HESI RN
Community Health HESI 2023
1. A public health nurse is working with a community to improve access to dental care. Which intervention is most likely to be effective?
- A. Setting up dental clinics in accessible locations
- B. Distributing flyers with information about dental services
- C. Offering transportation vouchers for dental appointments
- D. Partnering with local businesses to promote dental health
Correct answer: A
Rationale: Setting up dental clinics in accessible locations is the most effective intervention to improve access to dental care. By having dental clinics in easily reachable places, community members are more likely to seek and utilize dental services. Distributing flyers may raise awareness, but it may not address the issue of physical accessibility to dental care. Offering transportation vouchers could help with transportation barriers but might not address the core issue of proximity to dental services. Partnering with local businesses to promote dental health is a good initiative, but it may not directly improve access to dental care as setting up clinics in accessible locations would.
2. In conducting a health assessment for a family with a history of diabetes, which family member should be prioritized for further evaluation and intervention?
- A. a 50-year-old mother with a history of hypertension
- B. a 45-year-old father who is overweight and has high cholesterol
- C. a 17-year-old daughter who is inactive
- D. a 12-year-old son who has a normal weight and is active
Correct answer: B
Rationale: The correct answer is the 45-year-old father who is overweight and has high cholesterol. He possesses multiple risk factors for diabetes, indicating a need for prioritized evaluation and intervention. The mother's hypertension, the daughter's inactivity, and the son's normal weight and activity level are important factors to consider but do not present as immediate red flags for diabetes risk compared to the father's combination of being overweight and having high cholesterol.
3. During the physical assessment, which finding should the nurse recognize as a normal finding?
- A. Regular pulsation at the epigastric area when the client is supine.
- B. A loud, harsh murmur at the second right intercostal space.
- C. Dullness over the lung fields.
- D. Increased tactile fremitus.
Correct answer: A
Rationale: The regular pulsation at the epigastric area when the client is supine is a normal finding. This phenomenon is caused by the regular and recurrent expansion and contraction of an artery due to waves of pressure caused by the ejection of blood from the left ventricle. Choices B, C, and D describe abnormal findings during a physical assessment. A loud, harsh murmur at the second right intercostal space indicates an abnormal heart sound, dullness over the lung fields may suggest consolidation or fluid in the lungs, and increased tactile fremitus can be a sign of lung consolidation or pathology.
4. A client with a history of alcohol abuse is admitted with cirrhosis. Which finding requires immediate intervention?
- A. Jaundice.
- B. Ascites.
- C. Peripheral edema.
- D. Spider angiomas.
Correct answer: C
Rationale: Peripheral edema in a client with cirrhosis can indicate fluid overload and worsening liver function, necessitating immediate intervention to prevent further complications such as respiratory distress, cardiac issues, or renal impairment. Jaundice (choice A) is a common manifestation of cirrhosis but may not require immediate intervention unless severe. Ascites (choice B) is also a common complication of cirrhosis that may require intervention but is not as urgent as addressing peripheral edema. Spider angiomas (choice D) are typically benign skin lesions associated with cirrhosis but do not require immediate intervention unless bleeding or rupture occurs.
5. A female client with a history of chronic obstructive pulmonary disease (COPD) is being treated at home and is currently receiving oxygen at 2 liters via nasal cannula. The spouse, who is the caregiver, reports that the client requires assistance when ambulating short distances, including going to the bathroom. Which suggestion should the health care nurse provide to the caregiver?
- A. disconnect oxygen when ambulating to the bathroom
- B. administer a breathing treatment prior to ambulation
- C. suggest obtaining a bedside commode for toileting
- D. ask for additional assistance to reduce the risk of falls
Correct answer: C
Rationale: For a client with COPD requiring assistance for short-distance ambulation, suggesting a bedside commode for toileting is the most appropriate intervention. This recommendation helps reduce the need for the client to walk long distances, thereby minimizing the risk of exertion and potential falls. Disconnecting oxygen during ambulation (Choice A) is not safe for a client with COPD, as oxygen therapy should be continuous. Administering a breathing treatment before ambulation (Choice B) may not directly address the client's need for assistance with toileting. Asking for additional assistance (Choice D) can be beneficial but providing a bedside commode specifically addresses the current issue of ambulating short distances for toileting.
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