HESI RN
Community Health HESI
1. Community health nurses are particularly concerned with the source of communicable diseases such as hepatitis A. Which group of individuals have a higher risk of contracting that type of hepatitis?
- A. IV drug users who share needles
- B. low-income families living in cramped quarters
- C. those who have recently received a blood transfusion
- D. sexually active persons with multiple partners
Correct answer: B
Rationale: The correct answer is B. Hepatitis A is often spread through close personal contact and poor sanitary conditions, which are more common in low-income, cramped living situations. IV drug users sharing needles are at higher risk of hepatitis B and C due to bloodborne transmission. Those who have recently received a blood transfusion are at risk of hepatitis C or other bloodborne infections. Sexually active persons with multiple partners are at risk of hepatitis B, which can be transmitted through sexual contact.
2. The nurse is providing discharge teaching to a client with a new diagnosis of diabetes mellitus. Which statement by the client indicates a need for further teaching?
- A. I will need to monitor my blood sugar levels daily.
- B. I will follow a diet low in carbohydrates.
- C. I will rotate the injection sites for my insulin.
- D. I will exercise regularly to help manage my diabetes.
Correct answer: B
Rationale: The correct answer is B. The statement 'I will follow a diet low in carbohydrates' indicates a need for further teaching. In diabetes mellitus, it is essential to follow a balanced diet that includes carbohydrates, proteins, and fats. Carbohydrates are a major source of energy and should be included in moderation to help manage blood sugar levels. Monitoring blood sugar levels daily (A), rotating injection sites for insulin (C), and exercising regularly (D) are all appropriate self-management strategies for individuals with diabetes mellitus.
3. Who is likely to have the most influence on these women's perceptions about their children's healthcare needs?
- A. husbands
- B. clinic healthcare provider
- C. older females
- D. tribal chief
Correct answer: C
Rationale: In many cultures, older women, such as grandmothers or aunts, hold significant influence over health-related decisions and practices within the family. They are often the ones consulted for advice on healthcare matters concerning children. Husbands (choice A) may have influence in other areas, but when it comes to healthcare decisions for children, older females are typically more influential. Clinic healthcare providers (choice B) may offer guidance, but the influence of older females within the community is usually stronger. Tribal chiefs (choice D) may hold authority but might not be as directly involved in individual healthcare decisions within families as older females.
4. During the physical assessment, which finding should the nurse recognize as a normal finding?
- A. Regular pulsation at the epigastric area when the client is supine.
- B. A loud, harsh murmur at the second right intercostal space.
- C. Dullness over the lung fields.
- D. Increased tactile fremitus.
Correct answer: A
Rationale: The regular pulsation at the epigastric area when the client is supine is a normal finding. This phenomenon is caused by the regular and recurrent expansion and contraction of an artery due to waves of pressure caused by the ejection of blood from the left ventricle. Choices B, C, and D describe abnormal findings during a physical assessment. A loud, harsh murmur at the second right intercostal space indicates an abnormal heart sound, dullness over the lung fields may suggest consolidation or fluid in the lungs, and increased tactile fremitus can be a sign of lung consolidation or pathology.
5. The nurse must delegate some aspects of a homebound client's care to a home health aide. Which intervention should the nurse delegate to the home health aide?
- A. evaluating a pressure sore
- B. applying a prosthetic device
- C. performing a sterile dressing change
- D. assessing the client's need for an elevated toilet seat
Correct answer: B
Rationale: The correct answer is B: applying a prosthetic device. Home health aides are trained and authorized to assist with the application and management of prosthetic devices for clients. Evaluating a pressure sore (choice A) requires clinical assessment and judgment typically performed by a licensed healthcare provider such as a nurse. Performing a sterile dressing change (choice C) involves aseptic technique and wound care skills that are usually performed by licensed healthcare professionals. Assessing the client's need for an elevated toilet seat (choice D) involves a level of assessment and decision-making that is beyond the scope of practice for a home health aide.
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