HESI RN
Community Health HESI 2023
1. A client with a history of alcoholism is admitted with pancreatitis. Which assessment finding is most important for the nurse to report to the healthcare provider?
- A. Nausea and vomiting.
- B. Epigastric pain radiating to the back.
- C. Temperature of 102°F (38.9°C).
- D. Mild jaundice.
Correct answer: C
Rationale: A temperature of 102°F (38.9°C) is the most important assessment finding to report to the healthcare provider in a client with pancreatitis and a history of alcoholism. Fever in this context can indicate infection, which is a serious complication requiring immediate intervention. Nausea and vomiting (choice A) are common symptoms of pancreatitis but may not require immediate intervention unless severe. Epigastric pain radiating to the back (choice B) is a classic symptom of pancreatitis and should be addressed, but a fever takes precedence. Mild jaundice (choice D) may be present in pancreatitis but is not as urgent as a high temperature signaling possible infection.
2. During a home visit, the nurse observes that an elderly client has numerous bruises on her arms and appears fearful of her caregiver. What should the nurse do first?
- A. report the findings to adult protective services
- B. ask the client how she got the bruises
- C. document the observations in the client's medical record
- D. discuss the observations with the caregiver
Correct answer: B
Rationale: The initial step for the nurse should be to ask the client how she got the bruises. This approach allows the nurse to directly assess the situation, gather information from the client, and potentially uncover signs of abuse. Reporting to adult protective services should come after obtaining more details from the client to ensure appropriate action. Documenting the observations is important but should follow gathering information from the client. Discussing the observations with the caregiver may not be appropriate as the caregiver could be the source of abuse, and involving them first may jeopardize the client's safety.
3. A public health nurse is working with a community to improve vaccination rates. Which intervention is most likely to be effective?
- A. Setting up vaccination clinics in accessible locations
- B. Distributing flyers with information about vaccines
- C. Offering incentives for getting vaccinated
- D. Partnering with local businesses to promote vaccination
Correct answer: A
Rationale: Setting up vaccination clinics in accessible locations is the most effective intervention to improve vaccination rates. This intervention ensures easy access to vaccination services for community members, removing barriers such as transportation or time constraints. Distributing flyers (Choice B) may increase awareness but may not directly address access issues. Offering incentives (Choice C) might temporarily boost vaccination rates but may not lead to sustained behavior change. Partnering with local businesses (Choice D) could be beneficial for promotion but may not directly impact vaccination accessibility.
4. The healthcare provider provides teaching to a group of evacuees in a mass casualty center after a natural flooding disaster. Which information should the healthcare provider include in the teaching plan? (select one that does not apply.)
- A. wash all fruits and vegetables thoroughly in running tap water
- B. identify all sexual contacts since the evacuation process
- C. take all doses of prophylactic prescriptions for diarrhea
- D. clean hands using soap, clean water, or waterless antibacterial solutions
Correct answer: B
Rationale: In the aftermath of a flooding disaster, educating evacuees on proper hygiene practices like washing fruits and vegetables, taking prophylactic prescriptions, and practicing hand hygiene is crucial to prevent the spread of diseases. Option B, identifying sexual contacts, is not relevant to preventing post-disaster health risks and should not be included in the teaching plan.
5. A community health nurse is applying for a federal grant to support a smoking cessation educational program. In which order should the nurse prioritize these nursing activities? Arrange in order top to bottom.
- A. Determine the target aggregate that will be served by the program
- B. Consider pros and cons of different methods of data gathering
- C. Select and train the data collection personnel
- D. All of the above
Correct answer: D
Rationale: The correct answer is 'D' - All of the above. The nurse should first determine the target aggregate that will be served by the program to understand the specific population in need. Subsequently, they should consider the pros and cons of different methods of data gathering to ensure the most appropriate data collection strategies are employed. Finally, selecting and training the data collection personnel is essential for the successful implementation of the program. These steps provide a logical progression from identifying the target group to analyzing the collected data. Choices A, B, and C are all crucial steps that must be taken in sequence to effectively develop and implement the smoking cessation educational program.
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