HESI RN
Community Health HESI
1. A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with pneumonia. Which finding requires immediate intervention?
- A. Oxygen saturation of 88%
- B. Respiratory rate of 24 breaths per minute
- C. Heart rate of 90 beats per minute
- D. Productive cough with green sputum
Correct answer: D
Rationale: In a client with COPD admitted with pneumonia, a productive cough with green sputum indicates a potential bacterial infection. Green sputum is commonly associated with bacterial pneumonia, which requires immediate intervention with appropriate antibiotics. Monitoring oxygen saturation, respiratory rate, and heart rate are essential in COPD patients, but the presence of green sputum suggests an urgent need for targeted treatment to address the underlying infection. Oxygen saturation of 88% is concerning but may not directly indicate the need for immediate intervention in the absence of other critical symptoms. Respiratory rate of 24 breaths per minute and a heart rate of 90 beats per minute are within normal limits and may not be indicative of an acute issue requiring immediate intervention in this context.
2. The nurse is assessing a client with a suspected deep vein thrombosis (DVT). Which finding supports this diagnosis?
- A. Positive Homan's sign.
- B. Unilateral leg swelling.
- C. Bilateral calf pain.
- D. Redness and warmth in the affected leg.
Correct answer: D
Rationale: The correct answer is D: Redness and warmth in the affected leg. These are classic signs of deep vein thrombosis (DVT) and support the diagnosis. Choice A, Positive Homan's sign, is an outdated and unreliable test for DVT, so it is not the best choice. Choice B, Unilateral leg swelling, can be seen in DVT but is less specific compared to redness and warmth. Choice C, Bilateral calf pain, is not a typical finding in DVT, as the pain in DVT is usually unilateral.
3. What information should the nurse provide a client who has undergone cryosurgery for stage 1A cervical cancer?
- A. Expect heavy, watery vaginal discharge for 3 to 6 weeks.
- B. Use a tampon instead of a sanitary napkin.
- C. Report any severe cramping immediately.
- D. Avoid sexual intercourse for 3 to 6 weeks.
Correct answer: D
Rationale: After cryosurgery for stage 1A cervical cancer, clients should avoid sexual intercourse for 3 to 6 weeks to reduce the risk of infection. Heavy, watery vaginal discharge is expected but not the focus of post-procedure instructions. Using tampons is contraindicated as they can introduce bacteria into the healing cervix. While reporting severe cramping is important, avoiding sexual intercourse is the priority to prevent complications.
4. When assessing the health of a community, what is the most important information for the nurse to obtain?
- A. life expectancy of community members
- B. mortality rates in the community
- C. description of health problems by community leaders
- D. expressed needs of community members
Correct answer: D
Rationale: The most important information for a nurse to obtain when assessing the health of a community is the expressed needs of community members. This information helps in tailoring health interventions to address specific concerns directly expressed by the community. Options A and B focus on statistical data rather than individual needs. Option C, while valuable, may not always capture the full spectrum of health issues faced by the community as perceived by the residents themselves.
5. A community health nurse is conducting a neighborhood discussion group about disaster planning. What information regarding transmission of anthrax should the nurse provide to the group?
- A. Infection is acquired when anthrax spores enter a host.
- B. Mature anthrax bacteria live dormant on inanimate objects.
- C. Spores cannot survive for extended periods outside a living host.
- D. Anthrax is transmitted by respiratory droplets from person to person.
Correct answer: A
Rationale: The correct answer is A: Infection is acquired when anthrax spores enter a host. Anthrax is primarily transmitted through spores entering the body, either through the skin, inhalation, or ingestion. Person-to-person transmission of anthrax is extremely rare and not a significant mode of transmission. Choices B and C are incorrect because mature anthrax bacteria do not live dormant on inanimate objects, and spores can survive for extended periods outside a living host. Choice D is incorrect as anthrax is not transmitted by respiratory droplets from person to person.
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