HESI RN
Community Health HESI 2023
1. A client with hypertension is being seen in a community clinic. The nurse notes that the client has not been taking their prescribed medication regularly. What is the most appropriate initial intervention?
- A. Educate the client on the importance of medication adherence
- B. Explore the reasons for non-adherence with the client
- C. Refer the client to a hypertension specialist
- D. Adjust the client's medication regimen
Correct answer: B
Rationale: The most appropriate initial intervention when a client is not adhering to prescribed medication is to explore the reasons for non-adherence with the client. Understanding the client's perspective can help identify barriers to adherence, such as side effects, cost, forgetfulness, or misunderstanding of the treatment. By addressing these reasons, the nurse can work collaboratively with the client to develop strategies to improve medication compliance. Educating the client on the importance of adherence (Choice A) may be necessary but should come after exploring the reasons for non-adherence. Referring the client to a hypertension specialist (Choice C) or adjusting the medication regimen (Choice D) should be considered after addressing the underlying reasons for non-adherence.
2. 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.
3. The healthcare professional is developing a community health program to address the high rates of childhood asthma in a neighborhood. Which intervention should the healthcare professional prioritize?
- A. conducting home visits to identify asthma triggers
- B. distributing asthma education materials at schools
- C. holding workshops on asthma management for parents
- D. partnering with local healthcare providers to offer free asthma screenings
Correct answer: A
Rationale: The healthcare professional should prioritize conducting home visits to identify asthma triggers as it is crucial for reducing asthma attacks in children. By identifying triggers in the home environment, interventions can be implemented to create a safer living space for children with asthma. This approach directly addresses the root cause of asthma exacerbations. Distributing asthma education materials at schools is beneficial for raising awareness but may not address individual triggers. Holding workshops on asthma management for parents is valuable for education but does not directly tackle trigger identification. Partnering with local healthcare providers to offer free asthma screenings focuses on detection rather than prevention through trigger identification.
4. During a home visit, a nurse observes an older client who is attempting to ambulate to the bathroom and notes that the client is unsteady and holds onto the furniture while refusing any assistance. Which action should the nurse implement?
- A. determine home navigational safety hazards
- B. maintain the client's privacy while in the bathroom
- C. recommend that the client obtain a walker
- D. encourage the client to obtain a medical alert device
Correct answer: A
Rationale: The correct action for the nurse to implement is to determine home navigational safety hazards. In this scenario, the client is unsteady and holds onto furniture while refusing assistance, indicating a risk of falls. By identifying and addressing home safety hazards, the nurse can help prevent potential accidents. Maintaining privacy in the bathroom (Choice B) is important but not the priority in this situation. Recommending a walker (Choice C) or a medical alert device (Choice D) may be appropriate interventions later but addressing home safety hazards is the immediate concern.
5. 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.
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