the nurse is preparing to administer a scheduled dose of digoxin lanoxin to a client which assessment finding should the nurse report to the healthcar
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Nursing Elites

HESI RN

HESI Community Health

1. The nurse is preparing to administer a scheduled dose of digoxin (Lanoxin) to a client. Which assessment finding should the nurse report to the healthcare provider?

Correct answer: D

Rationale: Seeing halos around lights is a symptom of digoxin toxicity, which should be reported to the healthcare provider. This visual disturbance is a serious adverse effect of digoxin and indicates potential toxicity. Reporting this finding promptly is crucial to prevent further complications. Choices A, B, and C are within normal limits and do not indicate an immediate need for intervention related to digoxin administration.

2. A 56-year-old female client is receiving intracavitary radiation via a radium implant. Which nurse should be assigned to care for this client?

Correct answer: B

Rationale: A nurse with Marfan syndrome who is postmenopausal can safely care for the client because Marfan syndrome does not affect the ability to care for this client, and postmenopausal status minimizes the risk of radiation exposure affecting reproductive health. Choice A is incorrect because pregnancy increases the risk of radiation exposure to the fetus. Choice C is incorrect because a nurse with a cold may have a compromised immune system and should not be exposed to radiation therapy. Choice D is incorrect because lactation can increase the risk of radiation exposure to breast tissue.

3. A client who is taking clonidine (Catapres, Duraclon) reports drowsiness. Which additional assessment should the nurse make?

Correct answer: A

Rationale: The correct answer is A. When a client reports drowsiness while taking clonidine, the nurse should assess how long the client has been taking the medication. Drowsiness is a common side effect that can occur in the early weeks of treatment with clonidine. By understanding the duration of medication use, the nurse can determine if the drowsiness is a temporary effect that may decrease over time. Choices B, C, and D are incorrect because assessing the client's dietary habits, checking for signs of infection, or evaluating the client's sleep pattern would not directly address the drowsiness associated with clonidine use.

4. A community health nurse is developing a program to increase physical activity among adults in the community. Which intervention is most likely to be successful?

Correct answer: B

Rationale: Organizing free community exercise classes is the most likely successful intervention as it provides a structured and accessible opportunity for adults to engage in physical activity. This choice directly offers a practical solution by providing a regular and organized setting for individuals to participate in physical activity. Distributing flyers about the benefits of exercise, while informative, may not lead to actual participation. Partnering with local gyms to offer discounts relies on individuals taking the initiative to sign up for gym memberships, which may not be feasible for everyone. Hosting a health fair with information booths is informative but may not directly address the need for increased physical activity among adults in the community.

5. A public health nurse is working with a community to improve vaccination rates. Which intervention is most likely to be effective?

Correct answer: A

Rationale: Setting up vaccination clinics in accessible locations is the most effective intervention to improve vaccination rates. This intervention ensures easy access to vaccination services for community members, removing barriers such as transportation or time constraints. Distributing flyers (Choice B) may increase awareness but may not directly address access issues. Offering incentives (Choice C) might temporarily boost vaccination rates but may not lead to sustained behavior change. Partnering with local businesses (Choice D) could be beneficial for promotion but may not directly impact vaccination accessibility.

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