a newborn presents with a pronounced cephalic hematoma following a birth in the posterior position which nursing diagnosis should guide the plan of ca
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Nursing Elites

HESI LPN

Community Health HESI Test Bank 2023

1. A newborn presents with a pronounced cephalic hematoma following a birth in the posterior position. Which nursing diagnosis should guide the plan of care?

Correct answer: C

Rationale: The correct nursing diagnosis to guide the plan of care for a newborn with a pronounced cephalic hematoma following a birth in the posterior position is 'Parental anxiety related to knowledge deficit.' This is appropriate because the parents may be worried about the appearance and potential complications of the cephalic hematoma. They may require education and reassurance from the nurse. Choices A, B, and D are incorrect because they do not address the emotional needs of the parents and the knowledge deficit they may have regarding the condition.

2. Which of the following is an example of a modifiable risk factor for chronic diseases?

Correct answer: D

Rationale: Physical inactivity is a modifiable risk factor for chronic diseases because individuals have control over their level of physical activity. By increasing physical activity, the risk of chronic diseases can be reduced. Choices A, B, and C are not modifiable risk factors: Age is a non-modifiable factor, gender is a biological characteristic, and genetic predisposition is inherent and cannot be altered.

3. The nurse is teaching a 27-year-old client with asthma about the management of their therapeutic regimen. Which statement would indicate the need for additional instruction?

Correct answer: C

Rationale: Exercise, especially aerobic activities, is beneficial for clients with asthma as long as it is well-managed. Limiting exercise is not generally recommended unless specifically advised by a healthcare provider, indicating a need for further instruction in this case. Monitoring peak flow, contacting the clinic for increased medication use, and learning stress reduction techniques are all appropriate self-management strategies for asthma, indicating good understanding by the client.

4. The nurse is working in a community health clinic that serves a diverse population. Which of the following actions best demonstrates cultural competence?

Correct answer: A

Rationale: Learning about the cultural practices of the clinic's client population is the best way to demonstrate cultural competence. This action shows respect for the diverse backgrounds of the clients and helps in providing care that is sensitive to their cultural beliefs and practices. Providing translation services (Choice B) is important for effective communication but may not address the deeper aspects of cultural competence. Treating all clients the same (Choice C) may overlook the unique needs that arise from cultural differences. Encouraging clients to adopt mainstream health practices (Choice D) may not be appropriate or respectful of their cultural traditions and preferences.

5. The nurse is caring for an acutely ill 10-year-old client. Which of the following assessments would require the nurse's immediate attention?

Correct answer: D

Rationale: The correct answer is D, slow, irregular respirations. In an acutely ill child, this assessment can indicate impending respiratory failure or neurological compromise, necessitating immediate intervention. Rapid bounding pulse (choice A) may indicate tachycardia but is not as immediately concerning as compromised respirations. A temperature of 38.5 degrees Celsius (choice B) is elevated but may not be the most urgent concern unless accompanied by other symptoms. Profuse diaphoresis (choice C) can indicate increased sympathetic activity but is not as critical as respiratory compromise.

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