HESI RN
HESI Community Health
1. The nurse obtains a heart rate of 92 and a blood pressure of 110/76 before administering a scheduled dose of verapamil (Calan) for a client with atrial flutter. Which action should the nurse implement?
- A. Administer the dose as prescribed.
- B. Hold the medication.
- C. Call the healthcare provider.
- D. Repeat the vital signs in 30 minutes.
Correct answer: A
Rationale: The correct action is to administer the dose as prescribed. Verapamil slows sinoatrial nodal automaticity and delays atrioventricular nodal conduction, which helps in slowing the ventricular rate. The heart rate of 92 and blood pressure of 110/76 are within an acceptable range for administering verapamil in a client with atrial flutter. Holding the medication, calling the healthcare provider, or repeating the vital signs in 30 minutes are not necessary based on the vital signs obtained and the action of verapamil in this scenario.
2. A community health nurse is developing a program to increase physical activity among adults in the community. Which intervention is most likely to be successful?
- A. distributing flyers about the benefits of exercise
- B. organizing free community exercise classes
- C. partnering with local gyms to offer discounts
- D. hosting a health fair with information booths
Correct answer: B
Rationale: Organizing free community exercise classes is the most likely successful intervention as it provides a structured and accessible opportunity for adults to engage in physical activity. This choice directly offers a practical solution by providing a regular and organized setting for individuals to participate in physical activity. Distributing flyers about the benefits of exercise, while informative, may not lead to actual participation. Partnering with local gyms to offer discounts relies on individuals taking the initiative to sign up for gym memberships, which may not be feasible for everyone. Hosting a health fair with information booths is informative but may not directly address the need for increased physical activity among adults in the community.
3. The healthcare provider is assessing a client who has just returned from hemodialysis. Which finding requires immediate intervention?
- A. Weight gain of 2 pounds.
- B. Dizziness.
- C. Blood pressure of 150/90 mm Hg.
- D. Heart rate of 88 beats per minute.
Correct answer: B
Rationale: Dizziness after hemodialysis can indicate hypovolemia, hypotension, or other complications that require immediate intervention to prevent further deterioration or adverse events. Weight gain of 2 pounds may not be immediately concerning post-hemodialysis. A blood pressure of 150/90 mm Hg is slightly elevated but may not require immediate intervention unless accompanied by symptoms. A heart rate of 88 beats per minute falls within the normal range and may not be an immediate cause for concern after hemodialysis.
4. A public health nurse is planning a vaccination clinic for a rural community. Which vaccine should the nurse prioritize for adults in this area?
- A. hepatitis A
- B. influenza
- C. varicella
- D. measles, mumps, rubella (MMR)
Correct answer: B
Rationale: The correct answer is 'B: influenza.' Influenza vaccination is crucial for adults, particularly in rural areas where access to healthcare may be limited. Influenza can cause serious illness and complications, and vaccination helps protect individuals and prevent the spread of the virus. While vaccines for hepatitis A, varicella, and measles, mumps, rubella (MMR) are important, prioritizing influenza vaccination in this scenario is essential due to its seasonal prevalence and potential impact on public health. Hepatitis A and varicella vaccines are also important but may not be as immediately critical for this population. MMR vaccine is typically administered in childhood, so it is not the priority for adults in this scenario.
5. A client with a history of epilepsy is admitted with status epilepticus. Which medication should the nurse prepare to administer?
- A. Acetaminophen (Tylenol)
- B. Lorazepam (Ativan)
- C. Phenytoin (Dilantin)
- D. Carbamazepine (Tegretol)
Correct answer: B
Rationale: In the management of status epilepticus, the initial medication of choice is a benzodiazepine such as lorazepam (Ativan) to rapidly terminate the seizure activity. Lorazepam acts quickly and effectively in stopping seizures. Phenytoin (Dilantin) is often used as a second-line agent for status epilepticus, and carbamazepine (Tegretol) is not typically indicated for the acute treatment of status epilepticus. Acetaminophen (Tylenol) is a pain reliever and antipyretic but is not used in the treatment of status epilepticus.
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