HESI RN
HESI Community Health
1. Which intervention by the community health nurse is an example of a secondary level of prevention?
- A. providing a needle exchange program at a community mental health clinic
- B. developing an educational program for clients with diabetes mellitus
- C. administering influenza vaccines to residents of a nursing home
- D. initiating contact notifications for sexual partners of an HIV client
Correct answer: C
Rationale: Administering influenza vaccines to residents of a nursing home is an example of secondary prevention. Secondary prevention aims to detect and treat a disease or condition in its early stages to prevent complications. In this case, administering influenza vaccines helps prevent the spread of the flu among vulnerable individuals. Choices A, B, and D are not examples of secondary prevention. Providing a needle exchange program (Choice A) is a harm reduction strategy (tertiary prevention). Developing an educational program for clients with diabetes mellitus (Choice B) focuses on health promotion and primary prevention. Initiating contact notifications for sexual partners of an HIV client (Choice D) is a measure to prevent further transmission of the disease but is more aligned with tertiary prevention.
2. A client with a history of coronary artery disease is admitted with chest pain. Which assessment finding requires immediate intervention?
- A. Heart rate of 90 beats per minute.
- B. Respiratory rate of 20 breaths per minute.
- C. Blood pressure of 130/80 mm Hg.
- D. Chest pain radiating to the left arm.
Correct answer: D
Rationale: Chest pain radiating to the left arm is a classic symptom of a myocardial infarction (heart attack) in individuals with coronary artery disease. This finding indicates that the heart muscle may not be receiving adequate oxygen, which requires immediate intervention to prevent further damage or complications. The other assessment findings (heart rate of 90 beats per minute, respiratory rate of 20 breaths per minute, blood pressure of 130/80 mm Hg) are within normal limits and do not suggest an acute, life-threatening condition like myocardial infarction.
3. Several employees who have a 10-year or longer smoking history ask for assistance with smoking cessation. A nurse develops a 2-month program that includes weekly group sessions on lifestyle changes and use of over-the-counter nicotine substitute products. Which measurement provides the best indication of the program's effectiveness?
- A. survey employees to determine how many are smoking 2 months after the end of the program
- B. test the employees' knowledge of OTC nicotine substitute products at the end of the program
- C. ask employees to inform the group if they stop smoking and if they start smoking again
- D. design a questionnaire that identifies lifestyle changes contributing to smoking cessation
Correct answer: A
Rationale: Surveying employees to determine how many are smoking 2 months after the end of the program provides a direct assessment of the program's effectiveness. This measurement evaluates the actual behavior change related to smoking cessation. Choice B, testing knowledge of OTC nicotine substitute products, does not directly measure smoking cessation outcomes. Choice C relies on self-reporting, which may not be accurate or reliable. Choice D focuses on identifying lifestyle changes but does not directly assess the program's impact on smoking cessation.
4. 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.
5. The parish nurse notes that an elderly male client has had a 5 lbs weight loss since his check-up one month ago. The client has good hygiene, still drives a car, and lives alone. To which agency should the nurse refer this client?
- A. the adult day care center
- B. the social security administration office
- C. the women, infants, and children office
- D. the senior citizen center
Correct answer: D
Rationale: The correct answer is 'D: the senior citizen center.' In this scenario, the elderly male client is experiencing unexplained weight loss, which could be indicative of underlying health issues or social isolation. Referring him to the senior citizen center is appropriate as it can provide social support, resources, and programs tailored to address the client's weight loss and overall well-being. Choice A, the adult day care center, is not the most suitable option as the client is still independent and living alone. Choice B, the social security administration office, and Choice C, the women, infants, and children office, are not relevant in this context and do not address the client's specific needs related to weight loss and social support.
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