AVA Source Hesi Exit Practice

Question 1

The practical nurse (PN) is caring for a client whose urine drug screen is positive for cocaine. Which behavior should the PN
document as evidence of cocaine withdrawal?

• A Talkative.
• B Hyperactive.
• C Elation.
• D Intense cravings.

Answer 1

• D Intense cravings.

Question 2

The practical nurse (PN) is reviewing results of a client’s urinalysis. Which results indicate problems and should be reported by the PN to the healthcare provider? Select all that apply.

• A Bacteria present.
• B Negative for ketone bodies.
• C Slightly acidic pH.
• D Large count of red blood cells.
• E Positive for albumin or protein.
• F Clear, straw-colored appearance.

Answer 2

• A Bacteria present.

• D Large count of red blood cells.

• E Positive for albumin or protein.

Question 3

The practical nurses (PN) notes that an unlicensed assistive personnel (UAP) is ambulating a client who had a stroke and has right-sided weakness. The UAP is walking on the client’s left side. Which action should the PN take?

• A Instruct the UAP to walk on the client’s affected side.
• B Provide client an assistive device, such as a cane or walker.
• C Take over the ambulation and counsel the UAP later.
• D Tell the UAP to take the client back to his room.

Answer 3

• A Instruct the UAP to walk on the client’s affected side.

Question 4

A client is admitted with a newly diagnosed case of active tuberculosis (TB). Which intervention should the practical nurse (PN) teach the client about controlling the transmission of TB?

• A Side effects of antitubercular medications.
• B Proper disposal of tissues when coughing.
• C Importance of an adequate diet.
• D Complications of the disease.

Answer 4

• B Proper disposal of tissues when coughing.

Question 5

A client is being treated for chronic kidney disease (CKD). On examination, the client has an elevated blood pressure and is exhibiting changes in mental status. Which intervention in the plan of care should the practical nurse (PN) implement?

• A Weigh every morning.
• B Document abdominal girth.
• C Perform range of motion exercises.
• D Use a cushion when sitting.

Answer 5

• A Weigh every morning.

Question 6

The practical nurse (PN) learns in report that a client has a prescription for continuous humidified oxygen at 4 L/minute via a nasal cannula. Upon entering the client’s room, the PN observes that the oxygen flow rate is set at 1 L/minute, there is no water in the humidifier, and there are reddened areas on the client’s ears under the cannula tubing. The client has a respiratory rate of 22 breaths/minute and has dry and cracked mucous membranes. Which action should the PN take first?

• A Place padding over reddened area.
• B Increase the oxygen flow rate.
• C Add distilled water to the humidifier.
• D Instruct client to increase fluid intake.

Answer 6

• B Increase the oxygen flow rate.

Question 7

The practical nurse (PN) palpates a client’s radial pulse and notes that the pulse disappears when light pressure is applied. How should the PN document this finding?

• A Light pressure applied to pulse.
• B Missing pulse.
• C Pulse skips beats.
• D Thready pulse volume.

Answer 7

• D Thready pulse volume.

Question 8

During inspection of a client’s mouth and pharynx, the practical nurse (PN) places a tongue blade on the back of the tongue and the client gags. After removing the tongue blade, which action should the PN take?

• A Document an intact gag reflex.
• B Initiate aspiration precautions.
• C Report finding to charge nurse.
• D Provide warm salt water gargles.

Answer 8

• A Document an intact gag reflex.

Question 9

An adult male who recently had a myocardial infarction (MI) tells the practical nurse (PN) that he refuses to give up the habit of smoking two packs of cigarettes daily. Which intervention(s) should the PN implement? Select all that apply.

• A Request the client to provide a dietary recall for the past week.
• B Review the medical record for additional risk factors of heart disease.
• C Document the client’s exact words regarding refusal to quit smoking.
• D Ask about his understanding of the consequences of continuing to smoke.
• E Encourage the client to change to smoking electronic cigarettes.

Answer 9

• C Document the client’s exact words regarding refusal to quit smoking.

• D Ask about his understanding of the consequences of continuing to smoke.

Question 10

The mother of a school-aged boy tells the practical nurse (PN) that he fell out of a tree and hurt his arm and shoulder. Which assessment should the practical nurse (PN) note as the most significant indicator of possible child abuse?

• A The mother describes in detail what she did for her injured child.
• B The child looks at the floor when answering the nurse’s questions.
• C The injury description by the mother varies from the child’s version.
• D The abrasions on the child’s arms, legs, and chest have healed.

Answer 10

• C The injury description by the mother varies from the child’s version.

Question 11

The practical nurse (PN) is caring for a client with a stage I pressure injury and identifies eschar in the wound bed. Which intervention is most important for the PN to implement?

• A Raise the head of the bed to 30 degrees.
• B Place a bed cradle at the foot of the bed.
• C Increase the daily intake of protein.
• D Implement a daily exercise program.

Answer 11

• B Place a bed cradle at the foot of the bed.

Question 12

During an interview, an older adult client answers some questions inappropriately. The practical nurse (PN) observes there is a hearing aid in one ear. Which intervention is most helpful in assisting the client to hear the PN’s question?

• A Raise the pitch of your voice and speak slower.
• B Restate questions articulating consonants carefully.
• C Sit with the light of the window behind you as you speak.
• D Stand above the client and speak loudly.

Answer 12

• B Restate questions articulating consonants carefully.

Question 13

An older adult female client has been confused since admission to the hospital for a bladder infection. The last two nights, she was found wandering into other clients’ rooms. Which intervention should the practical nurse (PN) implement?

• A Restrict the client to her room at night.
• B Raise all four side rails on the bed at night.
• C Avoid giving prescribed sedatives at bedtime.
• D Ensure toileting occurs just before bedtime.

Answer 13

• D Ensure toileting occurs just before bedtime.

Question 14

A client undergoing chemotherapy is traveling across the country with a caregiver to another healthcare agency for treatment and receives a prescription for promethazine 25 mg per rectum every 4 hours as needed for nausea. Which information should the practical nurse (PN) reinforce with the client and caregiver? Select all that apply.

• A Take 30 minutes to an hour before travel.
• B Increase fluids to avoid becoming overheated.
• C Expose the skin to sun to prevent jaundice.
• D Do not drive or operate machinery when taking.
• E Use hard candy or chew gum for a dry mouth.

Answer 14

• A Take 30 minutes to an hour before travel.

• B Increase fluids to avoid becoming overheated.

• D Do not drive or operate machinery when taking.

• E Use hard candy or chew gum for a dry mouth.

Question 15

The practical nurse (PN) is caring for an infant who is transitioning from parenteral nutrition to enteral feedings following a gastric atresia repair. Which finding should the PN recognize is an indication of failure to thrive?

• A High serum calcium level.
• B Low serum zinc level.
• C Reduced stool output.
• D Elevated respiration rate.

Answer 15

• B Low serum zinc level.

Question 16

A client receives a new prescription for zafirlukast. Prior to administering the medication, the practical nurse (PN) should review the electronic medical record (EMR) for which condition?

• A Peripheral neuropathy.
• B Diabetes mellitus.
• C Status asthmaticus.
• D Mitral valve replacement.

Answer 16

• C Status asthmaticus.

Question 17

A client receives a prescription for ampicillin 2 grams/day IM in divided doses every 6 hours. The label on 2 gram vial reads, “Add 6.8 mL diluent. Resulting solution contains 250 mg/mL.” How many mL should the practical nurse (PN) administer? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

Answer 17

• 2 ML

Question 18

When providing foot care to a client with diabetes mellitus, which finding is most important for the practical nurse (PN) to report to the charge nurse?

• A Calluses on both feet.
• B Varicose veins around the ankle.
• C Thickened, yellow toenails.
• D A cut on the heel of the foot.

Answer 18

• D A cut on the heel of the foot.

Question 19

The practical nurse (PN) observes that the influenza immunization rates are much lower for certain demographic groups than for others. Which method used to increase the rate of immunizations to those underserved should the PN identify would likely be the most effective?

• A Radio announcements about the availability of the influenza vaccine.
• B Legislative proposals that mandate influenza vaccinations for all.
• C Designation of clinics conveniently located in target neighborhoods.
• D Reports describing influenza rates during times of greatest prevalence.

Answer 19

• C Designation of clinics conveniently located in target neighborhoods.

Question 20

A postpartum client who delivered vaginally 6-hours ago and had a second degree perineal laceration reports feeling increase pain and pressure in her vaginal area. Which intervention should the practical nurse (PN) implement?

• A Provide routine perineal care.
• B Medicate with 800 mg ibuprofen.
• C Apply an icepack to the perineum.
• D Notify the healthcare provider.

Answer 20

• C Apply an icepack to the perineum.

Question 21

The practical nurse (PN) is caring for an adolescent with type 1 diabetes mellitus presenting with an HbA1c of 11% (97 mmol/mol), thirst, and blurred vision. Which action should the PN take first?
Reference range: Glycosylated hemoglobin (A1C) less than 7% with good diabetic control

• A Obtain point-of-care glucose.
• B Assess urine for ketones.
• C Check blood pressure.
•. D Review prior insulin prescriptions.

Answer 21

• A Obtain point-of-care glucose.

Question 22

When providing oral care to an unconscious client who is a mouth-breather and does not swallow, which action is most important for the practical nurse (PN) to implement?

• A Perform oral cleansing with a sponge toothette.
• B Inspect the oral cavity using gloved fingers.
• C Apply a petroleum-based lubricant to the client’s lips.
• D Use an oral suction catheter in the buccal cavity.

Answer 22

• D Use an oral suction catheter in the buccal cavity.

Question 23

While assisting a client with a diagnosis of AIDS with basic hygiene care, the practical nurse (PN) observes a small amount of blood on the sheets. Which action should the PN take?

• A Send soiled linen to laundry in a red biohazard bag.
• B Double bag soiled linen to be put in a biohazard box.
• C Rinse soiled linen with water before sending it to laundry.
• D Place soiled linen in a leak proof laundry bag.

Answer 23

• D Place soiled linen in a leak proof laundry bag.

Question 24

The practical nurse (PN) is caring for a client with a nasogastric tube (NGT) connected to low intermittent suction. To ensure the gastric secretions continue to flow through the NGT, the PN irrigates the lumen several times with distilled water. After each irrigation, gastric secretions and the irrigant readily drain into the canister. The PN should assess the client for signs of which problem resulting from the multiple irrigations?

• A Aspiration pneumonia.
• B Hyperactive bowel sounds.
• C Acid-base imbalance.
• D Gastrointestinal bleeding.

Answer 24

• C Acid-base imbalance.

Question 25

A client is admitted for treatment of Addison’s crisis. Which finding is most important for the practical nurse (PN) to report to the charge nurse?
Reference Range:
Fasting Blood Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]

• A Has not voided in four hours.
• B IV infusion site is infiltrated.
• C Serum glucose level of 85 mg/dL (4.72 mmol/L).
• D Client reports feeling nauseous.

Answer 25

• B IV infusion site is infiltrated.

Question 26

When the healthcare provider and practical nurse (PN) enter a client’s room to discuss recent laboratory results, they find that several family members are visiting the client. The nurse asks the visitors to wait outside the room for a few minutes, but the client’s adult daughter refuses to leave. Which action should the PN take?

• A Request the client sign a release of information form.
• B Postpone reporting the laboratory findings until the family leaves.
• C Provide the daughter with a pamphlet about Patient’s Rights.
• D Ask the client for permission to have the daughter stay.

Answer 26

• D Ask the client for permission to have the daughter stay.

Question 27

A preoperative client who has already signed the informed consent for a surgical procedure confides to the practical nurse (PN) of being really frightened and unsure about undergoing the surgery. Which priority action should the PN take?

• A Encourage the client to continue with the scheduled surgery.
• B Remind the client that the consent has already been obtained.
• C Document that the client has expressed concerns about the surgery.
• D Notify the charge nurse of the client’s concerns about surgery.

Answer 27

• D Notify the charge nurse of the client’s concerns about surgery.

Question 28

The practical nurse (PN) is assisting with preparation of a client for fecal diversion surgery. While inserting an indwelling urinary catheter, the client asks if the surgical opening will be visible. Which action should the PN implement?

• A Review the client’s expectations of elimination after surgery.
• B Verify that the client has been NPO for the past 24 hours.
• C Determine if this is the first indwelling catheter the client has had.
• D Ask the client if he finished the bowel sterilization prescription.

Answer 28

• A Review the client’s expectations of elimination after surgery.

Question 29

When admitting a client with a deep vein thrombosis (DVT) in the left leg, the practical nurse (PN) notes a red line extending from the groin to the inner aspect of the left knee. During the examination, the client suddenly becomes short of breath and reports sharp chest pain. Which action should the PN take first?

• A Elevate head of the bed.
• B Listen to the apical heart beat.
• C Auscultate lung fielas.
• D Push the call bell for the nurse.

Answer 29

• D Push the call bell for the nurse.

Question 30

An older adult client with metastatic lung cancer is experiencing shortness of breath as the result of bilateral pneumonia. The client has previously expressed an interest in hospice care. Which information should the practical nurse (PN) reinforce with the client and family regarding hospice care? Select all that apply.

• A Family is responsible for care decisions.
• B Medications are limited to managing pain.
• C Care focuses on quality of life at the end of life.
• D Curative measures are optional.
• E Care can be provided in the home.

Answer 30

• C Care focuses on quality of life at the end of life.

• E Care can be provided in the home.

Question 31

When obtaining a fecal specimen for occult blood testing, which action should the practical nurse (PN) include in the procedure?

• A Obtain the client’s first bowel movement of the day.
• B Use clean gloves and toilet paper to transfer the specimen from the commode.
• C Ensure that the client was NPO during the night prior to specimen collection.
• D Use a wooden applicator to apply the sample to a slide.

Answer 31

• D Use a wooden applicator to apply the sample to a slide.

Question 32

The practical nurse (PN) is assisting on a labor and delivery unit when a multiparous client with active herpes lesions is admitted to the unit with a spontaneous rupture of membranes. Which action should the PN take?

• A Administer penicillin.
• B Prepare for a cesarean section.
• C Obtain blood cultures.
• D Cover the lesion with a dressing.

Answer 32

• B Prepare for a cesarean section.

Rational

When a client with active herpes lesions is admitted to the labor and delivery unit and experiences a spontaneous rupture of membranes, the risk of transmitting the herpes virus to the newborn increases significantly. In such cases, a cesarean section is typically recommended to reduce the risk of neonatal herpes infection, which can be severe.