while assessing a client in an outpatient facility with a panic disorder the nurse completes a thorough health history and physical exam which finding
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Community Health HESI Study Guide

1. While assessing a client in an outpatient facility with a panic disorder, the nurse completes a thorough health history and physical exam. Which finding is most significant for this client?

Correct answer: B

Rationale: The correct answer is B: 'Sense of impending doom.' In panic disorder, a sense of impending doom is a hallmark symptom often experienced by clients. This intense feeling of dread or fear is a key feature of panic attacks. Compulsive behavior (choice A) may be more indicative of obsessive-compulsive disorder rather than panic disorder. Fear of flying (choice C) may be more related to specific phobias rather than panic disorder. Predictable episodes (choice D) do not align with the unpredictable nature of panic attacks.

2. The home health care agency can expect to obtain Medicare reimbursement for which home visit performed by a registered nurse (RN) or a practical nurse (PN)?

Correct answer: C

Rationale: The correct answer is C because wound care for a postoperative infection is a skilled service that qualifies for Medicare reimbursement. Choices A, B, and D involve assessments, teaching, and evaluation, which may not meet the criteria for Medicare reimbursement as they do not directly involve a skilled nursing service related to a postoperative condition.

3. How do integrative models of human health see health factors?

Correct answer: B

Rationale: Integrative models of human health consider health factors as intertwined and interactive, involving various components like physical, psychological, and social aspects. This holistic approach recognizes that health is influenced by a combination of factors, not just physical phenomena (choice A). While psychosocial problems can impact health, integrative models go beyond attributing health solely to psychosocial issues (choice C). Additionally, integrative models do not imply that health is effective only when combined with alternative therapies (choice D), but rather emphasize the interconnectedness of various health components.

4. While caring for a client with infective endocarditis, the nurse must be alert for signs of pulmonary embolism. Which of the following assessment findings suggests this complication?

Correct answer: C

Rationale: The correct answer is C: 'Dyspnea and cough.' Pulmonary embolism often presents with a sudden onset of dyspnea (difficulty breathing) and cough, which are due to the obstruction of blood flow in the pulmonary arteries. Choices A, B, and D are incorrect. Positive Homan's sign is associated with deep vein thrombosis, fever and chills are nonspecific symptoms commonly seen in infective endocarditis, and sensory impairment is not typically indicative of pulmonary embolism.

5. During the care of a client with Legionnaire's disease, which finding would require the nurse's immediate attention?

Correct answer: D

Rationale: A decrease in chest wall expansion suggests that the client may be experiencing a serious complication, such as worsening pneumonia or respiratory failure, requiring immediate medical attention. This finding indicates a potential decrease in lung function, which could lead to respiratory distress. Pleuritic pain on inspiration may be related to the disease process but does not indicate an immediate need for intervention. Dry mucus membranes in the mouth may require attention but are not as critical as a decrease in chest wall expansion. A decrease in respiratory rate could be concerning but is not as urgent as a decrease in chest wall expansion, which directly impacts respiratory function.

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