HESI LPN
Community Health HESI Exam
1. A community health action that focuses on reducing the frequency and severity of asthma in inner-city children by requiring a local incinerator to install particulate filters is an example of:
- A. downstream intervention
- B. risk management
- C. primary prevention
- D. upstream intervention
Correct answer: D
Rationale: The correct answer is D: upstream intervention. Upstream thinking addresses the root causes of health problems to create long-term solutions. In this scenario, requiring the incinerator to install particulate filters tackles the root cause of asthma triggers, which is pollution, rather than just managing the symptoms or risks associated with asthma. Choice A, downstream intervention, would focus more on treating asthma symptoms after they have already occurred rather than preventing them. Choice B, risk management, typically involves strategies to assess, control, or mitigate risks, which may not directly address the root cause. Choice C, primary prevention, usually refers to actions taken to prevent a disease or condition before it occurs, but in this case, the action is targeting the underlying cause rather than preventing asthma itself.
2. A child with sickle cell anemia develops severe chest pain, fever, a cough, and dyspnea. What should the nurse do first?
- A. Administer 100% oxygen to relieve hypoxia
- B. Administer pain medication to relieve symptoms
- C. Notify the practitioner because chest syndrome is suspected
- D. Notify the practitioner because the child may be having a stroke
Correct answer: C
Rationale: The correct action to take first when a child with sickle cell anemia presents with severe chest pain, fever, cough, and dyspnea is to notify the practitioner because acute chest syndrome is suspected. This condition is a medical emergency requiring prompt intervention. Administering oxygen or pain medication may be necessary interventions but should not precede notifying the practitioner. Stroke is not typically associated with these symptoms in sickle cell anemia.
3. An older adult client just diagnosed with colon cancer asks the nurse what the primary care provider is going to do. The provider will be making rounds within the hour. Which of the following nursing actions is appropriate?
- A. Help the client write down the questions to ask the provider, so that the client doesn’t forget
- B. Reassure the client that everything will be explained
- C. Explain the procedure in detail yourself
- D. Direct the client to search for information online
Correct answer: A
Rationale: Assisting the client in preparing questions is the most appropriate action as it helps ensure that all concerns are addressed during the provider's visit. By helping the client write down questions, the nurse empowers the client to actively participate in their care and communicate effectively with the provider. Reassuring the client, while well-intentioned, may not address the specific questions or fears the client has. Explaining the procedure in detail may not be what the client is seeking at this moment, as their primary concern is about the provider's actions. Directing the client to search for information online is not recommended as it may lead to confusion or misinformation, and the information may not be tailored to the client's specific situation.
4. What information would the nurse include in the preoperative plan of care for an infant with myelomeningocele?
- A. Positioning the infant supine with a pillow under the buttocks
- B. Covering the sac with saline-soaked nonadhesive gauze
- C. Wrapping the infant snugly in a blanket
- D. Applying a diaper to prevent fecal soiling of the sac
Correct answer: B
Rationale: The correct answer is B: Covering the sac with saline-soaked nonadhesive gauze. This intervention is essential in caring for an infant with myelomeningocele as it helps prevent infection and maintains a moist environment around the sac before surgical repair. Positioning the infant supine with a pillow under the buttocks (Choice A) may be suitable for comfort but is not directly related to managing the myelomeningocele. Wrapping the infant snugly in a blanket (Choice C) and applying a diaper (Choice D) are not recommended as they can increase the risk of infection and damage to the sac.
5. A 2-year-old child with a diagnosis of atopic dermatitis is being discharged. What should the nurse include in the discharge teaching?
- A. Avoid triggers that cause flare-ups
- B. Apply topical corticosteroids as prescribed
- C. Use a soft toothbrush for oral care
- D. Avoid contact with sick individuals
Correct answer: B
Rationale: The correct answer is to apply topical corticosteroids as prescribed. Atopic dermatitis is a chronic inflammatory skin condition that can be managed with topical corticosteroids to reduce inflammation and itching. While avoiding triggers that cause flare-ups is important in managing atopic dermatitis, the primary treatment approach involves using prescribed medications like corticosteroids. Using a soft toothbrush for oral care and avoiding contact with sick individuals are not directly related to managing atopic dermatitis and are not the priority discharge teachings in this case.