HESI RN
Community Health HESI 2023
1. A graduate nursing student requests information, including laboratory findings and chest x-ray results, about all clients with symptoms of H1N1 who have been seen during the last month in a community health clinic. Which action should the charge nurse take?
- A. Ask if permission has been obtained from the research committee.
- B. Ask the student to sign a standard waiver form.
- C. Obtain written authorization from clients to release the information.
- D. Provide the information for research purposes only.
Correct answer: C
Rationale: The correct action for the charge nurse to take is to obtain written authorization from clients to release the information. This step is crucial to ensure compliance with privacy laws and ethical standards. Asking for permission from the research committee (Choice A) may not address the individual clients' rights to privacy. Asking the student to sign a standard waiver form (Choice B) is not appropriate, as the authorization should come from the clients themselves. Providing the information for research purposes only (Choice D) without proper authorization violates client confidentiality and privacy.
2. Which bioterrorism agent is at high risk for use as a potential biological weapon that is readily transmitted by several portals of entry?
- A. anthrax
- B. smallpox
- C. botulism
- D. tularemia
Correct answer: A
Rationale: Anthrax is the correct answer. Anthrax spores can be transmitted through inhalation, ingestion, or skin contact, making it a high-risk agent for bioterrorism. Smallpox, botulism, and tularemia are also potential bioterrorism agents, but they do not have the same versatility in terms of multiple portals of entry, unlike anthrax.
3. 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.
4. A client with a history of hypertension is admitted with a blood pressure of 200/120 mm Hg. Which medication should the nurse prepare to administer?
- A. Metoprolol (Lopressor).
- B. Furosemide (Lasix).
- C. Lisinopril (Zestril).
- D. Nitroprusside (Nipride).
Correct answer: D
Rationale: The correct answer is D, Nitroprusside (Nipride). In this scenario of severe hypertension (200/120 mm Hg), a hypertensive emergency is present, requiring rapid reduction of blood pressure. Nitroprusside is a vasodilator that acts quickly to lower blood pressure in such emergencies. Options A, B, and C are incorrect: A) Metoprolol is a beta-blocker that lowers blood pressure but is not indicated for hypertensive emergencies requiring rapid reduction. B) Furosemide is a diuretic that helps with fluid retention but does not rapidly lower blood pressure. C) Lisinopril is an ACE inhibitor used for long-term management of hypertension, not for immediate reduction in hypertensive emergencies.
5. The healthcare provider is assessing a client who has a new arteriovenous fistula in the left arm for hemodialysis. Which finding requires immediate intervention?
- A. A thrill is palpable on the fistula.
- B. The client's arm is warm and red.
- C. The fistula has a bruit on auscultation.
- D. There is no bruit on auscultation.
Correct answer: B
Rationale: The correct answer is B. Warmth and redness in the client's arm suggest infection or thrombosis of the arteriovenous fistula, which requires immediate intervention to prevent complications. A thrill (A) is a normal finding in a functional arteriovenous fistula, indicating good blood flow. A bruit (C) is also a normal finding on auscultation of a functioning arteriovenous fistula, indicating proper blood flow. The absence of a bruit (D) may indicate a non-functioning fistula, which would need further evaluation but does not require immediate intervention as warmth and redness do.
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