HESI LPN
Community Health HESI Exam
1. A client comes into the community health center upset and crying stating, “I will die of cancer now that I have this disease.” And then the client hands the nurse a paper with one word written on it: 'Pheochromocytoma.' Which response should the nurse state initially?
- A. 'Pheochromocytomas usually aren't cancerous (malignant). But they may be associated with cancerous tumors in other endocrine glands such as the thyroid (medullary carcinoma of the thyroid).'
- B. 'This problem is diagnosed by blood and urine tests that reveal elevated levels of adrenaline and noradrenaline.'
- C. 'Computerized tomography (CT) or magnetic resonance imaging (MRI) are used to detect an adrenal tumor.'
- D. 'You probably have had episodes of sweating, heart pounding, and headaches.'
Correct answer: A
Rationale: The correct initial response for the nurse to provide in this situation is to offer reassurance. Stating that 'Pheochromocytomas usually aren't cancerous (malignant)' helps to alleviate the client's anxiety and fear of having cancer. This response also establishes a foundation for further discussion about the condition, allowing the nurse to address the client's concerns and provide accurate information. Choice B is incorrect as it focuses solely on the diagnostic tests for pheochromocytoma but does not address the client's emotional distress. Choice C is incorrect as it discusses imaging modalities without directly addressing the client's concerns. Choice D is also incorrect as it assumes symptoms without first addressing the client's emotional state and fear of cancer.
2. The client with atrial fibrillation is being taught about the use of Coumadin (warfarin) at home. Which of these should be emphasized to the client to avoid?
- A. Large indoor gatherings
- B. Exposure to sunlight
- C. Active physical exercise
- D. Foods rich in vitamin K
Correct answer: D
Rationale: The correct answer is D: Foods rich in vitamin K. Foods rich in vitamin K can interfere with the effectiveness of Coumadin (warfarin) by promoting blood clotting. It is crucial for clients on this medication to maintain a consistent intake of vitamin K and avoid sudden dietary changes. Choices A, B, and C are incorrect as they are not directly related to the interaction of Coumadin (warfarin) with vitamin K. Large indoor gatherings, exposure to sunlight, and active physical exercise do not have a significant impact on the effectiveness of Coumadin (warfarin) in comparison to the interaction with foods rich in vitamin K.
3. Which of the following measures the frequency of new cases of the phenomenon during a given period of time?
- A. prevalence rate
- B. proportionate mortality rate
- C. case fatality rate
- D. incidence rate
Correct answer: D
Rationale: The correct answer is D, incidence rate. Incidence rate measures the frequency of new cases of a phenomenon, providing important information about the risk of developing the condition. Prevalence rate (choice A) reflects both old and new cases, proportionate mortality rate (choice B) is the proportion of deaths due to a specific cause, and case fatality rate (choice C) measures the proportion of deaths among confirmed cases, not just new cases.
4. A hospitalized child suddenly has a seizure while his family is visiting. The nurse notes whole body rigidity followed by general jerking movements. The child vomits immediately after the seizure. A priority nursing diagnosis for the child is
- A. High risk for infection related to vomiting
- B. Altered family processes related to chronic illness
- C. Fluid volume deficit related to vomiting
- D. Risk for aspiration related to loss of consciousness
Correct answer: D
Rationale: Risk for aspiration is a priority concern following a seizure, especially when the child vomits, as there is a danger of aspirating the vomit into the lungs, leading to respiratory complications. The other options are not the priority in this situation. While infection risk and fluid volume deficit are important, ensuring the child's airway is clear and there is no risk of aspiration takes precedence. Altered family processes may be a concern but addressing the immediate physiological risk is the priority.
5. Under the present system, which of the following is the local government unit responsible for?
- A. Operation and maintenance of health facilities
- B. All of these activities
- C. Implementation of health programs/projects
- D. Delivery of health services
Correct answer: B
Rationale: Under the present system, the local government unit is responsible for all the listed activities. This includes the operation and maintenance of health facilities, implementation of health programs/projects, and delivery of health services. Therefore, choice B, 'All of these activities,' is the correct answer. Choices A, C, and D are incorrect because they are all responsibilities that fall under the local government unit's jurisdiction as well.
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