HESI LPN
Leadership and Management HESI Test Bank
1. Which insulin has the most rapid onset of action?
- A. Lente
- B. Lispro
- C. Ultralente
- D. Humulin N
Correct answer: B
Rationale: Lispro insulin has the most rapid onset of action among the options provided. It is a rapid-acting insulin analog that is designed to control postprandial hyperglycemia effectively. Lente insulin (Choice A) and Ultralente insulin (Choice C) are intermediate-acting insulins, which have a slower onset of action compared to Lispro. Humulin N (Choice D) is a neutral protamine Hagedorn (NPH) insulin, which is an intermediate-acting insulin, not rapid-acting like Lispro. Therefore, the correct choice is Lispro.
2. Based on the signs and symptoms of erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems, and skin nodules in your 32-year-old female patient, what disorder would you most likely suspect?
- A. Leukemia
- B. Histoplasmosis
- C. Pneumocystis jiroveci
- D. Rheumatoid arthritis
Correct answer: D
Rationale: The signs and symptoms described point towards rheumatoid arthritis. Erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac issues, and skin nodules are classic manifestations of rheumatic fever, which is a complication of untreated streptococcal infection. This condition can lead to rheumatoid arthritis over time. Choices A, B, and C are incorrect as they do not align with the provided signs and symptoms, and they are not associated with the clinical presentation described.
3. Nurses on an inpatient care unit are working to help reduce unit costs. Which of the following actions is appropriate to include in the cost-containment plan?
- A. Store opened bottles of normal saline in a refrigerator for up to 48 hours.
- B. Return unused supplies from the bedside to the unit's supply stock.
- C. Wait to dispose of sharps containers until they are completely full.
- D. Use clean gloves rather than sterile gloves for colostomy care.
Correct answer: D
Rationale: Using clean gloves rather than sterile gloves for colostomy care is a cost-effective measure without compromising care quality. This choice helps in reducing costs without compromising patient safety. Storing opened bottles of normal saline in a refrigerator for up to 48 hours (Choice A) may lead to contamination risks. Returning unused supplies to the unit's supply stock (Choice B) can be inefficient and lead to potential waste. Waiting to dispose of sharps containers until they are completely full (Choice C) may pose safety hazards and not directly impact cost savings.
4. Nurse Andy has finished teaching a client with diabetes mellitus how to administer insulin. He evaluates the learning has occurred when the client makes which statement?
- A. I should check my blood sugar immediately prior to the administration.
- B. I should provide direct pressure over the site following the injection.
- C. I should use the abdominal area only for insulin injections.
- D. I should only use a calibrated insulin syringe for the injections.
Correct answer: D
Rationale: The correct answer is D because using a calibrated insulin syringe is crucial for accurate dosing when administering insulin. Choice A is incorrect because checking blood sugar before administration is essential but not the specific evaluation of learning in this context. Choice B is incorrect as applying direct pressure over the injection site is not a key indicator of learning about insulin administration. Choice C is incorrect as insulin injections can also be administered in other sites like the thigh or arm; it is not limited to the abdominal area.
5. Which individual is most at risk for Osgood-Schlatter disease?
- A. An elderly female who is hospitalized with a hip fracture and on bed rest
- B. A middle-aged male patient who has been exposed to asbestos in the shipping industry
- C. An adolescent who is physically active and the captain of their soccer team
- D. An infant of low birth weight and a gestational age of 28 weeks
Correct answer: C
Rationale: Osgood-Schlatter disease is a condition that commonly affects adolescents who are physically active, especially during growth spurts. It is caused by overuse of the knee, leading to inflammation of the patellar ligament at the tibial tuberosity. The repetitive stress on the growth plate during activities like running and jumping can trigger this condition. Therefore, an adolescent who is physically active and the captain of their soccer team is most at risk for Osgood-Schlatter disease. Choices A, B, and D are not at high risk for this condition as it is primarily seen in active adolescents.
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