HESI LPN
Community Health HESI Practice Exam
1. A female client makes routine visits to a neighborhood community health center. The nurse notes that this client often presents with facial bruising, particularly around the eyes. The nurse discusses prevention of domestic violence with the client even though the client does not admit to being battered. What level of prevention has the nurse applied in this situation?
- A. primary prevention
- B. secondary prevention
- C. tertiary prevention
- D. health promotion
Correct answer: B
Rationale: The correct answer is B: secondary prevention. Secondary prevention involves identifying and addressing issues early to prevent further harm. In this scenario, the nurse is intervening by discussing domestic violence prevention with the client who is showing signs of facial bruising, aiming to prevent further harm even though the client has not disclosed being battered. Choice A (primary prevention) focuses on preventing the onset of a problem before it occurs, like educating about healthy relationships before violence happens. Choice C (tertiary prevention) involves managing and treating the effects of a problem that has already occurred, such as providing counseling to a domestic violence survivor. Choice D (health promotion) aims to enhance well-being and prevent health problems through educational and environmental interventions, which may include aspects of preventing domestic violence, but in this case, the nurse's direct intervention is more about early identification and prevention of harm, aligning it with secondary prevention.
2. What should be assessed in a child with suspected appendicitis?
- A. Level of consciousness
- B. Bowel sounds and pain location
- C. Skin color and temperature
- D. Heart rate and blood pressure
Correct answer: B
Rationale: The correct answer is to assess bowel sounds and pain location. In a child with suspected appendicitis, focusing on bowel sounds and pain location, particularly in the lower right quadrant, is crucial. This assessment helps to identify symptoms commonly associated with appendicitis. Assessing the level of consciousness (Choice A) is important in other conditions such as head injuries or neurological issues. Skin color and temperature (Choice C) are more indicative of circulatory or skin-related problems. Heart rate and blood pressure (Choice D) are vital signs that are essential to assess in various conditions but are not specific to suspected appendicitis.
3. A client with a diagnosis of depression is prescribed an SSRI. What is the most important information the nurse should provide?
- A. Take the medication as prescribed.
- B. Avoid consuming grapefruit juice.
- C. Report any thoughts of self-harm immediately.
- D. Understand that improvement may take weeks.
Correct answer: C
Rationale: The most important information the nurse should provide to a client prescribed an SSRI for depression is to report any thoughts of self-harm immediately. SSRIs can increase suicidal ideation, especially at the beginning of treatment, so it is crucial to monitor for this and take appropriate actions. While it is important to take the medication as prescribed (Choice A), the immediate need for reporting self-harm ideation takes precedence. Avoiding grapefruit juice (Choice B) is a general precaution with certain medications but not as critical in this scenario. Understanding that improvement may take weeks (Choice D) is important for managing treatment expectations, but ensuring the client's safety in the context of suicidal ideation is the top priority.
4. What factor predisposes the urinary tract to infection in children?
- A. increased fluid intake
- B. short urethra in young girls
- C. prostatic secretions in males
- D. frequent emptying of the bladder
Correct answer: B
Rationale: The short urethra in young girls is a significant factor that predisposes them to urinary tract infections. Girls have a shorter urethra than boys, making it easier for bacteria to travel up the urinary tract, leading to infections. Increased fluid intake (Choice A) is actually a preventive measure as it helps flush out bacteria from the urinary tract. Prostatic secretions in males (Choice C) do not predispose the urinary tract to infection in children. Frequent emptying of the bladder (Choice D) is also a good practice to prevent urinary tract infections by reducing the chances of bacterial growth in the urinary tract.
5. The client with hypertension is being taught about lifestyle modifications. What topic is most important?
- A. Stress management
- B. Salt intake reduction
- C. Regular physical activity
- D. Weight loss
Correct answer: B
Rationale: Reducing salt intake is crucial for managing hypertension. Excessive salt consumption can lead to fluid retention, increasing blood pressure. While stress management, regular physical activity, and weight loss are beneficial for overall health, reducing salt intake is the most important lifestyle modification for controlling hypertension. Stress management may help reduce overall stress levels but does not directly impact blood pressure as salt intake does. Regular physical activity and weight loss can also benefit blood pressure control, but the immediate impact of reducing salt intake is more significant.