HESI RN
Community Health HESI
1. A client with hyperthyroidism is receiving radioactive iodine therapy. Which statement by the client indicates a need for further teaching?
- A. I should avoid close contact with pregnant women and children for a few days.
- B. I may experience dry mouth and taste changes for a few days.
- C. I may experience some neck swelling.
- D. I should expect to have no side effects.
Correct answer: D
Rationale: The correct answer is 'D.' The client stating 'I should expect to have no side effects' indicates a need for further teaching as it is incorrect. With radioactive iodine therapy, side effects like dry mouth, taste changes, and neck swelling are common. Choices A and B are correct statements; the client should avoid close contact with pregnant women and children due to radiation exposure, and dry mouth and taste changes are common side effects. Choice C is also correct, making D the correct answer.
2. A public health nurse is evaluating a program designed to reduce the incidence of diabetes in the community. Which outcome indicates that the program is successful?
- A. increased participation in diabetes education sessions
- B. higher rates of blood glucose monitoring
- C. reduced incidence of diabetes-related complications
- D. greater knowledge of diabetes prevention methods
Correct answer: C
Rationale: The correct answer is C: 'reduced incidence of diabetes-related complications.' This outcome indicates that the program is successful because it shows that individuals are effectively managing their condition, leading to fewer complications. Increased participation in education sessions (choice A) and higher rates of blood glucose monitoring (choice B) are important but are more process indicators rather than direct outcomes of improved health. Greater knowledge of prevention methods (choice D) is beneficial but may not directly reflect a reduction in diabetes incidence or complications.
3. A community health nurse is helping a group of nursing students plan a tertiary prevention program for a local community clinic that serves a majority Hispanic population. Which service project meets the requirement of a tertiary prevention program and would best serve this population?
- A. teaching clients about recommended immunizations for children
- B. demonstrating foot care to a group of clients who have diabetes
- C. taking blood pressures at a local shopping mall in the community
- D. instructing teens about prevention of sexually transmitted diseases
Correct answer: B
Rationale: The correct answer is B. Tertiary prevention focuses on managing and improving health outcomes for existing conditions, such as diabetes. Demonstrating foot care to clients with diabetes aligns with this level of prevention by helping to prevent complications and promote better health outcomes. Choices A, C, and D do not specifically target existing conditions or chronic diseases, which are the focus of tertiary prevention programs.
4. During a home health visit, the nurse notices that an older male client with type 2 diabetes mellitus is wearing loose cloth slippers. The client reports that he cannot comfortably wear other shoes because his toenails get in the way. The nurse inspects the client's feet and finds long thick nails that curl down under some of the toes. Which action should the nurse take?
- A. demonstrate proper foot care to the client and family
- B. have a home health aide assist the client with hygiene weekly
- C. schedule an appointment for the client with a podiatrist
- D. trim the client's toenails gradually over several visits
Correct answer: C
Rationale: Scheduling an appointment with a podiatrist is the most appropriate action in this scenario. For a client with long thick nails that curl under the toes, professional foot care by a podiatrist is necessary to prevent complications, especially in a client with diabetes mellitus. Demonstrating proper foot care (choice A) may not address the immediate need for nail trimming. Having a home health aide assist with hygiene weekly (choice B) may not be sufficient for managing the client's toenail issue effectively. Trimming the client's toenails gradually over several visits (choice D) should be performed by a professional like a podiatrist to avoid potential complications.
5. The nurse notices that the influenza immunization rate is much lower for certain demographic groups than for others. Which intervention is likely to be most useful in increasing the rates of immunization in the underserved community groups?
- A. designated clinics conveniently located in target neighborhoods
- B. reports on decreasing influenza rates during times of greatest prevalence
- C. legislative proposals that mandate influenza vaccinations for all
- D. radio announcements about the availability of the influenza vaccine
Correct answer: A
Rationale: Conveniently located clinics in target neighborhoods increase accessibility, making it easier for underserved community groups to receive influenza immunizations. This intervention directly addresses the issue of lower immunization rates by improving convenience and access. Reports on decreasing influenza rates (choice B) may not directly impact immunization rates. Legislative proposals mandating vaccinations (choice C) could face resistance and may not always be the most effective or practical solution. Radio announcements (choice D) may raise awareness but may not address the underlying barriers to immunization faced by underserved communities.
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