the nurse is assessing a newborn the day after birth a high pitched cry irritability and lack of interest in feeding are noted the mother signed her o
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Nursing Elites

HESI LPN

Community Health HESI Test Bank 2023

1. The nurse is assessing a newborn the day after birth. A high-pitched cry, irritability, and lack of interest in feeding are noted. The mother signed her own discharge against medical advice. What intervention is appropriate nursing care?

Correct answer: A

Rationale: The correct intervention is to reduce the environmental stimuli. In this scenario, the newborn is displaying signs of overstimulation and distress, which can be exacerbated by environmental factors. Offering formula every 2 hours (Choice B) may not address the underlying issue of overstimulation. Talking to the newborn while feeding (Choice C) and rocking the baby frequently (Choice D) may further stimulate the newborn, which is not appropriate in this case.

2. The Philippine Family Program seeks to improve and maintain which of the following life-saving measures?

Correct answer: D

Rationale: The correct answer is D, all of the above. The Philippine Family Program aims to enhance and sustain proper spacing of pregnancies, proper timing of pregnancies, and reducing the number of pregnancies. These measures are essential for promoting maternal and child health, preventing complications, and ensuring better outcomes. Choices A, B, and C are all part of the comprehensive approach taken by the program to safeguard the well-being of families and contribute to overall public health.

3. As a community health nurse engaged in the process of community empowerment, which action is essential for you to take?

Correct answer: C

Rationale: In the process of community empowerment, forming partnerships with people in the community is essential. This fosters collaboration, engagement, and shared decision-making, enabling the community to identify its needs, resources, and priorities. Gathering data from the community (Choice A) is important for understanding the community's health status but forming partnerships goes beyond data collection by actively involving community members in decision-making. Making decisions for people in the community (Choice B) undermines empowerment as it takes away their autonomy and control. Accepting responsibility for people’s actions (Choice D) is not synonymous with empowerment and can lead to disempowerment by creating dependency rather than fostering self-reliance and self-determination.

4. The nurse is screening children at a local community health clinic for infectious diseases. Which child is at highest risk for hepatitis B virus (HBV)?

Correct answer: A

Rationale: The correct answer is A: a newborn. Newborns are at the highest risk for HBV due to potential transmission from the mother. The hepatitis B virus can be transmitted from an infected mother to her baby during childbirth. Choices B, C, and D are incorrect because newborns have a higher risk due to this mode of transmission, making them more vulnerable compared to older children.

5. A client has developed thrombophlebitis of the left leg. Which nursing intervention should be given the highest priority?

Correct answer: A

Rationale: The highest priority nursing intervention for a client with thrombophlebitis of the left leg is to elevate the leg on 2 pillows. Elevating the leg helps reduce swelling and pain associated with thrombophlebitis by promoting venous return. Applying support stockings (choice B) can be beneficial but is not the highest priority as elevation is more effective in the acute phase. Applying warm compresses (choice C) may worsen the condition by dilating the blood vessels, leading to increased pain and swelling. Maintaining complete bed rest (choice D) is important, but elevation takes precedence to improve circulation and reduce the risk of complications.

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