HESI RN
Community Health HESI
1. The nurse is planning an immunization campaign targeting the children of migrant farm workers in the community. Which data should the nurse review before exploring solution options when developing this program plan?
- A. uncertain risks
- B. potential outcomes
- C. priority of solutions
- D. target population data
Correct answer: D
Rationale: Correct. Before designing an immunization campaign for the children of migrant farm workers, the nurse should review target population data. This includes understanding the specific demographics, health needs, and challenges faced by this population to create a tailored and effective program. Reviewing uncertain risks (choice A) may not provide actionable insights for program development. Considering potential outcomes (choice B) is important but comes after understanding the target population. Evaluating the priority of solutions (choice C) is premature without knowing the specific characteristics and needs of the target population.
2. On a day when the temperature is expected to drop below freezing during the night, the nurse is asked to determine which homeless adults are most in need of the limited spaces available in a shelter. It is most important for which person to be admitted at night?
- A. an adult who was hit by a car 3 weeks ago
- B. a young person with diabetes mellitus
- C. a middle-aged person who has hypertension
- D. an older person who is malnourished
Correct answer: D
Rationale: Malnourished individuals are at higher risk of severe complications from cold exposure due to their weakened immune system and decreased ability to regulate body temperature. This places them at a greater risk of hypothermia and other cold-related conditions, making them the most vulnerable group in need of shelter. Choice A is not the most critical as the injury is from 3 weeks ago and should have received appropriate medical care by now. Choice B, a young person with diabetes mellitus, while vulnerable, can manage their condition with proper medication and care. Choice C, a middle-aged person with hypertension, may need monitoring but is less susceptible to immediate harm from cold exposure compared to a malnourished individual.
3. A first-grade boy is sent to the school nurse after he fainted while playing tag during recess. When he arrives in the clinic he is alert and oriented and his vital signs include temperature of 97.8°F, pulse 96 bpm, respirations 15 breaths/minute, and blood pressure 80/56 mmHg. Which intervention is most important for the nurse to implement?
- A. request transport of the child to his pediatrician's office
- B. call the child's parents and send him home for the day
- C. compare the child's body mass index to normal values
- D. measure the child's pulse and blood pressure every 15 minutes
Correct answer: D
Rationale: In this scenario, the most important intervention for the nurse to implement is to measure the child's pulse and blood pressure every 15 minutes. The child experienced a syncopal episode (fainting) which could be due to various reasons, including dehydration or cardiac issues. Monitoring vital signs frequently will help detect any changes that may indicate underlying health issues. Requesting transport to the pediatrician's office or sending the child home without continuous monitoring may not provide immediate assessment and intervention. Comparing the child's body mass index to normal values is not relevant in addressing the immediate concern of monitoring vital signs after a syncopal episode.
4. The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?
- A. Note in the student records that the second dose of the MMR vaccine should be administered prior to entering first grade
- B. Send notices home with the children on the first day of class advising that MMR vaccine series must be completed
- C. Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year
- D. Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children
Correct answer: C
Rationale: The correct intervention for the school nurse is to contact kindergarten parents to remind them that the second dose of the MMR vaccine is due at the start of the school year. This approach directly addresses the issue of incomplete vaccination coverage and ensures that children receive the complete vaccination on time. Choice A is incorrect as it only notes the need for the second dose without actively engaging parents. Choice B is not as effective as directly contacting parents and may lead to delays in completing the vaccination series. Choice D, while promoting immunization, does not directly address the current situation of incomplete MMR vaccination among the kindergarten students.
5. A nurse starts classes for clients with type 2 diabetes. Which information would the nurse use as an outcome evaluation for the class?
- A. Parking convenience for attendees continues to be a major concern.
- B. Fasting blood glucose average readings were 20% lower by the end of classes.
- C. Discussion of food exchanges and calories was a well-attended class.
- D. Demonstrating the use of a blood glucose meter was an effective teaching strategy.
Correct answer: B
Rationale: A reduction in fasting blood glucose levels indicates the effectiveness of the diabetes management education provided. Monitoring blood glucose levels is a crucial aspect of diabetes management, and a decrease in average readings signifies improvement in managing blood sugar levels. Choices A, C, and D are not direct outcome evaluations related to the effectiveness of the education provided in managing diabetes. Parking convenience, attendance, and teaching strategies are not direct indicators of the impact on the clients' health outcomes.
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