HESI RN
HESI Community Health
1. The healthcare professional is developing a community health program to address the high rates of childhood asthma in a neighborhood. Which intervention should the healthcare professional prioritize?
- A. conducting home visits to identify asthma triggers
- B. distributing asthma education materials at schools
- C. holding workshops on asthma management for parents
- D. partnering with local healthcare providers to offer free asthma screenings
Correct answer: A
Rationale: The healthcare professional should prioritize conducting home visits to identify asthma triggers as it is crucial for reducing asthma attacks in children. By identifying triggers in the home environment, interventions can be implemented to create a safer living space for children with asthma. This approach directly addresses the root cause of asthma exacerbations. Distributing asthma education materials at schools is beneficial for raising awareness but may not address individual triggers. Holding workshops on asthma management for parents is valuable for education but does not directly tackle trigger identification. Partnering with local healthcare providers to offer free asthma screenings focuses on detection rather than prevention through trigger identification.
2. The healthcare provider is preparing to administer an intravenous antibiotic to a client with a central venous catheter. Which action is most important?
- A. Flush the catheter with heparin.
- B. Change the dressing at the insertion site.
- C. Check for blood return before administering the antibiotic.
- D. Use sterile technique when accessing the catheter.
Correct answer: D
Rationale: Using sterile technique when accessing the catheter is crucial to prevent infection in clients with a central venous catheter. This action helps maintain asepsis and reduces the risk of introducing pathogens into the catheter system. Flushing the catheter with heparin helps prevent occlusion but is not as crucial as ensuring sterile technique. Changing the dressing at the insertion site is important for assessing the site's condition but does not directly impact the administration of the antibiotic. Checking for blood return is essential to ensure proper catheter function, but sterile technique takes precedence to prevent infections.
3. On a day when the temperature is expected to drop below freezing during the night, the nurse is asked to determine which homeless adults are most in need of the limited spaces available in a shelter. It is most important for which person to be admitted at night?
- A. an adult who was hit by a car 3 weeks ago
- B. a young person with diabetes mellitus
- C. a middle-aged person who has hypertension
- D. an older person who is malnourished
Correct answer: D
Rationale: Malnourished individuals are at higher risk of severe complications from cold exposure due to their weakened immune system and decreased ability to regulate body temperature. This places them at a greater risk of hypothermia and other cold-related conditions, making them the most vulnerable group in need of shelter. Choice A is not the most critical as the injury is from 3 weeks ago and should have received appropriate medical care by now. Choice B, a young person with diabetes mellitus, while vulnerable, can manage their condition with proper medication and care. Choice C, a middle-aged person with hypertension, may need monitoring but is less susceptible to immediate harm from cold exposure compared to a malnourished individual.
4. The nurse is caring for a client with hyperthyroidism. Which assessment finding requires immediate intervention?
- A. Heart rate of 100 beats per minute.
- B. Blood pressure of 150/90 mm Hg.
- C. Respiratory rate of 24 breaths per minute.
- D. Weight loss of 5 pounds in one week.
Correct answer: D
Rationale: Weight loss of 5 pounds in one week in a client with hyperthyroidism is concerning as it may indicate severe hypermetabolism, leading to potential complications such as cardiac arrhythmias, muscle weakness, and other metabolic disturbances. Rapid weight loss in hyperthyroidism indicates an accelerated metabolic rate and increased energy expenditure, which can be detrimental to the client's health. The other assessment findings (heart rate of 100 beats per minute, blood pressure of 150/90 mm Hg, respiratory rate of 24 breaths per minute) are commonly seen in clients with hyperthyroidism and may not necessarily require immediate intervention unless they are significantly outside the normal range or causing distress to the client.
5. The healthcare provider is caring for a client with a chest tube. Which observation indicates that the chest tube is functioning effectively?
- A. Continuous bubbling in the water-seal chamber.
- B. Intermittent bubbling in the suction control chamber.
- C. No fluctuation (tidaling) in the water-seal chamber.
- D. Drainage of clear, pale yellow fluid from the chest tube.
Correct answer: B
Rationale: Intermittent bubbling in the suction control chamber is the correct observation indicating effective functioning of the chest tube. This bubbling signifies that the suction system is working correctly and maintaining the desired negative pressure in the pleural space. Continuous bubbling in the water-seal chamber suggests an air leak, which is not a normal finding. No fluctuation (tidaling) in the water-seal chamber may indicate a blockage or lack of communication between the pleural space and the water-seal, which is not ideal. Drainage of clear, pale yellow fluid from the chest tube is a normal finding, but it does not specifically indicate the effectiveness of the chest tube function.
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