HESI RN
HESI Community Health
1. The occupational health nurse is completing a yearly self-evaluation. Which activity should the nurse document as an example of proficient performance criteria in professionalism?
- A. contributes money to a professional society or organization
- B. maintains chairmanship of the hospital nursing council
- C. documents the nursing process in care management
- D. develops policy initiatives that impact occupational health and safety
Correct answer: D
Rationale: The correct answer is D because developing policy initiatives that impact occupational health and safety demonstrates leadership and proficiency in contributing to the field. Choices A, B, and C do not directly relate to professionalism criteria in the context of occupational health nursing. Contributing money to a professional society, maintaining chairmanship of a nursing council, or documenting the nursing process, while important, do not specifically highlight the nurse's impact on occupational health and safety through policy development.
2. The nurse obtains a heart rate of 92 and a blood pressure of 110/76 before administering a scheduled dose of verapamil (Calan) for a client with atrial flutter. Which action should the nurse implement?
- A. Administer the dose as prescribed.
- B. Hold the medication.
- C. Call the healthcare provider.
- D. Repeat the vital signs in 30 minutes.
Correct answer: A
Rationale: The correct action is to administer the dose as prescribed. Verapamil slows sinoatrial nodal automaticity and delays atrioventricular nodal conduction, which helps in slowing the ventricular rate. The heart rate of 92 and blood pressure of 110/76 are within an acceptable range for administering verapamil in a client with atrial flutter. Holding the medication, calling the healthcare provider, or repeating the vital signs in 30 minutes are not necessary based on the vital signs obtained and the action of verapamil in this scenario.
3. Which intervention by the community health nurse is an example of a secondary level of prevention?
- A. providing a needle exchange program at a community mental health clinic
- B. developing an educational program for clients with diabetes mellitus
- C. administering influenza vaccines to residents of a nursing home
- D. initiating contact notifications for sexual partners of an HIV client
Correct answer: C
Rationale: Administering influenza vaccines to residents of a nursing home is an example of secondary prevention. Secondary prevention aims to detect and treat a disease or condition in its early stages to prevent complications. In this case, administering influenza vaccines helps prevent the spread of the flu among vulnerable individuals. Choices A, B, and D are not examples of secondary prevention. Providing a needle exchange program (Choice A) is a harm reduction strategy (tertiary prevention). Developing an educational program for clients with diabetes mellitus (Choice B) focuses on health promotion and primary prevention. Initiating contact notifications for sexual partners of an HIV client (Choice D) is a measure to prevent further transmission of the disease but is more aligned with tertiary prevention.
4. The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?
- A. Note in the student records that the second dose of the MMR vaccine should be administered prior to entering first grade
- B. Send notices home with the children on the first day of class advising that MMR vaccine series must be completed
- C. Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year
- D. Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children
Correct answer: C
Rationale: The correct intervention for the school nurse is to contact kindergarten parents to remind them that the second dose of the MMR vaccine is due at the start of the school year. This approach directly addresses the issue of incomplete vaccination coverage and ensures that children receive the complete vaccination on time. Choice A is incorrect as it only notes the need for the second dose without actively engaging parents. Choice B is not as effective as directly contacting parents and may lead to delays in completing the vaccination series. Choice D, while promoting immunization, does not directly address the current situation of incomplete MMR vaccination among the kindergarten students.
5. During a health assessment for a family with a history of cardiovascular disease, which family member should be prioritized for further evaluation and intervention?
- A. a 45-year-old father who smokes and has high cholesterol
- B. a 17-year-old daughter who is overweight and inactive
- C. a 50-year-old mother with a history of hypertension
- D. a 12-year-old son who has a normal weight and is active
Correct answer: A
Rationale: The 45-year-old father who smokes and has high cholesterol should be prioritized for further evaluation and intervention. He has multiple risk factors for cardiovascular disease, including smoking and high cholesterol, which significantly increase his risk. Addressing these modifiable risk factors is crucial in preventing cardiovascular events. The daughter (Choice B) and mother (Choice C) also have risk factors, but the father's combination of smoking and high cholesterol places him at higher immediate risk, demanding priority intervention. The 12-year-old son (Choice D) with a normal weight and an active lifestyle has a lower risk profile and does not require immediate intervention compared to the father.
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