HESI RN
HESI Community Health
1. While screening all children in the third grade for head lice, the school nurse observes that one girl has a brownish thickening on her neck. Which action should the nurse take in response to this finding?
- A. review the child's medical folder for a list of allergies
- B. instruct the child's parents to begin treatment
- C. advise the child's parents to obtain a medical evaluation of the child
- D. none of the above
Correct answer: C
Rationale: The correct action for the nurse to take is to advise the child's parents to obtain a medical evaluation of the child. This is important because a medical professional needs to properly diagnose and treat the brownish thickening observed on the child's neck. Reviewing the child's medical folder for allergies (Choice A) is not appropriate in this situation as it does not address the specific concern. Instructing the child's parents to begin treatment (Choice B) without a proper diagnosis can be harmful and ineffective. Choosing 'none of the above' (Choice D) is not the best option when a potential health issue is identified; seeking a medical evaluation is the most appropriate course of action.
2. A community health nurse is planning a program to address the rising rates of obesity in the community. Which intervention should the nurse prioritize?
- A. organizing community exercise programs
- B. distributing educational materials on healthy eating
- C. partnering with local grocery stores to provide discounts on healthy foods
- D. conducting health screenings for early detection of obesity-related conditions
Correct answer: A
Rationale: The correct answer is A: organizing community exercise programs. Physical activity plays a crucial role in weight management and reducing obesity rates. While educating about healthy eating (choice B) is important, focusing on exercise programs can have a more direct impact on addressing obesity. Partnering with local grocery stores for discounts on healthy foods (choice C) is beneficial but may not address the root cause of obesity. Conducting health screenings (choice D) is more reactive than proactive in addressing rising obesity rates.
3. What information should the nurse provide a client who has undergone cryosurgery for stage 1A cervical cancer?
- A. Expect heavy, watery vaginal discharge for 3 to 6 weeks.
- B. Use a tampon instead of a sanitary napkin.
- C. Report any severe cramping immediately.
- D. Avoid sexual intercourse for 3 to 6 weeks.
Correct answer: D
Rationale: After cryosurgery for stage 1A cervical cancer, clients should avoid sexual intercourse for 3 to 6 weeks to reduce the risk of infection. Heavy, watery vaginal discharge is expected but not the focus of post-procedure instructions. Using tampons is contraindicated as they can introduce bacteria into the healing cervix. While reporting severe cramping is important, avoiding sexual intercourse is the priority to prevent complications.
4. During a repeat home visit to see an 84-year-old widow, the nurse discovers that the client is unkempt, smells of stale urine, and does not recognize her neighbors or the nurse. What action should the nurse take?
- A. Call the pharmacy to determine what medications she is taking
- B. Seek the family's assistance in taking care of the client
- C. Complete a physical and mental exam on the client
- D. Call the adult protective services to obtain emergency nursing home placement
Correct answer: C
Rationale: In this scenario, the nurse should prioritize completing a physical and mental exam on the client. This action is crucial to assess the client's health status comprehensively and identify any underlying issues contributing to her unkempt appearance, odor of stale urine, and confusion. Calling the pharmacy to determine medications (Choice A) may be important but is not the immediate priority. Seeking family assistance (Choice B) can be helpful, but the client's condition requires a thorough assessment first. While adult protective services (Choice D) may be necessary in the future, the immediate action should be to assess the client's physical and mental health status.
5. A client who is receiving intravenous heparin therapy has an activated partial thromboplastin time (aPTT) of 90 seconds. Which action should the nurse take?
- A. Continue the heparin infusion as prescribed.
- B. Decrease the heparin infusion rate.
- C. Increase the heparin infusion rate.
- D. Stop the heparin infusion and notify the healthcare provider.
Correct answer: D
Rationale: An aPTT of 90 seconds is significantly elevated, indicating a high risk of bleeding due to excessive anticoagulation. In this case, the heparin infusion should be stopped immediately to prevent further anticoagulation and an increased bleeding risk. Notifying the healthcare provider is essential to discuss alternative anticoagulation strategies or interventions. Continuing heparin therapy without action could lead to severe bleeding complications. Decreasing or increasing the heparin infusion rate would exacerbate the risk of bleeding, making options A, B, and C incorrect.
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