HESI RN
Community Health HESI 2023 Quizlet
1. A client who is taking clonidine (Catapres, Duraclon) reports drowsiness. Which additional assessment should the nurse make?
- A. How long has the client been taking the medication?
- B. Assess the client's dietary habits.
- C. Check for signs of infection.
- D. Evaluate the client's sleep pattern.
Correct answer: A
Rationale: The correct answer is A. When a client reports drowsiness while taking clonidine, the nurse should assess how long the client has been taking the medication. Drowsiness is a common side effect that can occur in the early weeks of treatment with clonidine. By understanding the duration of medication use, the nurse can determine if the drowsiness is a temporary effect that may decrease over time. Choices B, C, and D are incorrect because assessing the client's dietary habits, checking for signs of infection, or evaluating the client's sleep pattern would not directly address the drowsiness associated with clonidine use.
2. A client with end-stage renal disease (ESRD) is receiving hemodialysis. Which laboratory value should the nurse monitor closely?
- A. Serum calcium level of 9 mg/dl
- B. Serum potassium level of 4.5 mEq/L
- C. Serum creatinine level of 2.0 mg/dl
- D. Serum sodium level of 138 mEq/L
Correct answer: C
Rationale: The correct answer is C: Serum creatinine level of 2.0 mg/dl. In a client with ESRD receiving hemodialysis, serum creatinine should be closely monitored. Elevated creatinine levels indicate impaired kidney function. Monitoring serum calcium levels (Choice A), serum potassium levels (Choice B), and serum sodium levels (Choice D) is also important in clients with ESRD, but the most crucial indicator of kidney function in this case is serum creatinine.
3. The client with breast cancer is receiving cyclophosphamide (Neosar). The nurse is reinforcing medication instructions and advises the client to:
- A. Take the medication with food.
- B. Increase fluid intake to 2000 to 3000 mL daily.
- C. Decrease sodium intake while taking the medication.
- D. Increase potassium intake while taking the medication.
Correct answer: B
Rationale: The correct answer is to increase fluid intake to 2000 to 3000 mL daily. Cyclophosphamide can cause hemorrhagic cystitis as a toxic effect. By increasing fluid intake, the client can help prevent this complication by promoting frequent urination, which reduces the concentration of the drug and its metabolites in the bladder. This dilution effect can help reduce the risk of bladder toxicity.
4. A male client is admitted to the psychiatric inpatient unit with a bandaged flesh wound after attempting to shoot himself. He was divorced one year ago, lost his job four months ago, and suffered a breakup of his current relationship last week. What is the most likely source of this client’s current feelings of depression?
- A. Feelings of frustration.
- B. A sense of loss.
- C. Poor self-esteem.
- D. A lack of intimate relationships.
Correct answer: B
Rationale: The client's recent history of divorce, job loss, and breakup of a current relationship indicates a series of significant losses. These losses are likely the primary source of his feelings of depression, leading to a sense of loss. While feelings of frustration (choice A) and poor self-esteem (choice C) could be contributing factors, the immediate trigger for his current emotional state appears to be the series of losses. A lack of intimate relationships (choice D) may be a consequence of the client's depressive symptoms rather than the root cause in this scenario.
5. A community health nurse is addressing the issue of domestic violence in the community. Which intervention should the nurse implement first?
- A. establishing a support group for survivors of domestic violence
- B. developing educational materials on recognizing signs of abuse
- C. partnering with local law enforcement to increase awareness
- D. conducting a community needs assessment to identify resources
Correct answer: D
Rationale: Conducting a community needs assessment is the most appropriate initial intervention when addressing domestic violence in the community. This step helps the nurse identify existing resources, gaps, and specific needs of the community related to domestic violence. By understanding the community's needs through a needs assessment, the nurse can tailor subsequent interventions effectively. Option A, establishing a support group, may be beneficial later but should not be the first step. Developing educational materials (Option B) and partnering with law enforcement (Option C) are important strategies; however, without understanding the community's specific needs through a needs assessment, the interventions may not be as targeted or effective.