HESI LPN
Community Health HESI Practice Exam
1. The school RN is assessing a group of middle school students for signs of scoliosis and discovers a female student with noticeable unequal symmetry of the upper and lower back. Which intervention is most important for the RN to implement?
- A. Send the student home
- B. Make a referral to have the scoliosis further evaluated.
- C. Withdraw the student from all physical activities
- D. Tell the student not to carry her backpack on her back
Correct answer: B
Rationale: Referring the student for further evaluation of scoliosis is crucial to confirm the diagnosis and determine the appropriate management plan. Sending the student home (choice A) without proper assessment and intervention is not the best course of action. Withdrawing the student from all physical activities (choice C) is not necessary and may cause unnecessary distress. Instructing the student not to carry her backpack on her back (choice D) does not address the underlying issue of scoliosis and is not the most important intervention at this point.
2. When a nurse teaches a community about the importance of hand hygiene, the nurse is engaging in:
- A. Primary prevention
- B. Secondary prevention
- C. Tertiary prevention
- D. Quaternary prevention
Correct answer: A
Rationale: The correct answer is A: Primary prevention. Primary prevention aims to prevent the occurrence of a disease or injury before it happens. Teaching about hand hygiene to the community helps in preventing infections from occurring in the first place. Choice B, Secondary prevention, involves early detection and treatment to halt or slow the progress of a condition. This would involve screening or early intervention after exposure. Choice C, Tertiary prevention, focuses on managing the disease to prevent complications, recurrence, or deterioration. This would include rehabilitation and monitoring to prevent further complications. Choice D, Quaternary prevention, relates to actions taken to avoid unnecessary interventions or over-medicalization. This usually involves questioning the necessity of certain medical procedures or treatments to prevent harm to patients.
3. A client is scheduled to have a blood test for cholesterol and triglycerides the next day. The nurse would tell the client
- A. ''Be sure to eat a fat-free diet until the test.''
- B. ''Do not eat or drink anything but water for 12 hours before the blood test.''
- C. ''Have the blood drawn within 2 hours of eating breakfast.''
- D. ''Stay at the laboratory so 2 blood samples can be drawn an hour apart.''
Correct answer: B
Rationale: Fasting for at least 12 hours is necessary before a cholesterol and triglyceride test to ensure accurate results by avoiding fluctuations that can occur after eating. Choice A is incorrect because a fat-free diet is not required; fasting is. Choice C is incorrect as it suggests having the test right after eating, which can affect the results. Choice D is incorrect as there is no need to stay at the laboratory for 2 blood samples unless specifically instructed by a healthcare provider.
4. The client with asthma who is sensitive to house dust-mites is being instructed by the nurse. Which information about prevention of asthma episodes would be the most helpful to include during the teaching?
- A. Change the pillow covers every month
- B. Wash bed linens in warm water with a cold rinse
- C. Wash and rinse the bed linens in hot water
- D. Use air filters in the furnace system
Correct answer: C
Rationale: The correct answer is to wash and rinse the bed linens in hot water to help eliminate dust mites, a common trigger for asthma episodes. Washing in hot water is more effective in killing dust mites compared to warm water. Changing pillow covers every month may help but is not as effective as washing bed linens in hot water. Using air filters in the furnace system may improve air quality but does not directly target dust mites on bed linens.
5. The home health care agency can expect to obtain Medicare reimbursement for which home visit performed by a registered nurse or a practical nurse?
- A. assessment of the speech pattern of a mobile adult who had a mild stroke last year
- B. safety teaching for an older male client whose wife complains that he uses an unsafe ladder while painting
- C. wound care for a client who had postoperative infection following abdominal surgery two weeks ago
- D. evaluation of crutch use by a 65-year-old client who broke his tibia while snow skiing
Correct answer: C
Rationale: The correct answer is C because wound care for a postoperative infection qualifies for Medicare reimbursement. Medicare typically covers skilled nursing care, like wound care, required due to a postoperative infection. Choices A, B, and D involve assessments, teaching, and evaluation, which may not always be eligible for Medicare reimbursement unless they are directly related to skilled nursing care for a specific medical condition.
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