HESI RN
Community Health HESI
1. A public health nurse is planning a campaign to increase immunization rates among children in a low-income community. Which intervention should the nurse prioritize?
- A. Provide free immunizations at local schools
- B. Create educational materials about vaccine safety
- C. Organize a community forum to discuss immunization concerns
- D. Partner with local media to promote the importance of vaccines
Correct answer: A
Rationale: The correct answer is A: Provide free immunizations at local schools. This intervention directly addresses financial barriers and increases accessibility for families in low-income communities. By offering free immunizations at local schools, the nurse can ensure that more children receive the necessary vaccines without worrying about the cost. Choice B, creating educational materials, may be helpful but may not directly address the financial barriers that low-income families face. Choice C, organizing a community forum, can be beneficial for addressing concerns but may not result in immediate action to increase immunization rates. Choice D, partnering with local media, can help raise awareness but may not directly provide the solution of making immunizations more accessible by removing financial barriers.
2. An 80-year-old client is given morphine sulfate for postoperative pain. Which concomitant medication should the nurse question that poses a potential development of urinary retention in this geriatric client?
- A. Nonsteroidal anti-inflammatory agents.
- B. Antihistamines.
- C. Tricyclic antidepressants.
- D. Antibiotics.
Correct answer: C
Rationale: The correct answer is C: Tricyclic antidepressants. Drugs with anticholinergic properties, such as tricyclic antidepressants, can exacerbate urinary retention associated with opioids in older clients. Nonsteroidal anti-inflammatory agents (Choice A) do not typically cause urinary retention. Antihistamines (Choice B) may cause urinary retention but are not the primary concern in this scenario. Antibiotics (Choice D) are not associated with an increased risk of urinary retention compared to tricyclic antidepressants.
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. The nurse is assessing a client who complains of weight loss, racing heart rate, and difficulty sleeping. The nurse determines the client has moist skin with fine hair, prominent eyes, lid retraction, and a staring expression. These findings are consistent with which disorder?
- A. Graves' disease.
- B. Cushing's syndrome.
- C. Addison's disease.
- D. Hypothyroidism.
Correct answer: A
Rationale: The correct answer is A, Graves' disease. The symptoms described in the client are classic manifestations of hyperthyroidism, which is commonly caused by Graves' disease, an autoimmune condition affecting the thyroid. Weight loss, racing heart rate, difficulty sleeping, moist skin with fine hair, prominent eyes, lid retraction, and a staring expression are all indicative of hyperthyroidism. Choice B, Cushing's syndrome, is characterized by weight gain, hypertension, and a rounded face due to excess cortisol. Choice C, Addison's disease, presents with symptoms such as weight loss, fatigue, and hyperpigmentation due to adrenal insufficiency. Choice D, hypothyroidism, typically features symptoms opposite to those described in the client, such as weight gain, bradycardia, and dry skin.
5. In conducting a health assessment for a family with a history of cardiovascular disease, which family member should be prioritized for further evaluation and intervention?
- A. a 45-year-old father who smokes and has high cholesterol
- B. a 17-year-old daughter who is overweight and inactive
- C. a 50-year-old mother with a history of hypertension
- D. a 12-year-old son who has a normal weight and is active
Correct answer: A
Rationale: The 45-year-old father who smokes and has high cholesterol is at a higher risk for cardiovascular disease due to multiple risk factors. Smoking and high cholesterol are significant contributors to the development of cardiovascular issues. Prioritizing his evaluation and intervention is crucial to address these modifiable risk factors. The other family members, though they may have risk factors as well, do not present with the same level of immediate risk based on the information provided.
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