HESI LPN
Community Health HESI Study Guide
1. A 23-year-old single client is in the 33rd week of her first pregnancy. She tells the nurse that she has everything ready for the baby and has made plans for the first weeks together at home. Which normal emotional reaction does the nurse recognize?
- A. Acceptance of the pregnancy
- B. Focus on fetal development
- C. Anticipation of the birth
- D. Ambivalence about pregnancy
Correct answer: C
Rationale: The correct answer is C: 'Anticipation of the birth.' In the third trimester, it is common for expectant mothers to feel excited and prepared for the upcoming birth of their baby. This includes making plans for the baby's arrival and the early days at home. Choice A, 'Acceptance of the pregnancy,' may occur earlier in the pregnancy and does not specifically relate to the third trimester. Choice B, 'Focus on fetal development,' is more common in the earlier stages of pregnancy when the mother may be more concerned with the baby's growth and milestones. Choice D, 'Ambivalence about pregnancy,' suggests conflicting feelings which are less likely in this scenario where the client expresses readiness and plans for the baby's arrival.
2. When caring for a client receiving warfarin sodium (Coumadin), which lab test would the nurse monitor to determine therapeutic response to the drug?
- A. Bleeding time
- B. Coagulation time
- C. Prothrombin time
- D. Partial thromboplastin time
Correct answer: C
Rationale: The correct answer is C: Prothrombin time (PT). Prothrombin time is monitored to assess the therapeutic response to warfarin therapy. Warfarin works by inhibiting vitamin K-dependent clotting factors, which prolongs the PT. Monitoring PT helps determine if the client's blood is clotting within the desired therapeutic range. Choices A, B, and D are incorrect because bleeding time, coagulation time, and partial thromboplastin time are not specifically used to monitor the therapeutic response to warfarin. Bleeding time assesses platelet function, coagulation time is a general term and not a specific test, and partial thromboplastin time is more relevant in monitoring heparin therapy, not warfarin.
3. A client reports insomnia. Which of the following actions should the nurse perform shortly before bedtime?
- A. Provide a late supper
- B. Offer a wet washcloth for the client to wash their face
- C. Perform range of motion exercises
- D. Prepare a hot cocoa or tea for the client
Correct answer: B
Rationale: Offering a wet washcloth for the client to wash their face is a soothing and calming activity that can help the client relax before bedtime, promoting better sleep. Providing a late supper can lead to indigestion and disrupt sleep. Performing range of motion exercises may increase alertness rather than promoting relaxation. Preparing a hot cocoa or tea containing caffeine close to bedtime can interfere with falling asleep.
4. A healthcare provider is assessing a client with a diagnosis of acute pancreatitis. Which laboratory value would be most concerning?
- A. Serum amylase of 200 U/L
- B. Serum lipase of 250 U/L
- C. Blood glucose of 200 mg/dL
- D. Serum calcium of 7.5 mg/dL
Correct answer: D
Rationale: In acute pancreatitis, hypocalcemia (low serum calcium) is a critical finding that is associated with a poor prognosis and requires immediate attention. Serum amylase and lipase are typically elevated in acute pancreatitis due to pancreatic inflammation, but they are not indicators of severity. Blood glucose levels may be elevated due to stress or underlying conditions but are not directly related to the severity of acute pancreatitis. Therefore, the most concerning value in this scenario is the low serum calcium level, which can have significant implications for the client's prognosis.
5. In order to be effective as an occupational health nurse, you should be equipped with knowledge and skills in which of the following:
- A. public health science
- B. research process
- C. interviewing and counseling
- D. oral and written communication
Correct answer: D
Rationale: To be effective as an occupational health nurse, having knowledge and skills in public health science, the research process, interviewing and counseling, and oral and written communication are all important. However, communication skills, both oral and written, are crucial for conveying information, educating employees, documenting findings, and collaborating with other healthcare professionals. While public health science, research process, interviewing, and counseling are essential, oral and written communication is fundamental for effective communication and coordination in the workplace, making it the most critical skill for an occupational health nurse.