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 public health nurse is assessing a community's readiness for a new smoking cessation program. Which factor is most important to evaluate?
- A. the community's smoking rates
- B. the availability of smoking cessation resources
- C. the community's attitude towards smoking
- D. the local healthcare providers' support for the program
Correct answer: C
Rationale: The most critical factor to evaluate when assessing a community's readiness for a smoking cessation program is the community's attitude towards smoking. Understanding the community's perceptions, beliefs, and behaviors related to smoking is crucial as it helps determine the level of receptiveness and potential success of the program. Assessing smoking rates (Choice A) could provide valuable epidemiological data but may not reflect the community's readiness for change. While the availability of smoking cessation resources (Choice B) is important, without considering the community's attitude, the program's effectiveness may be limited. Local healthcare providers' support (Choice D) is valuable but secondary to the community's attitude, which directly influences the program's acceptance and impact.
3. A client who is receiving total parenteral nutrition (TPN) has an elevated blood glucose level. Which action should the nurse take first?
- A. Stop the TPN infusion.
- B. Administer insulin as prescribed.
- C. Notify the healthcare provider.
- D. Check the TPN infusion rate.
Correct answer: D
Rationale: The correct first action for a client receiving TPN with an elevated blood glucose level is to check the TPN infusion rate. Elevated blood glucose levels in clients receiving TPN can be due to incorrect infusion rates leading to increased glucose delivery. By checking the TPN infusion rate, the nurse can verify if the rate is appropriate and make necessary adjustments. Stopping the TPN infusion abruptly could lead to complications from sudden nutrient deprivation. Administering insulin as prescribed may be necessary but should come after ensuring the correct TPN infusion rate. Notifying the healthcare provider is important but addressing the immediate need to check the infusion rate takes priority to manage hyperglycemia effectively.
4. In conducting a health assessment for a family with a history of cardiovascular disease, which family member should be prioritized for further evaluation and intervention?
- A. a 45-year-old father who smokes and has high cholesterol
- B. a 17-year-old daughter who is overweight and inactive
- C. a 50-year-old mother with a history of hypertension
- D. a 12-year-old son who has a normal weight and is active
Correct answer: A
Rationale: The 45-year-old father who smokes and has high cholesterol is at a higher risk for cardiovascular disease due to multiple risk factors. Smoking and high cholesterol are significant contributors to the development of cardiovascular issues. Prioritizing his evaluation and intervention is crucial to address these modifiable risk factors. The other family members, though they may have risk factors as well, do not present with the same level of immediate risk based on the information provided.
5. After coronary artery bypass graft surgery, a male client is admitted to the coronary care unit. Which nursing diagnosis is of the highest priority?
- A. Ineffective breathing pattern.
- B. Impaired gas exchange.
- C. Acute pain.
- D. Risk for infection.
Correct answer: B
Rationale: Impaired gas exchange is the highest priority nursing diagnosis because it directly impacts the client's oxygenation. Following coronary artery bypass graft surgery, ensuring adequate oxygen exchange is crucial for the client's recovery. Ineffective breathing pattern, although important, may not be as critical as impaired gas exchange in the immediate postoperative period. Acute pain, while significant, can be managed effectively with appropriate interventions and is not as emergent as addressing impaired gas exchange. Risk for infection is also a valid concern post-surgery, but ensuring optimal gas exchange takes precedence to prevent complications associated with inadequate oxygenation.
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