HESI LPN
Community Health HESI Practice Exam
1. 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.
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. When caring for premature newborns in an intensive care setting, a nurse carefully monitors oxygen concentration. What is the most common complication of this therapy?
- A. Intraventricular hemorrhage
- B. Retinopathy of prematurity
- C. Bronchopulmonary dysplasia
- D. Necrotizing enterocolitis
Correct answer: B
Rationale: Retinopathy of prematurity is the most common complication in premature infants exposed to high concentrations of oxygen. This condition leads to abnormal blood vessel growth in the retina, which can potentially result in blindness if not managed promptly. Intraventricular hemorrhage, though a significant concern in premature infants, is not directly related to oxygen therapy. Bronchopulmonary dysplasia is primarily associated with mechanical ventilation and oxygen exposure over time, not specifically with oxygen concentration monitoring. Necrotizing enterocolitis is more linked to gastrointestinal issues and is not the most common complication of oxygen therapy in premature newborns.
4. The nurse is planning care for a client with increased intracranial pressure. The best position for this client is
- A. Trendelenburg
- B. Prone
- C. Semi-Fowler's
- D. Side-lying with head flat
Correct answer: C
Rationale: The correct answer is C, Semi-Fowler's. This position helps to reduce intracranial pressure by promoting venous drainage from the head while maintaining adequate oxygenation. Option A, Trendelenburg position, is incorrect as it involves placing the patient with the head lower than the body, which can increase intracranial pressure. Option B, Prone position, is also incorrect as it involves lying on the stomach, which can further elevate intracranial pressure. Option D, Side-lying with head flat, does not provide the same benefits as the Semi-Fowler's position in terms of promoting venous drainage and maintaining oxygenation in a client with increased intracranial pressure.
5. In a long term rehabilitation care unit a client with spinal cord injury complains of a pounding headache. The client is sitting in a wheelchair watching television in the assigned room. Further assessment by the nurse reveals excessive sweating, a splotchy rash, pilomotor erection, facial flushing, congested nasal passages and a heart rate of 50. The nurse should do which action next?
- A. Take the client's respirations, blood pressure (BP), temperature and then pupillary responses
- B. Place the client into the bed and administer the ordered PRN analgesic
- C. Check the client for bladder distention and the client's urinary catheter for kinks
- D. Turn the television off and then assist client to use relaxation techniques
Correct answer: C
Rationale: These symptoms suggest autonomic dysreflexia, often triggered by bladder distention.
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