HESI LPN
Community Health HESI Practice Exam
1. The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?
- A. Decreased anteroposterior diameter
- B. Hyperresonance on percussion
- C. Increased breath sounds
- D. Prolonged expiratory phase
Correct answer: D
Rationale: The correct answer is D: Prolonged expiratory phase. In COPD, there is airflow obstruction leading to difficulty in exhaling air. This results in a prolonged expiratory phase. Choices A, B, and C are incorrect. Decreased anteroposterior diameter is associated with conditions like barrel chest in emphysema, not COPD. Hyperresonance on percussion is typical in conditions like emphysema, not necessarily in COPD. Increased breath sounds are not a typical finding in COPD; instead, diminished breath sounds may be present due to air trapping.
2. A female client makes routine visits to a neighborhood community health center. The nurse notes that this client often presents with facial bruising, particularly around the eyes. The nurse discusses prevention of domestic violence with the client even though the client does not admit to being battered. What level of prevention has the nurse applied in this situation?
- A. primary prevention
- B. secondary prevention
- C. tertiary prevention
- D. health promotion
Correct answer: B
Rationale: The correct answer is B: secondary prevention. Secondary prevention involves identifying and addressing issues early to prevent further harm. In this scenario, the nurse is intervening by discussing domestic violence prevention with the client who is showing signs of facial bruising, aiming to prevent further harm even though the client has not disclosed being battered. Choice A (primary prevention) focuses on preventing the onset of a problem before it occurs, like educating about healthy relationships before violence happens. Choice C (tertiary prevention) involves managing and treating the effects of a problem that has already occurred, such as providing counseling to a domestic violence survivor. Choice D (health promotion) aims to enhance well-being and prevent health problems through educational and environmental interventions, which may include aspects of preventing domestic violence, but in this case, the nurse's direct intervention is more about early identification and prevention of harm, aligning it with secondary prevention.
3. A 4-month-old child taking digoxin (Lanoxin) has a blood pressure of 92/78; resting pulse of 78; respirations 28, and a potassium level of 4.8 mEq/L. The client is irritable and has vomited twice since the morning dose of digoxin. Which finding is most indicative of digoxin toxicity?
- A. Bradycardia
- B. Lethargy
- C. Irritability
- D. Vomiting
Correct answer: A
Rationale: Bradycardia (abnormally slow heart rate) is a key sign of digoxin toxicity. In this scenario, the child's symptoms of irritability, vomiting, along with the resting pulse of 78 despite being on digoxin, suggest an impending bradycardia due to digoxin toxicity. Lethargy can also be a sign, but in this case, the child is irritable rather than lethargic. Vomiting, though a symptom, is not as specific to digoxin toxicity as bradycardia. Irritability, while present, is not the most indicative finding of digoxin toxicity compared to bradycardia.
4. An example of the continuum health model of health and wellness would be:
- A. a person is either well or not, and the emphasis is on continuously and aggressively treating people who are ill
- B. predicting that a person will most likely continue good health practices, based on his or her health practices in the past, such as getting flu shots
- C. using acupuncture and therapeutic touch to cure disease instead of traditional medical therapies
- D. none of the above
Correct answer: B
Rationale: The continuum health model emphasizes ongoing health practices based on past behaviors. Choice A is incorrect as it describes a more binary approach to health. Choice C is incorrect as it focuses on alternative therapies rather than the continuity of health practices.
5. The nurse is teaching childbirth preparation classes. One woman asks about her rights to develop a birthing plan. Which response made by the nurse would be best?
- A. "What is your reason for wanting such a plan?"
- B. "Have you talked with your health care provider about this?"
- C. "Let us discuss your rights as a couple."
- D. "Write your ideal plan for the next class."
Correct answer: C
Rationale: Discussing the rights as a couple allows for open communication and helps ensure that the birthing plan aligns with the couple's preferences and medical advice.
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