HESI LPN
Community Health HESI Study Guide
1. An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?
- A. "Feedings can begin in 5 to 7 days."
- B. "The use of the feeding tube can begin immediately."
- C. "The stomach contents and air must be drained first."
- D. "The incision healing must be complete before feeding."
Correct answer: C
Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.
2. The nurse is caring for a client admitted to the hospital with right lower lobe (RLL) pneumonia. On assessment, the nurse notes crackles over the RLL. The client has significant pleuritic pain and is unable to take in a deep breath in order to cough effectively.
- A. Impaired gas exchange related to acute infection and sputum production
- B. Ineffective airway clearance related to sputum production and ineffective cough
- C. Ineffective breathing pattern related to acute infection
- D. Anxiety related to hospitalization and role conflict
Correct answer: B
Rationale: The client's inability to effectively clear the airway due to pain and sputum production hinders the cough mechanism, making 'Ineffective airway clearance' the most appropriate nursing diagnosis. Although impaired gas exchange may occur due to the pneumonia, the immediate issue is the inability to clear the airway. 'Ineffective breathing pattern' does not address the specific issue of airway clearance. 'Anxiety' is not the priority when the focus should be on the physical complications of pneumonia.
3. The following are functions of the Provincial Nurse Supervisor except:
- A. interpreting policies, guidelines, and SDP to nursing and midwifery staff of the province
- B. assessing training needs and planning staff development programs for nursing and midwifery staff
- C. participating in planning, developing, and evaluating OJT for nurses and midwives conducted by the department
- D. collecting, consolidating, analyzing, and interpreting health records and reports and making recommendations as needed
Correct answer: D
Rationale: The correct answer is D. Collecting, consolidating, analyzing, and interpreting health records is not a primary function of a Provincial Nurse Supervisor. The primary functions of a Provincial Nurse Supervisor include interpreting policies, guidelines, and SDP to nursing and midwifery staff, assessing training needs, planning staff development programs, and participating in planning, developing, and evaluating OJT for nurses and midwives. While health records may be accessed for specific purposes, the core responsibilities of a Provincial Nurse Supervisor focus on staff management and development rather than direct involvement in health record analysis.
4. What is a key component of a successful smoking cessation program?
- A. Providing nicotine replacement therapy
- B. Offering surgical interventions
- C. Conducting regular health screenings
- D. Promoting alcohol consumption
Correct answer: A
Rationale: The correct answer is A. Providing nicotine replacement therapy is a key component of smoking cessation programs as it helps individuals manage nicotine withdrawal symptoms. Nicotine replacement therapy includes options like nicotine gum, patches, lozenges, or inhalers. Choice B, offering surgical interventions, is incorrect as smoking cessation programs primarily focus on behavioral and pharmacological interventions rather than surgical procedures. Choice C, conducting regular health screenings, is also incorrect as it is not a direct key component of smoking cessation programs. Choice D, promoting alcohol consumption, is not only incorrect but counterproductive, as it can be detrimental to overall health and hinder smoking cessation efforts.
5. The occurrence of non-communicable diseases (NCDs) is on the rise and is attributed to the changing lifestyle of Filipinos. The major NCDs are cardiovascular diseases (CVDs), cancer, chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DM). The community health nurse can help address these problems. The major risk factors common to the above-mentioned four major NCDs are:
- A. Unhealthy diet, physical inactivity, and smoking
- B. Hypertension, sedentary lifestyle, and poor stress management
- C. Obesity, sedentary lifestyle, and smoking
- D. Unhealthy diet, alcoholism, and sedentary lifestyle
Correct answer: A
Rationale: The correct answer is A: 'Unhealthy diet, physical inactivity, and smoking.' These are major risk factors associated with cardiovascular diseases (CVDs), cancer, chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DM). Unhealthy diet can lead to obesity and other health issues, physical inactivity contributes to various chronic conditions, and smoking is a well-known risk factor for cancer and respiratory diseases. Choice B is incorrect as hypertension is a condition that can result from these risk factors rather than being a risk factor itself. Poor stress management, although important for overall health, is not a major risk factor for the mentioned NCDs. Choice C is incorrect as although obesity is a risk factor, it is not mentioned in the question stem. Choice D is incorrect as alcoholism is not listed among the major NCDs or the common risk factors provided.
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