HESI RN
Community Health HESI
1. The nurse notices that the influenza immunization rate is much lower for certain demographic groups than for others. Which intervention is likely to be most useful in increasing the rates of immunization in the underserved community groups?
- A. designated clinics conveniently located in target neighborhoods
- B. reports on decreasing influenza rates during times of greatest prevalence
- C. legislative proposals that mandate influenza vaccinations for all
- D. radio announcements about the availability of the influenza vaccine
Correct answer: A
Rationale: Conveniently located clinics in target neighborhoods increase accessibility, making it easier for underserved community groups to receive influenza immunizations. This intervention directly addresses the issue of lower immunization rates by improving convenience and access. Reports on decreasing influenza rates (choice B) may not directly impact immunization rates. Legislative proposals mandating vaccinations (choice C) could face resistance and may not always be the most effective or practical solution. Radio announcements (choice D) may raise awareness but may not address the underlying barriers to immunization faced by underserved communities.
2. The nurse instructs a client to use an incentive spirometer. The client performs a return demonstration as seen in the video. Which action should the nurse take in response to the return demonstration?
- A. Instruct the client to inhale more deeply
- B. Remind the client to cough after using the spirometer
- C. Praise the client for correct usage
- D. Suggest increasing the frequency of spirometer use
Correct answer: B
Rationale: The correct action for the nurse to take in response to the return demonstration of using an incentive spirometer is to remind the client to cough after using the device. Coughing helps clear secretions from the lungs and promotes lung expansion. Instructing the client to inhale more deeply (Choice A) is not necessary as the primary focus after using the spirometer is to clear secretions. Praising the client for correct usage (Choice C) is positive but does not address the essential step of coughing. Suggesting increasing the frequency of spirometer use (Choice D) is not the immediate action needed after the demonstration.
3. When should the surgical correction of hypospadias in a newborn infant typically be done?
- A. Repair should be done by one month to prevent bladder infection.
- B. To form a proper urethra repair, it should be done after sexual maturity.
- C. Repairs typically should be done before the child is potty trained.
- D. Delaying the repair until school age reduces castration fears.
Correct answer: C
Rationale: Surgical repairs for hypospadias are typically recommended to be performed before the child is potty trained. This timing helps in avoiding complications, ensures better outcomes, and makes the surgical process smoother. Early correction also minimizes the psychological impact on the child regarding genital differences and can improve long-term psychological well-being. Choices A, B, and D are incorrect because repairing hypospadias at one month to prevent bladder infection, after sexual maturity to form a proper urethra, or delaying the repair until school age to reduce castration fears are not the standard recommendations. The optimal timing for surgical correction is before the child is potty trained to achieve the best results and psychological outcomes.
4. A female patient will receive doxycycline to treat a sexually transmitted infection (STI). What information will the nurse include when teaching this patient about this medication?
- A. Nausea and vomiting are uncommon adverse effects.
- B. The drug may cause possible teratogenic effects.
- C. Increase intake of dairy products with each dose of this medication.
- D. Use a backup method of contraception if taking oral contraceptives.
Correct answer: D
Rationale: The correct answer is D. The desired action of oral contraceptives can be reduced when taken with tetracyclines like doxycycline. Therefore, patients on oral contraceptives should be advised to use a backup contraception method while taking doxycycline. Choice A is incorrect because nausea and vomiting are common adverse effects of doxycycline. Choice B is incorrect because doxycycline is not known for causing teratogenic effects. Choice C is incorrect because dairy products can interfere with the absorption of doxycycline, so they should be avoided when taking this medication.
5. What is the most effective nursing intervention to prevent atelectasis from developing in a postoperative client?
- A. Maintain adequate hydration
- B. Assist the client to turn, deep breathe, and cough
- C. Ambulate the client within 12 hours
- D. Splint the incision
Correct answer: B
Rationale: The correct answer is to assist the client to turn, deep breathe, and cough. This intervention helps to expand the lungs and prevent atelectasis in postoperative clients. Maintaining adequate hydration is important for overall health but is not the most effective intervention for preventing atelectasis. Ambulating the client within 12 hours is beneficial for preventing complications after surgery, but it may not be as directly effective in preventing atelectasis as turning, deep breathing, and coughing. Splinting the incision is important for postoperative care, but it does not specifically address the prevention of atelectasis.