HESI RN
Community Health HESI 2023
1. A client with a history of peptic ulcer disease is admitted with severe abdominal pain. Which assessment finding requires immediate intervention?
- A. Epigastric tenderness.
- B. Bowel sounds are hypoactive.
- C. The client reports sudden, severe abdominal pain.
- D. Bowel sounds are hyperactive.
Correct answer: C
Rationale: The correct answer is C. Sudden, severe abdominal pain can indicate a perforated ulcer, which is a medical emergency requiring immediate intervention. Epigastric tenderness (choice A) may be expected in a client with peptic ulcer disease but does not necessarily require immediate intervention. Hypoactive bowel sounds (choice B) are concerning but not as urgent as sudden, severe abdominal pain. Hyperactive bowel sounds (choice D) are more indicative of conditions like gastroenteritis rather than a perforated ulcer, making it a less critical finding compared to sudden, severe abdominal pain.
2. The nurse is preparing to administer an oral medication to a client with dysphagia. Which action should the nurse take?
- A. Crush the medication and mix it with applesauce.
- B. Have the client drink a full glass of water with the medication.
- C. Administer the medication with a small amount of pudding.
- D. Place the medication at the back of the client's tongue.
Correct answer: C
Rationale: The correct action for the nurse to take when administering oral medication to a client with dysphagia is to administer the medication with a small amount of pudding. This method helps prevent aspiration in clients with dysphagia by ensuring easier swallowing. Crushing the medication and mixing it with applesauce (Choice A) might alter the medication's efficacy. Having the client drink a full glass of water with the medication (Choice B) may not be suitable for a client with dysphagia as it can increase the risk of aspiration. Placing the medication at the back of the client's tongue (Choice D) can also lead to aspiration and is not recommended.
3. A community health nurse is evaluating the effectiveness of a recent smoking cessation program. Which outcome indicates success?
- A. increased attendance at support group meetings
- B. reduced number of cigarettes smoked per day
- C. higher sales of nicotine replacement products
- D. lower relapse rate among participants
Correct answer: D
Rationale: The correct answer is D: lower relapse rate among participants. A lower relapse rate indicates that participants are successfully quitting smoking and maintaining their cessation, which is the ultimate goal of a smoking cessation program. Increased attendance at support group meetings (choice A) may demonstrate engagement but does not necessarily indicate successful smoking cessation. Similarly, higher sales of nicotine replacement products (choice C) may reflect increased product usage but not necessarily successful smoking cessation. While reducing the number of cigarettes smoked per day (choice B) is a positive change, it does not guarantee successful smoking cessation or long-term abstinence.
4. The nurse is planning an immunization campaign targeting the children of migrant farm workers in the community. Which data should the nurse review before exploring solution options when developing this program plan?
- A. uncertain risks
- B. potential outcomes
- C. priority of solutions
- D. target population data
Correct answer: D
Rationale: Correct. Before designing an immunization campaign for the children of migrant farm workers, the nurse should review target population data. This includes understanding the specific demographics, health needs, and challenges faced by this population to create a tailored and effective program. Reviewing uncertain risks (choice A) may not provide actionable insights for program development. Considering potential outcomes (choice B) is important but comes after understanding the target population. Evaluating the priority of solutions (choice C) is premature without knowing the specific characteristics and needs of the target population.
5. A client with a history of hypertension is admitted with acute renal failure. Which assessment finding requires immediate intervention?
- A. Blood pressure of 180/100 mm Hg.
- B. Urine output of 50 mL in 4 hours.
- C. Heart rate of 100 beats per minute.
- D. Nausea and vomiting.
Correct answer: B
Rationale: Urine output of 50 mL in 4 hours indicates oliguria, which can be a sign of worsening renal function and requires immediate intervention. In acute renal failure, maintaining adequate urine output is crucial to prevent further kidney damage and manage fluid balance. A high blood pressure reading (Option A) is concerning but may not require immediate intervention in this scenario as it could be due to the history of hypertension. A heart rate of 100 beats per minute (Option C) is slightly elevated but may not be the most critical finding at this moment. Nausea and vomiting (Option D) are important to assess but are not as urgent as addressing oliguria in a client with acute renal failure.
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