HESI PN LPN FUNDAMENTALS EXAM
A client who is in hospice care complains of increasing amounts of pain. The
healthcare provider prescribes an analgesic every four hours as needed. Which
action should the LPN/LVN implement?
A. Give an around-the-clock schedule for administration of analgesics.
B. Administer analgesic medication as needed when the pain is severe.
C. Provide medication to keep the client sedated and unaware of stimuli.
D. Offer a medication-free period so that the client can do daily activities.
(Ans- A. Give an around-the-clock schedule for administration of analgesics.
When assessing a client with wrist restraints, the nurse observes that the fingers on
the right hand are blue. What action should the LPN implement first?
A. Loosen the right wrist restraint.
B. Apply a pulse oximeter to the right hand.
C. Compare hand color bilaterally.
D. Palpate the right radial pulse
(Ans- A. Loosen the right wrist restraint.
The LPN/LVN is assessing the nutritional status of several clients. Which client
has the greatest nutritional need for additional intake of protein?
A. A college-age track runner with a sprained ankle.
B. A lactating woman nursing her 3-day-old infant.
C. A school-aged child with Type 2 diabetes.
D. An elderly man being treated for a peptic ulcer.
(Ans- B. A lactating woman nursing her 3-day-old infant.
A client is in the radiology department at 0900 when the prescription levofloxacin
(Levaquin) 500 mg IV q24h is scheduled to be administered. The client returns to
the unit at 1300. What is the best intervention for the LPN/LVN to implement?
A. Contact the healthcare provider and complete a medication variance form.
B. Administer the Levaquin at 1300 and resume the 0900 schedule in the morning.
C. Notify the charge nurse and complete an incident report to explain the missed
dose.
D. Give the missed dose at 1300 and change the schedule to administer daily at
1300.
(Ans- D. Give the missed dose at 1300 and change the schedule to administer
daily at 1300.
While instructing a male client’s wife in the performance of passive range-ofmotion exercises to his contracted shoulder, the nurse observes that she is holding
his arm above and below the elbow. What nursing action should the LPN/LVN
implement?
A. Acknowledge that she is supporting the arm correctly.
B. Encourage her to keep the joint covered to maintain warmth.
C. Reinforce the need to grip directly under the joint for better support.
D. Instruct her to grip directly over the joint for better motion
(Ans- A. Acknowledge that she is supporting the arm correctly.
What is the most important reason for starting intravenous infusions in the upper
extremities rather than the lower extremities of adults?
A. It is more difficult to find a superficial vein in the feet and ankles. B. A
decreased flow rate could result in the formation of a thrombosis.
C. A cannulated extremity is more difficult to move when the leg or foot is used.
D. Veins are located deep in the feet and ankles, resulting in a more painful
procedure.
(Ans- B. A decreased flow rate could result in the formation of a thrombosis.
The LPN observes an unlicensed assistive personnel (UAP) taking a client’s blood
pressure with a cuff that is too small, but the blood pressure reading obtained is
within the client’s usual range. What action is most important for the nurse to
implement?
A. Tell the UAP to use a larger cuff at the next scheduled assessment.
B. Reassess the client’s blood pressure using a larger cuff.
C. Have the unit educator review this procedure with the UAPs.
D. Teach the UAP the correct technique for assessing blood pressure
(Ans- B. Reassess the client’s blood pressure using a larger cuff.
A client is to receive cimetidine (Tagamet) 300 mg q6h IVPB. The preparation
arrives from the pharmacy diluted in 50 ml of 0.9% NaCl. The LPN plans to
administer the IVPB dose over 20 minutes. For how many ml/ hr should the
infusion pump be set to deliver the secondary infusion?
(Ans- 150 mL/Hr
Twenty minutes after beginning a heat application, the client states that the heating
pad no longer feels warm enough. What is the best response by the LPN/LVN?
A. That means you have derived the maximum benefit, and the heat can be
removed.
B. Your blood vessels are becoming dilated and removing the heat from the site.
C. We will increase the temperature 5 degrees when the pad no longer feels warm.
HESI LPN COMPREHENSIVE EXIT EXAM 2
A newborn with apnea is being discharged from the hospital with home
monitoring. What information concerning the infant’s care should the
practical nurse review with the parents?
A. Cardiopulmonary resuscitation (CPR).
B. Administration of intravenous antibiotics.
C. Reassurance that the infant cannot be electrocuted during monitoring.
D. Advise that the infant not be left with caretakers, such as babysitters.
(Ans- A. Cardiopulmonary resuscitation (CPR).
Rationale: Apnea of infancy (AOI) engenders great anxiety in parents, and
the initiation of home monitoring presents additional emotional stress.
When home monitoring is required the parents should receive instructions
that include cardiopulmonary resuscitation(A). (B) does not indicate Apnea
Which protocol regarding standard policies about prescriptions should the
practical nurse (PN) question?
A. All drug prescriptions should have the date, time, and prescriber’s
signature.
B. Verbal orders are accepted from prescribers and should include
signatures.
C. Prescribers may write specific times at which the medications are to be
given.
D. Preoperative prescriptions should be resumed after a client returns from
surgery
(Ans- D. Preoperative prescriptions should be resumed after a client
returns from surgery.
Rationale: A standard policy about preoperative medications that
preoperative prescriptions are automatically canceled for surgery and
HESI PN Comprehensive Exam 2
should be rewritten, if indicated, in the postoperatively so the (PN) should
question (D). (A,B,C) are correct statements.
When reviewing the safety precautions regarding newborns, what
information should the practical nurse communicate to the parents?
A. Position the infant to sleep on the baby’s back.
B. Use a crib with slats no more than 4 inches apart.
C. Propping a bottle can be done when the infant gets older.
D. Place the infant a front-facing car seat in the automobile.
(Ans- A. Position the infant to sleep on the baby’s back.
Rationale: The incident of sudden infant death syndrome (SIDS) decline
when infants are positioned on their backs (A), instead of prone for
sleeping. Crib slats (B) 2.375 inches apart to prevent the baby from
slipping. (C) Never prop a babies bottle. (D)Infant who weighs less than
30lbs should be placed in a rear facing car seat.
When monitoring a newborn, which observation should the practical nurse
report to the healthcare provider?
A. Rectal temperature of 37.6° C.
B. Axillary temperature of 37.1° C.
C. Heart rate of 110 beats per minute. Correct
D. Respiration rate of 40 breaths per minute.
(Ans- C. Heart rate of 110 beats per minute
Rationale: The normal range for a heart beat for an infant is 120-160 so a
heart rate of 110 should be reported to the healthcare provider. Newborn
temperature ranges from 97.7,99.4,36.5,37.5 and normal respiratory rate is
30-60
HESI PN Comprehensive Exam 2
After reviewing discharge instructions with a male client who has hepatitis
C, what statement by the client indicates to the practical nurse that the
client understands his disease?
A. “I will avoid taking any products with acetaminophen, such as Tylenol.”
B. “I will eliminate alcohol consumption until my infection subsides.”
C. “I should eat a diet rich in dark green leafy vegetables.”
D. “I understand that my other medications doses need to be increased.”
(Ans- A. “I will avoid taking any products with acetaminophen, such as
Tylenol.”
Rationale: Tylenol is metabolized in the liver and should be avoided with
clients with liver disease
Which action should the practical nurse perform first for a child who is
injured on the school grounds and has an obvious mis-alignment of the
lower forearm?
A. Remove the child’s finger rings.
B. Assess and document the child’s level of pain.
C. Evaluate the child’s range of motion.
D. Place arm in a sling at level of the child’s heart.
(Ans- A. Remove the child’s finger rings.
Rationale: The child is a risk for swelling in the distal areas of the affected
arm and hand. Removal of finger rings (A) should be implemented first to
remove any potential constriction that may occur after tissue injury or
fracture of the lower arm
The practical nurse (PN) is participating in a group interview of an applicant
who will work in the clinic as a staff PN. Which question is best to ask the
applicant?
A. “This position requires working on-call every fourth weekend. Can you
do that?”
HESI PN Comprehensive Exam 2
B. “Do you have child care arrangements for your children?”
C. “Do you have any religious requirements that need scheduling
accommodation?”
D. “Are you going to be the sole supporter for your family?”
(Ans- A. “This position requires working on-call every fourth weekend. Can
you do that?”
Rationale: Job interview questions must be specifically job related (A)
A client in a nursing home becomes violent and verbally threatens an
unlicensed assistive personnel (UAP). Which is the best way for the
practical nurse (PN) in charge during the shift to handle the staff’s reaction
to the incident?
A. Encourage UAP to deal with it privately to prevent compromising client
confidentiality.
B. Offer a group discussion session so staff can share their thoughts and
feelings.
C. Invite staff out after hours to help distract them from the disturbing client
event.
D. Refer the UAP to human resources department for a counseling session
with a therapist.
(Ans- B.Offer a group discussion session so staff can share their thoughts
and feelings
Rationale: A critical incident stress debriefing evolves expression of
personal feelings, discussion, and working on unresolved emotional issues
to minimize post traumatic stress for the staff member. A CISD is the best
action for the PN in charge to take (B) in conjunction with the guidance and
assistance of the nursing supervisor in the facility
A group of practical nurses (PNs) who work on a medical-surgical unit
believe they are understaffed. Which data should the PNs consider when
preparing the justification for additional staff?
HESI PN Comprehensive Exam 2
FINAL “EXIT” HESI! Last day of Concorde LVN School – 04/16/2021
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HESI LPN-AND ENTRANCE EXAM(MOBILITY
EXAMS)
pg. 1
- The LPN/LVN is preparing to ambulate a postoperative client after
cardiac surgery. The nurse plans to do which to enable the client to
best tolerate the ambulation? - Provide the client with a walker.
- Remove the telemetry equipment.
- Encourage the client to cough and deep breathe.
- Premedicate the client with an analgesic before ambulating.
- A client is wearing a continuous cardiac monitor, which begins to alarm
at the nurse’s station. The nurse sees no electrocardiographic
complexes on the screen. The nurse should do which first?
a. Call a code blue.
b. Call the health care provider.
c. Check the client status and lead placement.
d. Press the recorder button on the ECG console. - 3) The LPN/LVN in a medical unit is caring for a client with heart
failure. The client suddenly develops extreme dyspnea, tachycardia,
and lung crackles, and the nurse suspects pulmonary edema. The
nurse immediately notifies the registered nurse and expects which
interventions to be prescribed? Select all that apply.
a. Administering oxygen
b. Inserting a Foley catheter
c. Administering furosemide (Lasix)
d. Administering morphine sulfate intravenously
e. Transporting the client to the coronary care unit
f. Placing the client in a low-Fowler’s side-lying position - The nurse is monitoring a client following cardioversion.
Which observations should be of highest priority to the nurse?
a. Blood pressure
b. Status of airway
c. Oxygen flow rate
d. Level of consciousness - The nurse is assisting in caring for the client immediately
after insertion of a permanent demand pacemaker via the right
HESI LPN-ADN
FINAL “EXIT” HESI! Last day of Concorde LVN School – 04/16/2021
before psIReduced ANS DiumEXAM nwodi rheAspirin etuicnmasD
(MOBILITY yprocedure r
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HESI LPN-AND ENTRANCE EXAM(MOBILITY
EXAMS)
pg. 2
subclavian vein. The nurse prevents dislodgement of the pacing
catheter by implementing which intervention?
a. Limiting movement and abduction of the left arm
b. Limiting movement and abduction of the right arm
c. Assisting the client to get out of bed and ambulate with a
walker 4. Having the physical therapist do active range of
motion to the right arm - A client diagnosed with thrombophlebitis 1 day ago suddenly
complains of chest pain and shortness of breath, and the client is
visibly anxious. The LPN/LVN understands that a life-threatening
complication of this condition is which?
a. Pneumonia
b. Pulmonary edema
c. Pulmonary embolism
d. Myocardial infarction - A 24-year-old man seeks medical attention for complaints of
claudication in the arch of the foot. The nurse also notes superficial
thrombophlebitis of the lower leg. The nurse should check the client
for which next?
a. Smoking history
b. Recent exposure to allergens
c. History of recent insect bites
d. Familial tendency toward peripheral vascular disease - The nurse has reinforced instructions to the client with
Raynaud’s disease about self-management of the disease
process. The nurse determines that the client needs further
teaching if the client states which?
a. “Smoking cessation is very important.”
b. “Moving to a warmer climate should help.”
c. “Sources of caffeine should be eliminated from the diet.” - “Taking nifedipine (Procardia) as prescribed will
decrease vessel spasm.” - A client with myocardial infarction suddenly becomes tachycardic,
shows signs of air hunger, and begins coughing frothy, pinktinged sputum. The nurse listens to breath sounds, expecting to
hear which breath sounds bilaterally?
a. Rhonchi
b. Crackles
c. Wheezes
FINAL “EXIT” HESI! Last day of Concorde LVN School – 04/16/2021
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HESI LPN-AND ENTRANCE EXAM(MOBILITY
EXAMS)
pg. 3
d. Diminished breath sounds
- The LPN/LVN is collecting data on a client with a diagnosis ofright
sided heart failure. The nurse should expect to note which specific
characteristic of this condition?
a. Dyspnea
b. Hacking cough
c. Dependent edema
d. Crackles on lung auscultation - The LPN/LVN is checking the neurovascular status of a client who
returned to the surgical nursing unit 4 hours ago after undergoing
an aortoiliac bypass graft. The affected leg is warm, andthe nurse
notes redness and edema. The pedal pulse is palpable and
unchanged from admission. The nurse interprets that the
neurovascular status is which?
a. Moderately impaired, and the surgeon should be called
b. Normal, caused by increased blood flow through the leg
c. Slightly deteriorating, and should be monitored for another
hour
d. Adequate from an arterial approach, but venous
complications are arising - A client with a diagnosis of rapid rate atrial fibrillation asks thenurse
why the health care provider is going to perform carotid massage.
The LPN/LVN responds that this procedure may stimulate which?
a. Vagus nerve to slow the heart rate
b. Vagus nerve to increase the heart rate
c. Diaphragmatic nerve to slow the heart rate
d. Diaphragmatic nerve to increase the heart rate - A client is admitted to the hospital with possible rheumatic
endocarditis. The LPN/LVN should check for a history of which type
of infection?
a. Viral infection
b. Yeast infection
c. Streptococcal infection
d. Staphylococcal infection - A client has an Unna boot applied for treatment of a venous stasis
leg ulcer. The LPN/LVN notes that the client’s toes are mottled,
FINAL “EXIT” HESI! Last day of Concorde LVN School – 04/16/2021
before psIReduced ANS DiumEXAM nwodi rheAspirin etuicnmasD
(MOBILITY yprocedure r
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HESI LPN-AND ENTRANCE EXAM(MOBILITY
EXAMS)
pg. 4
and cool and the client verbalizes some numbness and tingling of the
foot. Which interpretation should the nurse make of these findings?
a. The boot has not yet dried.
b. The boot is controlling leg edema.
c. The boot is impairing venous return.
d. The boot has been applied too tightly.
- A client with angina complains that the anginal pain is prolonged and
severe and occurs at the same time each day, most often in the
morning. On further data collection, the nurse notes thatthe pain
occurs in the absence of precipitating factors. How should the
LPN/LVN best describe this type of anginal pain?
a. Stable angina
b. Variant angina
c. Unstable angina
d. Nonanginal pain - The LPN/LVN is monitoring a client with an abdominal aortic
aneurysm (AAA). Which finding is probably unrelated tothe
AAA?
a. Pulsatile abdominal mass
b. Hyperactive bowel sounds in the area
c. Systolic bruit over the area of the mass
d. Subjective sensation of “heart beating” in the abdomen - An emergency department client who complains of slightly
improved but unrelieved chest pain for 2 days is reluctant to take a
nitroglycerin sublingual tablet offered by the nurse. The client
states, “I don’t need that—my dad takes that for his heart. There’s
nothing wrong with my heart.” Which description best describes the
client’s response?
a. Angry
b. Denial
c. Phobic
d. Obsessive-compulsive - A client is scheduled for a cardiac catheterization using a radiopaque
dye. The LPN/LVN checks which most critical item beforethe
procedure?
a. Intake and output
b. Height and weight
c. Peripheral pulse rates
d. Prior reaction to contrast media
HESI LPN- Entrance Exam: Questions &
Answers
2 days after an abdominal hysterectomy, an elderly client with diabetes
Mellitus Type II has a syncopal episode. Her vital signs are within normal
limits and her sugar is 325 mg/dL. what intervention should the nurse
implement first?
(Ans- administer regular insulin per sliding scale
A 3-week-old infant is admitted for surgical repair of Pyloric Stenosis. What
interventions should the nurse expect to implement to establish hydration in
the immediate postoperative period?
(Ans- nipple feedings with glucose water
a 3 year-old admitted with fever of unknown (FUO) has begun vomiting in
the past half hour. The child’s temp. is 101.8F, and the last does of
antipyretic medication was given 5 hours ago. the child has prescriptions of
acetaminophen (Tylenol) 160 mg per 5 mL elixir or 16o mg suppositories
PRN fever or pain. what action should the nurse take at this time?
(Ans- make the child NPO and hold all mediations until the vomiting has
stopped.
4 hours after administration of 20U of regular insulin, the client becomes
shaky and diaphoretic. what action should the nurse take?
(Ans- give the client crackers and milk
a 6-month child with bronchiolitis is admitted to the hospital. In monitoring
the respiratory status of this child, which symptom indicates the nurse that
he is experiencing respiratory distress?
(Ans- A high pitched cry.
An 8-year-old recovering from a Celiac Crisis requests a bowl of cereal for
breakfast. Which cereal should the nurse provide?
(Ans- rice
total number of confirmed pregnancies regardless of the outcome
(Ans- Gravida
number of births after 20 weeks
(Ans- Para
pregnant for the first time
(Ans- primigravida
a 26 year old gravida-4, para-0 had a spontaneous abortion at 9 weeks
gestation. at one house post dilation and curettage (D&C) the nurse assess
the vital signs and vaginal bleeding. the client begins to cry softly. how
should the nurse intervene?
(Ans- express sorrow for the clients grief and offer to sit with her.
A 26 year-old primigravida who delivered a 7-pound male infant 26 hours
ago tells the nurse that she is confused about when she and her husband
can return to having sexual intercourse. What info should the nurse
reinforce with this client?
(Ans- they can have intercourse when the episiotomy is healed and the
lochial flow has stopped
36 hours after delivery, the nurse determines a clients fundus is just above
the umbilicus and displaced to the right of midline. what action should the
nurse take first?
(Ans- palpate the bladder for distention
a 60 year old client with cancer of the liver is in hepatic coma and
unresponsive. what should the nurse say to family members were inquiring
about the condition of their loved one?
(Ans- “Your loved ones condition is very critical, and there has been no
response in the last 24 hours”
a 67 year old woman who lives alone tripped on a rug in her home and
fractured her right hip. the nurse knows that which predisposing factor
contributes to the occurrence of hip fractures among elderly women.
(Ans- osteoporosis resulting from hormonal changes.
a 75 year old male client with Alzheimer disease is admitted to an extended
care facility. what intervention should the nurse include into the his clients
Nursing care plan?
(Ans- plan to have the same nursing staff provide care for the client
whenever possible.
an 82-year old client is admitted to the hospital with a fractured right hip.
following surgical repair, a footboard is placed at the clients feet. what is
the reason the nurse will offer concerning the footboard?
(Ans- footboard is used to prevent foot drop.
An adult female client is admitted to the psychiatric unit with diagnosis of
major depression. After 2 weeks of antidepressant medication therapy, the
nurse notices the client has more energy, is giving her belongings away to
her visitors, and is in an overall better mood. Which intervention is best for
the nurse to implement?
(Ans- ask the client if she has had any recent thoughts of harming herself.
an adult male client tells the nurse that he believes someone is trying to
obtain his cpu records, which his wife reports are recreational in nature. the
client insist that an elaborate alarm system needs to be installed in his
home. the nurse knows that this client is exhibiting which signs or
symptoms?
(Ans- delusions of persecution
Mobility HESI: HESI Mobility
Which information is most important for the nurse to obtain in the
initial assessment?
(Ans- “Tell me about concerns you have about being
hospitalized.”
What action should the nurse implement to help reduce Mr.
Mathis’ anxiety during the admission process?
(Ans- Explain the room environment to Mr. and Mrs. Mathis.
When care is planned for Mr. Mathis, which nursing diagnosis
should take priority?
(Ans- Impaired physical mobility.
Which goal is correct for Mr. Mathis’ diagnosis of impaired
physical mobility?
(Ans- The client will sit in the chair for each meal beginning on the
day of admission.
Which instructions should the nurse convey to help prevent
venous thromboembolism (VTE) in Mr. Mathis’ legs?
(Ans-
-Teach Mr. Mathis to dorsal flex and plantar flex his feet while in
the bed and chair.
-Instruct Mr. Mathis to wear sequential compression stockings.
-Explain that enoxaparin injections will be administered routinely.
The nurse is observing a student nurse perform a peripheral
assessment on Mr. Mathis. Which action requires the nurse to
intervene?
(Ans- Assessing the Homan’s sign in bilateral extremities.
The HCP has prescribed thigh-high antiembolic hose for Mr.
Mathis. The nurse assesses the client’s legs every 8 hours. Which
assessment finding reflects signs of possible thrombophlebitis
that should be reported to the HCP?
(Ans- Unilateral calf edema.
Which instruction should the nurse give to the unlicensed
assistive personnel (UAP) for positioning Mr. Mathis’ legs?
(Ans- Use two pillows and place one lengthwise under each calf.
Mobility / LPN-RN Transition Course
Rehab Team
(Ans- collaborative approach, patients are members of the team as well as
family, doctors, OT, PT, and social workers.
PULSES
(AnsAssessment of functional ability
p- physical condition
u- upper limb function
l- lower limb function
s- sensort
e- bladder control
s- supprt
risk factors for developing pressure ulcers
(Ans- immobility, impaired sensory perception, decreased tissue perfusion,
decreased nutritional status, friction and shear, increased moisture
assessment for the prevention of pressure ulcers
(Ans- assessment of skin, evaluate mobility, evaluate circulatory status and
neurological status, evaluate nutrition, broaden scale.
Intervention to prevent pressure ulcer formation
(Ans- relieve pressure, position patient reduction friction and shear,
minimize moisture, improve mobility
stage 1 pressure ulcer
(Ans- Non-blanchable erythema
remove pressure, prevent moisture, promote proper nutrition
Stage 2 pressure ulcer
(AnsPartial thickness
Partial thickness loss of dermis presenting as a shallow open ulcer with a
red pink wound bed, without slough
*clean with sterile saline poly dressing
stage 3 pressure ulcer
(Ans- full thickness skin loss
Full thickness tissue loss. Subcutaneous fat may be visible but bone,
tendon or muscle are not exposed.
*debide, wet to damp dressing, possible surgical debridement
Stage 4 pressure ulcer
(Ans- Full thickness tissue loss with exposed bone, tendon or muscle.
Slough or eschar may be present.
*surgical debridement maybe needed
HESI PN Mobility Exam Review
What term is used to describe the direction or prevention of disorder of
body function that is used in locomotion?
(Ans- orthopedics
What function of the skeletal system is essential to all other cells and
tissues?
(Ans- producing blood cells
A patient with severe osteoarthritis is having a surgical hip replacement that
is possible because the hip join found in the hip is?
(Ans- ball and socket
A nurse is teach an older adult about activity. What information should be
included in the teaching?
(Ans- importance of regular exercise
Charles Yu is a 15 year old pt who is complaining of left ankle pain from
being tackled while playing football. He’s asking the nurse what tests needs
to be done to determine if its a sprain or a break?
(Ans- xray
The nurse caring for a immobile malnourished patient recognizes the best
treatment to protect the patients integument is to?
(Ans- turning the patient every 2 hours
Which of the following patients would you expect to have decreased
activity?
(Ansa) 80 years old
b) obese
Which of the following posture deformities might be assessed in a
teenager?
(Ans- scoliosis
A nurse is assessing the muscles of an older adult what would be
assessed?
(Ans- mass, tone, strength
A 32 year old male construction work presents to the ER with complaints of
headache, abdominal cramps, nausea, light headiness and extreme
fatigue. The patient states that he started feeling ill at the job. the nurse
gathered the following data: temp 99.8, pulse 96, RR 30, BP 136/72. The
patients skin is cold and clammy, and the patient is having difficulty
answering questions. He tells the nurse he is never sick and he’s never
been in the hospital. What additional information would help determine if he
is experiencing heat exhaustion or hyperthermia?
(Ans- the type of work he is doing, his food and fluid intake, and the
environmental temperature