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. In planning for the nursing care of the sick person in the home, the major point that the nurse must keep in mind is:
- A. who will be responsible for the patient during the nurse's absence from the home
- B. economic level of the family
- C. the availability of the nearest hospital
- D. whether or not the patient is under a private physician
Correct answer: A
Rationale: The correct answer is A because ensuring someone is responsible for the patient is crucial for continuous care. The presence of a caregiver during the nurse's absence ensures the patient's safety and well-being. Choice B, economic level of the family, is important but not the major point when planning nursing care in the home. Choice C, the availability of the nearest hospital, is significant but doesn't address the day-to-day care in the home. Choice D, whether or not the patient is under a private physician, is relevant but not as critical as ensuring someone is available to care for the patient at all times.
3. The appropriate order of steps in active management of the third stage of labor includes:
- A. Cord clamping and cutting, controlled cord traction, ergometrine administration, and inspection to ensure the placenta is intact.
- B. Intravenous oxytocin, cord clamping and cutting, and fundal massage.
- C. Intramuscular injection of oxytocin, controlled cord traction with counter traction to the uterus, and uterine massage.
- D. Controlled cord traction, fundal massage, and oxytocin.
Correct answer: C
Rationale: The correct sequence of steps in active management of the third stage of labor includes intramuscular injection of oxytocin to prevent postpartum hemorrhage, controlled cord traction with counter traction to the uterus to facilitate placental delivery, and uterine massage to aid in uterine contraction and prevent excessive bleeding. Choice A is incorrect because ergometrine administration is not routinely recommended in active management. Choice B is incorrect as intravenous oxytocin is not the preferred route of administration. Choice D is incorrect as the order of steps is not accurate.
4. Barangay Mabulaklak has poor hygienic practices and poor environmental conditions. These are contributing factors to which of the following disease conditions?
- A. influenza
- B. hepatitis B
- C. parasitism
- D. measles
Correct answer: C
Rationale: Poor hygienic practices and poor environmental conditions often create an environment conducive to the spread of parasites. Parasitism refers to the condition where parasites live on or in a host organism, potentially causing harm. In this scenario, the unsanitary conditions in Barangay Mabulaklak can lead to an increased risk of parasitic infections. The other options, influenza, hepatitis B, and measles, are not directly linked to poor hygiene and environmental conditions as parasitism is.
5. The nurse is assigned to a client with Parkinson's disease. Which findings would the nurse anticipate?
- A. Non-intention tremors and urgency with voiding
- B. Echolalia and a shuffling gait
- C. Muscle spasm and a bent-over posture
- D. Intention tremor and jerky movement of the elbows
Correct answer: B
Rationale: The correct answer is B. Echolalia (repeating others' words) and a shuffling gait are common symptoms of Parkinson's disease. These symptoms result from the degeneration of the basal ganglia in the brain that controls movement and speech. Choice A is incorrect because non-intention tremors are not typically associated with Parkinson's disease. Choice C is incorrect as muscle spasm and a bent-over posture are not classic manifestations of Parkinson's disease. Choice D is incorrect since intention tremors and jerky movement of the elbows are not characteristic of Parkinson's disease.
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