HESI RN
Community Health HESI
1. A school nurse is developing a program to address bullying among students. Which component is most important to include?
- A. education on the effects of bullying
- B. training for teachers on how to handle bullying incidents
- C. a peer mentoring program
- D. a zero-tolerance policy for bullying
Correct answer: B
Rationale: Training for teachers is the most important component to include in addressing bullying among students. Teachers play a crucial role in identifying, intervening, and preventing bullying incidents. By providing teachers with training on how to handle bullying, they can effectively address such situations, support victims, and educate students on appropriate behavior. While education on the effects of bullying (Choice A) is important, teachers need practical skills to intervene. Peer mentoring programs (Choice C) and zero-tolerance policies (Choice D) are valuable but may not be as effective without teachers being equipped to address bullying incidents directly.
2. The healthcare provider is caring for a client with a chest tube. Which observation indicates that the chest tube is functioning effectively?
- A. Continuous bubbling in the water-seal chamber.
- B. Intermittent bubbling in the suction control chamber.
- C. No fluctuation (tidaling) in the water-seal chamber.
- D. Drainage of clear, pale yellow fluid from the chest tube.
Correct answer: B
Rationale: Intermittent bubbling in the suction control chamber is the correct observation indicating effective functioning of the chest tube. This bubbling signifies that the suction system is working correctly and maintaining the desired negative pressure in the pleural space. Continuous bubbling in the water-seal chamber suggests an air leak, which is not a normal finding. No fluctuation (tidaling) in the water-seal chamber may indicate a blockage or lack of communication between the pleural space and the water-seal, which is not ideal. Drainage of clear, pale yellow fluid from the chest tube is a normal finding, but it does not specifically indicate the effectiveness of the chest tube function.
3. The healthcare professional is developing a teaching plan for an adolescent with a Milwaukee brace. Which instruction should the healthcare professional include?
- A. Wear the brace over a T-shirt for 23 hours a day.
- B. Remove the brace while sleeping.
- C. Wear the brace directly against the skin.
- D. Remove the brace while eating.
Correct answer: A
Rationale: The correct answer is A. A Milwaukee brace should be worn over a T-shirt for 23 hours a day to reduce friction and chafing of the skin. This ensures that the brace is not directly against the skin, which can cause discomfort and skin irritation. Choice B is incorrect because the brace should typically be worn continuously, even while sleeping, unless otherwise instructed by a healthcare provider. Choice C is incorrect as wearing the brace directly against the skin can lead to skin issues. Choice D is incorrect since the brace should not be removed while eating to maintain the prescribed wear time.
4. The client is receiving warfarin (Coumadin) therapy. Which statement by the client indicates a need for further teaching?
- A. I will avoid eating foods high in vitamin K.
- B. I will use a soft toothbrush and an electric razor.
- C. I will keep all appointments for blood tests.
- D. I will avoid participating in contact sports.
Correct answer: D
Rationale: The correct answer is D because participating in contact sports can increase the risk of injury and bleeding in a client receiving warfarin therapy. Warfarin is a blood thinner, and activities with a higher risk of injury should be avoided to prevent bleeding complications. Choices A, B, and C are all correct statements for a client on warfarin therapy. Avoiding foods high in vitamin K helps maintain consistent anticoagulation levels, using a soft toothbrush and an electric razor reduces the risk of bleeding gums and cuts, and keeping appointments for blood tests ensures proper monitoring of the client's international normalized ratio (INR) levels.
5. During a follow-up visit, a client with hypertension reports that they often forget to take their medication. What should the nurse do first?
- A. educate the client on the importance of medication adherence
- B. explore the reasons for the client's forgetfulness
- C. provide the client with a pill organizer
- D. adjust the client's medication schedule
Correct answer: B
Rationale: The correct first action for the nurse is to explore the reasons for the client's forgetfulness. By understanding the underlying causes, the nurse can provide tailored interventions to help the client improve medication adherence. Providing education on the importance of adherence (Choice A) may be necessary but should come after identifying the reasons for forgetfulness. Simply providing a pill organizer (Choice C) or adjusting the medication schedule (Choice D) does not address the root cause of the forgetfulness and may not lead to sustained improvement in adherence.
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