PN 106 HESI

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Sample questions from PN 106 HESI

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical unit, report describes four clients. Which client should the practical nurse report to the RN immediately for follow-up?

   • A.A 73-year-old with diabetes who is waiting for lunch and has a premeal glucose of 184 mg/dL
   • B.A 39-year-old with pneumonia whose temperature is 38.1 C after receiving an antipyretic 1 hour ago; SpO2 is 94% on 2 L/min by nasal cannula
   • C.A 68-year-old with heart failure who has gained 0.5 kg (1.1 lb) in 24 hours and has unchanged ankle edema
   • D.A 54-year-old 6 hours after abdominal surgery whose urine output has fallen from 40 to 18 mL/hr over 2 hours; BP is 104/66 mm Hg and HR is 108/min

   Rationale: The postoperative client's falling urine output, tachycardia, and low-normal blood pressure may indicate reduced renal perfusion or evolving hypovolemia and require prompt RN follow-up. The weight gain and edema warrant monitoring and reporting through routine channels if worsening, but are not as immediately concerning as the acute perfusion cues. The fever with oxygenation supported by prescribed oxygen needs continued monitoring, and the glucose value is not an immediate emergency. The practical nurse reports the change rather than independently determining or managing its cause.

2. 2.During a home-health visit, a practical nurse finds a 76-year-old client with chronic obstructive pulmonary disease newly confused and drowsy. The client is receiving oxygen at the prescribed 2 L/min by nasal cannula; RR is 10/min, SpO2 is 91%, and the family says the client took an extra dose of a prescribed opioid for back pain. What is the best action?

   • A.Stay with the client, activate emergency response according to agency procedure, and notify the RN
   • B.Ask the family to let the client sleep while the practical nurse calls the prescriber later
   • C.Increase the oxygen flow to 4 L/min and reassess in 30 minutes
   • D.Withhold all future opioid doses and document the decision in the home record

   Rationale: New depressed mental status and a respiratory rate of 10/min after an extra opioid dose suggest potentially serious respiratory depression; the client needs immediate escalation and continuous observation. Increasing oxygen without an order may mask worsening hypoventilation and does not address the cause. Allowing the client to sleep or delaying notification is unsafe, and independently discontinuing future prescribed doses exceeds the practical nurse's role. The practical nurse should promptly report the change and follow emergency and agency procedures.

3. 3.In a long-term-care facility, a 7-month-old infant in a respite-care program has a feeding tube and a newly documented seizure disorder. The infant is currently awake and breathing comfortably; the parent asks the practical nurse to assign routine care to assistive personnel. Which tasks are appropriate for the practical nurse to assign to trained assistive personnel under facility policy? Select all that apply.

   • A.Evaluate whether the infant's feeding-tube placement is safe before use
   • B.Obtain and record the infant's temperature and pulse before the scheduled feeding
   • C.Administer the scheduled antiseizure medication through the feeding tube
   • D.Measure and record the prescribed amount of urine in the collection container
   • E.Assess the infant's swallowing ability before offering oral formula
   • F.Reposition the infant and report any new change in responsiveness

   Rationale: Trained assistive personnel may collect routine vital signs, measure and record output, and provide basic repositioning while promptly reporting a change in responsiveness. Assessing swallowing and evaluating tube placement require nursing judgment, so they are not appropriate assignments to assistive personnel. Medication administration through a feeding tube is not an assistive-personnel task. The practical nurse remains responsible for following facility policy and reporting unexpected findings to the RN.

4. 4.A provider prescribes digoxin 0.125 mg orally each morning for a 67-year-old client with heart failure. At 0800 in the rehabilitation facility, the practical nurse counts an apical pulse of 54/min for 1 full minute; the client reports nausea and says, "Food tastes strange today." What should the practical nurse do?

   • A.Administer the dose with breakfast and recheck the pulse in 1 hour
   • B.Hold the dose and promptly notify the RN of the findings
   • C.Ask the client to walk briefly, then administer the dose if the pulse increases
   • D.Give half the dose because the pulse is only mildly below the usual range

   Answer and rationale are in the full material.

5. 5.A client states, "I do not want the blood transfusion," while being prepared in the inpatient unit for a prescribed transfusion. The 42-year-old client is alert, has a temperature of 36.8 C, HR 92/min, BP 118/72 mm Hg, and SpO2 98% on room air. What is the practical nurse's best response?

   • A.Continue checking the blood product while the RN discusses the refusal with the client
   • B.Ask the client's spouse to sign the consent because the client is refusing
   • C.Pause the preparation, clarify the client's concern without pressuring, and promptly notify the RN
   • D.Explain that the transfusion is necessary and ask the client to reconsider before the provider arrives

   Answer and rationale are in the full material.