HESI RN
Community Health HESI Quizlet
1. A public health nurse is implementing a program to improve vaccination rates among children in the community. Which intervention is most likely to be effective?
- A. Offering vaccinations at convenient locations and times
- B. Distributing educational materials about vaccines
- C. Providing incentives for getting vaccinated
- D. Hosting informational sessions for parents
Correct answer: A
Rationale: Offering vaccinations at convenient locations and times is the most effective intervention as it reduces barriers to access and makes it easier for parents to get their children vaccinated. This strategy directly addresses the issue of convenience and accessibility, which are common reasons for low vaccination rates. Distributing educational materials about vaccines (Choice B) can be helpful but may not directly address access issues. Providing incentives for getting vaccinated (Choice C) may be controversial and not sustainable in the long term. Hosting informational sessions for parents (Choice D) can be beneficial for education but may not directly improve vaccination rates as much as increasing access.
2. A client with chronic kidney disease (CKD) is admitted with hyperkalemia. Which assessment finding is most concerning?
- A. Bradycardia
- B. Muscle weakness
- C. Peaked T waves on the ECG
- D. Decreased deep tendon reflexes
Correct answer: C
Rationale: The correct answer is C: Peaked T waves on the ECG. In hyperkalemia, elevated potassium levels can affect the heart's electrical activity, leading to changes on the ECG such as peaked T waves. This finding is concerning as it can progress to serious cardiac arrhythmias, including ventricular tachycardia and fibrillation. Bradycardia (choice A) and decreased deep tendon reflexes (choice D) are not typically associated with hyperkalemia. While muscle weakness (choice B) can occur in hyperkalemia due to its effect on neuromuscular function, the most concerning assessment finding indicating the need for immediate intervention in this scenario is peaked T waves on the ECG.
3. The nurse is caring for a client with a history of atrial fibrillation who is receiving warfarin (Coumadin). Which laboratory value should be closely monitored?
- A. Serum potassium level
- B. Prothrombin time (PT)
- C. International Normalized Ratio (INR)
- D. Serum sodium level
Correct answer: C
Rationale: The correct answer is C, International Normalized Ratio (INR). The INR should be closely monitored in a client receiving warfarin (Coumadin) to assess the effectiveness and safety of anticoagulation therapy. Monitoring the INR helps ensure that the client is within the therapeutic range for anticoagulation to prevent complications such as bleeding or clotting. Choices A, B, and D are incorrect. While monitoring electrolyte levels like serum potassium and sodium is important in overall client care, they are not specific to monitoring the effects of warfarin therapy. Prothrombin time (PT) is a component of INR and helps in monitoring warfarin therapy, but INR gives a standardized result that is independent of the laboratory method used, making it the preferred choice for monitoring warfarin therapy.
4. At 6-8 weeks of pregnancy, the breast changes include:
- A. Colostrum can be expressed.
- B. Breasts become tender.
- C. Montgomery's tubercles are prominent.
- D. Nipples become prominent and mobile.
Correct answer: C
Rationale: At 6-8 weeks of pregnancy, one of the changes in the breast includes the prominence of Montgomery's tubercles. These sebaceous glands around the nipple become more noticeable at this stage. Colostrum production usually occurs later in pregnancy, typically closer to the third trimester. While breast tenderness is a common symptom of early pregnancy, it is not specific to the 6-8 week timeframe. Nipples becoming more prominent and mobile may happen later in pregnancy as the body prepares for breastfeeding, but it is not a typical change seen specifically at 6-8 weeks.
5. A female client, who is wearing dirty clothes and has a foul body odor, comes to the clinic reporting feeling scared because she is being stalked. What should the nurse do first?
- A. Offer the client a safe place to relax before interviewing her.
- B. Ask the client to describe why she is being stalked.
- C. Recommend that the client talk with a social worker.
- D. Assure the client that the healthcare provider will see her today.
Correct answer: A
Rationale: When a client presents with signs of distress and potential safety concerns, the priority is to provide a safe environment. Offering a safe place to relax can help the client feel secure and ready for further assessment and support. This action allows the nurse to establish rapport, ensure the client's immediate safety, and create a trusting relationship before delving into the details of the situation. Asking the client to describe why she is being stalked (Choice B) may exacerbate her distress and should come after ensuring her safety. Recommending that the client talk with a social worker (Choice C) is important but should follow immediate safety measures. Assuring the client that the healthcare provider will see her today (Choice D) is less critical than addressing her safety concerns and emotional state.