HESI RN
Community Health HESI 2023
1. The nurse is preparing an orientation class for new employees at an inner-city clinic that serves a low-income population. Which information should the nurse include in the presentation to these new employees?
- A. A lack of transportation is the major impediment for the clinic's clients.
- B. Basic physiological needs are likely to be unmet in this clinic's client population.
- C. Printed material is less effective for this population that has limited reading skills.
- D. A group education class is often poorly attended by non-compliant clients.
Correct answer: A
Rationale: The correct answer is A. Addressing transportation issues is crucial when working with low-income populations as lack of transportation can be a significant barrier to accessing healthcare services. This information is important for new employees to understand the challenges faced by the clinic's clients and to strategize ways to overcome this barrier. Choices B, C, and D are incorrect because while they may be relevant considerations, addressing transportation barriers should be a priority given its impact on accessing care for this specific population.
2. The healthcare provider is assessing a client who has returned from surgery. Which finding requires immediate intervention?
- A. Heart rate of 90 beats per minute.
- B. Oxygen saturation of 92%.
- C. Temperature of 99°F (37.2°C).
- D. Pain at the surgical site.
Correct answer: C
Rationale: A temperature of 99°F (37.2°C) in a postoperative client requires immediate intervention as it may indicate the presence of infection. Elevated temperature post-surgery can be a sign of surgical site infection or systemic infection, which can lead to serious complications if not addressed promptly. Monitoring and managing a fever in a postoperative client is crucial to prevent further complications. The other findings, such as a heart rate of 90 beats per minute, oxygen saturation of 92%, and pain at the surgical site, are common postoperative assessments that may not necessarily require immediate intervention unless they are significantly out of normal range or causing severe distress to the client.
3. A community health nurse is planning a program to reduce the incidence of heart disease in the community. Which intervention should the nurse prioritize?
- A. Distributing educational materials on heart-healthy diets
- B. Organizing free cholesterol screenings
- C. Holding workshops on stress management
- D. Partnering with local gyms to offer fitness classes
Correct answer: B
Rationale: The correct answer is B: Organizing free cholesterol screenings. This intervention is crucial because it helps identify individuals at risk for heart disease by assessing their cholesterol levels. High cholesterol is a significant risk factor for heart disease, and identifying it early can lead to timely interventions and medical care. Choices A, C, and D, while beneficial for overall health, may not directly address the specific risk factor of high cholesterol associated with heart disease. Distributing educational materials on heart-healthy diets (A) could be helpful in preventing heart disease, but identifying individuals already at risk is a more urgent need. Holding workshops on stress management (C) and partnering with local gyms for fitness classes (D) are important for overall health promotion but may not target the specific risk factor of high cholesterol as directly as organizing cholesterol screenings.
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. A client with a history of peptic ulcer disease is admitted with sudden severe abdominal pain. Which finding indicates the possibility of a perforated ulcer?
- A. Bowel sounds are hyperactive in all quadrants.
- B. Abdomen is soft and nondistended.
- C. The client reports sudden severe abdominal pain.
- D. Blood pressure of 110/70 mm Hg.
Correct answer: C
Rationale: The correct answer is C. Sudden severe abdominal pain is a key clinical manifestation of a perforated ulcer. The sudden onset of severe pain is concerning for a perforation in the ulcer, which can lead to peritonitis if not promptly addressed. Choices A, B, and D are incorrect because hyperactive bowel sounds, a soft and nondistended abdomen, and a blood pressure of 110/70 mm Hg are not specific indicators of a perforated ulcer. Hyperactive bowel sounds may suggest increased gastrointestinal motility, a soft abdomen may not necessarily indicate a perforation, and a blood pressure of 110/70 mm Hg is within normal limits and does not directly relate to a perforated ulcer.
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