HESI LPN
Community Health HESI Test Bank 2023
1. 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.
2. You are called to a residence for a "sick" 5-year-old child. When you arrive and begin your assessment, you note that the child is unconscious with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Management of this child should consist of
- A. 100% oxygen via a non-rebreathing mask and rapid transport
- B. positive pressure ventilations with a BVM device and rapid transport
- C. chest compressions, artificial ventilations, and rapid transport
- D. back blows and chest thrusts while attempting artificial ventilations
Correct answer: C
Rationale: In a pediatric patient with an unconscious state, a respiratory rate of 8 breaths/min, and a heart rate of 50 beats/min, the appropriate management involves chest compressions, artificial ventilations, and rapid transport. These signs indicate severe respiratory and circulatory compromise, requiring immediate intervention to support breathing and circulation. Choice A (100% oxygen via a non-rebreathing mask) is not sufficient in this critical situation as the child requires more than just oxygen supplementation. Choice B (positive pressure ventilations with a BVM device) may be needed, but chest compressions are crucial in this scenario due to the presence of bradycardia. Choice D (back blows and chest thrusts) are not indicated for an unconscious child with respiratory and circulatory compromise; instead, immediate chest compressions are necessary to provide circulatory support.
3. A female client is admitted to the psychiatric unit with a diagnosis of anorexia nervosa. What is the priority nursing intervention?
- A. Monitor the client's vital signs regularly.
- B. Encourage the client to participate in group therapy.
- C. Offer the client frequent, high-calorie snacks.
- D. Weigh the client daily at the same time.
Correct answer: D
Rationale: The correct answer is to weigh the client daily at the same time. Daily weights are crucial in monitoring the client's nutritional status and guiding treatment for weight restoration in anorexia nervosa. Monitoring vital signs is important but weighing the client daily takes precedence in this situation. Encouraging group therapy and offering high-calorie snacks are important aspects of treatment but do not take priority over monitoring the client's weight.
4. What is an important consideration when administering medications to a child with hepatic dysfunction?
- A. Increased dosing intervals
- B. Adjustments in dosage due to altered metabolism
- C. Avoid all medications
- D. Use only topical medications
Correct answer: B
Rationale: When administering medications to a child with hepatic dysfunction, it is crucial to make adjustments in dosage due to altered metabolism. Hepatic dysfunction can affect the way medications are metabolized in the body, potentially leading to drug toxicity or reduced effectiveness. This is why adjusting the dosage is essential to ensure the medication is both safe and efficient. Choices A, C, and D are incorrect because increasing dosing intervals, avoiding all medications, or using only topical medications do not address the specific issue of altered drug metabolism in hepatic dysfunction.
5. The nurse is caring for a multiparous client who is 8 centimeters dilated, 100% effaced, and the fetal head is at 0 station. The client is shivering and states extreme discomfort with the urge to bear down. Which intervention should the nurse implement?
- A. Administer IV pain medication
- B. Perform a vaginal exam
- C. Reposition to side-lying
- D. Encourage pushing with each contraction
Correct answer: C
Rationale: Repositioning the client to a side-lying position is the most appropriate intervention in this scenario. This position can help relieve pressure on the cervix and reduce the urge to push prematurely, allowing the cervix to continue dilating. Administering IV pain medication may not address the underlying cause of the discomfort, and pushing prematurely can lead to cervical trauma. Performing a vaginal exam is not necessary at this point as the client is already 8 centimeters dilated, and the fetal head is at 0 station.