HESI LPN
Community Health HESI Test Bank 2023
1. A client with rheumatoid arthritis is receiving methotrexate (Rheumatrex). The nurse should monitor the client for which of the following adverse effects?
- A. Leukopenia
- B. Hyperglycemia
- C. Hypertension
- D. Hypokalemia
Correct answer: A
Rationale: The correct answer is A: Leukopenia. Methotrexate, used in the treatment of rheumatoid arthritis, can lead to bone marrow suppression, resulting in leukopenia. This condition increases the risk of infections due to decreased white blood cell count. Choices B, C, and D are incorrect because methotrexate is not known to cause hyperglycemia, hypertension, or hypokalemia as its primary adverse effects.
2. A client with chronic kidney disease is receiving epoetin alfa (Epogen). Which laboratory value should the nurse monitor to determine the effectiveness of this medication?
- A. Serum creatinine
- B. Hemoglobin
- C. Blood urea nitrogen (BUN)
- D. Platelet count
Correct answer: B
Rationale: The correct answer is B: Hemoglobin. Epoetin alfa (Epogen) is a medication commonly used in clients with chronic kidney disease to stimulate red blood cell production. Monitoring hemoglobin levels is crucial to assess the effectiveness of epoetin alfa therapy. Hemoglobin levels reflect the oxygen-carrying capacity of the blood and indicate if the medication is successfully treating anemia associated with chronic kidney disease. Option A, serum creatinine, is a marker of kidney function, not the primary indicator of epoetin alfa effectiveness. Option C, blood urea nitrogen (BUN), is a measure of kidney function and hydration status. Option D, platelet count, assesses clotting ability and is unrelated to monitoring the effectiveness of epoetin alfa in treating anemia in chronic kidney disease.
3. Which of the following strategies can help reduce healthcare-associated infections?
- A. Using outdated medical equipment
- B. Implementing strict hygiene protocols
- C. Increasing patient wait times
- D. Reducing nursing staff
Correct answer: B
Rationale: Correct Answer: Implementing strict hygiene protocols can help reduce healthcare-associated infections. By maintaining high standards of hygiene, such as proper handwashing, sterilization of equipment, and cleanliness of the environment, the spread of infections can be minimized. Choices A, C, and D are incorrect. Using outdated medical equipment can increase the risk of infections due to lack of proper maintenance and sterilization. Increasing patient wait times may lead to frustration but does not directly impact infection rates. Reducing nursing staff can compromise patient care and monitoring but is not specifically related to reducing healthcare-associated infections.
4. A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the health care provider immediately and instruct the client to stop taking the medication?
- A. The client is experiencing vision and hearing loss.
- B. The client has an erection lasting longer than 4 hours.
- C. The client is complaining of nasal congestion.
- D. The client is complaining of feeling flushed.
Correct answer: A
Rationale: The correct answer is A. If a client prescribed sildenafil for pulmonary hypertension experiences vision and/or hearing loss or an erection lasting more than 4 hours, the practical nurse should instruct the client to discontinue the medication immediately and notify the health care provider. These symptoms could indicate serious side effects that require prompt medical attention to prevent complications. Choices B, C, and D are incorrect because an erection lasting more than 2 hours (not 4 hours as stated in choice B) is a critical adverse effect that warrants immediate medical attention. Nasal congestion (choice C) and feeling flushed (choice D) are common side effects of sildenafil and typically do not necessitate immediate discontinuation of the medication or emergency intervention.
5. An adult client is found to be unresponsive during morning rounds. After checking for responsiveness and calling for help, what should the nurse do next?
- A. Check the carotid pulse
- B. Deliver 5 abdominal thrusts
- C. Give 2 rescue breaths
- D. Open the client's airway
Correct answer: D
Rationale: After confirming unresponsiveness and calling for help, the next step in basic life support is to open the client's airway. This ensures that the airway is clear and allows for effective ventilation. Checking the carotid pulse is not necessary at this stage as airway management takes precedence. Delivering abdominal thrusts is not indicated for an unresponsive client as it is for conscious choking individuals. Giving rescue breaths should only be done after ensuring the airway is open to allow for effective ventilation.