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 nurse is caring for a client with acute pancreatitis who is reporting severe abdominal pain. Which nursing intervention should the nurse implement first?
- A. Assess the client's bowel sounds
- B. Administer prescribed pain medication
- C. Encourage the client to sit upright
- D. Provide clear fluids to the client
Correct answer: B
Rationale: In a client with acute pancreatitis experiencing severe abdominal pain, the priority nursing intervention is to provide pain relief. Administering prescribed pain medication is essential to improve comfort and reduce pain, which can help stabilize the client's condition. Assessing bowel sounds (Choice A) may be necessary but is not the immediate priority over pain management. Encouraging the client to sit upright (Choice C) and providing clear fluids (Choice D) are not the primary interventions for addressing severe abdominal pain in acute pancreatitis.
3. A client with a history of heart failure is admitted to the hospital with worsening dyspnea. The nurse notes that the client has a productive cough with pink, frothy sputum. What action should the nurse take first?
- A. Administer oxygen
- B. Perform chest physiotherapy
- C. Elevate the head of the bed
- D. Obtain a sputum specimen
Correct answer: A
Rationale: In a client with heart failure presenting with worsening dyspnea and pink, frothy sputum (indicating pulmonary edema), the priority action for the nurse is to administer oxygen. Oxygen therapy helps improve oxygenation and alleviate dyspnea by increasing the oxygen supply to the lungs. Performing chest physiotherapy, elevating the head of the bed, or obtaining a sputum specimen are not the initial actions indicated in this situation and may delay addressing the client's immediate need for improved oxygenation.
4. What function does cholesterol, a phospholipid, serve within the cell membrane?
- A. It builds up fats to make the structure more flexible
- B. It allows protein channels to form
- C. It makes the structure very rigid and impermeable
- D. It stabilizes the membrane structure
Correct answer: D
Rationale: Cholesterol helps to maintain the fluidity and stability of the cell membrane by fitting between the phospholipid molecules. Choice A is incorrect because cholesterol does not build up fats in the cell membrane. Choice B is incorrect as protein channels are formed by proteins, not cholesterol. Choice C is incorrect as cholesterol actually helps regulate the fluidity of the membrane, making it less rigid and more permeable.
5. A client with liver cirrhosis is receiving lactulose for hepatic encephalopathy. Which finding indicates the medication is effective?
- A. The client's level of consciousness improves.
- B. The client's ammonia level decreases.
- C. The client has three bowel movements daily.
- D. The client's liver enzymes return to normal.
Correct answer: B
Rationale: The correct answer is B: "The client's ammonia level decreases." In hepatic encephalopathy, elevated ammonia levels contribute to neurological symptoms. Lactulose works by promoting the excretion of ammonia in the stool, leading to decreased serum ammonia levels. Therefore, a decrease in ammonia levels indicates that lactulose is effectively reducing ammonia buildup, improving hepatic encephalopathy symptoms. Choices A, C, and D are incorrect because improvement in level of consciousness, bowel movements, or normalization of liver enzymes may not directly reflect the effectiveness of lactulose in reducing ammonia levels and improving hepatic encephalopathy.