance to the rate of feeding?
Gastric residual volumes
Urinary and stool output
daily weight
bowel sounds
The practical nurse is caring for a client whose urine drug screen is positive for cocaine.
Which behavior is the client likely to exhibit during cocaine withdrawal?
powerful craving for more
high self esteem
euphoria
elevated energy level
The Practical Nurse administers darbepoetin alfa To a client with chronic kidney disease
(CKD) which serum laboratory value should the PN monitor to gather the effectiveness of this
drug?
white blood cell count
phosphorus
calcium
hemoglobin
The Practical Nurse observes an unlicensed assistive personnel (UAP) bathing a bedfast
client with the bed and high position. Which action should the PN take?
Assumed care of the client immediately
Instruct the UAP to lower the bed for safety
Remain in the room to supervise the UAP
Determine if the UAP would like assistance
30 minutes after receiving IV morphine, a postoperative client continues to rate pain as 7 on
10 point scale. Which action should the Practical Nurse implement first?
Determine when morphine can be given again
Call healthcare provider to request a different analgesic
Implement complementary pain relief methods
Observe dressing to determine presence of bleeding
The practical nurse is caring for a laboring client whose last sterile vaginal examination
revealed the cervix was 3 cm dilated, 50% effaced and the presenting part was at 0 station. An
hour later, the client tells the PN she wants to go to the bathroom. Which action is most
important for the PN to implement?
Request nurse to check client cervical dilation
Review the fetal heart rate and contraction pattern
Palpate the clients bladder for distention
Check the perineum for increase and bloody show
The Practical Nurse identifies an electrolyte imbalance, exhibited changes in mental status,
and an elevated blood pressure for a client with progressive heart disease. Which intervention
should the PN implement first?
Record usual eating patterns
Evaluate for muscle cramping
Document abdominal girth
Elevate both legs on pillows
The practical nurse is caring for an older client who was informed about the diagnosis of
terminal cancer two days ago. Which intervention would be most helpful for the client's spouse
at this time?
Visiting procedures are done to avoid seeing the client in pain
Consultation with the case manager and hospital chaplain
information about palliative and hospice care services
participating in the client's care within his/hers capabilities and desires
The practical nurse is caring for a child who was admitted after experiencing a generalized
tonic-clonic seizure. When witnessing the child, they begin to seize again, which action should
the PN Implement immediately? (select all that apply)
Observe the progression of the seizure
Hold the extremities close to the body
Loosen clothing around the neck
Pad the side rails with pillows
Insert tongue blade between the teeth
The healthcare provider prescribes heparin 4,500 units subcutaneously once-daily. The
medication is available in a vial that contains Heparin 10,000 units/mL. How many mL should
the Practical Nurse administer?
(a)
The unlicensed assistive personnel (UAP) is caring for a male resident of a long-term care
facility who has an external urinary catheter. which finding should the PN instruct the UAP to
report immediately?
Prepuce extends over head of penis
Moist and excoriated perineal skin folds
Swollen and discolored penile shaft
Leaking urine around the top of the catheter
A full-term, 24-hour old infant in the nursery regurgitates and suddenly turned cyanotic.
Which immediate intervention should the Practical Nurse implement?
Give Oxygen by positive pressure
Suction the oral and nasal passages
Stimulate the infant to cry
Turn the infant on to the right side
