HESI RN TEST BANK

HESI Community Health

During a follow-up home visit, the nurse observes that a client with chronic obstructive pulmonary disease (COPD) is using accessory muscles to breathe and has a pulse oximetry reading of 88%. What action should the nurse take first?

    A. Administer a prescribed bronchodilator

    B. Increase the oxygen flow rate

    C. Instruct the client to perform pursed-lip breathing

    D. Notify the healthcare provider immediately

Correct Answer:
Rationale: In this situation, the nurse should first instruct the client to perform pursed-lip breathing. Pursed-lip breathing helps improve oxygenation and decrease the work of breathing in clients with COPD. Administering a bronchodilator or increasing the oxygen flow rate may be necessary interventions but addressing the breathing technique through pursed-lip breathing is the initial action to optimize oxygenation. Notifying the healthcare provider immediately is not the first action indicated in this scenario; the nurse should intervene promptly to assist the client in improving breathing before escalating the situation.

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.

A cl ient presents at a community-based cl inic wi th complaints of shortness of breath, headache, often uses a gasol ine-powered pressure w asher to clean equipment and farm bui ldi ngs. Which type of poi so ni ng i s the most l ikel y etiology of t his cli ent's symptoms?

  • A. asbestos
  • B. si l ica dust
  • C. histopl asmosi s
  • D. carbon monoxi de -

Correct Answer: D
Rationale: Carbon monoxide poisoning is associated with symptoms like shortness of breath and headache and can occur from exposure to gas-powered equipment in poorly ventilated areas.

The nurse is preparing a presentation on sexually transmitted infections (STIs) for a group of high school students. Which strategy is most effective for this age group?

  • A. providing detailed statistical data on STI rates
  • B. distributing brochures about STI prevention
  • C. showing a documentary on the impact of STIs
  • D. facilitating a discussion on safe sex practices

Correct Answer: D
Rationale: Facilitating a discussion allows students to ask questions, share experiences, and engage with the topic in a meaningful way.

A community health nurse is evaluating the effectiveness of a diabetes management program. Which outcome indicates that the program is successful?

  • A. increased attendance at diabetes education sessions
  • B. reduced incidence of diabetes-related hospitalizations
  • C. higher rates of blood glucose monitoring among participants
  • D. greater knowledge of diabetes management techniques

Correct Answer: B
Rationale: The correct answer is B: reduced incidence of diabetes-related hospitalizations. This outcome is a strong indicator of successful diabetes management, as it suggests that participants are effectively controlling their condition and experiencing fewer severe complications that require hospitalization. Increased attendance at education sessions (choice A) may not directly correlate with improved health outcomes. While higher rates of blood glucose monitoring (choice C) are important, they alone may not reflect overall program success. Greater knowledge of diabetes management techniques (choice D) is valuable but does not directly measure the impact of the program on health outcomes like reduced hospitalizations.

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