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Community Health HESI Test Bank
1. A client with a history of deep vein thrombosis (DVT) is receiving warfarin (Coumadin). The nurse should monitor the client for which of the following laboratory values?
- A. Prothrombin time (PT)
- B. Serum potassium
- C. Blood urea nitrogen (BUN)
- D. White blood cell count (WBC)
Correct answer: A
Rationale: The correct answer is A: Prothrombin time (PT). Prothrombin time is monitored to assess the effectiveness of warfarin therapy. Warfarin is an anticoagulant medication that works by inhibiting the synthesis of vitamin K-dependent clotting factors, including factors II, VII, IX, and X. Monitoring the PT helps ensure that the client's blood is clotting within the desired therapeutic range to prevent complications such as recurrent DVT or excessive bleeding. Choices B, C, and D are incorrect because serum potassium, blood urea nitrogen, and white blood cell count are not directly related to monitoring warfarin therapy in a client with a history of DVT.
2. A client with hypothyroidism is receiving levothyroxine (Synthroid). The nurse should monitor the client for which of the following side effects?
- A. Tachycardia
- B. Hypotension
- C. Weight gain
- D. Bradycardia
Correct answer: A
Rationale: The correct answer is A: Tachycardia. Levothyroxine, used to treat hypothyroidism, can lead to increased metabolism, causing tachycardia as a side effect. Monitoring for tachycardia is essential to ensure the client's safety. Choices B, Hypotension, and C, Weight gain, are incorrect as levothyroxine is not typically associated with causing hypotension or weight gain. Choice D, Bradycardia, is also incorrect as levothyroxine-induced bradycardia is not a common side effect.
3. In this municipality, what should the nursing health care plan focus on?
- A. Rehabilitative services
- B. All of these services
- C. Health promotion and disease prevention
- D. Curative services
Correct answer: C
Rationale: In this municipality, the nursing health care plan should primarily focus on health promotion and disease prevention. This approach addresses the underlying causes of health problems, promotes overall well-being, and helps prevent illnesses before they occur. While rehabilitative and curative services are important, health promotion and disease prevention are crucial for fostering a healthier community in the long term. Therefore, choices A, B, and D are not the best options as they do not prioritize preventing health issues at the root cause.
4. Which ethnic group has the highest risk for diabetes?
- A. African Americans
- B. Hispanic Americans
- C. Asian Americans
- D. Native Americans
Correct answer: D
Rationale: Native Americans have the highest risk for diabetes compared to other ethnic groups. This is due to genetic predisposition, lifestyle factors, and limited access to healthcare. African Americans, Hispanic Americans, and Asian Americans also have an increased risk of developing diabetes, but statistically, Native Americans have the highest prevalence of the disease. Therefore, choices A, B, and C are incorrect.
5. A 67-year-old client is admitted with substernal chest pain with radiation to the jaw. His admitting diagnosis is Acute Myocardial Infarction (MI). The priority nursing diagnosis for this client during the immediate 24 hours is
- A. Constipation related to immobility
- B. High risk for infection
- C. Impaired gas exchange
- D. Fluid volume deficit
Correct answer: C
Rationale: The correct answer is C: Impaired gas exchange. In a client with an acute myocardial infarction, impaired gas exchange is a priority nursing diagnosis due to compromised heart function, which affects oxygenated blood circulation. Close monitoring and interventions are crucial to ensure adequate oxygenation. Choices A, B, and D are incorrect: A) Constipation related to immobility is not the priority in this acute situation; B) High risk for infection is not the immediate concern related to the client's primary diagnosis; D) Fluid volume deficit, while important, is not the priority compared to addressing impaired gas exchange in acute MI.
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