HESI RN
Community Health HESI 2023
1. The school nurse is conducting an audit of incident reports for adolescent students. Which finding is the best indication that the Healthy People 2020 objectives are being addressed?
- A. the absenteeism rate has increased greatly over the past two years
- B. during the last year fewer firearms were retrieved on school property
- C. the number of requests for pregnancy testing is higher than last year
- D. decline in the number of students enrolled in school during the year
Correct answer: B
Rationale: The correct answer is B. A decrease in firearms retrieved on school property is a positive indication that the Healthy People 2020 objectives are being addressed. This finding suggests progress in reducing violence and improving safety in schools, which aligns with the goals of promoting overall health and safety among adolescents. Choices A, C, and D do not directly relate to the Healthy People 2020 objectives. Increased absenteeism, higher requests for pregnancy testing, and a decline in student enrollment do not necessarily reflect the specific health and safety goals outlined in Healthy People 2020.
2. A client who is receiving intravenous heparin therapy has an activated partial thromboplastin time (aPTT) of 90 seconds. Which action should the nurse take?
- A. Continue the heparin infusion as prescribed.
- B. Decrease the heparin infusion rate.
- C. Increase the heparin infusion rate.
- D. Stop the heparin infusion and notify the healthcare provider.
Correct answer: D
Rationale: An aPTT of 90 seconds is significantly elevated, indicating a high risk of bleeding due to excessive anticoagulation. In this case, the heparin infusion should be stopped immediately to prevent further anticoagulation and an increased bleeding risk. Notifying the healthcare provider is essential to discuss alternative anticoagulation strategies or interventions. Continuing heparin therapy without action could lead to severe bleeding complications. Decreasing or increasing the heparin infusion rate would exacerbate the risk of bleeding, making options A, B, and C incorrect.
3. The client with newly diagnosed type 1 diabetes mellitus is being taught about insulin administration by the nurse. Which statement indicates that the client needs further teaching?
- A. I will inject my insulin into my abdomen for the fastest absorption.
- B. I will rotate injection sites to prevent lipodystrophy.
- C. I will store my insulin in the refrigerator at all times.
- D. I will rotate injection sites to prevent lipodystrophy.
Correct answer: C
Rationale: The correct answer is C. Insulin should not be stored in the refrigerator at all times; it should be kept at room temperature when in use to avoid irritation at the injection site. Storing insulin in the refrigerator can cause it to thicken and may lead to discomfort upon injection. Choices A and D are correct statements as injecting insulin into the abdomen for faster absorption and rotating injection sites to prevent lipodystrophy are appropriate insulin administration techniques. Therefore, the client does not need further teaching on these aspects.
4. 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.
5. The nurse is developing a workshop on cancer prevention for a group of adults at a wellness bar. Which recommendation should the nurse include in the workshop?
- A. Know the four warning signs of cancer
- B. Maintain a healthy weight and exercise regularly
- C. Refrain from alcohol
- D. Obtain at least 6 to 10 hours of sleep per night
Correct answer: B
Rationale: Maintaining a healthy weight and exercising regularly are crucial recommendations in cancer prevention. These habits help reduce the risk of developing cancer by promoting overall health and reducing factors associated with cancer development. Knowing the warning signs of cancer (Choice A) is important for early detection but does not directly prevent cancer. While refraining from alcohol (Choice C) is beneficial for some cancers, it is not as universally applicable as maintaining a healthy weight and exercising. Getting adequate sleep (Choice D) is essential for overall health but is not as directly linked to cancer prevention as maintaining a healthy weight and regular exercise.
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