HESI RN
Community Health HESI 2023
1. The community health nurse believes that immunization rates in a lower socioeconomic section of the city are probably below the target set by the state health department. What action should the nurse take first to intervene with this health problem?
- A. join a political action group that focuses attention on the issue in the local news media
- B. partner with a local children's hospital in setting up free 'shot' clinics in the neighborhood
- C. review current epidemiological population data that might document a low immunization rate
- D. call a meeting of citizens to inform them of the importance of having their children immunized
Correct answer: C
Rationale: The most appropriate initial action for the community health nurse to take when addressing low immunization rates in a lower socioeconomic area is to review current epidemiological data. By reviewing this data, the nurse can gather evidence that documents the low immunization rate in the community. This information is crucial to support the need for targeted interventions to increase immunization rates. Choices A, B, and D involve actions that may be important at later stages of intervention but are not the first step. Joining a political action group, partnering with a hospital for clinics, or holding a community meeting are all valuable strategies, but they should be based on evidence obtained from reviewing epidemiological data to ensure targeted and effective interventions.
2. During a home visit, the nurse observes that an elderly client has a cluttered living environment and poor lighting. What should the nurse do first?
- A. suggest that the client hires a cleaning service
- B. assist the client in organizing the living space
- C. assess the client's risk for falls
- D. provide the client with information on home safety
Correct answer: C
Rationale: The correct first action for the nurse to take is to assess the client's risk for falls. A cluttered living environment and poor lighting are significant risk factors for falls in the elderly. By assessing the client's risk for falls, the nurse can identify potential hazards and implement appropriate interventions to prevent falls. Suggesting hiring a cleaning service or assisting in organizing the living space may address the symptoms but not the root cause of the fall risk. Providing information on home safety is important but should come after assessing the specific risk factors for falls in this scenario.
3. A client with a history of hypertension is admitted with acute renal failure. Which assessment finding requires immediate intervention?
- A. Blood pressure of 180/100 mm Hg.
- B. Urine output of 50 mL in 4 hours.
- C. Heart rate of 100 beats per minute.
- D. Nausea and vomiting.
Correct answer: B
Rationale: Urine output of 50 mL in 4 hours indicates oliguria, which can be a sign of worsening renal function and requires immediate intervention. In acute renal failure, maintaining adequate urine output is crucial to prevent further kidney damage and manage fluid balance. A high blood pressure reading (Option A) is concerning but may not require immediate intervention in this scenario as it could be due to the history of hypertension. A heart rate of 100 beats per minute (Option C) is slightly elevated but may not be the most critical finding at this moment. Nausea and vomiting (Option D) are important to assess but are not as urgent as addressing oliguria in a client with acute renal failure.
4. The nurse is providing discharge teaching to a client with chronic obstructive pulmonary disease (COPD). Which statement by the client indicates a need for further teaching?
- A. I will use my albuterol inhaler before exercising.
- B. I will avoid secondhand smoke.
- C. I will get a flu shot every year.
- D. I will limit my fluid intake to 2 liters per day.
Correct answer: A
Rationale: Using an albuterol inhaler before exercising is appropriate for clients with COPD to prevent exercise-induced bronchospasm.
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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