HESI LPN
Community Health HESI Test Bank 2023
1. The appropriate order of steps in active management of the third stage of labor includes:
- A. Cord clamping and cutting, controlled cord traction, ergometrine administration, and inspection to ensure the placenta is intact.
- B. Intravenous oxytocin, cord clamping and cutting, and fundal massage.
- C. Intramuscular injection of oxytocin, controlled cord traction with counter traction to the uterus, and uterine massage.
- D. Controlled cord traction, fundal massage, and oxytocin.
Correct answer: C
Rationale: The correct sequence of steps in active management of the third stage of labor includes intramuscular injection of oxytocin to prevent postpartum hemorrhage, controlled cord traction with counter traction to the uterus to facilitate placental delivery, and uterine massage to aid in uterine contraction and prevent excessive bleeding. Choice A is incorrect because ergometrine administration is not routinely recommended in active management. Choice B is incorrect as intravenous oxytocin is not the preferred route of administration. Choice D is incorrect as the order of steps is not accurate.
2. The healthcare provider is evaluating the health status of a 16-year-old client with a history of Type 1 diabetes. Which laboratory test would provide the most accurate information about long-term blood glucose control?
- A. Blood glucose level
- B. Glycosylated hemoglobin
- C. Urine ketones
- D. Serum insulin level
Correct answer: B
Rationale: The correct answer is B: Glycosylated hemoglobin (HbA1c). Glycosylated hemoglobin provides valuable information about blood glucose control over the past 2-3 months. This test measures the average blood sugar levels during this period, offering a more comprehensive view of long-term glycemic control. Choice A, blood glucose level, reflects the blood sugar concentration at the time of testing and may fluctuate throughout the day. Choice C, urine ketones, indicates the presence of ketones and is more relevant for assessing acute complications like diabetic ketoacidosis. Choice D, serum insulin level, evaluates insulin production and is not a direct indicator of long-term blood glucose control in diabetes management.
3. At a routine health assessment, a client tells the nurse that she is planning a pregnancy in the near future. She asks about preconception diet changes. Which of the statements made by the nurse is best?
- A. Include fibers in your daily diet.
- B. Increase green leafy vegetable intake.
- C. Drink a glass of milk with each meal.
- D. Eat at least 1 serving of fish weekly.
Correct answer: B
Rationale: The correct answer is B: "Increase green leafy vegetable intake." This is the best advice because green leafy vegetables are rich in folic acid, which is essential for fetal development and helps prevent neural tube defects. Choice A is not specific enough and does not address the importance of folic acid. Choice C, drinking milk with each meal, does not provide the necessary folic acid intake. Choice D, eating fish weekly, is not as crucial for preconception diet changes as increasing folic acid intake.
4. In the immediate postoperative period for a cleft lip repair in a 2-month-old infant, which nursing approach should be the priority?
- A. Remove protective arm devices one at a time for short periods with supervision
- B. Initiate oral feedings when alert
- C. Introduce the parents to the suture line cleansing protocol
- D. Position the infant on the back after feedings throughout the day
Correct answer: A
Rationale: The correct nursing approach in the immediate postoperative period for a cleft lip repair in an infant is to remove protective arm devices one at a time for short periods with supervision. This approach helps prevent injury to the surgical site while ensuring the infant's comfort and safety. Choice B is incorrect as initiating oral feedings immediately after surgery may not be appropriate and could compromise the surgical site. Choice C is incorrect as introducing parents to the suture line cleansing protocol is important but not the immediate priority. Choice D is incorrect as positioning the infant on the back after feedings is not specific to the immediate postoperative period for a cleft lip repair.
5. A nurse is practicing community health nursing when:
- A. leading a support group for obese adolescents
- B. visiting an old woman in her condominium to change her postsurgical dressing
- C. being in a clinic instructing a couple about newborn care
- D. performing any of these activities
Correct answer: D
Rationale: Correct! Community health nursing involves a broad scope of activities that focus on promoting and preserving the health of populations rather than individuals. This includes leading support groups, providing home care, and educating communities. The other options represent different aspects of nursing care such as home health nursing, wound care, and maternal-child health - which are not exclusive to community health nursing.
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