HESI LPN
Community Health HESI Practice Exam
1. Environmental sanitation is the primary problem in community Y. As a stranger to the health unit, one of the major strategies in your plan is the improvement of the environmental health conditions of the community. To indicate this, which of the following would you do?
- A. meet with youth officials and parents' group leaders
- B. meet with religious and educational leaders
- C. request mayors to create a task force to help implement your project
- D. inform local announcers to disseminate the what and why of your project
Correct answer: C
Rationale: In this scenario, requesting mayors to create a task force is the most effective strategy to improve environmental health conditions in the community. Engaging with local government officials ensures the allocation of resources, coordination of efforts, and the implementation of sustainable solutions. While meeting with youth officials, parents' group leaders, religious and educational leaders are important, involving mayors in creating a task force will lead to broader community involvement and support. Informing local announcers about the project, although helpful for awareness, is not as impactful as engaging with local authorities for tangible change.
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. After 3 days, the nurse notes that James has chest indrawing and stridor. His mother returned him to the health center immediately. The nurse should:
- A. Change the antibiotic to second-line antibiotics
- B. Advise the mother to observe the child and continue giving the antibiotics
- C. Give the first dose of antibiotics and refer urgently
- D. Observe the child at the center
Correct answer: C
Rationale: Chest indrawing and stridor are signs of severe respiratory distress. In this situation, immediate referral is essential. Giving the first dose of antibiotics before referral can help initiate treatment, but urgent referral for further evaluation and management is crucial. Choice A is incorrect because simply changing the antibiotic without assessing the severity of the symptoms and providing urgent care is not appropriate. Choice B is incorrect as advising the mother to observe the child and continue antibiotics delays necessary intervention for a potentially life-threatening condition. Choice D is incorrect as observing the child at the center is not sufficient when signs of severe illness are present.
4. A client with a history of alcoholism is admitted to the hospital for detoxification. The nurse knows that the client's risk for withdrawal symptoms is greatest within:
- A. 2-4 hours
- B. 4-6 hours
- C. 6-12 hours
- D. 12-24 hours
Correct answer: D
Rationale: The correct answer is D: 12-24 hours. Withdrawal symptoms typically begin within 12-24 hours after the last drink. This period is when the client is at the highest risk for experiencing withdrawal symptoms. Choices A, B, and C are incorrect because they do not align with the typical timeline for alcohol withdrawal symptoms to manifest. Symptoms usually peak within the first 24 to 48 hours after the last drink, making the 12-24 hour window critical for monitoring and managing any potential withdrawal complications.
5. Which topic should be included in planning a secondary prevention project for the local retirement community?
- A. Safety measures in the home.
- B. Adult immunization program.
- C. Rehabilitation after surgery.
- D. Vision and hearing screening.
Correct answer: D
Rationale: In planning a secondary prevention project for the local retirement community, vision and hearing screening should be included. This is crucial as sensory impairments are common among older adults and early detection through screening can help in preventing further complications. Safety measures in the home, adult immunization programs, and rehabilitation after surgery are important but fall more under primary or tertiary prevention strategies rather than secondary prevention, which focuses on early detection and intervention to prevent the progression of health conditions.
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