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 new graduate nurse interviews for a position in a nursing department of a large health care agency, described by the interviewer as having shared governance. Which of these statements best illustrates the shared governance model?
- A. An appointed board oversees any administrative decisions
- B. Nursing departments share responsibility for client outcomes
- C. Staff groups are appointed to discuss nursing practice and client education issues
- D. Non-nurse managers supervise nursing staff in groups of units
Correct answer: B
Rationale: The correct answer is B because shared governance involves nurses and other staff sharing responsibility for decisions related to patient care and outcomes, promoting collaborative practice and shared accountability. Choice A is incorrect as shared governance includes active participation of frontline staff, not just an appointed board. Choice C is incorrect because shared governance goes beyond just discussing issues to actively sharing responsibility for decision-making. Choice D is incorrect as shared governance encourages nurses to have a significant role in decision-making rather than being supervised by non-nurse managers.
3. A client with heart failure is receiving digoxin (Lanoxin). The nurse should monitor the client for which of the following signs of digoxin toxicity?
- A. Tachycardia
- B. Hypotension
- C. Bradycardia
- D. Hyperglycemia
Correct answer: C
Rationale: The correct answer is C: Bradycardia. Digoxin toxicity often presents with bradycardia, which is a common sign of toxicity associated with this medication. Tachycardia (Choice A) is not typically seen with digoxin toxicity. Hypotension (Choice B) can occur but is less specific to digoxin toxicity. Hyperglycemia (Choice D) is not a typical sign of digoxin toxicity. Therefore, monitoring for bradycardia is crucial in clients receiving digoxin to detect toxicity early.
4. What components should a nurse include when conducting a community health assessment?
- A. Personal health history of community members
- B. Number of hospitals in the community
- C. Demographic data, health status indicators, and community resources
- D. Results of laboratory tests
Correct answer: C
Rationale: When conducting a community health assessment, it is essential to gather demographic data (such as age, gender, ethnicity), health status indicators (like prevalence of diseases, mortality rates), and information on community resources (such as healthcare facilities, social services). These components help in understanding the health needs of the community and planning appropriate interventions. Choices A, B, and D are not typically part of a community health assessment as they focus on individual health data or specific medical information rather than the broader population health perspective required for community assessments.
5. What is an important basis in preparing the family health care plan?
- A. Needs and problems gathered and recognized by the nurse herself
- B. Data gathered from the health center
- C. Needs and problems as seen and accepted by the family
- D. Needs as expected by the midwife assigned in the area where the family resides
Correct answer: C
Rationale: In preparing a family health care plan, it is crucial to consider the needs and problems as perceived and accepted by the family members themselves. This ensures that the plan aligns with the family's beliefs, values, and preferences, leading to better acceptance and adherence. Choices A, B, and D are incorrect because the active involvement and acceptance of the family in recognizing their needs and problems are essential for effective health care planning.
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