HESI RN
Community Health HESI
1. During a 2-week postoperative follow-up home visit, a female client who had gastric bypass surgery exhibits abdominal tenderness, shoulder pain, and describes feelings of malaise. Her vital signs are: T 101.8, BP 100/50, HR 104, and RR 18. Which action should the RN take?
- A. have the client transported via ambulance to the hospital
- B. recheck the client's vital signs in 30 minutes
- C. instruct the client to drive to the hospital for admission
- D. assess the client's current symptoms
Correct answer: A
Rationale: The client is presenting with signs of a potential postoperative complication, such as fever, low blood pressure, and tachycardia, which could indicate sepsis or another serious issue. These symptoms require immediate hospital evaluation and management. Option B of rechecking vital signs in 30 minutes could delay crucial intervention in a potentially life-threatening situation. Option C is unsafe as the client should not drive herself due to her condition. Option D is vague and does not address the urgency of the situation.
2. A client with a history of asthma is admitted with shortness of breath. Which finding requires immediate intervention?
- A. Increased respiratory rate.
- B. Absence of breath sounds.
- C. Expiratory wheezes.
- D. Productive cough with green sputum.
Correct answer: B
Rationale: The correct answer is B: Absence of breath sounds. This finding can indicate a pneumothorax or severe asthma exacerbation, both of which require immediate intervention to ensure adequate ventilation and prevent further complications. Increased respiratory rate (choice A) is common in asthma exacerbations but may not always necessitate immediate intervention. Expiratory wheezes (choice C) are typical in asthma and may not always indicate a critical condition. A productive cough with green sputum (choice D) suggests a possible respiratory infection but does not warrant immediate intervention as much as the absence of breath sounds.
3. The nurse is planning a community health fair to promote mental health awareness. Which activity is most likely to engage participants?
- A. a lecture on the signs and symptoms of depression
- B. a workshop on stress management techniques
- C. a panel discussion with mental health experts
- D. a booth distributing brochures on mental health resources
Correct answer: B
Rationale: A workshop on stress management techniques is the most engaging activity as it allows participants to actively participate, learn practical skills, and interact with others. This hands-on approach fosters engagement and provides attendees with tools they can directly apply in their lives. Choice A, a lecture, may be informative but lacks the interactive element that promotes engagement. Choice C, a panel discussion, might be informative but could be passive for attendees. Choice D, distributing brochures, is informative but lacks the interactive and engaging nature of a workshop.
4. A female client is admitted with a tentative diagnosis of Guillain-Barre syndrome. Which finding is most important for the nurse to report to the healthcare provider?
- A. Facial weakness and difficulty speaking.
- B. Decreased deep tendon reflexes in the legs.
- C. Inability to move the eyes.
- D. Respiratory distress and cyanosis.
Correct answer: B
Rationale: In Guillain-Barre syndrome, decreased deep tendon reflexes are a critical finding that may indicate impending respiratory failure. This is due to the involvement of the peripheral nervous system affecting the muscles, including those involved in breathing. Reporting decreased deep tendon reflexes promptly is essential to prevent respiratory compromise. Facial weakness, difficulty speaking, and inability to move the eyes are common manifestations of Guillain-Barre syndrome but are not as immediately concerning as respiratory distress and impending respiratory failure.
5. The nurse notices that the influenza immunization rate is much lower for certain demographic groups than for others. Which intervention is likely to be most useful in increasing the rates of immunization in the underserved community groups?
- A. designated clinics conveniently located in target neighborhoods
- B. reports on decreasing influenza rates during times of greatest prevalence
- C. legislative proposals that mandate influenza vaccinations for all
- D. radio announcements about the availability of the influenza vaccine
Correct answer: A
Rationale: Conveniently located clinics in target neighborhoods increase accessibility, making it easier for underserved community groups to receive influenza immunizations. This intervention directly addresses the issue of lower immunization rates by improving convenience and access. Reports on decreasing influenza rates (choice B) may not directly impact immunization rates. Legislative proposals mandating vaccinations (choice C) could face resistance and may not always be the most effective or practical solution. Radio announcements (choice D) may raise awareness but may not address the underlying barriers to immunization faced by underserved communities.
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