HESI LPN
Community Health HESI Practice Exam
1. A female client makes routine visits to a neighborhood community health center. The nurse notes that this client often presents with facial bruising, particularly around the eyes. The nurse discusses prevention of domestic violence with the client even though the client does not admit to being battered. What level of prevention has the nurse applied in this situation?
- A. primary prevention
- B. secondary prevention
- C. tertiary prevention
- D. health promotion
Correct answer: B
Rationale: The correct answer is B: secondary prevention. Secondary prevention involves identifying and addressing issues early to prevent further harm. In this scenario, the nurse is intervening by discussing domestic violence prevention with the client who is showing signs of facial bruising, aiming to prevent further harm even though the client has not disclosed being battered. Choice A (primary prevention) focuses on preventing the onset of a problem before it occurs, like educating about healthy relationships before violence happens. Choice C (tertiary prevention) involves managing and treating the effects of a problem that has already occurred, such as providing counseling to a domestic violence survivor. Choice D (health promotion) aims to enhance well-being and prevent health problems through educational and environmental interventions, which may include aspects of preventing domestic violence, but in this case, the nurse's direct intervention is more about early identification and prevention of harm, aligning it with secondary prevention.
2. Which statement specifically describes occupational health nursing?
- A. Involves prevention, recognition, and treatment of injury and illness
- B. All of these
- C. The application of nursing principles in conserving the health of workers in all occupations
- D. Requires special skills in the field of health, education, and counseling
Correct answer: B
Rationale: The correct answer is B. Occupational health nursing involves all aspects mentioned in the statements: prevention, recognition, treatment of injury and illness, application of nursing principles in conserving workers' health, and the requirement of special skills in health, education, and counseling. Choice A focuses on prevention, recognition, and treatment but does not encompass all aspects of occupational health nursing. Choice C only mentions the application of nursing principles without including prevention and treatment. Choice D specifically highlights the need for special skills but does not cover all the aspects of occupational health nursing.
3. During an initial clinic visit, the nurse is taking the history for a client who wants to confirm her pregnancy. The client's last child has a history of low-birth-weight (LBW). Which additional finding is most important for the nurse to consider?
- A. Cigarette smoking.
- B. African American ethnicity.
- C. Poor nutritional status.
- D. Limited maternal education.
Correct answer: A
Rationale: The correct answer is A: Cigarette smoking. Cigarette smoking is a significant risk factor for low birth weight. Smoking during pregnancy reduces the amount of oxygen available to the baby, leading to LBW. Choice B, African American ethnicity, while it may be a risk factor, is not as directly linked to LBW as cigarette smoking. Choice C, poor nutritional status, can contribute to LBW but is not as significant as cigarette smoking in this case. Choice D, limited maternal education, is an important social determinant of health but is not as directly related to LBW as cigarette smoking.
4. The healthcare provider is screening children at a local community health clinic for infectious diseases. Which child is at the highest risk for hepatitis B virus?
- A. a newborn
- B. a 3-year-old
- C. a 7-year-old
- D. an 11-year-old
Correct answer: A
Rationale: Newborns are at the highest risk for hepatitis B virus due to potential transmission from the mother. The hepatitis B virus can be transmitted from an infected mother to her baby during childbirth. Children born to mothers infected with hepatitis B are at the highest risk of acquiring the infection. Choices B, C, and D are at lower risk compared to a newborn as they are less likely to have been exposed to the virus during childbirth.
5. The nurse is caring for a 4-year-old child with a greenstick fracture. In explaining this type of fracture to the parents, the best response by the nurse should be that
- A. A child's bone is more flexible and can be bent 45 degrees before breaking
- B. Bones of children are more porous than adults and often have incomplete breaks
- C. Compression of porous bones produces a buckle or torus type break
- D. Bone fragments often remain attached by a periosteal hinge
Correct answer: B
Rationale: The correct answer is B. Greenstick fractures are common in children because their bones are softer and more porous than adult bones, leading to incomplete breaks when force is applied. Choice A is incorrect as greenstick fractures are not due to bone flexibility but rather the porous nature of children's bones. Choice C is incorrect as it describes a buckle or torus type break, which is not characteristic of a greenstick fracture. Choice D is incorrect as greenstick fractures do not involve bone fragments remaining attached by a periosteal hinge.
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