HESI RN
Community Health HESI 2023
1. The healthcare provider is assessing a client who has a nasogastric tube to low intermittent suction. Which finding indicates that the client may have developed hypokalemia?
- A. Muscle weakness and cramps.
- B. Nausea and vomiting.
- C. Constipation.
- D. Increased blood pressure.
Correct answer: A
Rationale: Muscle weakness and cramps are characteristic signs of hypokalemia, a condition marked by low levels of potassium in the blood. Potassium is essential for proper muscle function, and its deficiency can lead to muscle weakness and cramps. In the context of a client with a nasogastric tube to low intermittent suction, the loss of potassium through suctioning can contribute to the development of hypokalemia. Nausea and vomiting (choice B) are more commonly associated with gastrointestinal issues rather than hypokalemia. Constipation (choice C) is not a typical finding of hypokalemia; instead, it can be a sign of other gastrointestinal problems. Increased blood pressure (choice D) is not a direct manifestation of hypokalemia; in fact, low potassium levels are more commonly associated with decreased blood pressure.
2. A client who has active tuberculosis (TB) is admitted to the medical unit. What action is most important for the nurse to implement?
- A. Wear a gown and gloves.
- B. Have the client wear a mask.
- C. Perform hand hygiene.
- D. Assign the client to a negative air-flow room.
Correct answer: D
Rationale: The correct answer is to assign the client to a negative air-flow room (Choice D). Active tuberculosis requires implementation of airborne precautions, including isolating the client in a negative pressure air-flow room to prevent the spread of the infection to others. Choice A (Wear a gown and gloves) is important for standard precautions but does not address the specific airborne precautions needed for tuberculosis. Choice B (Have the client wear a mask) may help reduce the spread of respiratory droplets but does not provide adequate protection for healthcare workers or other patients. Choice C (Perform hand hygiene) is essential for infection control but is not the most critical action when dealing with an airborne infection like tuberculosis.
3. 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.
4. A public health nurse is implementing a program to improve vaccination rates among children in the community. Which intervention is most likely to be effective?
- A. Offering vaccinations at convenient locations and times
- B. Distributing educational materials about vaccines
- C. Providing incentives for getting vaccinated
- D. Hosting informational sessions for parents
Correct answer: A
Rationale: Offering vaccinations at convenient locations and times is the most effective intervention as it reduces barriers to access and makes it easier for parents to get their children vaccinated. This strategy directly addresses the issue of convenience and accessibility, which are common reasons for low vaccination rates. Distributing educational materials about vaccines (Choice B) can be helpful but may not directly address access issues. Providing incentives for getting vaccinated (Choice C) may be controversial and not sustainable in the long term. Hosting informational sessions for parents (Choice D) can be beneficial for education but may not directly improve vaccination rates as much as increasing access.
5. 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.
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