HESI RN
Community Health HESI
1. The nurse is caring for a client with a nasogastric tube to continuous suction. Which electrolyte imbalance should the nurse monitor for?
- A. Hypercalcemia.
- B. Hypokalemia.
- C. Hyponatremia.
- D. Hypomagnesemia.
Correct answer: B
Rationale: The correct answer is B: Hypokalemia. When a client has a nasogastric tube to continuous suction, potassium loss through gastric fluids can lead to hypokalemia. Hypercalcemia (Choice A) is not typically associated with continuous suction. Hyponatremia (Choice C) involves sodium imbalance and is not directly related to nasogastric suction. Hypomagnesemia (Choice D) is not the primary concern in this situation, as potassium loss is more significant with gastric suction.
2. A client with cirrhosis is admitted with ascites and jaundice. Which assessment finding is most concerning?
- A. Peripheral edema
- B. Confusion and altered mental status
- C. Increased abdominal girth
- D. Yellowing of the skin
Correct answer: B
Rationale: Confusion and altered mental status are concerning signs of hepatic encephalopathy in a client with cirrhosis. Hepatic encephalopathy is a serious complication of liver disease that requires immediate intervention. Peripheral edema may be present due to fluid accumulation, increased abdominal girth can indicate ascites which is common in cirrhosis, and yellowing of the skin is a typical manifestation of jaundice in liver dysfunction, all of which are important but not as immediately concerning as signs of hepatic encephalopathy.
3. The public health nurse is creating a plan to increase state funding for a local health clinic. Which strategy is likely to be most effective in obtaining funding for the clinic?
- A. Run the health clinic economically and promote the services the clinic provides.
- B. Organize concerned citizens to write letters and call state representatives.
- C. Highlight to the media the valuable services offered by the community clinic.
- D. Hire a professional lobbyist to convince Congress of the local clinic's value.
Correct answer: B
Rationale: Organizing concerned citizens to contact state representatives is likely the most effective strategy to secure state funding for the local health clinic. By mobilizing a group of citizens who are directly impacted by the clinic's services, the public health nurse can create a strong advocacy group that can influence decision-makers. Option A, running the health clinic economically and promoting its services, may be necessary but does not directly address the funding aspect. Option C, highlighting services to the media, may raise awareness but does not guarantee funding. Option D, hiring a professional lobbyist, may be costly and may not have the same grassroots impact as organizing citizens.
4. After fertilization, cell division occurs through a process of:
- A. Binary fission
- B. Meiosis
- C. Budding
- D. Mitosis
Correct answer: D
Rationale: After fertilization, the zygote undergoes cell division through the process of mitosis. Mitosis is the type of cell division that results in two daughter cells with the same number of chromosomes as the parent cell. Choice A, binary fission, is a form of asexual reproduction in prokaryotes, not the process that occurs after fertilization in multicellular organisms. Choice B, meiosis, is a type of cell division that leads to the formation of gametes with half the number of chromosomes, not the process that occurs after fertilization. Choice C, budding, is a form of asexual reproduction seen in some organisms like yeast, but it is not the process of cell division after fertilization.
5. A client is admitted for cellulitis surrounding an insect bite on the lower right arm, and intravenous (IV) antibiotic therapy is prescribed. Which action should the nurse implement before performing venipuncture?
- A. Lower the right arm below the level of the heart.
- B. Elevate the right arm on a pillow.
- C. Apply a tourniquet above the insertion site.
- D. Apply a warm compress to the insertion site.
Correct answer: A
Rationale: Before performing venipuncture for IV therapy, the nurse should lower the right arm below the level of the heart. Lowering the arm helps dilate the veins, making it easier to locate and access a suitable vein for the procedure. Elevating the arm on a pillow, applying a tourniquet above the insertion site, or applying a warm compress to the insertion site are not appropriate actions before venipuncture as they can affect the venous blood flow and make the procedure more challenging.