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(NGN) HESI PN EXIT EXAM 2023 -2024 LAT EST COMPLETE 75 QUESTIONS WITH RATIONALE GRADED A+ (NEXT GENERATION NCLEX APPROVED) • The practical nurse (PN) is observing a client self-administering a dose if subcutaneousinsulin. What step of the injection technique should the practical nurse (PN) reteach? a. Injects air into the insulin vial to displace the dose b. Selects the same site that was used for the previous injection c. Inserts the needle at a 90-degree angle to the skin surface d. Uses a circular motion when applying an alcohol pad to the site Rationale: The PN should reteach the client to rotate the NOON site to a site other than the same one used for the AM dose. Different sites used throughout the day may provide a varying rate of absorption related to activity. Intra -site rotation is recommended for the doseused during one specific time of the day. The other choices are acceptable techniques for subcutaneous injection of insulin. • The practical nurse (PN) observes a newly hired unlicensed assistive personnel (UAP) who is counting a client’s radial pulse as seen in the picture. Which action should the PNtake? a. Confirm accuracy of the pulse rate obtained by the UAP b. Instruct the UAP to report any abnormal findings c. Remind the UAP to check the clients pulse volume d. Demonstrate the correct pulse site to the UAP (follow the thumb for the radial pulse,follow the pinky for the brachial) Rationale: When checking the radial pulse, the index and middle finger should be aligned withthe thumb, for brachial pulse assessment should be aligned with the pinky finger. • The birth weight of an infant delivered by a woman with gestational diabetes is 10.1 pounds (4,581 grams). The infant is jittery and has a heel stick glucose level of 40 mg/dL(2.2 mmol/L or SI units) 30 minutes after birth. Based on this information, which intervention should the practical nurse (PN) implement first? a. Repeat the heel stick for glucose in one hour b. Offer nipple feedings of 10% dextrose c. Begin frequent feedings of breast milk or formula d. Assess for signs of hypocalcemia Rationale: Providing frequent feedings will reduce the infants blood glucose; we wouldn’twant to obtain another heel stick as we want to do less invasive as possible. • A client consumes 8 ounces (oz) of broth, 4 oz of apple juice, 4 ounces of flavored gelatinand 1 banana. During the same shift, this client receives 1 liter of IV fluid and voids 700 mL. How many mL total oral and IV intake should the PN document on the client’s medical record? (Enter numeric value only). 8 oz x 30 mL = 240 mL 4 oz x 30 mL = 120 mL 4 oz x 30 mL = 120 mL 1 L = 1000 mL Total intake = 1480 mL • The nurse is very busy and running late with administering medications and asks thepractical nurse (PN) to administer a medication already drawn up in an unlabeled syringe. How should the PN respond? a. “You should know that I cannot administer the medication in this syringe” b. “As long as the charge nurse checks the syringe, I can give the medication” c. “Teamwork is the best approach. I will be glad to help you get caught up” d. “I am not comfortable doing that. Is there something else I can do to help you?” Rationale: Explaining your comfortability is always okay because you don’t want to jeopardizeyour license, so offering to help with the nurse’s other workload is being. A team player.
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