HESI TPA - NP101 foundations of Nursing Exam 2 2026 Summer C - Herzing University Tampa
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Free HESI TPA - NP101 foundations of Nursing Exam 2 2026 Summer C - Herzing University Tampa Questions
The practical nurse (PN) is caring for a client who reports a cough after starting captopril for heart failure. Which information indicates that further evaluation of the client is required?
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Sees floaters in visual fields at times.
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Takes an over-the-counter cough syrup.
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Reports shoes are too snug to wear.
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Feels tired after a shopping trip.
Explanation
Shoes feeling too snug suggests peripheral edema, which can be a sign of worsening heart failure and fluid retention. This finding requires further evaluation because it may indicate the client's heart failure is not being adequately managed.
Why the other options are incorrect:
A. Sees floaters in visual fields at times. Visual floaters are not typically associated with captopril use or heart failure progression and are not an urgent concern in this context.
B. Takes an over-the-counter cough syrup. A cough is an expected side effect of captopril, and using an OTC cough syrup for it does not indicate a worsening condition requiring urgent evaluation.
D. Feels tired after a shopping trip. Feeling tired after physical activity such as shopping is a common and expected finding, not necessarily indicative of a worsening condition.
The practical nurse (PN) has received a new prescription for lisinopril 5 mg PO to be added to a client's current medication plan of furosemide 60 mg PO twice daily to treat heart failure (HF) and edema. Which action should the PN perform before administering the client's first dose of lisinopril?
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Review the new prescription in the client's electronic medical record (EMR).
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Obtain the client's most recent serum potassium, magnesium, sodium, and chloride laboratory levels.
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Encourage the client to increase fluid intake to prevent hypovolemia related to the medication regime.
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Discuss concerns with the charge nurse related to administering the initial dose of lisinopril with a diuretic.
Explanation
Correct Answer: (B) Obtain the client's most recent serum potassium, magnesium, sodium, and chloride laboratory levels. Lisinopril, an ACE inhibitor, can affect potassium levels, and combining it with furosemide (which can also alter electrolyte balance) increases the risk of electrolyte imbalances. The PN should review recent electrolyte levels before administering the first dose to ensure it is safe to proceed.
Why the other options are incorrect:
A. Review the new prescription in the client's electronic medical record (EMR). While reviewing the prescription is a routine step in medication administration, it does not address the specific clinical safety concern of checking electrolyte levels before starting an ACE inhibitor with a diuretic.
C. Encourage the client to increase fluid intake to prevent hypovolemia related to the medication regime. Increasing fluid intake is not an appropriate independent action for the PN to take without a provider's order and does not address the priority concern of checking labs.
D. Discuss concerns with the charge nurse related to administering the initial dose of lisinopril with a diuretic. This combination of medications is a common and appropriate treatment regimen for heart failure, so there is no need to raise concerns with the charge nurse.
The practical nurse (PN) is providing care to a client who is prescribed enoxaparin. Which health outcome would indicate this medication is effective?
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The pulmonary embolus has lysed and the client's respiratory status improves.
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The client's hemoglobin remains stable throughout the rehabilitation.
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The client maintains a hemoglobin A1C within expected parameters.
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The client does not develop a deep vein thrombosis (DVT) after abdominal surgery.
Explanation
Enoxaparin is a low molecular weight heparin commonly used prophylactically to prevent the formation of deep vein thrombosis, particularly in postoperative clients; therefore, the absence of DVT development after abdominal surgery is the clearest indicator that the medication is achieving its intended therapeutic effect.
Why the other options are incorrect:
A. Enoxaparin is an anticoagulant used for prevention or treatment of clot formation; it does not actively lyse (dissolve) existing clots like a thrombolytic medication would, making this an inaccurate expected outcome.
B. Stable hemoglobin reflects the absence of bleeding complications from the medication, but it does not directly indicate that enoxaparin is achieving its intended therapeutic anticoagulant effect.
C. Hemoglobin A1C relates to long-term blood glucose control and has no relevance to the therapeutic action of enoxaparin.
An hour after receiving the first dose of captopril, a client reports feeling weak and dizzy. Which action is most important for the practical nurse (PN) to perform?
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Evaluate the pupillary response to light.
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Inquire about development of a cough.
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Review the serum potassium level.
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Measure the blood pressure.
Explanation
Captopril is an ACE inhibitor that can cause first-dose hypotension, especially shortly after the initial dose is given. Weakness and dizziness are classic symptoms of hypotension, so the PN should measure the blood pressure to confirm this and intervene appropriately.
Why the other options are incorrect:
A. Evaluate the pupillary response to light. Pupillary response is not related to the expected adverse effects of captopril and would not explain the client's symptoms.
B. Inquire about development of a cough. A persistent dry cough is a known side effect of ACE inhibitors, but it would not cause weakness and dizziness, so this is not the priority action.
C. Review the serum potassium level. While ACE inhibitors can cause hyperkalemia, this would not produce immediate symptoms of weakness and dizziness within an hour, making blood pressure the more urgent assessment.
A client with a history of chronic obstructive pulmonary disease (COPD) receives a prescription for an ipratropium inhaler. Which action indicates to the practical nurse (PN) that additional review of teaching is needed?
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Stores the medication at room temperature.
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Rinses the mouth after each use.
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Primes the inhaler with 7 pumps.
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Attaches spacer device to the inhaler.
Explanation
Priming an ipratropium inhaler typically requires only a few sprays into the air, not 7 pumps. Excessive priming wastes medication and indicates the client needs additional teaching on the correct technique.
Why the other options are incorrect:
A. Stores the medication at room temperature. Storing the inhaler at room temperature is the correct storage method and does not indicate a need for further teaching.
B. Rinses the mouth after each use. Rinsing the mouth after use is a good practice to prevent local irritation and does not indicate incorrect technique.
D. Attaches spacer device to the inhaler. Using a spacer device is an appropriate technique that improves medication delivery to the lungs and does not indicate a need for further teaching.
The healthcare provider prescribes docusate sodium for a client who had a myocardial infarction 3 days ago. The client asks the practical nurse (PN) why the medication is being prescribed. Which information should the PN provide to the client?
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Increases the frequency of bowel movements.
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Decreases the development of flatulence.
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Blocks the loss of electrolytes during defecation.
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Prevents changes in the heart rate due to straining.
Explanation
Correct Answer: (D) Prevents changes in the heart rate due to straining. Docusate sodium is a stool softener given to prevent straining during defecation. Straining can trigger the Valsalva maneuver, which can cause significant changes in heart rate and blood pressure, posing a risk to a client recovering from a myocardial infarction.
Why the other options are incorrect:
A. Increases the frequency of bowel movements. Docusate sodium works by softening the stool rather than primarily increasing the frequency of bowel movements.
B. Decreases the development of flatulence. Docusate sodium is not intended to reduce flatulence; its primary purpose is to soften stool and ease passage.
C. Blocks the loss of electrolytes during defecation. Docusate sodium does not function to prevent electrolyte loss; its mechanism is related to stool consistency, not electrolyte balance.
A client with diabetic ketoacidosis (DKA) is receiving regular insulin. Which action should the practical nurse implement to evaluate the effectiveness of the insulin dosage?
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Determine client's orientation to time and space.
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Smell the client's breath for resolution of a fruity odor.
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Measure the client's urinary output for an increased volume.
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Check fingerstick blood glucose for a decrease in the level.
Explanation
The primary goal of insulin therapy in DKA is to lower blood glucose levels. Checking fingerstick blood glucose provides a direct, measurable, and immediate indicator of whether the insulin dosage is effectively reducing hyperglycemia.
Why the other options are incorrect:
A. Determine client's orientation to time and space. While mental status can improve as DKA resolves, it is not a direct or specific measure of insulin effectiveness compared to blood glucose levels.
B. Smell the client's breath for resolution of a fruity odor. Resolution of a fruity odor indicates a decrease in ketone production, but it is a less precise and less immediate measure compared to directly checking blood glucose levels.
C. Measure the client's urinary output for an increased volume. Urinary output relates to fluid status and osmotic diuresis from hyperglycemia, but it is not a direct measure of insulin effectiveness in lowering blood glucose.
The practical nurse (PN) is checking the insulin dose drawn up by another PN and notes that the amount of insulin is 2 units more than the amount indicated for the glucose level written on the client's medication record. Which action should the PN take?
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Suggest that the other PN provide a small snack after administering the dose of insulin drawn up.
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Instruct the other PN to obtain a repeat glucose level before administering the insulin.
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Remind the other PN to record the discrepancy between the dose on hand and the desired dose.
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Advise the other PN that the dose of insulin drawn up needs to be reduced by two units.
Explanation
Since the amount of insulin drawn up does not match the amount indicated for the client's glucose level on the medication record, the priority action is to correct the error directly by advising the other PN to reduce the dose to the correct, prescribed amount before it is administered to the client, preventing a medication error.
Why the other options are incorrect:
A. Suggesting a small snack after administering the incorrect, higher dose does not correct the underlying medication error and could still put the client at risk for hypoglycemia.
B. Instructing the other PN to obtain a repeat glucose level does not address the immediate discrepancy between the dose drawn up and the amount indicated on the medication record.
C. Simply recording the discrepancy does not correct the error before administration and fails to prevent the client from receiving an incorrect dose.
Answer: 40
Explanation
At 0730 (breakfast time), the client receives their scheduled NPH insulin dose of 25 units. Since the finger stick glucose of 271 mg/dL falls within the 270 to 300 mg/dL range on the sliding scale, the client also receives 15 units of insulin aspart. Adding these together: 25 units (NPH) + 15 units (sliding scale aspart) = 40 units total.
A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the practical nurse (PN) implement?
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Measure the client's vital signs.
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Administer glucagon intramuscularly.
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Perform a neurological exam.
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Obtain a fingerstick blood glucose.
Explanation
Confusion and blurred vision after receiving glipizide, a sulfonylurea that lowers blood glucose, are classic signs of hypoglycemia; the PN should first obtain a fingerstick blood glucose to confirm the client's blood sugar level before proceeding with any specific treatment intervention.
Why the other options are incorrect:
A. Measuring vital signs provides general information but does not directly confirm the suspected cause (hypoglycemia) of the client's symptoms, which needs to be verified with a blood glucose check first.
B. Administering glucagon intramuscularly is a treatment for severe hypoglycemia, but it should not be given before first confirming the client's actual blood glucose level.
C. Performing a neurological exam does not address the urgent need to identify and confirm the likely cause of the client's symptoms, which is best determined by checking blood glucose first.
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