HESI LPN
Community Health HESI Study Guide
1. A 67-year-old client is admitted with substernal chest pain with radiation to the jaw. His admitting diagnosis is Acute Myocardial Infarction (MI). The priority nursing diagnosis for this client during the immediate 24 hours is
- A. Constipation related to immobility
- B. High risk for infection
- C. Impaired gas exchange
- D. Fluid volume deficit
Correct answer: C
Rationale: The correct answer is C: Impaired gas exchange. In a client with an acute myocardial infarction, impaired gas exchange is a priority nursing diagnosis due to compromised heart function, which affects oxygenated blood circulation. Close monitoring and interventions are crucial to ensure adequate oxygenation. Choices A, B, and D are incorrect: A) Constipation related to immobility is not the priority in this acute situation; B) High risk for infection is not the immediate concern related to the client's primary diagnosis; D) Fluid volume deficit, while important, is not the priority compared to addressing impaired gas exchange in acute MI.
2. A client with hypothyroidism is receiving levothyroxine (Synthroid). The nurse should monitor the client for which of the following side effects?
- A. Tachycardia
- B. Hypotension
- C. Weight gain
- D. Bradycardia
Correct answer: A
Rationale: The correct answer is A: Tachycardia. Levothyroxine, used to treat hypothyroidism, can lead to increased metabolism, causing tachycardia as a side effect. Monitoring for tachycardia is essential to ensure the client's safety. Choices B, Hypotension, and C, Weight gain, are incorrect as levothyroxine is not typically associated with causing hypotension or weight gain. Choice D, Bradycardia, is also incorrect as levothyroxine-induced bradycardia is not a common side effect.
3. The healthcare provider is evaluating the health status of a 16-year-old client with a history of Type 1 diabetes. Which laboratory test would provide the most accurate information about long-term blood glucose control?
- A. Blood glucose level
- B. Glycosylated hemoglobin
- C. Urine ketones
- D. Serum insulin level
Correct answer: B
Rationale: The correct answer is B: Glycosylated hemoglobin (HbA1c). Glycosylated hemoglobin provides valuable information about blood glucose control over the past 2-3 months. This test measures the average blood sugar levels during this period, offering a more comprehensive view of long-term glycemic control. Choice A, blood glucose level, reflects the blood sugar concentration at the time of testing and may fluctuate throughout the day. Choice C, urine ketones, indicates the presence of ketones and is more relevant for assessing acute complications like diabetic ketoacidosis. Choice D, serum insulin level, evaluates insulin production and is not a direct indicator of long-term blood glucose control in diabetes management.
4. What title should be given to this occupational health nurse job description? A registered nurse who functions in a comprehensive executive role to set goals, formulate policy, and direct and evaluate the health service.
- A. manager
- B. researcher
- C. health educator
- D. health promotion specialist
Correct answer: A
Rationale: The correct answer is 'manager.' In the job description provided, the role involves setting goals, formulating policy, and directing and evaluating health services, which aligns with the responsibilities of a manager. A 'researcher' primarily focuses on conducting research, a 'health educator' specializes in educating individuals about health-related topics, and a 'health promotion specialist' concentrates on promoting health and wellness initiatives. Therefore, 'manager' is the most suitable title for the described role.
5. What is usually the first contact between community members and other levels of health facilities called?
- A. Secondary level health care
- B. Primary health care
- C. Tertiary level care
- D. Intermediate level care
Correct answer: B
Rationale: The correct answer is B: Primary health care. Primary health care is the initial point of contact between community members and the healthcare system. This level of care focuses on preventive and primary treatment services. Choices A, C, and D are incorrect because secondary, tertiary, and intermediate care levels are more specialized and are usually accessed after primary care, depending on the complexity of the health issue.
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