HESI RN
Community Health HESI
1. A 6-year-old child is alert but quiet when brought to the emergency center with periorbital ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and continues to assess the child for additional manifestations of a basilar skull fracture. What assessment finding would be consistent with the basilar skull fracture?
- A. Blurred vision.
- B. Shoulder pain.
- C. Abdominal pain.
- D. Rhinorrhea or otorrhea with halo sign.
Correct answer: D
Rationale: The correct answer is D: Rhinorrhea or otorrhea with halo sign. Raccoon eyes (periorbital ecchymosis) and Battle's sign (ecchymosis behind the ear) are signs of a basilar skull fracture, indicating the need to assess for possible meningeal tears that manifest as a halo sign with cerebrospinal fluid (CSF) leakage from the ears or nose. Choices A, B, and C are incorrect because blurred vision, shoulder pain, and abdominal pain are not typically associated with a basilar skull fracture.
2. The occupational health nurse is completing a yearly self-evaluation. Which activity should the nurse document as an example of proficient performance criteria in professionalism?
- A. contributes money to a professional society or organization
- B. maintains chairmanship of the hospital nursing council
- C. documents the nursing process in care management
- D. develops policy initiatives that impact occupational health and safety
Correct answer: D
Rationale: The correct answer is D because developing policy initiatives that impact occupational health and safety demonstrates leadership and proficiency in contributing to the field. Choices A, B, and C do not directly relate to professionalism criteria in the context of occupational health nursing. Contributing money to a professional society, maintaining chairmanship of a nursing council, or documenting the nursing process, while important, do not specifically highlight the nurse's impact on occupational health and safety through policy development.
3. The nurse is caring for a client with cirrhosis of the liver. Which laboratory result requires immediate intervention?
- A. Serum albumin of 3.5 g/dL.
- B. Prothrombin time (PT) of 12 seconds.
- C. Hemoglobin of 10 g/dL.
- D. Serum ammonia level of 180 mcg/dL.
Correct answer: D
Rationale: The correct answer is D, the serum ammonia level of 180 mcg/dL. An elevated serum ammonia level indicates hepatic dysfunction and can lead to hepatic encephalopathy, which is a medical emergency requiring immediate intervention. Options A, B, and C are within normal ranges or slightly abnormal values for clients with cirrhosis and do not pose an immediate threat. Serum albumin levels may indicate malnutrition, prothrombin time may reflect liver synthetic function, and hemoglobin levels can be affected by various factors but do not require immediate intervention in this scenario.
4. When examining sources for funding, which criteria should the nurse clarify about the program for the community group?
- A. a prescription from the healthcare provider for each visit made
- B. documentation of a skilled care service provided during the visit
- C. a copy of the client's health history and social security card
- D. a record of the preventive healthcare services provided during the visit
Correct answer: C
Rationale: The correct answer is C because when seeking funding sources for a community outreach program, it is essential to clarify aspects related to the client's personal information, such as health history and identification details. This information helps in demonstrating the need for the program and understanding the target population. Choices A, B, and D are incorrect because they focus on clinical documentation, services provided during visits, and preventive healthcare services, which are not directly related to clarifying funding criteria about the program.
5. A community health nurse is planning a program to address the rising rates of obesity in the community. Which intervention should the nurse prioritize?
- A. organizing community exercise programs
- B. distributing educational materials on healthy eating
- C. partnering with local grocery stores to provide discounts on healthy foods
- D. conducting health screenings for early detection of obesity-related conditions
Correct answer: A
Rationale: The correct answer is A: organizing community exercise programs. Physical activity plays a crucial role in weight management and reducing obesity rates. While educating about healthy eating (choice B) is important, focusing on exercise programs can have a more direct impact on addressing obesity. Partnering with local grocery stores for discounts on healthy foods (choice C) is beneficial but may not address the root cause of obesity. Conducting health screenings (choice D) is more reactive than proactive in addressing rising obesity rates.
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