HESI LPN
Community Health HESI Study Guide
1. The hospital is planning to downsize and eliminate a number of staff positions as a cost-saving measure. To assist staff in this change process, the nurse manager is preparing for the "unfreezing" phase of change. With this approach and phase the nurse manager should
- A. Discuss with the staff how to deal with any defensive behavior
- B. Explain to the unit staff why change is necessary
- C. Assist the staff during the acceptance of the new changes
- D. Clarify what the changes mean to the community and hospital
Correct answer: B
Rationale: The "unfreezing" phase involves preparing staff for change by explaining the necessity and benefits of the change, helping them to understand and accept it.
2. A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the following actions should the nurse take first?
- A. Discuss time management strategies with the nurses
- B. Provide coverage for the nurses' breaks
- C. Determine the reasons the nurses are not taking scheduled breaks
- D. Review policies for taking scheduled breaks
Correct answer: C
Rationale: The correct answer is to determine the reasons the nurses are not taking scheduled breaks. This action is crucial as it allows the charge nurse to understand the underlying causes for the behavior. By identifying the reasons, the nurse can then address the root of the issue effectively. Option A is incorrect because discussing time management strategies may not address the specific reasons for not taking breaks. Option B is incorrect as providing coverage for breaks does not address the underlying cause of the issue. Option D is also incorrect as reviewing policies should come after understanding the reasons for the behavior.
3. What should be assessed in a child with suspected appendicitis?
- A. Level of consciousness
- B. Bowel sounds and pain location
- C. Skin color and temperature
- D. Heart rate and blood pressure
Correct answer: B
Rationale: The correct answer is to assess bowel sounds and pain location. In a child with suspected appendicitis, focusing on bowel sounds and pain location, particularly in the lower right quadrant, is crucial. This assessment helps to identify symptoms commonly associated with appendicitis. Assessing the level of consciousness (Choice A) is important in other conditions such as head injuries or neurological issues. Skin color and temperature (Choice C) are more indicative of circulatory or skin-related problems. Heart rate and blood pressure (Choice D) are vital signs that are essential to assess in various conditions but are not specific to suspected appendicitis.
4. The clinician is assessing a client with a Stage 2 skin ulcer. Which of the following treatments is most effective to promote healing?
- A. Covering the wound with a dry dressing
- B. Using hydrogen peroxide soaks
- C. Leaving the area open to dry
- D. Applying a hydrocolloid or foam dressing
Correct answer: D
Rationale: Applying a hydrocolloid or foam dressing is the most effective treatment to promote healing for a Stage 2 skin ulcer. These dressings create a moist environment that supports healing and prevents further tissue damage. Option A (covering the wound with a dry dressing) can lead to drying out the wound bed, hindering healing. Option B (using hydrogen peroxide soaks) can be too harsh and may damage the surrounding healthy tissue. Option C (leaving the area open to dry) can delay healing as it does not provide the necessary moist environment for optimal wound healing.
5. A client with diabetes mellitus type 1 is prescribed insulin lispro. When should the nurse instruct the client to administer this medication?
- A. 5-10 minutes before meals
- B. 15 minutes after meals
- C. 30 minutes before meals
- D. 1 hour after meals
Correct answer: A
Rationale: Corrected Rationale: Insulin lispro is a rapid-acting insulin that should be administered 5-10 minutes before meals. This timing helps synchronize the peak action of insulin with the rise in blood glucose levels after eating, effectively managing postprandial hyperglycemia. Choice B, administering 15 minutes after meals, is incorrect because rapid-acting insulins like lispro are meant to act quickly to cover the rise in blood glucose levels after meals. Choices C and D are also incorrect as they do not align with the rapid onset of action required to manage postprandial hyperglycemia in patients with diabetes mellitus type 1.