HESI LPN
Community Health HESI Exam
1. During a large community disaster, a man states that the blast threw him out of a second-story window. Which action should the nurse implement first?
- A. Logroll the client to his side and assess for back injuries
- B. Perform a complete neurological assessment
- C. Open the client's airway immediately
- D. Place the nurse's hands around the client's neck to stabilize
Correct answer: D
Rationale: In this situation, the nurse should first stabilize the client's neck to prevent potential spinal cord injuries. Logrolling the client or performing other assessments should only be done after ensuring spinal stabilization. Opening the airway immediately is important in cases of airway obstruction, but stabilizing the neck takes priority in this scenario. Performing a complete neurological assessment may delay immediate stabilization, which is crucial in suspected spinal injuries.
2. A community health action that focuses on reducing the frequency and severity of asthma in inner-city children by requiring a local incinerator to install particulate filters is an example of:
- A. downstream intervention
- B. risk management
- C. primary prevention
- D. upstream intervention
Correct answer: D
Rationale: The correct answer is D: upstream intervention. Upstream thinking addresses the root causes of health problems to create long-term solutions. In this scenario, requiring the incinerator to install particulate filters tackles the root cause of asthma triggers, which is pollution, rather than just managing the symptoms or risks associated with asthma. Choice A, downstream intervention, would focus more on treating asthma symptoms after they have already occurred rather than preventing them. Choice B, risk management, typically involves strategies to assess, control, or mitigate risks, which may not directly address the root cause. Choice C, primary prevention, usually refers to actions taken to prevent a disease or condition before it occurs, but in this case, the action is targeting the underlying cause rather than preventing asthma itself.
3. A 16-year-old female client returns to the clinic because she is pregnant for the third time by a new boyfriend. Which vaccine should the nurse plan to administer?
- A. MMR
- B. Hepatitis B
- C. Human papillomavirus
- D. Pneumococcal
Correct answer: B
Rationale: The correct answer is B, Hepatitis B. The Hepatitis B vaccine is crucial for pregnant women to prevent transmission of the virus to the baby during childbirth. Option A, MMR (Measles, Mumps, Rubella) vaccine, is not indicated during pregnancy. Option C, Human papillomavirus vaccine, is recommended for prevention of HPV infections but is not specifically indicated during pregnancy. Option D, Pneumococcal vaccine, is important for certain populations but is not the priority vaccine for a pregnant woman in this scenario.
4. A client with a history of deep vein thrombosis (DVT) is receiving warfarin (Coumadin). The nurse should monitor the client for which of the following laboratory values?
- A. Prothrombin time (PT)
- B. Serum potassium
- C. Blood urea nitrogen (BUN)
- D. White blood cell count (WBC)
Correct answer: A
Rationale: The correct answer is A: Prothrombin time (PT). Prothrombin time is monitored to assess the effectiveness of warfarin therapy. Warfarin is an anticoagulant medication that works by inhibiting the synthesis of vitamin K-dependent clotting factors, including factors II, VII, IX, and X. Monitoring the PT helps ensure that the client's blood is clotting within the desired therapeutic range to prevent complications such as recurrent DVT or excessive bleeding. Choices B, C, and D are incorrect because serum potassium, blood urea nitrogen, and white blood cell count are not directly related to monitoring warfarin therapy in a client with a history of DVT.
5. What title should be given to this occupational health nurse job description? A registered nurse who functions in a comprehensive executive role to set goals, formulate policy, and direct and evaluate the health service.
- A. manager
- B. researcher
- C. health educator
- D. health promotion specialist
Correct answer: A
Rationale: The correct answer is 'manager.' In the job description provided, the role involves setting goals, formulating policy, and directing and evaluating health services, which aligns with the responsibilities of a manager. A 'researcher' primarily focuses on conducting research, a 'health educator' specializes in educating individuals about health-related topics, and a 'health promotion specialist' concentrates on promoting health and wellness initiatives. Therefore, 'manager' is the most suitable title for the described role.
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