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. The term 'epidemiology' is best defined as the study of:
- A. The causes of disease
- B. The distribution and determinants of health-related states in populations
- C. The treatment and prevention of disease
- D. The healthcare system and its effectiveness
Correct answer: B
Rationale: Epidemiology is the study of the distribution and determinants of health-related states in populations. Choice A is incorrect because epidemiology focuses on more than just causes but also on distribution and determinants. Choice C is incorrect as it specifically relates to public health and not just treatment and prevention. Choice D is incorrect as epidemiology is broader than just focusing on the healthcare system and its effectiveness.
3. A client with chronic congestive heart failure should be instructed to contact the home health nurse if which finding occurs?
- A. Weight gain of 2 pounds or more in a 48-hour period
- B. Urinating 4 to 5 times a day
- C. A significant decrease in appetite
- D. Appearance of non-pitting ankle edema
Correct answer: A
Rationale: A rapid weight gain of 2 pounds or more in a 48-hour period may indicate fluid retention and worsening heart failure, requiring prompt medical evaluation and intervention. This finding is crucial in managing chronic congestive heart failure as it signifies a potential exacerbation of the condition. Choices B, C, and D are less concerning in this context. Urinating 4 to 5 times a day is within the normal range for most individuals and may not be directly related to heart failure. A significant decrease in appetite may be due to various factors and might not be an immediate cause for concern in heart failure patients. The appearance of non-pitting ankle edema, although related to heart failure, is a more chronic and less urgent symptom when compared to a rapid weight gain, which requires immediate attention.
4. An example of individual influences on health status would be:
- A. Cigarette smoking
- B. A parent with adult-onset diabetes
- C. Exposure to toxic substances in the workplace
- D. All of the above
Correct answer: D
Rationale: The correct answer is 'D' because all the listed factors - cigarette smoking, a parent with adult-onset diabetes, and exposure to toxic substances in the workplace - can individually influence a person's health status. Cigarette smoking directly impacts health by increasing the risk of various diseases. Having a parent with adult-onset diabetes can also influence one's health due to genetic predisposition and lifestyle factors. Exposure to toxic substances in the workplace can lead to health issues. Choices A, B, and C are not mutually exclusive but rather represent different aspects of individual influences on health status, making 'D' the most comprehensive and accurate answer.
5. The client with Raynaud's phenomenon would benefit most by which teaching intervention?
- A. Stop smoking
- B. Keep feet dry
- C. Reduce stress
- D. Avoid caffeine
Correct answer: A
Rationale: The correct answer is A: Stop smoking. Smoking causes vasoconstriction, worsening the symptoms of Raynaud's phenomenon. Quitting smoking is crucial in managing this condition effectively. Choices B, C, and D are not as directly related to the pathophysiology of Raynaud's phenomenon. While keeping feet dry and reducing stress can be beneficial for overall health, they are not as directly linked to managing Raynaud's phenomenon as smoking cessation.
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