HESI RN
Community Health HESI 2023
1. A community health nurse is planning an intervention to reduce the incidence of type 2 diabetes in the community. Which strategy is most effective?
- A. Hosting cooking classes on preparing healthy meals
- B. Offering free blood glucose screenings
- C. Distributing pamphlets on diabetes prevention
- D. Organizing a community walking program
Correct answer: A
Rationale: The most effective strategy to reduce the incidence of type 2 diabetes in the community is hosting cooking classes on preparing healthy meals. This intervention provides practical skills and education that can directly impact dietary habits, leading to a decreased risk of developing type 2 diabetes. Offering free blood glucose screenings (Choice B) may help in early detection but does not address prevention. Distributing pamphlets on diabetes prevention (Choice C) provides information but lacks the interactive and hands-on approach of cooking classes. Organizing a community walking program (Choice D) promotes physical activity, which is beneficial, but dietary changes have a more significant impact on preventing type 2 diabetes.
2. A female client with acute respiratory distress syndrome (ARDS) is sedated and on a ventilator with 50% FIO2. What assessment finding warrants immediate intervention?
- A. Assess the client’s lung sounds bilaterally.
- B. Diminished left lower lobe sounds.
- C. Monitor ventilator settings for changes in oxygen levels.
- D. Increased sputum production and shortness of breath.
Correct answer: B
Rationale: Diminished breath sounds in a sedated client with ARDS and on a ventilator indicate collapsed alveoli, which requires immediate intervention, such as chest tube insertion, to prevent further lung damage. Assessing bilateral lung sounds (Choice A) is important but not as urgent as identifying diminished sounds in a specific location. Monitoring ventilator settings (Choice C) is essential but does not directly address the immediate need for intervention due to diminished breath sounds. Increased sputum production and shortness of breath (Choice D) may indicate other issues but are not specific to the urgency of addressing diminished breath sounds in ARDS.
3. The nurse is caring for a client in atrial fibrillation. The atrial heart rate is 250, and the ventricular rate is controlled at 75. Which of the following findings is cause for the most concern?
- A. Diminished bowel sounds
- B. Loss of appetite
- C. A cold, pale lower leg
- D. Tachypnea
Correct answer: C
Rationale: A cold, pale lower leg is cause for the most concern as it could indicate compromised blood circulation, potentially leading to serious complications like ischemia or thrombosis. Diminished bowel sounds, loss of appetite, and tachypnea are not directly related to the client's condition in atrial fibrillation and the heart rate discrepancy.
4. Which of the following options correctly lists the five stages of mitosis in order from beginning to end?
- A. Prophase, Prometaphase, Telophase, Metaphase, Anaphase
- B. Prophase, Prometaphase, Metaphase, Anaphase, Telophase
- C. Metaphase, Anaphase, Prophase, Prometaphase, Telophase
- D. Metaphase, Telophase, Anaphase, Prophase, Prometaphase
Correct answer: B
Rationale: The correct order of the stages of mitosis is Prophase, Prometaphase, Metaphase, Anaphase, and Telophase. Choice A is incorrect because it has Anaphase and Metaphase in the wrong order. Choice C is incorrect as it starts with Metaphase, which is not the first stage of mitosis. Choice D is incorrect as it also has the stages in the wrong order, and it starts with Metaphase, which is incorrect.
5. The healthcare provider assesses a client with cirrhosis and finds 4+ pitting edema of the feet and legs, and massive ascites. Which mechanism contributes to edema and ascites in clients with cirrhosis?
- A. Hyperaldosteronism causing increased sodium transport ion in renal tubules
- B. Decreased portacaval pressure with greater collateral circulation
- C. Decreased renin-angiotensin response related to increased renal blood flow
- D. Hypoalbuminemia that results in decreased colloidal oncotic pressure
Correct answer: D
Rationale: In clients with cirrhosis, hypoalbuminemia leads to decreased colloidal oncotic pressure. This reduction in oncotic pressure contributes to the development of edema in the feet and legs (pitting edema) and ascites in the abdomen. Hyperaldosteronism (choice A) would lead to sodium retention but is not the primary mechanism behind edema and ascites in cirrhosis. Decreased portacaval pressure with greater collateral circulation (choice B) is not directly related to the pathophysiology of edema and ascites in cirrhosis. Decreased renin-angiotensin response related to increased renal blood flow (choice C) does not play a significant role in the development of edema and ascites in cirrhosis compared to the impact of hypoalbuminemia on colloidal oncotic pressure.