HESI ACTUAL EXAM 2026/2027 |
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SECTION 1: LEVELS OF PREVENTION & COMMUNITY
ASSESSMENT (25 Questions)
Q1: A nurse implements tertiary prevention strategies as part of the quality management
process. Which of the following best describes a strategy the nurse would have used?
A. Mock fire drills are carried out twice a year to assess response and readiness.
B. All new employees complete a program on fire safety detailing what to do in the event of a
fire.
C. After evaluation of response to an actual fire, new procedures implemented in the fire
response protocols are distributed to employees. [CORRECT]
D. At the yearly employee picnic, teams compete in putting out trash can fires and racing
while carrying mock victims.
Correct Answer: C
Rationale: Tertiary prevention focuses on reducing the impact of an existing condition or
event and preventing recurrence or complications. After an actual fire has occurred,
evaluating the response and implementing new procedures to prevent future negative
outcomes represents tertiary prevention. Option A is secondary prevention (screening
preparedness), B is primary prevention (education before event occurs), and D is primary
prevention through education and skill-building.
Q2: A community health nurse organizes a walking group for healthy seniors at the local
community center. This is an example of which level of prevention?
A. Primary prevention [CORRECT]
B. Secondary prevention
,C. Tertiary prevention
D. Quaternary prevention
Correct Answer: A
Rationale: Primary prevention aims to prevent disease or injury before it occurs by promoting
health and protecting against risk factors. A walking group for healthy seniors promotes
cardiovascular health, prevents obesity, and maintains functional status before any health
problems develop. Secondary prevention involves early detection, while tertiary prevention
manages existing conditions.
Q3: The nurse plans to perform a windshield survey for a community. Which information is a
priority for the nurse to understand before conducting the survey?
A. The boundaries of the community [CORRECT]
B. The socioeconomic qualities of the community
C. The governmental structure of the community
D. The population size of the community
Correct Answer: A
Rationale: Before conducting a windshield survey, the nurse must first understand the
geographic boundaries of the community to define the area to be assessed. This provides the
framework for systematic observation of housing, transportation, services, and
environmental conditions. While socioeconomic qualities, governmental structure, and
population size are important community characteristics, boundaries must be established
first to guide the survey process.
Q4: Which of the following is an example of secondary prevention in community health?
A. Implementing a smoking cessation clinic for teenagers
B. Conducting blood pressure screenings at a health fair [CORRECT]
C. Establishing a cardiac rehabilitation program for post-MI patients
D. Developing nutrition education programs for elementary schools
Correct Answer: B
Rationale: Secondary prevention involves early identification of disease through screening to
enable prompt treatment and reduce severity. Blood pressure screenings detect hypertension
before symptoms develop. Smoking cessation (A) and nutrition education (D) are primary
prevention (preventing onset), while cardiac rehabilitation (C) is tertiary prevention (managing
existing disease).
,Q5: The goal of community-based nursing (CBN) is to:
A. Protect the health of entire populations through government policy
B. Manage acute or chronic conditions while promoting self-care among individuals and
families [CORRECT]
C. Conduct epidemiological research on disease patterns
D. Ensure all community members have equal access to healthcare resources
Correct Answer: B
Rationale: Community-based nursing focuses on managing acute and chronic health
conditions for individuals and families within their community setting, with emphasis on
promoting self-care capabilities. This differs from community-oriented nursing which focuses
on population-level health protection and promotion. CBN provides direct care to individuals
while helping them develop skills for self-management.
Q6: A nurse is conducting a community assessment. Which activities are part of the
assessment phase? (Select all that apply.)
A. Assisting communities to implement and evaluate plans and projects
B. Building constituencies to work with the community
C. Collecting, analyzing, and disseminating information [CORRECT]
D. Evaluating the social, economic, and environmental characteristics of the population
[CORRECT]
E. Questioning the availability of health services to the community [CORRECT]
Correct Answers: C, D, E
Rationale: The assessment phase of the nursing process involves systematic data collection
and analysis including: gathering and analyzing information (C), evaluating population
characteristics (D), and determining resource availability (E). Assisting with implementation
(A) is part of the intervention/assurance phase, while building constituencies (B) relates to
policy development and coalition building.
Q7: Which of the following best describes community-oriented care?
A. Providing one-on-one care to individuals in their homes
B. Emphasis on health protection, maintenance, promotion, and disease prevention for
populations [CORRECT]
C. Treating acute illnesses in community health centers
D. Managing chronic diseases through home health services
, Correct Answer: B
Rationale: Community-oriented care focuses on population-level health rather than individual
care. It emphasizes health protection (safeguarding from environmental threats), health
maintenance (preserving current health status), health promotion (enabling optimal
well-being), and disease prevention at the population level. This contrasts with
community-based nursing which provides individual direct care.
Q8: A nurse is implementing primary prevention strategies. Which intervention should be
included?
A. Pap smears for early detection of cervical cancer
B. Tuberculosis skin testing for high-risk populations
C. Smoking cessation clinics for teenagers [CORRECT]
D. Asthma self-management programs to reduce hospitalization
Correct Answer: C
Rationale: Primary prevention prevents disease before it occurs. Smoking cessation for
teenagers prevents nicotine addiction and future tobacco-related diseases. Pap smears (A)
and TB skin tests (B) are secondary prevention (early detection). Asthma self-management
(D) is tertiary prevention (managing existing disease to prevent complications).
Q9: Which windshield survey observation indicates a potential environmental health risk?
A. Presence of multiple parks and recreational facilities
B. Well-maintained sidewalks throughout the neighborhood
C. Industrial waste storage near residential water sources [CORRECT]
D. Active community centers with senior programs
Correct Answer: C
Rationale: Windshield surveys involve systematic observation of community environmental
conditions. Industrial waste storage near water sources poses contamination risks to the
population. Parks (A), sidewalks (B), and community centers (D) are positive community
assets. Environmental health risks include physical, chemical, biological, and social factors
that threaten population health.
Q10: A nurse is developing a program to track complications from vaccine-preventable
diseases over a 5-year period. This is an example of:
A. Primary prevention